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Brain: Subcortical Nuclei 109 1 Circular sulcus of insula 2 Long gyrus of insula 3 Short gyri of insula 4 Limen insulae 5 Opercula (cut) a Frontal operculum b Frontoparietal operculum c Temporal operculum 6 Corona radiata 7 Lentiform nucleus 8 Anterior commissure 9 Olfactory tract 10 Cerebral arcuate fibers 11 Optic radiation 12 Cerebral peduncle 13 Trigeminal nerve (n super cialis 80 mg free shipping erectile dysfunction pump.com. V) 14 Flocculus of cerebellum 15 Pyramidal tract 16 Decussation of pyramidal tract Insula (Reili) order 80 mg super cialis amex erectile dysfunction drugs injection. The opercula of the frontal, parietal, and temporal lobes have been 17 Internal capsule removed to display the insular gyri. The lateral ventricle has been opened, and the insular gyri and claustrum have been removed, revealing the lentiform nucleus and the internal capsule. Brain: Subcortical Nuclei 111 1 Anterior cerebral artery 2 Frontal lobe 3 Amygdala (amygdaloid body) 4 Olfactory tract 5 Internal carotid artery 6 Oculomotor nerve (n. The direction of flow of cerebrospinal fluid is indicated by Cast of ventricular cavities of the brain (posterior aspect). Brain: Ventricular System 113 1 2 3 4 5 6 7 8 9 10 2 11 12 Dissection of the brain (superior view of the lateral ventricle and of the subcortical nuclei of the brain). Cerebellar peduncles have been 8 Amygdaloid body severed, cerebellum and cerebral cortex have been removed. X) 14 Inferior olive 15 Medulla oblongata 16 Lentiform nucleus 17 Anterior commissure 18 Tail of caudate nucleus 19 Superior colliculus 20 Inferior colliculus 21 Trochlear nerve (n. Brain: Coronal and Cross Sections 117 10 1 61 61 25 36 Coronal section through the brain at the level of the inferior colliculus (posterior aspect). Cross section of the midbrain (mesencephalon) at the level of the superior colliculus (superior aspect). Brain: Horizontal Sections 119 1 Caudate nucleus 2 Lobus insularis (insula) 3 Lentiform nucleus 4 Claustrum 5 External capsule 6 Internal capsule 7 Thalamus 8 Inferior sagittal sinus 9 Superior sagittal sinus 10 Skin of scalp 11 Falx cerebri 12 Calvaria (diploe of skull) 13 Genu of corpus callosum 14 Anterior horn of lateral ventricle 15 Septum pellucidum 16 Column of fornix 17 Choroid plexus of third ventricle 18 Splenium of corpus callosum 19 Entrance to inferior horn of lateral ventricle with choroid plexus 20 Optic radiation 21 Third ventricle Horizontal section through the head at the level of third ventricle of internal capsule and neighboring nuclei. Brain: Horizontal Sections 121 1 Upper lid (tarsal plate) 2 L ns 3 Ethmoidal sinus 4 Optic nerve (n. The outer and middle ear and auditory ossicles and tube are shown (anterior aspect). Outer ear 1 Auricle 2 Lobule of auricle 3 Helix 4 Tragus 5 External acoustic meatus Middle ear 6 Tympanic membrane 7 Malleus 8 Incus 9 Stapes 10 Tympanic cavity 11 Mastoid process 12 Auditory tube 13 Tensor tympani muscle Inner ear 14 Anterior semicircular duct 15 Posterior semicircular duct 16 Lateral semicircular duct 17 Cochlea 18 Vestibulocochlear nerve 19 Petrous part of the temporal bone Additional structures 20 Superior ligament of malleus 21 Arcuate eminence 22 Internal carotid artery 23 Anterior surface of pyramid with dura mater Right auditory and vestibular apparatus (anterior aspect). The cochlea and semicircular canals have been further dissected (anterior aspect). Deeper dissection to display facial nerve and lesser and greater petrosal nerves (anterior aspect). Petrosquamous portion has been partly removed 21 Apex of cochlea (cupula) to display the semicircular canals. Malleus and tympanic membrane have been removed; mastoid air cells are opened (left side). External acoustic meatus and facial canal have been opened to expose the chorda tympani (magn. Auditory and Vestibular Apparatus: Middle Ear 127 1 2 3 4 5 6 Frontal section through the petrous part of the left temporal bone at the level of the cochlea (posterior aspect). Medial wall of tympanic cavity and its relation to neighboring structures of the inner ear, facial nerve, and blood vessels (schematic drawing). Malleus Internal ear (labyrinth) 1 Head 17 Lateral semicircular duct 2 Neck 18 Anterior semicircular duct 1 3 Lateral process 19 Posterior semicircular duct 4 Handle 20 Common crus 21 Ampulla 6 Incus 22 Beginning of endolymphatic 5 Articular facet for malleus duct 6 Long crus 23 Utricular prominence 7 Short crus 24 Saccular prominence 8 Body 25 Incus 13 9 Lenticular process 26 Malleus 4 27 Stapes Stapes 28 Cochlea 15 10 Head 14 11 Neck Tympanic cavity 12 Anterior and posterior crura 29 Epitympanic recess 16 13 Base 30 Mastoid antrum 31 Chorda tympani Walls of tympanic cavity 32 Tendon of stapedius muscle 14 Tympanic membrane 33 Round window 15 Promontory (fenestra cochleae) Position and movements of the auditory ossicles 16 Hypotympanic recess of (schematic drawing). Diagram showing the position of the bone partly removed, semicircular canals opened. Auditory and Vestibular Apparatus: Auditory Pathway and Areas 131 1 Left lateral ventricle and corpus callosum 2 Thalamus 3 Pineal gland (epiphysis) 4 Superior colliculus 5 Superior medullary velum and superior cerebellar peduncle 6 Rhomboid fossa 9 7 Vestibulocochlear nerve (n. Cerebellum and posterior part nucleus of the two hemispheres have been removed (dorsal aspect). Auditory areas in the left hemisphere (supero- Red = descending (efferent) pathway (olivocochlear tract of Rasmussen); lateral aspect). Parts of the frontal and parietal lobes green and blue = ascending (afferent) pathways. Levator palpebrae superioris A = Superior rectus muscle D = Lateral rectus muscle muscle has been severed. B = Inferior oblique muscle E = Inferior rectus muscle C = Medial rectus muscle F = Superior oblique muscle 3 Left orbit with eyeball and extra-ocular muscles (anterior aspect). The roof of the orbit has been 5 Superior rectus muscle 16 Nasolacrimal duct removed, the superior rectus muscle and the levator 6 Cornea 17 Inferior oblique muscle 7 Eyeball 18 Nasal bone palpebrae superioris muscle have been severed. V2) 4 Eyeball (sclera) 15 Trochlea and tendon of superior oblique muscle 5 Inferior oblique muscle 16 Superior oblique muscle 6 Inferior rectus muscle and inferior branch of oculomotor 17 Medial rectus muscle nerve 18 Levator palpebrae superioris muscle 7 Infra-orbital nerve 19 Superior rectus muscle 8 Superior rectus muscle and lacrimal nerve 20 Inferior rectus muscle 9 Optic nerve 21 Greater alar cartilage 10 Lateral rectus muscle 22 Supra-orbital nerve and levator palpebrae superioris muscle 11 Ciliary ganglion and abducens nerve (n. If lesions of the chiasma destroy the crossing portions of both retinae (blue and red in the drawing). In fibers of the nasal portions of the retina (B), both temporal the chiasma the fibers from the two retinal portions are fields of vision are lost (bitemporal hemianopsia). The fibers of the two both lateral angles of the chiasma are compressed (C), the eyes remain separated from each other throughout the en- nondecussating fibers from the temporal retinae are tire visual pathway up to their final termination in the cal- affected, resulting in loss of nasal visual fields (binasal carine cortex (21). Destruction of one optic nerve (A) produces visual cortex) result in a loss of the entire opposite field of blindness in the corresponding eye with loss of pupillary vision (homonymous hemianopsia). V) 18 Pituitary gland and infundibulum 27 Trigeminal ganglion Visual Apparatus and Orbit: Layers of the Orbit 141 Middle layer of the left orbit (superior aspect). The optic nerve has of the orbit and the superior extra-ocular muscles have now been removed. They contain three conchae, where openings to the ethmoidal and maxillary sinus are located. Posteriorly 1 the two nasal cavities open into the nasopharynx through the choanae. When the mouth is closed, the oral cavity is fully occupied by the tongue, which is characterized 3 by its high mobility, necessary for the 4 development of speech and song. Specific lymphatic organs (tonsils) are located at 5 6 the entrance of the nasopharynx in both 7 the nasal and oval cavities to protect the 8 digestive tract from infection. The respiratory and digestory tracts cross 9 10 each other within the nasopharynx, the most important requirement for the development of speech. The base of the skull forms an angle of about 150° at the sella turcica (dotted line). The tongue has been disposed to show the connection of the oral cavity with the pharynx and the position of the palatine tonsil. Nasal Cavity: Paranasal Sinuses 145 Median section through the head with nasal and oral cavities. The middle and inferior nasal conchae have been partly removed to show the openings of paranasal sinuses. Nasal Cavity: Nerves and Arteries 147 48 Greater petrosal nerve 49 Maxillary nerve 24 50 Olfactory bulb 51 Olfactory nerves 52 Internal nasal branches of anterior ethmoidal nerve 53 Lateral superior posterior nasal branches 54 Lateral inferior posterior nasal branches 55 Incisive canal with nasopalatine nerve 56 Greater palatine nerve 57 Deep petrosal nerve 58 Mandibular nerve 59 Nasal cavity and inferior nasal concha 60 Opening of auditory tube 61 Tensor veli palatini muscle 62 Levator veli palatini muscle 63 Pharyngeal recess in the nasopharynx 64 Uvula 65 Palatoglossal arch 66 Tonsillar branch of ascending palatine artery 67 Palatine tonsil Nerves of the lateral wall of nasal cavity. Carotid canal opened, mucous membranes of pharynx and 68 Palatopharyngeal arch nasal cavity partly removed. Dissection of palatine tonsil located in the lateral wall of Nerves of the lateral wall of nasal cavity. Mylohyoid muscle has been severed and reflected to display the lingual and hypoglossal nerves.

In addition discount 80 mg super cialis with amex how erectile dysfunction pills work, the concepts agreed upon by nurses and patients buy super cialis 80mg with visa injections for erectile dysfunction cost, 99 percent of provide ideas for research in nursing. Goal One of my goals was to identify what I call the attainment represents outcomes. Using the transaction process model is and foremost other human beings who give nurs- one way to achieve this goal. Recognizing that a conceptual process that can be observed in many situations system represents structure for a discipline, the when two or more people interact, such as in the next step in the process of knowledge develop- family and in social events (King, 1996). In your role as as one assesses the patient and the environment a nurse, after interacting with a patient, sit down and makes a nursing diagnosis, the concepts of per- and write down your behavior and that of the pa- ception, communication, and interaction represent tient. It is my belief that you can identify your per- knowledge the nurse uses to gather information ceptions, mental judgments, mental action, and and make a judgment. That is, did you exchange information to be attained, agree on the means to attain goals and set a goal with the patient? Did you explore the that represent the plan of care, and then implement means for the patient to use to achieve the goal? If not, you ask why, and the that most nurses use this process but are not aware process begins again. The pa- of the concepts and of the process, nurses have a tient’s record indicates the process used to achieve scientific base for practice that can be articulated goals. On discharge, the summary indicates goals clearly and documented to show quality care. One does not need multiple can a nurse document this transaction model in forms to complete when this documentation sys- practice? Why do nurses insist on designing critical Documentation System paths, various care plans, and other types of forms A documentation system was designed to imple- when, with knowledge of this system, the nurse ment the transaction process that leads to goal at- documents nursing care directly on the patient’s tainment (King, 1984a). Why do we use multiple forms to complicate nursing process of assess, diagnose, plan, imple- a process that is knowledge-based and also provides ment, and evaluate, which I call a method. My essential data to demonstrate outcomes and to transaction process provides the theoretical knowl- evaluate quality nursing care? My first faculty position was as an assistant profes- sor at Loyola University, Chicago. Because my area Goal Attainment Scale of study was curriculum and instruction, I was Analysis of nursing research literature in the 1970s selected to chair a faculty committee to develop a revealed that very few instruments were designed curriculum leading to a master of science degree for nursing research. This was one of the first master’s pro- at the University of Maryland, experts in measure- grams that used a nursing framework to design a ment and evaluation, applied for and received a curriculum. The theoretical model was designed by grant to conduct conferences to teach nurses to a nurse as part of a dissertation from the University design reliable and valid instruments. The model was privilege of participating in this two-year con- composed of three concepts—time, stress, and tinuing education conference, where I developed perception. This in- velop a new graduate program was revolutionary strument may be used to measure goal attainment. This activity provided the impetus for It may also be used as an assessment tool to pro- me to reflect on my knowledge of curriculum vide patient data to plan and implement nurs- and instruction, and also to think about struc- ing care. The rest is history and is recorded in my books and articles over the past 30 years (King, 1986a). Use of King’s Conceptual In the 1970s, the professional nursing staff at System and Theory the National League for Nursing conducted con- ferences to disseminate information about the cur- Over the years of presenting my ideas at theory riculum process for developing or revising a conferences throughout the world, nurses have baccalaureate nursing program (King, 1978). The asked many excellent questions, which I have tried major components in a curriculum discussed to answer. Initially, the questions pertained to, How at these conferences were “a philosophy, concep- does one implement this in practice? This moti- tual framework, course objectives, and evaluation vated me to design the documentation system to of the curriculum” (National League for Nurs- show the relationship between the nursing process ing, 1978). Prior The scope of knowledge is so vast that it is im- to presenting this at a national meeting, several staff possible to teach students everything they need to nurses tested this and suggested this system be im- learn to begin to practice nursing today and tomor- plemented in practice. It is imperative that nursing curricula be based they were not applying a theory, but were applying on a conceptual framework. This has structured to provide students with the essential become a repetitive statement of mine; that is, one concepts, skills, and values that serve as founda- cannot apply an abstraction, which is what concep- tions and as catalysts to continue to learn after tual frameworks, models, and theories represent. What one applies is the knowledge of the concepts As a participant observer who provided admin- of the structure and process proposed in the ab- istrative support for a faculty engaged in construct- stractions. Before retiring from a full-time teaching ing a new undergraduate curriculum, I witnessed position, the last thing I had to do was design an in- the development of a curriculum that moved nurs- strument to measure goal attainment. The use of ing education into the future (Daubenmire & King, my ideas in practice, education, administration, 1973). King’s Theory of Goal Attainment 241 based on my conceptual framework, was published between associate degree nursing programs and in 1989. A curriculum model and reasonable articulation between the two pro- which is conceptually based allows for updating grams when the same conceptual framework is content and skills without the necessity for major used. The philosophy When curricula are developed that identify is essential for faculty to identify a conceptual common concepts (knowledge), skills, and profes- framework and program objectives. A study was sional values, the practice of professional nursing conducted in order to identify the major terms will be the center of health care in the twenty-first used in stated philosophies in nursing programs to century. Increased technology and knowledge re- attempt to describe the philosophical foundations quire a conceptually based curriculum for the of nursing. A In the past 10 years, nurses have published their use pilot study was conducted from which a classifica- of my conceptual system and Theory of Goal tion resulted in the formation of 12 categories Attainment in practice. A table of random numbers was knowledge of the concepts to implement theory- used to select 20 percent of the schools within each based practice (Coker & Schreiber, 1989; Hanna, category and were distributed according to region 1995; Messmer, 1995; Smith, 1988). The conclusion reported dif- Nursing’s goal is to help individuals and groups ferences in use of the terms man, health, perception, attain, maintain, and regain a healthy state: “In role, social systems, and God by program type and by location of the program in a university, commu- Nursing’s goal is to help individuals and nity college, and hospital. The findings of this groups attain, maintain, and regain a national survey provided some information about healthy state. The terms nursing, envi- ronment, and interpersonal relations did not differ nursing situations where life and health goals significantly, which indicated a few commonalities are influenced by a severe illness, nurses give in those three programs. My statements of philosophy imply differences in cur- systems framework has described a holistic view of ricula, which in turn provide different kinds of the complexity in nursing within various groups, education for different kinds of nursing practice. This This study, done over 15 years ago, raised the ques- framework differs from other conceptual schema tions, What is the philosophy of nursing education? They determined The use of my conceptual system and Theory of that nurses could identify the published nursing di- Goal Attainment in family health was suggested agnoses in 1990 with the concepts in the frame- (King, 1983). Nurses in Canada, in social environment in which individuals grow and which two hospitals were involved at a distance develop and learn through interactions to set from each other, used the conceptual framework to goals. Nurses work with families and with individ- design a system for delivery of nursing care ual family members. The of nursing research and education in a large mu- family is also viewed as an interpersonal system. Congruence in ment used my framework and Theory of Goal perceptions of nurse and family members helps in Attainment (Benedict & Frey, 1995). The Theory of assessing a situation to identify concerns and/or Goal Attainment was used in adult orthopedic problems in the interpersonal system. Two cases were presented and the use Sneed (1991) stated that my interactive systems ap- of the Theory of Goal Attainment was described in proach of goal attainment is an ideal basis for each situation.

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They form an invisible network close to the surface of the body 80 mg super cialis overnight delivery erectile dysfunction and diabetes treatment, which links together all the fundamental textures and organs purchase super cialis 80 mg visa age related erectile dysfunction causes. Kaptchuk mentions 14 meridians in his book;12 other writers refer to different numbers ranging from 11 to 20. As the meridians unify all parts of the body and energy (qi) can pass along the channels, they are essential for the maintenance of harmonious balance. Set along the meridians are a number of points used by acupuncturists (see below). Fulder explains the function of the meridians thus:13 The meridian of the colon runs from a point on the nail of the index finger along the arm and over the shoulder and neck to the nose from whence it follows a deep pathway down to the colon. Because the meridian system connects the exterior of the body by pathways to the viscera, external factors can penetrate and produce symptoms such as abdominal pain, migraine, etc. Conversely, diseases of the internal organs will produce superficial symptoms that may appear along the lines of the meridians. Thus, kidney disease can induce back pain, while disease of the gall bladder can bring pain to the shoulder, these being areas through which the respective meridians pass. Chinese medicine recognises up to 28 pulses, which are palpable on the right and left wrists. The right-hand pulses represent conditions of the lung, spleen and kidney yang, whereas the left-hand pulses represent conditions of the heart, liver and kidney yin. The pulse is assessed in seven criteria: depth, fluency, rhythm, size/shape, speed, strength and tension. The experienced practi- tioner can deduce much information on the patient’s past and present health status from reading the pulses and palpating the body. The aim is to determine which organ(s) might be out of balance by considering all the elements outlined above, and to take appropriate action to rectify the problem according to the various principles outlined above. It appears to be a daunting task to the western healthcare professional, who is more used to making a decision on appropriate medication based on symptoms determined within a 3- to 5-min consultation. Treatment Treatment is by a range of different therapies; each is described below under the appropriate section headings. Over 90% of the trials in non-specialist journals evaluated herbal treatments that were mostly proprietary Chinese medicines. The 10 most common diseases in the trials were ischaemic heart disease, stroke, chronic viral hepatitis, peptic ulcer, childhood diarrhoea, hyperlipidaemia, primary hypertension, upper digestive tract bleeding, diabetes mellitus and pneumonia. Unfortunately much of the early research was considered to be inadmissible because of problems associated with:16 • poor translation of studies • the quality and design of the research not being up to western standards • the use of unvalidated methods • methodological difficulties of establishing control groups and sham procedures for the placebo arm of trials (e. From an initial sample of 37 313 articles identified in the China National Knowledge Infrastructure electronic database a study led by Wu of the Chinese Cochrane Centre at Sichuan University, found 3137 apparent randomized controlled trials on 20 common diseases published between 1994 and 2005. Interviews with the authors of 2235 of these reports revealed that only 207 studies adhered to accepted method- ology for randomisation and could on those grounds be deemed authentic randomised controlled. The reviewers considered that a randomisation sequence generated from a random number table, calculator, or comput- erised random number generator was authentic but that tossing a coin, drawing straws, or allocating a participant according to date of birth or hospital record number was not. It is vital that correct plant species are used when researching traditional herbal medicine and that tests are carried out on material prepared according to ethnic methods. Practi- tioners frequently use mixtures of ingredients and testing standardised indi- vidual elements may not be appropriate. Another significant factor with ethnic medicine is the charisma and seniority of the practitioner, which introduces a significant element of placebo response that cannot be quantified. However, there have been few systematic assessments of the quality of reporting of these trials. This has been in response to national planning needs to provide comprehensive healthcare services. Integration was guided by health officials trained in modern medicine; harmonisation with modern medicine was the goal. Western science methodologies have been employed to analyse the effectiveness of herbs and treatment on various individuals. Tang has asked whether the current western model of research – trying out unknown treatments in animals – is suitable for studying treatments that have long been used in humans. Some traditional therapies are undoubtedly effective but this does not mean that all are. Tang Traditional Chinese medicine | 133 suggests that there is a much greater need to determine whether Chinese medicinal herbs do work rather than how they might work. Overall, 95% of general hospitals in China have traditional medicine departments, which treat about 20% of outpatients daily. Acupuncture is used widely in western Asia, Australia, Canada and parts of Europe (Figure 6. Ancient works were generally written on bamboo strips and silk, and have not survived. Subsequently, it went into gradual decline until 1822, when it was finally banned by Emperor Dao Guang, who disapproved of its practices. In the early part of the twentieth century acupuncture became part of the ongoing debate as to whether Chinese culture should be overtaken by western influences or maintain its own traditions. With the arrival of western medicine, acupuncture was increasingly relegated to rural and remote back- waters. Acupuncture developed once again as people were quickly trained and pressed into service. News of the success of acupuncture was brought to the west in 1683 by Dr Willen Ten Rhijn, a physician working for the Dutch East Indies Company in Japan. Acupuncture was widely practised in France in the late eighteenth century with Dr Berlioz, a Parisian doctor, becoming the first western prac- titioner of acupuncture in the early nineteenth century. John Churchill, the first British acupuncturist, used the technique in the treatment of rheuma- tism in 1821. Acupuncture was even mentioned in the first edition of The Lancet in 1823 as being chiefly used in ‘diseases of the head and lower belly’. In Scotland, a random survey found that an impressive 94% of respondents in a random survey knew something about acupuncture and 25% said that they would consider using it, although in practice only about 6% had actually done so. Principles of acupuncture In addition to the classic principles of Chinese medicine outlined above, there is one key aspect of practice still to consider. This is the theory of acupuncture points that are stimulated usually by the superficial insertion of 136 | Traditional medicine needles into the skin. Other methods of stimulation include the application of pressure and the passing of a weak electrical current (see below). A further 1000 extra points and special use points may also be identi- fied on the hands, ears and scalp. It is not known how these points were discov- ered – probably it was by observation over hundreds if not thousands of years – nor is it known exactly how many points were first identified. Acupoints cannot be identified by their appearance and no consistent features of their anatomy have been found that distinguish them from other tissues. Practice of acupuncture There is archaeological evidence that shows that the earliest acupuncture needles date back to the Stone Age, when instruments called bian were thought to have been used in China.

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We help more when we feel empathy for the other person (Batson cheap 80 mg super cialis with visa impotence exercise, O‘Quin super cialis 80mg on-line erectile dysfunction band, Fultz, Varnderplas, & Isen, Empathy 1983). We are more likely to help if we can feel good about ourselves by doing so (Snyder, Omoto, & Lindsay, Benefits 2004). Personal responsibility We are more likely to help if it is clear that others are not helping. Self-presentation We may help in order to show others that we are good people (Hardy & Van Vugt, 2006). Influence of self-reported distress and empathy on egoistic versus altruistic motivation to help. Sacrificing time and effort for the good of others: The Attributed to Charles Stangor Saylor. The tendency to help others in need is in part a functional evolutionary adaptation. Although helping others can be costly to us as individuals, helping people who are related to us can perpetuate our own genes (Madsen et al. Burnstein, Crandall, and Kitayama (1994) found that students indicated they would be more likely to help a person who was closely related to them (e. People are more likely to donate kidneys to relatives than to strangers (Borgida, [4] Conner, & Manteufel, 1992), and even children indicate that they are more likely to help their [5] siblings than they are to help a friend (Tisak & Tisak, 1996). Although it makes evolutionary sense that we would help people who we are related to, why would we help people to whom we not related? One explanation for such behavior is based on the principle of reciprocal altruism (Krebs & Davies, 1987; Trivers, [6] 1971). Reciprocal altruismis the principle that, if we help other people now, those others will return the favor should we need their help in the future. By helping others, we both increase our chances of survival and reproductive success and help others increase their survival too. Over the course of evolution, those who engage in reciprocal altruism should be able to reproduce more often than those who do not, thus enabling this kind of altruism to continue. Furthermore, the prevalence of altruism was particularly high in children‘s shows. For [8] instance, Anderson and Bushman (2001) found that playing violent video games led to a decrease in helping. We are more likely to help when we receive rewards for doing so and less likely to help when helping is costly. Parents praise their children who share their toys with others, and may reprimand children who are selfish. We are more likely to help when we have plenty of time than [9] when we are in a hurry (Darley and Batson 1973). When we act altruistically, we gain a reputation as a person with high status who is able and willing to help others, and this status makes us more desirable in the eyes [10] of others (Hardy & Van Vugt, 2006). The outcome of the reinforcement and modeling of altruism is the development of social norms about helping—standards of behavior that we see as appropriate and desirable regarding helping. The reciprocity norm reminds us that we should follow the principles of reciprocal altruism. If someone helps us, then we should help them in the future, and we should help people now with the expectation that they will help us later if we need it. The reciprocity norm is found in everyday adages such as “Scratch my back and I‘ll scratch yours‖ and in religious and philosophical teachings such as the “Golden Rule‖: “Do unto other as you would have them do unto you. We might hope that our children internalize another relevant social norm that seems more altruistic: the social responsibility norm. The social responsibility norm tells us that we should try to help others who need assistance, even without any expectation of future paybacks. The teachings of many religions are based on the social responsibility norm; that we should, as good human beings, reach out and help other people whenever we can. How the Presence of Others Can Reduce Helping Attributed to Charles Stangor Saylor. When the police interviewed Kitty‘s neighbors about the crime, they discovered that 38 of the neighbors indicated that they had seen or heard the fight occurring but not one of them had bothered to intervene, and only one person had called the police. Video Clip: The Case of Kitty Genovese Was Kitty Genovese murdered because there were too many people who heard her cries? Two social psychologists, Bibb Latané and John Darley, were interested in the factors that [11] influenced people to help (or to not help) in such situations (Latané & Darley, 1968). The model has been extensively tested in many studies, and there is substantial support for it. Social psychologists have discovered that it was the 38 people themselves that contributed to the tragedy, because people are less likely to notice, interpret, and respond to the needs of others when they are with others than they are when they are alone. Latané and Darley (1968) demonstrated the important role of the social situation in noticing by asking research participants to complete a questionnaire in a small room. Some of the participants completed the questionnaire alone, whereas others completed the questionnaire in small groups in which two other participants were also working on questionnaires. A few minutes after the participants had begun the questionnaires, the experimenters started to let some white smoke come into the room through a vent in the wall. The experimenters timed how long it took before the first person in the room looked up and noticed the smoke. The people who were working alone noticed the smoke in about 5 seconds, and within 4 minutes most of the participants who were working alone had taken some action. On the other hand, on average, the first person in the group conditions did not notice the smoke until over 20 seconds had elapsed. And, although 75% of the participants who were working alone reported the smoke within 4 minutes, the smoke was reported in only 12% of the groups by that time. In fact, in only 3 of the 8 groups did anyone report the smoke, even after it had filled the room. You can see that the social situation has a powerful influence on noticing; we simply don‘t see emergencies when other people are with us. Were the cries of Kitty Genovese really calls for help, or were they simply an argument with a boyfriend? The problem is compounded when others are present, because when we are unsure how to interpret events we normally look to others to help us understand them, and at the same time they are looking to us for information. The problem is that each bystander thinks that other people aren‘t acting because they don‘t see an emergency. Believing that the others know something that they don‘t, each observer concludes that help is not required. Even if we have noticed the emergency and interpret it as being one, this does not necessarily mean that we will come to the rescue of the other person.

On the other hand super cialis 80mg on-line erectile dysfunction neurological causes, neuroplasticity continues to be [14] observed even in adults (Kolb & Fantie cheap super cialis 80 mg icd-9 erectile dysfunction diabetes, 1989). The principles of neuroplasticity help us understand how our brains develop to reflect our experiences. For instance, accomplished musicians have a larger auditory cortex compared with the general population (Bengtsson et al. Plasticity is also observed when there is damage to the brain or to parts of the body that are represented in the motor and sensory cortexes. When a tumor in the left hemisphere of the brain impairs language, the right hemisphere will begin to compensate to help the person recover the [17] ability to speak (Thiel et al. And if a person loses a finger, the area of the sensory cortex that previously received information from the missing finger will begin to receive input from adjacent fingers, causing the remaining digits to become more sensitive to touch (Fox, [18] 1984). Although neurons cannot repair or regenerate themselves as skin or blood vessels can, new evidence suggests that the brain can engage in neurogenesis,the forming of new neurons (Van [19] Praag, Zhao, Gage, & Gazzaniga, 2004). These new neurons originate deep in the brain and may then migrate to other brain areas where they form new connections with other neurons [20] (Gould, 2007). This leaves open the possibility that someday scientists might be able to “rebuild‖ damaged brains by creating drugs that help grow neurons. Research Focus: Identifying the Unique Functions of the Left and Right Hemispheres Using Split-Brain Patients We have seen that the left hemisphere of the brain primarily senses and controls the motor movements on the right side of the body, and vice versa. This fact provides an interesting way to studybrain lateralization—the idea that the left and the right hemispheres of the brain are specialized to perform different functions. Because the left and right hemispheres are separated, each hemisphere develops a mind of its own, [22] with its own sensations, concepts, and motivations (Gazzaniga, 2005). By doing so, they assured that—because the two hemispheres had been separated—the image of the shape was experienced only in the right brain hemisphere (remember that sensory input from the left side of the body is sent to the right side of the brain). In split-brain patients, the severed corpus callosum does not permit information to be transferred between hemispheres, which allows researchers to learn about the functions of each hemisphere. In the sample on the left, the split-brain patient could not choose which image had been presented because the left hemisphere cannot process visual information. In the sample on the right the patient could not read the passage because the right brain hemisphere cannot process language. This research, and many other studies following it, has demonstrated that the two brain hemispheres specialize in different abilities. In most people the ability to speak, write, and understand language is located in the left hemisphere. It is also superior in coordinating the order of complex movements—for example, lip movements needed for speech. The right hemisphere, on the other hand, has only very limited verbal abilities, and yet it excels in perceptual skills. The right hemisphere is able to recognize objects, including faces, patterns, and melodies, and it can put a puzzle together or draw a picture. Although Gazzaniga‘s research demonstrated that the brain is in fact lateralized, such that the two hemispheres specialize in different activities, this does not mean that when people behave in a certain way or perform a certain activity they are only using one hemisphere of their brains at a time. We normally use both hemispheres at the same time, and the difference between the [23] abilities of the two hemispheres is not absolute (Soroker et al. Across cultures and ethnic groups, about 90% of people are mainly right-handed, whereas only 10% are primarily left- [24] handed (Peters, Reimers, & Manning, 2006). This fact is puzzling, in part because the number of left-handers is so low, and in part because other animals, including our closest primate relatives, do not show any type of handedness. The existence of right-handers and left-handers provides an interesting example of the relationship among evolution, biology, and social factors and how the same phenomenon can be understood at different levels of analysis (Harris, [25] 1990; McManus, 2002). Ultrasound scans show that 9 out of 10 fetuses suck the thumb of [26] their right hand, suggesting that the preference is determined before birth (Hepper, Wells, & Lynch, 2005), and the [27] mechanism of transmission has been linked to a gene on the X chromosome (Jones & Martin, 2000). It has also been observed that left-handed people are likely to have fewer children, and this may be in part because the mothers of left-handers are more prone to miscarriages and other prenatal problems (McKeever, Cerone, Suter, & Wu, [28] 2000). In the past, left-handed children were forced to write with their right hands in many countries, and this practice continues, particularly in collectivistic cultures, such as India and Japan, where left- handedness is viewed negatively as compared with individualistic societies, such as the United States. For example, [29] India has about half as many left-handers as the United States (Ida & Mandal, 2003). There are both advantages and disadvantages to being left-handed in a world where most people are right-handed. This may explain in part why left-handers suffer [30] somewhat more accidents than do right-handers (Dutta & Mandal, 2006). Despite the potential difficulty living and working in a world designed for right-handers, there seem to be some advantages to being left-handed. Throughout history, a number of prominent artists have been left-handed, including Leonardo da Vinci, Michelangelo, Pablo Picasso, and Max Escher. Because the right hemisphere is superior in imaging and visual abilities, there may be some advantage to using the left hand for drawing or painting (Springer & [31] Deutsch, 1998). Left-handed people are also better at envisioning three-dimensional objects, which may explain why there is such a high number of left-handed architects, artists, and chess players in proportion to their numbers [32] (Coren, 1992). However, there are also more left-handers among those with reading disabilities, allergies, and [33] migraine headaches (Geschwind & Behan, 2007), perhaps due to the fact that a small minority of left-handers owe [34] their handedness to a birth trauma, such as being born prematurely (Betancur, Vélez, Cabanieu, & le Moal, 1990). In sports in which handedness may matter, such as tennis, boxing, fencing, or judo, left-handers may have an advantage. They play many games against right-handers and learn how to best handle their styles. Right-handers, however, play very few games against left-handers, which may make them more vulnerable. In other sports, such as golf, there are fewer left-handed players because the handedness of one player has no effect on the competition. The fact that left-handers excel in some sports suggests the possibility that they may have also had an evolutionary advantage because their ancestors may have been more successful in important skills such as hand-to-hand combat [35] (Bodmer & McKie, 1994). At this point, however, this idea remains only a hypothesis, and determinants of human handedness are yet to be fully understood. Other areas of the cortex act as association areas, responsible for integrating information. Body parts requiring the most control and dexterity take up the most space in the motor cortex. Body parts that are the most sensitive occupy the greatest amount of space in the sensory cortex. Consider your own experiences and speculate on which parts of your brain might be particularly well developed as a result of these experiences. Which brain hemisphere are you likely to be using when you search for a fork in the silverware drawer? Which brain hemisphere are you most likely to be using when you struggle to remember the name of an old friend? Do you think that encouraging left-handed children to use their right hands is a good idea? Long-term potentiation in the amygdala: A cellular mechanism of fear learning and memory. Positive reinforcement produced by electrical stimulation of septal area and other regions of rat brain.

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The carbohydrates in the membrane are covalently bonded to proteins (glycoproteins) or with lipids (glycolipids) buy 80 mg super cialis free shipping erectile dysfunction vitamin shoppe. A glycoside is composed of two moieties: sugar portion (glycone) and non-sugar portion (aglycone or genin) buy discount super cialis 80mg impotence in a sentence. For example, the hydrolysis of salicin produces a glucose unit and salicyl alcohol. Many of these glycosides are formed from phenols, polyphenols, steroidal and terpenoidal alcohols through glycosidic attachment to sugars. Among the sugars found in natural glycosides, D-glucose is the most prevalent one, but L-rhamnose, D- and L-fructose and L-arabinose also occur quite frequently. Of the pentoses, L-arabinose is more common than D-xylose and the sugars often occur as oligosaccharides. The sugar moiety of a glycoside can be joined to the aglycone in various ways, the most common being via an oxygen atom (O-glycoside). However, this bridging atom can also be a carbon (C-glycoside), a nitrogen (N-glycoside) or a sulphur atom (S-glycoside). For example, digitoxin is a cardiac glycoside found in the foxglove plant (Digitalis purpurea). The aglycone and the sugar parts are biosynthesized separately, and then coupled to form a glycoside. The coupling of the sugar and aglycone takes place in the same way, irrespective of the structural type of the aglycone. Similarly, when the sugars are fructose or galactose, the glycosides are called fructoside or galactoside, respectively. For example, in anthraquinone, flavonoid, iridoid, lignan or steroid glycosides, the aglycones are anthraquinone, flavonoid, iridoid, lignan or steroid, respectively. Biosynthetically, the aglycones of cyanogenic glycosides are derived from L-amino acids, e. Pharmaceutical uses and toxicity The extracts of plants that contain cyanogenic glycosides are used as flavouring agents in many pharmaceutical preparations. Some food- stuffs containing cyanogenic glycosides can cause poisoning (severe gastric irritations and damage) if not properly handled. Most of them possess an anthraquinone skeleton, and are called anthraquinone glycosides, e. A number of ‘over the counter’ laxative preparations contain anthraquinone glycosides. Anthraquinones are found extensively in various plant species, especially from the families Liliaceae, Polygonaceae, Rhamnaceae, Rubiaceae and Fabaceae. The following structural variations within anthra- quinone aglycones are most common in nature. Rhubarb (Rheum palmatum) also contains several different O-glycosides and cascarosides. A pink or violet colour in the base layer indicates the presence of anthraquinones in the plant sample. Biosynthesis of anthraquinone glycosides In higher plants, anthraquinones are biosynthesized either via acylpolyma- lonate (as in the plants of the families Polygonaceae and Rhamnaceae) or via shikimic acid pathways (as in the plants of the families Rubiaceae and Gesneriaceae) as presented in the following biosynthetic schemes. There are two major classes of isoprenoid glycosides: saponins and cardiac glycosides. Usually, the sugar is attached at C-3 in saponins, because in most sapogenins there is a hydroxyl group at C-3. Steroidal saponins are used in the commercial production of sex hormones for clinical use. Most aglycones of triterpenoidal saponins are pentacyclic compounds derived from one of the three basic structural classes represented by a-amyrin, b-amyrin and lupeol. Most crude drugs containing triterpenoid saponins are usually used as expectorants. Three major sources of triterpenoidal glycosides along with their uses are summarized below. Plants Botanical names (Family) Main constituents Uses Liquorice root Glycyrrhiza Glycyrrhizinic acid In addition to expectorant glabra (Fabaceae) derivatives action, it is also used as a flavouring agent. Quillaia bark Quillaja Several complex Tincture of this plant is saponaria (Rosaceae) triterpenoidal saponins, used as an emulsifying e. Ginseng Panax ginseng Ginsenosides As a tonic, and to (Araliaceae) promote the feeling of well being. Their effect is specifi- cally on myocardial contraction and atrioventricular conduction. The aglycones of cardiac glycosides are steroids with a side-chain containing an unsaturated lactone ring, either five membered g-lactone (called carde- nolides) or six membered d-lactone (called bufadienolides). The sugars present in these glycosides are mainly digitoxose, cymarose, digitalose, rhamnose and sarmentose. Liliaceae, Ranunculaceae, Apocynaceae and Scrophulariaceae are the major sources of these glycosides. Among the cardiac glycosides isolated to date, digitoxin and digoxin, isolated from Digitalis purpurea and Digitalis lanata, respec- tively, are the two most important cardiotonics. Both these cardiac glycosides are cardenolides, and the sugar present is the 2-deoxysugar digitoxose. The sugar part possibly is responsible for binding the glycoside to heart muscle, and the aglycone moiety has the desired effect on heart muscle once bound. It has been found that the lactone ring is essential for the pharmacological action. In large doses these glycosides lead to cardiac arrest and can be fatal, but at lower doses these glycosides are used in the treatment of congestive heart failure. For example, harpago- side, an active constituent of Harpagophytum procumbens, is an iridoid glycoside. Lamiaceae (especially genera Phlomis, Stachys and Eremostachys), Gentianaceae, Valerianaceae and Oleaceae, are good sources of these glycosides. Changes in functionalities at various other carbons in iridoid and secoiridoid skeletons are also found in nature, as shown below. Devil’s claw (Harpagophytum procumbens) Harpagophytum procum- bens is native to South Africa, Namibia and Madagascar, and traditionally used in the treatment of osteoarthritis, rheumatoid arthritis, indigestion and low back pain. However, this plant is said to have oxytocic properties and should be avoided in pregnancy. In addition, due to its reflex effect on the digestive system, it should be avoided in patients with gastric or duodenal ulcers. Picrorhiza (Picrorhiza kurroa) Picrorhiza kurroa is a small perennial herb that grows in hilly parts of India, particularly in the Himalayas between 3000 and 5000 m. The bitter rhizomes of this plant have been used for thousands of years in Ayurvedic traditional medicine to treat indigestion, dyspepsia, constipation, liver dysfunction, bronchial problems and fever. It is, in combination with various metals, useful in the treatment of acute viral hepatitis. Oleuropein, a secoiridoid glycoside Fraxinus excelsior (ash tree), Olea europaea (olive tree) and Ligustrum obtusifolium from the family Oleaceae are the major sources of oleuropein.