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Journal of Social and Personal Relationship cheap 150mg cleocin with mastercard, 12 generic cleocin 150 mg line, 163-175 buy cleocin 150 mg without prescription. The relationships of cohabiting lesbian and heterosexual couples: A comparison discount cleocin 150mg line. The lesbian family life cycle: A contextual approach cheap 150mg cleocin overnight delivery. Intimacy discount 150mg cleocin otc, maturity and its correlation in young married couples. Journal of Personality and Social Psychology, 50, 152-162. Couples in long term relationships often complain of lagging sexual energy. In fact, over half of the people in my "Retreat for Couples" sexuality workshops attend with the hope of increasing their sexual energy, and others want to know they are not perverts for enjoying sex, especially at midlife and beyond. They want to grow old together as lovers, not roommates. According to sexual older couples, keeping sexual energy is satisfying but not easy. Hidden sexual energy can be found when people know how and where to look. Most couples search for it where it feels comfortable, not where it is. Couples often act like the drunk searching for his keys under a street light because darkness prevents his looking for them where they are. Comfort, more than anxiety, obstructs sexual passion; yet, comfort is necessary to relationships. It affirms and sustains partners with closeness, familiarity and predictability. Staying exclusively in your personal comfort zone stifles sexual energy. Couples seek comfort (look only under the streetlight) and avoid anxiety (dodge the darkness). Anxiety is hard to bear, but managing it can fuel growth. Relationships without anxiety allow blandness to overshadow intimacy. A "no-growth" agreement prevails when partners avoid tension, discomfort, and knowing each other. The cost of rigidly maintaining comfort is the sacrifice of sexual energy. Being deeply sexual over time with your life partner produces both joy and anxiety. This means that consciously managed anxiety can promote, even escalate, erotic energy. For example, the ability to soothe your own anxiety instead of expecting your partner to do it for you helps you create a resource for erotic feelings. This is equally true for adult survivors of incest and other traumas. Integrity helps you judge which anxieties to risk, such as getting to know your hidden self with your partner, and which to forego, such as having an affair.

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If a child is betrayed in an important relationship cheap 150 mg cleocin, especially with a loved and trusted caretaker buy cleocin 150 mg amex, as is often the case buy cheap cleocin 150mg, then the trauma is not just about the sexual acts but about the break in the trusting relationship discount cleocin 150 mg on-line. This makes it harder to enter trusting intimate relationships later in life cleocin 150 mg generic. A man may have some kind of sexual dysfunction which buy cleocin 150mg otc, of course, affects his intimate relationships. He may be sexually compulsive, or feel numb during sex, especially if he feels, even for a moment, that he is not in charge of what is happening, so he may not allow himself to truly BE intimate with another person. David: Now, this may sound silly, but a lot of sexually abused men are concerned about this. Will male childhood sexual abuse affect your sexuality? It is an important question; it relates to a fear that makes many boys and men not talk about their abuse. Conventional wisdom is that early sexual contact with a man can "turn" a boy gay, but most clinicians believe that sexual orientation is well formed by the age of 5 or 6 and for boys, the average age of their first abuse is about 9. In addition, gay men with sexual abuse histories report that they usually had a sense that they were gay BEFORE the abuse occurred. The problem is that boys growing up to be gay, in almost all cases as they try to understand their sexuality, ask themselves "Why am I this way? David: Also, many times when we think of abuse, for whatever reasons, we think of men as the perpetrators of the abuse. Gartner: There are far more female abusers than most people believe. In a study at the University of Massachusetts at Boston they found that, of the men who acknowledged a history of abuse, about 40% said they had had a female abuser (this includes men who were abused by both men and women). Gartner: This does indeed sometimes happen, unfortunately. I have known of cases where both parents included the boy in some sexual act together. Is there a particular question about such a situation that you want to ask? David: I would imagine, especially after an experience like that, it would be hard to trust anyone again? Gartner: That is true -- yet many men have enormous resources within and can overcome even such a total betrayal. Have you known anyone to overcome this fear of giving and receiving love due to sexual abuse? Gartner: Yes, definitely -- it requires a lot of patience and often a relationship with a therapist is helpful here. Having someone to talk to about the distrust, and someone to, perhaps, learn to trust. Of course, some partners are also very patient and can be very helpful if they do not take the reluctance to show love as a personal attack. There are, for example, a number of books that can be helpful here -- a small number, but it is growing. Victims No Longer by Mike Lew, Abused Boys by Mic Hunter, and my own Betrayed as Boys (which is written for professionals but I believe is accessible to many men). So I would hope that men would reconsider their concerns about being in therapy. Are you not brought up to respect and honor your mother and father? Gartner: That is exactly right -- that is why the betrayal is so huge.

Individual meth addiction facilities should be contacted regarding specific policies order 150mg cleocin free shipping. For low or no-cost meth addiction treatment buy cleocin 150mg line, crystal meth addicts may also contact the State Substance Abuse Agency or call a SAMHSA help line for further details on meth addiction services buy cleocin 150 mg with amex. Substance Abuse and Mental Health Services Administration (SAMHSA): http://www buy 150 mg cleocin free shipping. Behavioral signs of an alcohol addict can be some of the easiest to notice but unfortunately also may cause some of the most damage to those around the alcoholic buy discount cleocin 150mg. Behavioral signs of an alcoholic may be seen by friends discount cleocin 150mg fast delivery, family or even coworkers of the alcoholic. Behavioral signs of an alcoholic include:Has legal trouble such as DUI, domestic abuse or assaultArrives for appointments, interviews, or meetings intoxicated, or misses them altogetherFrequently goes "on and off-the-wagon"Behaves in an uncharacteristic, impulsive, or inappropriate mannerIs increasingly angry or defiantOverreacts to ordinary circumstances and problems, advice and criticismIs uncharacteristically isolated and withdrawnDenies, lies, covers up or is secretive about behaviors and whereaboutsLoses interest in hobbies and activitiesTakes unnecessary risks or acts in a reckless mannerHas increasing financial problems (may borrow or steal from family and friends)Mental signs of an alcoholic can be more difficult to spot and are often noticed by those who live with the alcoholic. Mental symptoms of an alcoholic often indicate a severe worsening of the disease and should not be ignored. Mental alcoholic signs include:Has difficulty concentrating, focusing, or attending to a task, needs help to complete a taskFrequently appears distracted or disorientedMakes inappropriate or unreasonable choicesHas difficulty making decisionsOften needs directions repeatedHas difficulty recalling known detailsPhysical signs of an alcoholic are more difficult to pick up on then the behavioral signs of an alcoholic but once educated, alcoholic symptoms can be seen. Physical signs of an alcoholic are generally either caused by the drinking itself or by the withdrawal when the alcoholic is not drinking. Signs of an alcoholic at work include:Makes frequent performance mistakesGives questionable excuses or blames others for poor performanceHas difficulty adhering to schedulesMisses meetings and scheduled activities, is frequently lateLodges numerous complaints or grievancesUses excessive sick leave with poor excusesTakes long lunch hours and breaksReturns to work after breaks in a noticeably changed conditionAvoids supervisors and coworkersViolates company policies and proceduresWritten by Director Enoch Gordis, M. The primary goal of alcoholism treatment, as in other areas of medicine, is to help the patient to achieve and maintain long-term remission of disease. For alcohol addicts, remission means the continuous maintenance of sobriety. There is continuing and growing concern among clinicians about the high rate of relapse among their alcoholic patients, and the increasingly adverse consequences of continuing disease. For this reason, preventing relapse is, perhaps, the fundamental issue in alcoholism treatment today. Modern science, both biological and behavioral, has explored a number of different leads in the quest to prevent relapse. These range from pharmacological agents, such as the serotonin uptake blockers and disulfiram, to behavior constructs, such as cue extinction and skills training. Although these are promising leads that one day may improve significantly the chances of alcohol dependent persons to continue long-term sobriety, there are no definitive answers yet to this troubling aspect of alcoholism treatment. This research, however, must be confirmed by properly conducted controlled clinical trials before widespread application to treating alcohol dependency. Similarly, behavioral approaches have been well described by the talented scientists who undertook the initial studies; however, evidence of the effectiveness of these approaches in preventing relapse in dependent drinkers has not been documented in adequate controlled trials. Although we are not yet at the point where we can state definitively what works best in preventing relapse, I firmly believe that we are on the brink of a new period in alcoholism treatment research that ultimately will help us to develop this knowledge. For the present, therapists should examine critically the evidence for new nonpharmacological approaches before initiating them. Similarly, good clinical wisdom should discourage the use of unproven pharmacological agents to prevent alcoholism relapse until the efficacy of using such agents in this regard is proven. Urschel, our guest on the HealthyPlace Mental Health TV Show, talks about the addictive brain and a revolutionary addiction recovery program that has changed and saved lives. Watch the interview and learn about this new treatment program. We invite you to call our number at 1-888-883-8045 and share your experience in dealing with drug, alcohol or any other type of addiction. In its guide "Substance Abuse Treatment and Family Therapy," The Substance Abuse and Mental Health Services Administration identifies various family structures and how substance abuse may impact these families. A client who lives alone or with a partner - In this situation both partners need help. If one is chemically dependent and the other is not, issues of codependence arise. The spouse of the person abusing substances is likely to protect the children and assume the parenting duties of the parent abusing substances.

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The parent coach must stress that they are on the same side as the child buy generic cleocin 150 mg on-line. Too often the child feels like the parent is an adversary - an unfortunate residual effect of family conflict generic 150 mg cleocin. When a person observes they also must reflect upon those observations and compare them to previous learning and decide what strategies to keep and which to let go of 150mg cleocin with mastercard, so observation is only the first step discount 150mg cleocin otc. There is much more cognitive process that goes into the growth of social skills cheap 150mg cleocin visa. David: Sometimes it can be very frustrating for a parent to deal with their ADHD child buy cheap cleocin 150 mg line. They test our patience; they make it hard for us to find our coaching voice, but there is a helplessness that they are trying to compensate for in the conflict they create. I often ask parents to ask themselves "What is the coaching response" when conflict emerges. Help 1: Does an ADHD child usually show violence to others? Richfield: No - not in my experience - this is an exception, but impulsivity can lead others to fear violence. You can click on this link and sign up for the mail list at the top of the page. Richfield, would you say that repetition works well with ADHD kids? Richfield: Impulsivity is the fuel that runs the ADHD child - and it can be confusing to teachers, parents, and friends. Parents can help their kids understand how their energy needs a discharge path and offer alternate outlets. Repetition can be very helpful because it provides a structured pattern for the child to turn to when certain feeling states are triggered. Richfield: I recommend "walking paths" in classrooms and homes wherein the child can freely discharge their energy without feedback from adults. Pepper48: How do you get them past the point of fear and that is after high school? Richfield: The fear can be overwhelming but with our support they can take small steps. We need to recognize that these steps may start as symbolic ones and proceed slowly. Richfield: After high school the world can appear as an even more confusing place, and yes, we are striving for that result. It comes from taking steps in their life journey, whether it be making a call on their own or applying for a job. Remember that the small social interactions often do not come naturally. These more invisible rules of the social world need to be revealed. David: Besides the social and behavioral issues, how can we help our ADD children do better in school. Concentration seems to be a tough issue to deal with? Richfield: Some interventions offer on-site reminders, such as the "Stay Tuned In" Coaching Card, while others involve the teacher providing feedback for attending to tasks. We can use stopwatches at home to help extend attention processes and challenge them to beat their records. Richfield: I work with a lot of kids who enjoy competition, so I try to mobilize that healthy character trait in motivating them to control their ADD. David: Do you think home schooling is a better way for these children to learn? David: I asked that question because I was wondering if the school environment (lots of kids and things going on) would be too disruptive for some kids - that maybe it would trigger impulsive behaviors.

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Generic Name: SaxagliptinOnglyza is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus buy cleocin 150 mg mastercard. Onglyza should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis purchase cleocin 150 mg with amex, as it would not be effective in these settings 150mg cleocin with amex. Onglyza has not been studied in combination with insulin cheap cleocin 150 mg online. No dosage adjustment for Onglyza is recommended for patients with mild renal impairment (creatinine clearance [CrCl] >50 mL/min) generic 150 mg cleocin. Onglyza should be administered following hemodialysis order 150mg cleocin with amex. Onglyza has not been studied in patients undergoing peritoneal dialysis. Renal function can be estimated from serum creatinine using the Cockcroft-Gault formula or Modification of Diet in Renal Disease formula. Insulin secretagogues, such as sulfonylureas, cause hypoglycemia. Therefore, a lower dose of the insulin secretagogue may be required to reduce the risk of hypoglycemia when used in combination with Onglyza. Monotherapy and Add-On Combination TherapyIn two placebo-controlled monotherapy trials of 24-weeks duration, patients were treated with Onglyza 2. Three 24-week, placebo-controlled, add-on combination therapy trials were also conducted: one with metformin, one with a thiazolidinedione (pioglitazone or rosiglitazone), and one with glyburide. In these three trials, patients were randomized to add-on therapy with Onglyza 2. A saxagliptin 10 mg treatment arm was included in one of the monotherapy trials and in the add-on combination trial with metformin. In a prespecified pooled analysis of the 24-week data (regardless of glycemic rescue) from the two monotherapy trials, the add-on to metformin trial, the add-on to thiazolidinedione (TZD) trial, and the add-on to glyburide trial, the overall incidence of adverse events in patients treated with Onglyza 2. Discontinuation of therapy due to adverse events occurred in 2. The most common adverse events (reported in at least 2 patients treated with Onglyza 2. The adverse reactions in this pooled analysis reported (regardless of investigator assessment of causality) in ?-U5% of patients treated with Onglyza 5 mg, and more commonly than in patients treated with placebo are shown in Table 1. Table 1: Adverse Reactions (Regardless of Investigator Assessment of Causality) in Placebo-Controlled Trials* Reported in ?-U5% of Patients Treated with Onglyza 5 mg and More Commonly than in Patients Treated with PlaceboIn patients treated with Onglyza 2. In this pooled analysis, adverse reactions that were reported in ?-U2% of patients treated with Onglyza 2. In the add-on to TZD trial, the incidence of peripheral edema was higher for Onglyza 5 mg versus placebo (8. None of the reported adverse reactions of peripheral edema resulted in study drug discontinuation. The incidence rate of fracture events in patients who received Onglyza did not increase over time. Causality has not been established and nonclinical studies have not demonstrated adverse effects of saxagliptin on bone. An event of thrombocytopenia, consistent with a diagnosis of idiopathic thrombocytopenic purpura, was observed in the clinical program. The relationship of this event to Onglyza is not known. Adverse Reactions Associated with Onglyza Coadministered with Metformin in Treatment-Naive Patients with Type 2 DiabetesTable 2 shows the adverse reactions reported (regardless of investigator assessment of causality) in ?-U5% of patients participating in an additional 24-week, active-controlled trial of coadministered Onglyza and metformin in treatment-naive patients. Table 2: Initial Therapy with Combination of Onglyza and Metformin in Treatment-Naive Patients: Adverse Reactions Reported (Regardless of Investigator Assessment of Causality) in ?-U5% of Patients Treated with Combination Therapy of Onglyza 5 mg Plus Metformin (and More Commonly than in Patients Treated with Metformin Alone)Adverse reactions of hypoglycemia were based on all reports of hypoglycemia; a concurrent glucose measurement was not required. In the add-on to glyburide study, the overall incidence of reported hypoglycemia was higher for Onglyza 2.

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