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Although much has improved in regards to treatment zap discount celexa 40mg with visa social treatment dynamics florham park order celexa 40mg online, cultural medications hard on liver buy discount celexa 20 mg line, ethnic treatment xerophthalmia cheap celexa 20 mg without a prescription, and economic variables being accounted for in menopause research, the majority of data collected to date has a profound Western Caucasian bias (Hunter & Rendall, 2007; Gold, 2000, Sowers et al. Research is telling us that among women of different race, ethnicity, culture, and socioeconomic status, there are indeed profound differences in the experiences of the menopause, including age of onset, symptoms such as hot flashes or vaginal dryness, or risk factors for chronic disease. In speaking on these differences, Gold (2000) states: "Despite important methodologic differences and the limitations in the study designs used and the populations studied in the accumulating literature on the menopausal experience, an interesting and complex picture is emerging. Symptomatology and symptom reporting have also been shown to vary by culture, ethnicity/race, and socioeconomic status. For example, one systematic review revealed that hot flashes are the most common symptom in Western countries, shoulder/joint pain being the most common in Japan, and low vision as the most common symptom in India (Singh et al. Ethnicity is also related to timing of menopause and the risk for surgical menopause. For example, African American women are more likely to report heavy bleeding and opt for hysterectomy (Powell et al. Although very much dynamically intertwined with statistics on ethnicity and race, education, socioeconomic class, and employment also appear to have an effect on symptom reporting as well as age of onset, with individuals of lower education and socioeconomic class showing more symptom reporting and an earlier age of onset than those with higher education levels (Gold, 2000; Gold et al. This short overview of culture, race, ethnicity, and socioeconomic status is only just barely brushing the surface of this complex and multifaceted field of research. There is no end to the multivariate experiences of women across the world as they traverse the menopausal transition, and differences between women are hardly quantifiable. However, this type of variation in experiences really highlights the supportive role the herbalist can provide and necessary focus on the individual that holism imparts. Leaving us with an even more compelling challenge, Gold (2000) states: "Furthermore, increased understanding of the underlying physiological bases of these influences needs to include potential racial/ethnic differences in physiologic responses to lifestyle factors and other environmental exposures, as well as increased understanding of the cultural contexts, cultural differences, and cultural sensitivities that affect the presentation and experience of the menopausal transition" (p. As herbalists we are in a special position to attend to the individual, rather than a cohort that does not fully represent the potential attitudes, ideals, and experiences of aging, gender identity, sexuality, social roles, and everchanging physiology. Indeed, some argue that in Western society it is our aversion to decline, or the aging process in general, that drives the many fears, apprehensions, and experiences our clients might have about the menopause (Hunter & Rendall, 2007; Watkins, 2007). In essence, the menopause becomes a boundary marking the end of something, or rather the beginning of the end. The above discussions and theories line the hallways of the walk of fear and bring into question: What comes first, the chicken or the egg? Perhaps in highlighting the possible avenues by which our clients might traverse their experiences we can remember to stay focused on assisting with the reframing of "self," a picture devoid of victimization and filled with empowerment. This can be a difficult perspective to achieve and maintain, especially when clients arrive at your door with the self-proclaimed or diagnosed label of menopausal, and a host of symptoms from which they eagerly crave relief. These encounters are powerful, for both the herbalist and the client, and create an immediate theherbalacademy. To highlight this point, Weed (2010) states: "Because both orthodox and alternative practitioners in the United States believe that menopausal symptoms indicate a lack or an imbalance, they frequently prescribe hormones for healthy, but symptomatic, menopausal women. This makes it easy for women to remain in the role of victim: She is a victim of menopause, a victim of a body that is undependable and unable to age without medical intervention" (p. Keeping this notion in mind, you may notice that this lesson is not outlined by symptom experiences, but rather by the physiological, emotional, and even spiritual changes that might be taking place. As herbalists we are at our best when we assist our clients in focusing on supporting their human system and giving their body what it needs to do the work it was so intelligently designed to do. They may also have concerns about longer-term chronic disease prevention or support, especially in regards to cardiovascular disease, metabolic disease, osteoporosis, and cancer (Romm, 2010; Trickey, 2003). This last possibility is one that requires the herbalist tread carefully, as we are in no legal position to suggest that our clients come off of prescribed medication. These multi-faceted experiences involve every system in the body (even the emotional and spiritual body) and tracing their interconnectedness can be intense and confounding. However, what is often considered more confounding is teasing out whether or not some of these symptomatic experiences and chronic disease risk-factors are indeed products of transitioning hormone ecology, or instead, a process of somatic aging in general (general aging of the body) (Bradsher & McKinlay, 2000; Foxcroft, 2010; Santoro, 1996; Santoro et. This differentiation in causation between menopausal changes and somatic aging is an important discussion when highlighted from an allopathic perspective (see discussion on testosterone below for an example of this differentiation). Figuring out which health problems are related to which cause assists physicians in ascertaining pharmaceutical or surgical intervention, treatment, and prognosis. However, as herbalists this distinction may be a moot point inasmuch as our wellness protocols should remain focused on supporting a physiology that is under the influence of both hormone fluctuations and somatic aging. However, on occasion it may be important for the herbalist to differentiate the physiological processes resulting from hormonal transitions versus those resulting from aging.

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For each of the following cases treatment 2015 effective celexa 40mg, look at pictures of the chromosomes (karyotype) from normal human cells treatment example purchase celexa 40 mg amex. For each case medications list form celexa 10 mg overnight delivery, count the number of chromosomes in each type of cell treatment non hodgkins lymphoma discount celexa 20 mg with amex, and discuss their appearance. Investigation 7 S91 Case 1: HeLa cells HeLa cells are cervical cancer cells isolated from a woman named Henrietta Lacks. Her cells have been cultured since 1951 and used in numerous scientific experiments. Your teacher may ask you to read the Immortal Life of Henrietta Lacks by Rebecca Skloot. As you read it, think about the following questions: Should tissue be removed from a patient without his or her consent for research? Karyotype of a Patient with Chronic Myelogenous Leukemia Indicating Chromosomal Deformity Part 4: Modeling Meiosis Meiosis resembles mitosis but serves a very different purpose. Meiosis is a cell division resulting in the halving, or reduction, of chromosome number in each cell. A diploid organism has two sets of chromosomes (2n), while a haploid cell or organism has one set (1n). Meiosis produces gametes (ova and sperm) in animals and spores in fungi, plants, and protists. Three other important characteristics of meiosis are the exchange of genetic material ("crossing over") between homologous chromosomes, the independent assortment of the chromosomes, and the separation of alleles of the same gene (Figure 6). The hallmark of sexual reproduction is the great diversity seen in the gametes and in the resulting offspring produced by fertilization. Meiosis is integral to this process because this type of cell division produces the sex cells, gametes. Before you begin the modeling exercise, your teacher will ask you to discuss these questions. Meiotic Cell Division Emphasizing Chromosome Movement Part 5: Meiosis and Crossing Over in Sordaria the fungus Sordaria fimicola exchanges genetic material when two mycelia meet and fuse. The resulting zygote undergoes meiosis to produce asci; each ascus contains eight haploid spores. Sordaria Life Cycle Figure 8: Sordaria Cross Plate Investigation 7 S95 A cross was made between wild type (+; black) and tan (tn) strains. The resulting zygote produces either parental type asci, which have four black and four tan spores in a row (4:4 pattern), or recombinant asci, which do not have this pattern. Place a cover slip over the perithecia and put a scientific cleaning wipe over the cover slip. Count at least 50 asci, and score them as either parental or recombinant (crossing over). The percent of asci showing recombination divided by 2 equals the map units separating the spore-color gene from the centromere. The percent of asci showing recombination is divided by 2 because only half of the spores in each ascus are the result of a crossing-over event. The published map distance between the spore color gene and the centromere is 26 map units. How can you account for any disparities between the class data and the published data? Do you think the Philadelphia chromosome is a result of crossing over as seen in this part of the investigation or some other chromosomal abnormality? Do you think the cell cycle described for mitosis could be applied to meiosis as well? Can the same (or any) environmental factors you tested above affect the amount of crossing over that occurs in Sordaria? Consider the mechanisms such as crossing over, independent assortment, segregation, nondisjunction, and random fertilization.

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Step #7: Behavioral techniques Step #8: Use acceptance skills to medications covered by blue cross blue shield buy celexa 10mg let go of effort to medications known to cause nightmares purchase celexa 20mg fast delivery fix things you cannot change medicine reminder app discount 20 mg celexa otc. For example medications migraine headaches cheap 10 mg celexa fast delivery, we do not know exactly what questions will be on every test, and it may be healthiest to accept that we may get some questions wrong. Line of evidence #1: (likelihood) Past experience How has my anxiety and worry fluctuated over the years? Line of evidence #2: Ability to function with anxiety Have I been able to function at times, at least well enough to accomplish some of my goals, even with the anxiety and worry? Although anxiety is uncomfortable and does put stress on the body, remind yourself that it is not dangerous and does not lead to "going crazy" or becoming psychotic. Step #3: Emotion regulation and "acceptance of emotion" skills Remember that trying to "fix" or avoid anxiety reinforces the anxiety. I can do things that will help me reach my goals, instead of spending time trying so hard to get rid of this anxiety. Note: see "The only thing we have to fear is fear itself" for more help with "worry about worry," especially if worry has led to panic attacks. Line of evidence #2: Pros and cons of worrying to stay safe versus living with some risk What are the good things about worrying to stay safe? Step #2: Identify negative automatic thoughts and examine the evidence around the specific problems happening at this time. If there is no feasible solution, use acceptance skills to let go of attempts to control what cannot change. We use "lines of evidence" to gather facts about the situation; we look at the likelihood of bad things happening as well as ways to cope with the consequences of them happening. Use the examples on previous pages as a guide to ask questions about these thoughts and examine the evidence. Use the "Exam ining Thoughts" worksheet to write down the thoughts, possible cognitive distortions, and evidence you find. When these thoughts pop up during the course of the day, take out the "Examining Thoughts" worksheet or the note card to remind yourself of the evidence. While thoughts are an important part of generalized anxiety, there are other factors that influence how anxious we are on a daily basis. There are also factors, other than the way we think, that can contribute to generalized anxiety. Examples are the goals we set (and whether or not we are reaching them) and how busy we are. Some of these thoughts make it hard to move forward to address the anxiety problem assertively. If there are others you experience that are not listed below, write them in the provided box below. We learned what cognitive therapy skills are and how they work: we gather evidence to understand a situation as realistically and in as detailed a way as possible. Our goal is to Examine the Evidence and practice reminding ourselves of this evidence when we are in a challenging situation, in order to cope better with that situation. Cognitive skills are best used in combination with behavioral skills such as exposure. If we can understand how dangerous a situation is, we can make good decisions about whether or not it would improve our lives if we were to stop avoiding a situation or over-protecting ourselves, which can be limiting. We learned how to identify Negative Automatic Thoughts and the "worst-case scenario" thoughts that are often connected with them. Identifying Negative Automatic Thoughts is the first important step in using Cognitive Therapy Skills. We learned about Cognitive Distortions, such as "All-or-Nothing Thinking," which are unhelpful patterns of negative thinking. Sometimes it can be helpful to understand whether or not we have some of these patterns in order to more effectively battle our Negative Automatic Thoughts. We Examine the Evidence, using techniques to understand two important questions: 1. The Examining Thoughts Worksheet is one tool that can help us organize the evidence we gather when we are first learning cognitive skills.

Before students proceed to medications may be administered in which of the following ways order celexa 20 mg line designing and conducting their own nonlab investigations/research projects based on the following suggested topics symptoms lactose intolerance cheap celexa 20mg free shipping, it is helpful to medicine 6 year in us trusted celexa 20mg steer them in the right direction to medicine quotes doctor generic 10 mg celexa with amex gather some preinvestigation information. Topic A: Ask students to investigate enzymes that appear to be conserved across all living domains (bacteria, fungi, plants, and animals). Does this mean that the enzyme evolved numerous times in numerous organisms or just once early in the history of life? There are many similar enzyme systems - both catabolic and anabolic - that are found across our current and historical living domains. Students can find examples on the Internet and develop presentations for the class that address concerns, ideas, and conclusions. Can you find examples that would support or reject the concept that survival is a matter of a best-fit scenario for the organism and its abiotic and biotic pressures as related to enzymes? Can you suggest which abiotic factors need to be examined and then perform an experiment that might support your hypothesis? Investigation 13 T225 Considering Topic B: Soil science is a major course of study in agricultural programs. For example, Nalo Farms in Hawaii will condition the soil to be slightly acidic when growing leafy vegetables or slightly basic when growing tomatoes. Some seeds will germinate better in light (tobacco) while others germinate in darkness. Numerous colleges and universities have available soil science sites on the Internet. Students can explore these websites to gather information to begin their investigative research. Topic C: Ask students to consider evolutionary questions such as Have plants evolved different characteristics to cope with specific abiotic conditions, such as salt marsh (salinity issues), high mountain pastures, deserts, acidified environments (acid rain), and estuaries? Are there different optimums for the same abiotic factors within different plants? Have plants evolved over time because of the influence or selectivity due to the abiotic factors associated with their environments? Students can develop presentations for the class that help address their conclusions. Considering Topic C: the key to understanding evolution and natural selection is grasping that variations in a population of a species aid in the selective forces of the environment. To investigate this concept, some students might simply buy a few packages of seeds of a particular leafy vegetable, root vegetable, tomato, etc. Although the links among growth, environment, and enzymes are more difficult to connect, regardless of their approach, students are establishing a protocol to do further work on those plants that vary tremendously from each other. Have the students prepare laboratory notebooks and record their experimental designs, data, graphs, results, and conclusions. Ask students to make a strong argument for the role of enzymes in maintaining homeostasis at the cellular level. Students who would like to investigate supplemental research Topic B can perform a Google search to explore literally thousands of entries on soil, food, plant growth, and the role of the environmental in crop production. They speed up chemical reactions in biological systems by lowering the activation energy, the energy needed for molecules to begin reacting with each other. Enzymes do this by forming an enzyme-substrate complex that reduces energy required for the specific reaction to occur. If the shape of an enzyme is changed in any way, or the protein denatured, then the binding site also changes, thus disrupting enzymatic functions. Enzymes are fundamental to the survival of any living system and are organized into a number of groups depending on their specific activities. Two common groups are catabolic enzymes ("cata" or "kata-" from the Greek "to break down") - for instance, amylase breaks complex starches into simple sugars - and anabolic enzymes ("a-" or "an-" from the Greek "to build up"). Papain is an enzyme that comes from papaya and is used in some teeth whiteners to break down the bacterial film on teeth. People who are lactose intolerant cannot digest milk sugar (lactose); however, they can take supplements containing lactase, the enzyme they are missing. All of these enzymes hydrolyze large, complex molecules into their simpler components; bromelain and papain break proteins down to amino acids, while lactase breaks lactose down to simpler sugars. Another example is rubisco, an enzyme involved in the anabolic reactions of building sugar molecules in the Calvin cycle of photosynthesis.

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