Save Your Marriage

Save The Marriage

Lee Baucom, Ph. D. shows couples with marriage troubles a new way to save their marriage that is far more effective than any marriage counselor in this marriage course. In 4 easy-to-read modules, Dr. Baucom shows the step by step way to save a marriage that is in danger of ending any day. These show the top 5 mistakes that most people make in marriage, the REAL secrets to a happy marriage, why marriage counseling can actually HURT your marriage more, and how to move beyond your emotions into action. This module can actually have you saving your marriage in less than an hour, sometimes even 10 minutes. This book also comes with 4 bonus gifts free: Coping With a Midlife Marriage Crisis, Recovering from an Affair, 5 Rules for Fighting Fair, and an eBook written by a couple who was on the edge of divorce and the methods they used to get a happy marriage back. Marriage can be hard, but divorce is harder, on you and your children. Why risk it? More here...

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Recently several visitors of blog have asked me about this ebook, which is being advertised quite widely across the Internet. So I decided to buy a copy myself to find out what all the fuss was about.

Overall my first impression of this book is good. I think it was sincerely written and looks to be very helpful.

Marital Disruption and Union Dissolution

A substantial proportion of all marriages end in divorce or separation due to marital discord. The divorce rate, which reflects the number of divorces in a year relative to the number of married people, rose continuously for more than a century in the U.S. and many similar industrialized countries, then leveled off at a fairly high level in about 1980 (Goldstein 1999). In the U.S., the best estimates suggest that around one-half of all marriages will end in separation or divorce rather than in the death of one of the partners (Martin and Bumpass 1989). Recent data for the U.S. show that after five years, 20 of all first marriages have disrupted through separation or divorce. By 10 years after the wedding, 32 of white women's first marriages, 34 of Hispanic women's first marriages, and 47 of black women's first marriages have dissolved. Asian women show the lowest levels of marital disruption after 10 years only 20 have divorced or separated. The marriages most likely to end include...

Rule 3 Define the nature of your relationship with the person you want to help

1.What's your relationship to the person (parent, sibling, friend, teacher, significant other, spouse, employer) 5.How formal is your relationship (Are you an authority figure such as a parent, teacher, or employer who is more apt to be perceived as a superior than as an equal, or is the relationship equal in terms of power or status Are you peers in terms of age and life-stage ) Obviously, the nature of your relationship will influence how your efforts are received. If you're the parent of someone who is eating disordered, the ordinary stress, strain, and intensity of that parent-child relationship will color and magnify any reactions to your help. Even if you're 100 right, you might be met with more resistance and denial than a non-relative would. If your relationship with the person is more formal than personal, your efforts may be perceived as coercive or bullying. If you're confidantes, you risk jeopardizing the closeness of the relationship if the person isn't yet ready for...

Sociology and Psychiatry Some Paradigmatic Contrasts

By contrast, the assumption that mental disorder originates in the brains or other malfunctioning organs of individuals effectively turns the Mills assertion on its head by implying that the proper study of social problems is the study of personal problems. That is, certain social problems - e.g., school failure, drug and alcohol abuse, premarital pregnancy and marital disruption, unemployment and occupational instability, domestic violence, homelessness, and criminality, to name a few - result from the aberrant dispositions or inadequacies of individuals. One might conclude from this sort of orientation that the treatment - or incarceration -of the deficient and troubled individuals is the way to rid the society of some of its noxious problems. Of course, it is reasonable to suppose that social problems may contribute to personal problems and, once established among large numbers of disadvantaged people, personal problems exacerbate those that are social.

Structure of the Family

In the U.S. and many industrialized societies, the structure of the family looks quite different than it did a half a century ago. In fact, fewer people live in families as traditionally defined and more live in nonfamily households. The rise in nonfamily living can be traced to earlier nest-leaving by young adults (Goldscheider, Thornton, and Young-DeMarco 1993), to delayed marriage and to nonmarriage, to continued high rates of marital disruption with lower rates of remarriage (Cherlin 1992), and to increases in independent living at older ages (Michael, Fuchs, and Scott 1980). In 1998, 15 of all people lived in nonfamily households, 10 alone (U. S. Bureau of the Census 1999 Table 16), compared to 6 in nonfamily households in 1950 (U.S Bureau of the Census 1955).

When the Doctor Does Not Take Pain Seriously

You can also ask about a pain specialist or a pain consulting service, such as at a teaching hospital or in a hospital's anesthesiology department (see Appendix 1 for more resources on finding a pain specialist). You might say We have full confidence in you to supervise the cancer treatments, but we'd like to take advantage of the recent developments in cancer pain management. Not every doctor can stay abreast of every development in all cancer-related fields, such as pain and symptom control. We'd like access to state-of-the-art pain management techniques. Express your hope that including a specialist for pain management will eliminate concerns about distracting the oncologist from treating the cancer and will help preserve your relationship with the doctor.

Sociology of Mental Health

Sociology of mental health has been how inequalities in income, power, and prestige affect mental health. The results are clear low socio-economic status increases distress while high status enhances well-being (e.g. Link, Lennon, & Dohrenwend, 1990 Eaton & Mutaner, 1999 Dohrenwend, 2000 Mirowsky & Ross, 2003). Many reasons account for the strong association between socioeconomic status and mental health in addition to alienating conditions of labor including the degree of economic hardship, inability to reach desirable societal goals, and senses of inequity. The impact of poverty extends far beyond economic deprivation to encompass unstable and undesirable employment, physically hazardous environments, marital instability, and unhealthy lifestyles (McLeod & Nonnemaker, 1999). Economic inequality, and resulting social relationships, are a fundamental cause of health disparities, including mental health disparities (Link & Phelan, 1995). A continuing, unresolved, debate...

Power and Empowerment

Marriage timing is also a key issue in recent fertility in Japan delayed marriage age has substantially influenced falling fertility rates in that country. Here again, changes in women's position have been central to these demographic changes. Tsuya (2000) has examined marriage behavior of young Japanese women and has argued that women view marriage more negatively than do men, and unmarried women residing with their parents are particularly likely to see the negative consequences (both psychological and material) of marriage. The subordination of and constraints placed on women within marriage makes these issues particularly salient. As Tsuya has phrased it, the institution of marriage is not serving the needs and desires of adult Japanese, especially

Human Relationship Capacity

The next category, relatedness to other persons, involves an examination of how the child relates to you. While you are with the child, you should observe how he or she treats you as a person, how your relationship develops, and how differentiated it is. As is true for all these categories, observations belonging to this category begin in the waiting room. As you enter the waiting room and relax for a minute between patients, you want to observe both the interaction between the child and whoever brought him or her and the interaction between the child and others in the room. Is he or she being affectionate or withdrawn and aloof Is he or she making contact with others how much distance does he or she maintain from them Simply by watching for half a minute or so, you get an impression of how the child has negotiated all the available human relationships in the waiting room.

Rqgeliq Saenz and M Cristina Morales

The unique experience of these and other minority groups has major implications for the United States population. Race and ethnicity are important dimensions in understanding the demography of the United States, for racial and ethnic groups vary tremendously with respect to population composition, population processes, as well as their life chances and access to opportunity structures. Referring to the social world of African Americans, Weeks (2002 411) notes that ''being of black-African origin in the United States is associated with higher probabilities of death, lower levels of education, lower levels of occupational status, lower incomes, and higher levels of marital disruption than for the non-Hispanic white population.'' The inequality of groups in American society along racial and ethnic lines has important implications for the future of the United States because of the major demographic transformations already underway in this country. Of the 75.8 million inhabitants that the...

Theoretical Issues

The proximate determinants paradigm provides a second organizing framework. It rests on the observation that the sequential biological process is influenced through only a few mechanisms, specifically, variables that influence sexual activity, the likelihood of conception, and the likelihood that conceptions result in live births (see Davis and Blake 1956). Bongaarts and Potter's (1978) operationalization of the proximate determinants demonstrates that most fertility variability between populations and over time can be accounted for by the following four determinants (1) marriage and marital disruption (as indicators of the segments of the life cycle when women are sexually active), (2) postpartum infecundability (the period after a birth without ovulation its length is determined primarily by the duration and intensity of breastfeeding), (3) use and effectiveness of contraception, and (4) induced abortion. Three other determinants are

Life Course Perspectives Key Principles

The Intersection of Biography and History. Life course perspectives attend to elements of context that are often ignored or underemphasized by other conceptual frameworks. One of those is historical context. Elder's seminal Children of the Great Depression (1974), generally recognized as the work that first articulated life course perspectives, examined the effects of an historical event on lives in the short- and long-term, including the risk of mental health problems. Historical context takes multiple forms - not only highly visible events such as the Great Depression and wars, but also historical trends (e.g., increasing divorce rates) and changes in public policy (e.g., the deinstitutionalization of mental patients during the 1970s and 1980s). Not all life course studies focus specifically on historical context. Nonetheless, this principle is intended to remind all investigators that their

Assessment of Disability

Other medical and psychiatric problems in addition to the primary psychiatric disorder in question can result in work-related disabilities. Examiners should consider whether individuals have work-related impairments resulting from their psychiatric illness or another concurrent illness, such as substance abuse or depression. In addition, individuals involved in employment litigation or making disability claims are often not working. Secondary damaging effects typically arise when the beneficial personal, social, and financial aspects of work become unavailable. Often, financial and marital difficulties ensue. Examiners should distinguish impairment related to psychiatric illness from the consequences of not working (Gold and Shuman 2009).

Antisocial Impulsive And Borderlinenarcissistic Trends

The full range of personality disorders may be encouraged under conditions of cultural disintegration and rapid change. One reason for this may involve the loss of family cohesiveness, and the failure of children to receive necessary amounts of nurturance and consistent emotional support. Out of this comes a family structure that is virtually opposite to the traditional Confucian family that stresses structure, rules, cohesion, and marital stability. Although tensions can arise in a Confucian family, its supports and networks are able to buffer most encounters with adversity. To illustrate this point, cross-cultural research related to antisocial personality disorder shows that this form of psychopathology is rare or is nonexistent in cultures that have a Confucian family structure.50 According to some thinkers, the increasing prevalence of personality disorders and related forms of psychopathology is due to the combined effects of family and community breakdown. Temperamentally...

Theoretical Origins of Sociological Stress Research

Stress research has also contributed to many sub-disciplines of sociology through its systematic investigations of the proximal environments through which stratification affects health and well-being. Stressors are defined with reference to the geographic, organizational, and interpersonal contexts in which people live their lives, including the family, work, and neighborhoods (Aneshensel & Sucoff, 1996 Conger, Conger, Elder, Lorenz, Simons, & Whitbeck, 1992 Kohn & Schooler, 1983 Hill, Ross, & Angel, 2005). The resources with which people anticipate, avoid, and respond to stress are also attached to these contexts and are enacted within them. By defining and measuring major status-based experiences (e.g., financial deprivation), role strains and role conflicts (e.g., marital problems), and contextual stressors (e.g., neighborhood violence), stress researchers have taken from, and given back to, other sub-disciplines by developing tools with which to analyze the structure...

Copulatory frequencies

Intercourse declined with age, from a median value of twice each week (in men aged 16-24 years) to 0.75 times per week in middle age (45-49 years). Although the majority of sexual activity took place between married partners, and those in long-term relationships, Wellings et al. also found that 'among single people, more than a quarter of men (28.1 per cent) and close to one-fifth of women (17.5 per cent) reported two or more partners in the last year while 13.1 per cent of men and 6.1 per cent of women reported more than two partners, a pattern that contrasts markedly with that of married individuals.' The tendency for males to have a larger number of partners over time is interesting and probably does reflect a biological predisposition for males to be more sexually active. As an aside, I mention here a most interesting hypothesis advanced by Symons (1979) regarding high frequencies of sexual activity with multiple partners among some male homosexuals. Symons suggests that this...

New Base of Competence

By doing all this thinking and preplanning, you've effectively changed the focus of your life from problems to solutions, from negatives to positives. You've made a commitment to therapy and taken the first steps. You're now at a potential transition point in your relationship with family and friends you've confronted yourself and your eating disorder you've admitted the need for help and taken the steps to find it you've shown your strength and guts, and your willingness to grow. You've proven that you can be assertive and self-aware your words and actions show that you can be capable, rational, and assume appropriate control of some aspects of your life. You are building a foundation of competence success breeds success, and confidence comes with competence.

Psychosocial and Emotional Complications

Maternal depressive symptoms are elevated in families in which a child has asthma (Bender and Zhang 2008 Waxmonsky et al. 2006). In a sample of 242 children with asthma, ages 7-17, family observation ratings and self-reports of depressive symptoms indicated that maternal depression was linked to child depressive symptoms by way of negative parenting and to asthma disease activity by way of child depressive symptoms (Lim et al. 2008a). Similar patterns of findings have been identified for paternal depression and marital conflict (Lim et al. 2008b). Thus, family distress and asthma disease activity influence one another in mutual effect. Regardless of where the cycle begins, the reverberating impact of asthma on family disruption distress, and vice versa, constitutes a downward spiral that requires effective intervention to stem increasing asthma morbidity and mortality.

Psychosocial Adjustment

Understanding issues that can arise during various stages of psychological development can enhance therapeutic interventions. For example, with newborn screening and early diagnosis, a child and family need to learn early to cope with the illness related symptoms and complex, time-consuming treatment regimens. Discovering a sense of difference was a central phenomenon described in one study of children with cystic fibrosis during middle childhood years (D'Auria et al. 1997). In adolescents, delayed physical development due to cystic fibrosis may lead to poor body image, low self-esteem, and isolation. They may experience their physical symptoms as being intrusive and having negative impacts on peer activities. In young adulthood, long-term relationships are burdened with fears about prognosis and fear of rejection if the patient becomes ill. and Lester 2002 Quittner et al. 1998). A meta-analysis found evidence that parents of children with cystic fibrosis have decreased marital...

Family and Social Functioning

The effect of pediatric heart disease on mothers appears to vary depending on the level of reported stress and the type of coping used to address these stressors (Davis et al. 1998). A stressful component of parenting a child with a heart defect is the decision-making process associated with the heart surgery, which may cause caregivers and families to experience significant psychological distress, role reorganization, and remodeling of functioning (Lan et al. 2007). Maternal attachment style has been associated with maternal and child psychiatric outcomes. For example, maternal avoidant attachment has been associated with the deterioration of maternal mental health and marital satisfaction, as well as child emotional difficulties and poor self-image at age 7 years (Berant et al. 2008).

Transfusion Of The Wrong Blood 1951 1955 1972

Medical reasons) which they said led to the postpartum hemorrhage and for the transfusion error which they claimed had triggered the events that led to their marital breakdown. On appeal, most of their claims were dismissed, except that she was awarded 20 000 compensation to be paid by the hospital for the negligence of its employee in mixing up the bloods10.

Bring out the best in the Maybe Person

Surface conflicts and clarify options. Patiently explore, from the Maybe Person's point of view, all of the options and obstacles involved in the decision. Listen for words of hesitation like probably, that could be, and I think so as signals to explore more deeply. If the person is worried about how you will feel should he or she decide something, provide reassurance that you will be fine and it won't adversely affect your relationship.

Review of Empirical Research Using a Functional Perspective

In one study, for example, Wilson and Ross (2003) had undergraduates evaluate their current self and a self from the beginning of the term (i.e., a fixed time ago), which was couched as being either psychologically close or psychologically distant. Individuals in the psychologically close condition recalled their past self as similar to their current self (i.e., self-continuity). Those in the distant condition retrieved their past selves as inferior to their current self (i.e., self-enhancement). This research suggests that people not only use memory to maintain continuity but attempt to view recent selves as positive and continuous with their current self, while downgrading more distant past self memories as needed so as to feel more positive about themselves in the present (i.e., upward comparison). This enhancement adjustment in reflecting on the past occurs in other contexts as well, such as judging marital satisfaction (e.g., Karney & Frye, 2002). Thus,...

Marriage and Symphonies

Awaiting the verdict of the high court in Dresden, Schumann chose the day before Clara's 21st birthday, September 12, 1840 for their marriage in the village church of Schoenefeld, near Leipzig. They began writing a household and marriage diary together and collaborated on The Springtime of Love (opus 37).

How Do Seizures Affect Reproductive Endocrine Function In

Reproductive endocrine dysfunction is common in men with epilepsy.45-48 Hyposexuality, the most common clinical finding, is often a cause of great concern and, not infrequently, of marital difficulties. Its recognition is thus important, particularly because it is often treatable.

Impact of Pregnancy on the Patient

Postpartum depression, or the postpartum blues, may be related to the diminishing of excitement after delivery, the loss of sleep during labor, anxiety about the ability to care for the child, perineal pain, feeding difficulties, and concern about appearance. Fortunately, postpar-tum depression is usually self-limited and remits within a week. Women at greatest risk for the development of postpartum depression are those with an unwanted pregnancy and those with marital difficulties. Sympathetic reassurance and support can help a woman return to her baseline state.

Deciding What You Expect to Accomplish by Helping

It may mean one thing to you and something entirely different to the object of your attention. Your role will vary depending on your relationship with the person, the severity of the eating disorder, the level and intensity of ongoing therapy, and how much energy you choose to expend. It's impor

The OKeeffe Years 19161946

After his divorce, they married because he wanted marriage. She maintained her name. Several years into their relationship and after their marriage, O'Keeffe became severely depressed. She had already achieved considerable recognition and was financially secure yet her life and marriage unraveled. She recovered and her dependency on Stieglitz lessened she knew the worst side of him as well as his genius for encouragement. She stayed in the marriage until his death but spent significantly less time in New York and found a second home in New Mexico. In 1929 he established his last gallery, An American Place, which remained open until one month before his death in 1946. He showed his own photographs and those of Ansel Adams and Eliot Porter as well as the regulars of the Stieglitz circle.

Toward Ecological Modernity

On the human front, the Amish have no poverty, no crime, and almost no violence. Their rates of mental disturbance and suicide are far lower than those found outside their culture. Some Amish youths experiment with alcohol, but alcoholism is almost nonexistent among adults. Marital conflict is quite low and marriages never end in divorce. The people themselves are never subjected to large dehumanizing institutions, such as factories, big schools, nursing homes, and mental hospitals. The family tends to be a tightly knit unit that cares for everyone, regardless of age or degree of infirmity. They do not have insurance policies since the people are each other's insurance.

Couples and Family Skills

New York Viking Penguin. Another down-to-earth treasure for creating a satisfying marriage. Markman, H., S. Stanley, and S. L. Blumberg. Fighting for Your Marriage Positive Steps for Preventing Divorce and Preserving a Lasting Love. San Francisco Jossey-Bass. From conflict resolution to increasing fun. Practical. Based on solid research. Prevention and Relationship Enhancement Program Resources for a Loving Relationship. P.O. Box 102530, Denver, CO 80250-2530 (1-800-366-0166 www.prepinc.comj. Fighting for Your Marriage and other books. Four excellent, affordable videos help develop communication skills, solve problems, and promote intimacy. Well-researched and respected, PREP is not therapy but is educational and preventive in nature. Includes self-taught programs, workshops, and coached programs.

Prevalence and incidence of disturbances of sexual functioning

Marital disharmony was reported by 57 of the dysfunctional patients compared to 15 of the control group (Sabhesan & Natarajan, 1989). Of the spouses, 62 developed clinically recognisable depression and 28 showed symptoms of anxiety. A random trial among these patients indicated that counselling, education and behavioural therapy were helpful. The females' partners rated their sexual satisfaction as significantly lower after the injury as compared to their evaluation of themselves before the injury (Gosling & Oddy, 1999). Two of the women did not complete the postinjury questionnaire since both reported a complete cessation of their sexual relationship. Another 12 rated their sexual relationship as worse since the injury, three as the same, and only one as improved. Seven women reported that their partner's level of sexual interest had decreased since his injury, seven reported no change, and three reported an increase in interest. Comparison of the female partners' ratings of...

The Internets Impact on Clinical Psychiatry

As Internet technology makes more medical information available to the public, relationships between patients and physicians are changing. Patients often do not tell their physicians about what they learned or did online (Hart et al. 2004). Today, patients go online to research their symptoms and their illnesses, often arriving at the doctor's office with printouts or information they learned online. Pharmaceutical manufacturers have also been using the Internet for direct-to-consumer advertising of prescription medications. When a RealAge quiz became a popular link among users of social networking sites, a journalist found that the quiz was a clearinghouse for several large drug companies allowing them to use almost any combination of answers from the test to find people to market to, including whether someone is taking antidepressants, how sexually active they are and even if their marriage is happy (Clifford 2009). Social networking sites for health, such as PatientsLikeMe (http...

Know I should make more time for myself and my marriage but I feel uncomfortable and guilty about leaving my child with

Parents may feel guilty about leaving their child at all, but it's important to spend time focused on yourself and on your relationship with your spouse. You can teach a babysitter or relative how to take care of your child's special needs. You can also contact teachers at local special education schools or contact psychology departments at local colleges for students majoring in special education. Other contacts include your local autism organizations, chapters of ASA or the ARC (formerly known as the Association for Retarded Citizens).

Interpretation or Meaning of the Stressor

When listening for the precipitant of a crisis, it is important to understand the meaning of even minor stressors in the context of a patient's life. The robbery in Melinda's community had a personalized meaning to her that reawakened old wounds and PTSD symptoms, fueling a major emotional crisis. The following sequence of events, filtered through the lens of Melinda's select past personal experiences, created this current crisis. On learning of a local robbery, Melinda perceived a threat to her home and safety. This precipitant inundated her with traumatic memories of the hurricane and its aftereffects, which destroyed her home and her relationship. She felt anxious, insecure, and emotionally numb, and she was newly avoiding crowded places. The turmoil of her earlier relationship was being reenacted in her current marriage. Her nightmares interrupted her sleep, and she began using alcohol to fall asleep and quell her anxiety. Her alcohol abuse contributed to insomnia and feelings of...

The Divorce and Final Years

Sara had experienced depressions throughout her life. In later years she lost weight. She suffered from insomnia, although during her creative periods she would work on her poems during the night, and she also had trouble getting up in the mornings, typical symptoms of depression. She took Veronal as a sleeping tablet. Her moods varied with the seasons. Her depressions were worse in winter, and she hated the cold weather since it brought on her respiratory illnesses. As she grew older, external events led to an intensification of her depression (such as the marital problems of her friends, the Untermeyers, and the suicide of their son).

CARENurturance and Social Bonding

Another realm of human distress management where such chemistries might find a place is in marriage therapy. A cogent answer has recently been provided for the age-old question What makes some marriages happy, but others miserable The most powerful answer is to be found at an affective level those couples who have the social-emotional skills to make each other feel better tend to thrive whereas those who facilitate negative feelings get themselves into self-sustaining cycles of misery (Gottman et al., 2002). This immediately raises the issue of how social-skills learning might be utilized in conjunction with agents designed to facilitate the affective endpoints they desire. For instance, oxytocin can facilitate the intensity of natural social reward (Panksepp et al., 1999). Might such stimulants for social-neuropeptide systems be able to facilitate psychotherapeutic interventions that aspire to promote social skills to help solidify affectively positive interactions, and thereby...

Family Therapy Theory and Practice

The theory and practice of family therapy has been built on the foundation of the fields of psychology and psychiatry. For this reason, in this section you will find some of the same thinkers and researchers who were pioneers in these fields. Family therapy evolved from marital couple therapy and from attempts to create more supportive family structures for mentally ill patients. Along the way, it integrated the therapeutic concepts and tools of other forms of individual and group psychotherapy. It also created some of its own, custom-made for families.

Physician with Alcohol Use Disorders

Male physicians outnumber female physicians in studies of substance use disorders. Risk factors used in other patient groups apply to physicians as well (see online discussion of causative factors). The pattern of physician abuse differs from that in the general population by the increased use of alcohol, benzodiazepines, and prescription opiates (Hughes et al., 1992). Much of the prescription drug use is self-prescribed. Impairment is generally noted first in the alcohol-abusing physician's family and social life. Marital discord, relationship problems, and heavy drinking at social events can progress to work dysfunction and impairment (Talbott et al., 1987). The physician's thinking initially becomes impaired in spatial and constructive skills, along with negative effects on memory. Verbal skills are maintained, although cognition is affected as drinking continues. An alcoholic physician will frequently turn to benzodiazepines for relief of anxiety or stress symptoms. Further...

Obstructive Sleep Apnea

Some patients described as loud snorers do not snore during sleep studies. In such cases, snoring may be intermittent and related to alcohol use, body position, or allergies. Loud snoring that cannot be verified with objective assessment is sometimes an indication of marital problems.

Iiiiiiiii 2 4 6 8 10 12 14 16 18 Vaginal length

Does the thickness of the human penis have any significance as regards sexual selection during human evolution If human penile morphology evolved to promote pleasurable stimulation of the female partner, there might be at least two avenues of selective advantage. Firstly, if enduring relationships between the sexes with long-term reproductive benefit in terms of offspring survival are facilitated by pleasurable sexual activity, then penile morphology might be adaptive in this context. However, it will be recalled that in the monogamous and polygynous non-human primates, males tend to have the least specialized penile morphologies, despite the occurrence of long-term sexual relationships in such species. There is some evidence that women rate the thickness and length of a partner's penis as significant factors in their sexual satisfaction (Stulhofer 2006). Human mate choice and long-term relationship decisions are immensely complicated, however. Cross-cultural studies indicate that...

Psychosocial and Spiritual History

Because the perpetrator often accompanies the victim to the interview, ask any other person present to leave while you speak to the patient. Begin with the following direct question ''Since domestic violence is so common, I've begun to ask about it routinely. At any time, has your partner hit, kicked, or otherwise hurt or frightened you '' If the patient answers in the affirmative, encourage her to talk about it. Alternatively, you may ask, ''Do you feel safe in your relationship '' Always listen nonjudgmentally to encourage the patient to continue talking about the episode. Showing support is very important. A statement such as ''You are not alone'' or ''Help is available for you'' shows empathy. It is crucial to assess the danger to the patient as quickly as possible before she leaves the medical facility. If the patient is in imminent danger, determine whether she can stay with friends or family. A shelter for battered women may be an alternative. Finally, provide the patient with...

General Arousal States and Mood

In addition to the relationship of biological cycles, brain, and biochemical substrates to mood, more general variations in the autonomic nervous system and the skeletal-muscular system are probably related to mood (cf. Levenson, 1983). Research demonstrating this relationship has been done, but not to any great extent. Two studies of interest in this regard were conducted by Levenson and Gottman (1983, 1985). These investigators asked married couples to discuss a variety of marital situations on videotape while being monitored with physiological sensors (cardiovascular, skin conductance, and somatic activity). Next, these couples separately viewed the videotapes, and continuously adjusted a rating dial representing a scale from very negative to very positive feelings as different segments appeared. From these data, it was possible to predict marital satisfaction, but only on the basis of broad composites of the physiological and affective data taken across situations. Greater general...

Exchange Relationshipspostmarital Depression And Divorce Culture

The motives for divorce in companionate marriages can be quite subtle. Rather than reflecting indifference to or disregard for the partner, they seem more related to unconscious existential assessments made about one's progress with the Dream. With pragmatism no longer able to justify marital continuity, the Dream has achieved as much importance as the marital participants themselves. The modern marriage partner is expected to do his or her part in making the Dream a reality. If both have similar aspirations along these lines, some semblance of harmony will prevail, but if one partner begins to lose sight of the Dream, the other is likely to interpret this as a form of mutiny or rejection. Sometimes this is explained away with the reasoning that they have grown apart, but in reality the split has little to do with growth. With increasing frequency, marital breakdown is the result of the partners' falling out of step in their wider journeys as consumers. The viability of marriage is...

Pratyusha Tummala Narra

The long-term implications for sexual assault, such as risk of anxiety, depression, suicidal ideation, eating disorders, substance abuse, and sexual dysfunction, have been documented by researchers and clinicians working with survivors.1,2,3 The internal life of survivors is often marked with feelings of shame, self-blame, and powerlessness, all of which contribute to challenges in self-care and establishing safe and fulfilling relationships.2 Sexual violence further involves stress that is rooted in social injustice and requires attention on individual, community, and societal levels. Despite these challenges, survivors find ways to cope with the extraordinary demands of the aftermath of sexual violence. told you what happened to me (the rape). You seem like you can handle it. I've always been a strong person, independent. This feels different in here to talk about this stuff. Maybe this is being strong . . . I don't know. Malcolm's statement indicates a movement toward a possibly...

What Can I Do If I Think Im Getting Manic

A manic episode can wreak havoc with a person's life. It can drain finances, ruin marriages and long-term relationships, destroy a person's physical health, produce legal problems, and lead to loss of employment. It can even lead to loss of life. The fall-out can be long-lasting William Coryell and his colleagues at the University of Iowa Medical Center (1993) found that the social and job-related effects of a manic episode are observable for up to five years after the episode has resolved itself.

The Adolescent Interview

It can be challenging to maintain your composure when a teenager discloses high-risk behavior to you. You need to help the teenager appreciate the risk that he or she is incurring at the same time that you support your relationship with your patient. One way to handle this is to invite the teenager to reflect on his or her own behavior

Social Integration and Family Adaptation to Childhood Disability The Family School Autism Project

Severely compromising the ability of family members to develop and sustain critical social connections, both within and outside the home (Domingue, Cutler, & McTarnaghan, 2000 Gray, 1998 Moes, 1995 Norton & Drew, 1994). Integrative family activities, such as dinners together, weekend outings, and summer vacations, are often severely limited or curtailed (Fox, Vaughn, Wyatte, & Dunlap, 2002 Gray, 1998 Turnbull & Ruef, 1996), while marital discord may result as parents disagree on how to manage the cacophony of difficulties emanating from their child's pervasive developmental disorder (Fisman, Wolf, & Noh, 1989 Marcus, Kunce, & Schopler, 1997 Rodrigue, Morgan, & Geffken, 1990).

Work Leisure And Overeffort Pathologies

There are a variety of factors that contribute to the onset of workaholism. It has been said that this pattern of behavior can represent a compensation for fear of failure, a response to earlier deprivation, or an escape from intimacy. However, one factor that cannot be ignored is that our culture encourages and rewards this addiction.13 The associations between work and the fruits of material success have become so close that work can represent an indirect form of consumption and a symbolic enactment of the American Dream. At the same time, work fever, as it is sometimes called, carries many mental health penalties. It has been related to anxiety, stress, worry, hopelessness, frustration, grief, sleeplessness, and marital breakdown.14

The Hierarchy Of Treatment Evidence

Patterns of affect, self regulation, and interpersonal behavior. Diagrams of these patterns are collaboratively developed and modified with the patient during treatment. This study demonstrated that about half of the patients who completed 24 sessions of CAT no longer met full criteria for the BPD diagnosis at the end of treatment. In addition, at six-month follow-up, the patients who no longer met BPD diagnostic criteria were more likely to be employed and involved in long-term relationships. These authors found that more severe BPD features, history of parasuicide, alcohol abuse, and unemployment, were predictors of poorer outcomes, highlighting the influence of pretreatment severity on outcomes in BPD patients. Mean follow-up assessment scores showed continued improvement at 18-month post-treatment, but high attrition rates prohibited statistical analyses of follow-up assessments beyond the 18-month point.

Effects of Stress and Depression on Asthma

A series of multimethod (self-report, clinician report, family observation) studies has demonstrated that the chronic stress of negative family emotional climate, marital conflict, and negative parent-child relationship contributes to child anxiety and depression, which in turn are associated with increased asthma disease activity (Lim et al. 2008 Wood et al. 2006, 2008). These findings are consistent with a longitudinal study in which Klinnert et al. (2008) reported that a negative emotional environment was associated with active asthma and adjustment problems at age 4 in a high-risk population of children whose parents have asthma.

Psychological intervention

Entry in her notes says that this should not be attempted until 6 months stability on medication, providing she is motivated and can then be assessed. However, on consultation with a psychotherapist, it was agreed that such an approach was worth considering and was started relatively early in the course of her illness, initially using dynamic psychotherapy. Nicky accepted this for a number of months but complained that it was persistently dragging things up from the past and this was eventually discontinued after a further admission to hospital. Marital therapy was offered to Nicky and her husband, but not accepted. She was later offered psychological intervention using CBT with voices and participated in some individual work with a trainee under supervision and learned ways to lower voices giving greater control, but she ended this therapy when readmitted to hospital.

Development of the problem

Mary's difficulties appeared to have started about a year before her presentation to the services. She initially painted a rather confused picture, involving her husband and his daughter. She had at some time believed that her husband was going to evict her from the house that they shared, which he had bought. She no longer believed this so strongly, but was convinced that the daughter would throw her out of the house if her father died. This, she reported, was because the daughter was resentful of Mary replacing the daughter's own mother who had passed away. Mary had a number of overheard and third party conversations that seemed to back this up, involving comments made by the daughter and some confusion about whether her name was on the deeds of the house. The husband reported that this had been dealt with by a solicitor in the presence of Mary, and that there was no impropriety or confusion. He appeared to have gone to some lengths to make Mary feel secure within their marriage,...

Background and history

Mary left home at the age of 17 to get married to her first husband. While they were married he had a number of affairs, he physically and emotionally abused her, and was financially irresponsible, again making her feel vulnerable and insecure. He developed a depressive illness towards the end of their marriage, necessitating some time in a psychiatric hospital. She separated from her first husband when she was 48, and met her second five years later. She described this man as rather controlling at times, but extremely caring and loving.

Roles goals and plans

Ships are genuinely unhealthy and destructive, perhaps set about establishing newer, healthier relationships in their lives, as stressed in the interpersonal psychotherapy (IPT) approach (Weissman et al., 2000). This capacity to plan and develop healthy relationships has been dramatically demonstrated to be protective for individuals brought up in care (Quinton & Rutter, 1985) and for adults who had emotional and behavioural problems in childhood (Champion et al., 1995).

Mind content revisited

As we have discussed earlier, goals are hierarchically arranged. So, achieving the goal of being a good father requires the attainment of goals relating to various subsumed qualities. For example, achieving the goal of being around on Sunday afternoons to take the children to the park would, perhaps, facilitate the goal of being a good father. At other times goals are clearly inhibitory, so the goal of going to make a cup of coffee inhibits the short-term achievement of finishing this paragraph in the next 10 minutes. As with self-related goals, our representations of the goals of others can be mutually facilitative or inhibitory. In addition, the representations of goals of self and others may be either facilitatory or inhibitory. So, the woman who decides to leave her loving husband for another woman is pursuing her own goal in a way that inhibits the achievement of her husband's goal of a long and happy marriage, but most likely facilitates the achievement of her lover's goal to be...

Patient Encounter Part 1

A 52-year-old man with type 2 diabetes, hypertension, and dyslipidemia returns to your clinic for follow-up on his chronic disease states. When reviewing his history, he describes problems having satisfactory sexual intercourse. After further questioning, you determine that his dysfunction has progressively gotten worse over the last year. He is quite emotional and states that the problem is distressing and has caused significant marital discord. He wonders about those ads on television suggesting a pill.

Narcissistic Personality Disorder

In a long-term relationship with a narcissistic patient, the current splitting can be interpreted. This can be done by reminding patients that they previously praised the skill and abilities of the physician. Patients can be asked why they are now so critical and angry. When this is effective, it will allow patients to discuss their perception of insults to their self-esteem.

Before the crash

Rimel, Jane, and Bond (1990) summarised the cross-cultural research findings with TBI sufferers and note that someone sustaining a TBI is more likely to be male than female (two to three times more likely), between 15 and 29 years of age, single rather than married, unemployed, of lower socioeconomic status, living in a congested urban area, and more likely than the general population to have a previous history of alcohol and or drug abuse, marital discord, and learning disability (Kraus & Chu, 2005). Inevitably, this demographic picture has important implications for the focus of this discussion on the effects of TBI on emotional and behavioural functioning.


Beginning in the mid-1960s, however, states in the U.S. substantially liberalized and simplified their divorce laws. One of the key features of these changes was a shift from divorce based on fault or mutual consent to unilateral divorce, which required the willingness of only one spouse to end the marriage. Most states also adopted some form of ''no-fault'' divorce, which eliminated the need for one spouse to demonstrate a violation of the marriage contract by the other. The shift to unilateral or no-fault divorce laws was accompanied by a surge in divorce rates in the U.S. At least some of the increase in divorce rates appears to have resulted directly from the shift in the legal environment in which couples marry and decide to remain married or in which they divorce (Friedberg 1998). The link between divorce rates and laws that permit unilateral divorce has led several states to develop alternative, more binding, marriage contracts, such as covenant marriage. The institution of...


Two basic measures of marriage and divorce are based on events occurring in a calendar year as captured by vital statistics. The marriage rate is measured as the number of marriages in a year per 1,000 population. The divorce rate is measured as the number of divorces in a year per 1,000 population. These rates present snapshots of marital events, which can be compared across years to see if the events of marriage and divorce are taking place at a faster or slower rate than in the past and compared across countries to answer the same questions. These crude rates are sensitive to differences in the characteristics of the populations being compared, which limits their utility. MARITAL HISTORY LIFE TABLES. Marriage and divorce can be studied using life table techniques (Preston, Heuveline, and Guillot 2001). If research questions are addressed to surviving members of a cohort, first marriage can be treated as a single-decrement process, with marriage the only mode of leaving the...

Gender and Fertility

The connections between gender and fertility at the community societal level are clearly strong but complicated. Mason (1993 30ff) has hypothesized seven major links between women's position and fertility. These include the ways that women's economic and social independence might delay age at marriage and how women's access to knowledge and technology can influence women's innovative behavior,'' including fertility regulation. A series of potential links revolves around the way that women's position in society can influence motivations to limit fertility within marriage. Women will be less interested in limiting the number of children when their roles, status, and respect derive particularly from their position as mothers and when they are dependent on males (husbands and sons).

Family Factors

According to family systems theory, somatization may serve the function of drawing attention away from other areas of tension, such as marital conflict (Stuart and Noyes 1999). Minuchin et al. (1978) suggested that family enmeshment, overprotective-ness, rigidity, and lack of conflict resolution predisposed family members to the development of somatization. Parental overprotection has been associated with somatization and hypochondriasis (Noyes et al. 2002). Problematic parent interactions have been reported to be predictive of significant somatic complaints by children and adolescents (Borge and Nordhagen 2000 Lackner et al. 2004). R.J. Brown et al. (2005) found that patients with unexplained symptoms score lower on family cohesion and higher on ratings of conflict. Children in families with significant degrees of conflict may develop somatic complaints as a mechanism to avoid emotional expression that may potentially exacerbate familial stress.

Clinical Features

The onset of conversion symptoms is generally acute. Individual symptoms are generally shortlived, remitting within 2 weeks in most hospitalized patients (American Psychiatric Association 2000). Good prognostic factors include sudden onset, presence of an easily identifiable stressor, good premorbid adjustment, and absence of comorbid medical or psychiatric disorders (Crimlisk et al. 1998 Lazare 1981 Speed 1996). Patients with conversion seizures have a poorer prognosis than those with paralysis or blindness. The recurrence of symptoms is not uncommon, occurring in 20 -25 of cases within 1 year (American Psychiatric Association 2000). Comorbid mood, separation, and other anxiety disorders are common. Stressful family events such as recent divorce, current marital conflict, or death of a close family member (Wyllie et al. 1999), as well as overbearing and conflict-prone parenting style (Salmon et al. 2003), are also frequently associated. Estimates of the presence of concomitant...

Empirical Findings

In addition, the marital context for women still affects labor force participation, although wives' participation rates have risen relative to the 1950s (Gurak and Kritz 1996). Brinton, Lee, and Parish (1995), examining East Asian cases, found that where labor demand increases, married women joined the labor force, even where working wives had not been culturally accepted. Marital instability and divorce also lead to more continuous female employment (South 2001).

Marios Future

Flavia and Walter needed all the emotional support Mario's nurses, psychologists, and social workers could give them during their nearly two-year ordeal in the Jimmy Fund Clinic. But they made it through that time. Their marriage survived the enormous stress, and they never removed Mario from the educational track that they had always planned for him. When he turned three, he went to preschool every weekday except Mondays, his exhausting day at the clinic.


P., has demonstrated that there was a professional relationship between you and her, she has also established that you had a duty to her because of that relationship. Her next step is to demonstrate what that duty was. Once she has done that, she then has to show that you did not fulfill that duty. She has the burden of proving that you in fact breached the duty you owed her that you did not do all you could for her within the expectations of your relationship, or that you did not have and or use the required skill and judgment. Her goal is to show that you did not meet the standard of care.


G had a previous history of depression while in law school, for which he received counseling and a brief course of antidepressant medication. He had no other psychiatric or psychological treatment in his life. He has used alcohol regularly, more in recent months in conjunction with marital problems. Two weeks before his admission to the psychiatric unit, his wife left him, claiming that his time away from home and inattentiveness to her be

Helping Yourself

Lawsuits are most often brought by people with whom you have established a professional relationship. You can argue that the duty you owed the patient because of your relationship was not the duty that Ms. P. claimed you had. She will claim that you breached your duty. You have to be able to provide evidence to show that you performed the duty expected of you by the patient and by your profession. You also have to show that your services did not fall below the professional standard of care. This can be done by comparing your services to those in the professional guidelines or recommendations, the NSGC Code of Ethics, and the professional literature. It will be important to demonstrate that your skills and knowledge (1) at least meet a minimum standard by having certification and a valid license if available and (2) are up to date through continuing education credits.

Fridas Early Years

Matilde Calderon y Gonzales, Frida's mother, was of mixed Spanish and indigenous Mexican ancestry and a devout Catholic. Guillermo and Matilde were married shortly after his first wife died during the birth of their second child. Their marriage was quite unhappy, yet they did have four daughters. Frida was the third. Her father was surrounded by women and Frida was his favorite child.

Her Later Years

Throughout their marriage, Frida and Diego traveled a great deal, mostly to the United States. Diego loved the United States while Frida always longed for Mexico. During their marriage they lived in small apartments and in two major houses, Casa Azul and the San Angel, joined homes designed by the famous Mexican designer, Juan O'Gorman. They separated many times and were divorced and remarried. When they remarried in 1940, her later years, Frida lived in Casa Azul and Diego would reside with her frequently while still maintaining his O'Gorman home. Frida became more accepting of Diego's ways and attended to him as if he were her baby, which is best reflected in her painting, 'The Love Embrace of the Universe, the Earth, Me, Diego and Xolotl' (1949). In this piece, Frida cuddles a baby Diego while she is held by the Aztec goddess Xolotl.

Couples Skills

Although most people intend marriage to be a joyous experience, the National Marriage Project reported the percentage of first marriages that were very happy declined from 54 percent in 1976 to 38 percent in 1996. Considerable research2 indicates that two major factors predict marital satisfaction. Satisfied couples tolerate issues that can't be resolved, which occurs in nearly 70 percent of marriages. They seem to understand that it takes at least ten years for high-quality intimacy to develop, which is good because nearly 90 percent of couples who say their marriage is awful will describe it as pretty good or very good five years later. Thus, they tend to hang in during the difficult times and realize that a successful marriage takes effort. I think of one recently married woman who said, I wish someone had told me how hard it would be, and that there are times when you don't want to be with your spouse. Satisfied couples tend to realize that

Couples Conflict

Researchers at the University of Denver and authors of the acclaimed book Fighting for Your Marriage, Markman, Stanley, and Blumberg* described what we call complementary conflict patterns in men and women. In general, men become more aroused by conflict, and find that uncomfortable. So they tend to withdraw from conflict. They prefer that conflict have structure and rules, and be free of emotions.3 They also tend to want to solve the problem, and use sex as a means to be close to their partner. Women tend to approach problem solving somewhat differently. They tend to consider more feelings and relationship aspects of issues. The process of problem solving is often more important than finding an immediate solution. That is, rather than wanting to be given a solution which may seem to suggest that they are not capable of solving the problem they are likely to appreciate a spouse who encourages and supports a richer exploration of the problem. Women tend to want to talk in order to feel...

Postoperative Stage

Posttransplant, patients can experience acute mental status changes (e.g., delirium) and side effects from immunosuppressant medications that can affect physical appearance, emotional functioning, and sleep and eating patterns. Any posttransplant medical complications are understandably stressful. Once patients are medically stable, patients and families commonly experience a honeymoon period, followed by the reality of living with a new chronic illness. Although families are hopeful about an eventual return to a normal life, they often experience anxiety about leaving the safety of the hospital environment, because posttransplant care can appear overwhelming. In a study in which parents of pediatric heart transplant recipients completed questionnaires, nearly 40 of parents indicated moderate to severe posttraumatic stress symptoms relating to communication about the child's illness, balancing of various role demands, emotional strain, and supervision of the child's medical care...


The issue of when a relationship is established and what duties are then owed to the patient is an area of telemedicine that is also still evolving. Parallels to face-to-face relationships provide guidance for those standards. When a professional enters into a dialogue with a patient, complies with a request for an evaluation and offers advice on which the patient relies, a physician-patient relationship has been established. It does not matter which medium was used. A provider who has an ongoing relationship with a patient and who consults with another provider through the use of electronic techniques, still maintains a professional relationship with the patient. As a specialty consultant, your relationship with the patient will depend on the circumstances. You may be involved as a consultant in the patient's care either by working with the provider or with the patient directly. In a formal consultation setting, a relationship with the patient is established. Failing to provide...

Next Steps

What seems to be clear, though, is that the challenges related to fertility planning in sub-Saharan Africa differ substantially from those encountered, for the most part successfully, in Asia and Latin America in earlier decades. First, the nature of the demand for fertility planning seems to be substantially different. In Asia and Latin America, the first goal of most of the early adopters of contraception was fertility limitation within marriage, whereas in Africa the bulk of the early demand is for either the prevention of pregnancy prior to marriage or for birth spacing within marriage (Caldwell and Caldwell 2002). Second, the HIV AIDS epidemic obviously requires an even greater emphasis on education regarding reproductive risks and the mechanisms of the sexual transmission of disease, with serious consideration given to the options of dual protection or abstinence. A third difference, related to both the epidemic and to the importance of sex outside of marriage, is the need for...

Creative Women

Comparing the suicidal women and men, Lester found no differences in age at death, prior suicide attempts, or birth order. Like the women, the majority of the men were experiencing marital problems (separation or marital discord). The men seemed to have more experience of early loss than the women, though the numbers in the sample were small. Both the men and women had a high incidence of mood disorders, but the men appeared to have a greater incidence of alcohol abuse. As with the women, problems with their creative work was common.

Pliny The Elder

Sexual Dimorphism Humans

It may be helpful at this early stage to define the various types of mating systems that occur among the extant primates, as the mating systems of extinct forms will be discussed in comparative perspective. Five mating systems may be recognized (Table 1.2) based upon two important considerations. Firstly, do females usually mate with one partner, or with multiple partners and, secondly, are these sexual relationships long term and relatively exclusive or short term and non-exclusive Monogamy involves a long-term sexual relationship between a male and a female, whilst polygyny involves long-term sexual relationships between multiple females and a single male. Both these kinds of mating systems are widely represented among recent human cultures (Ford and Beach 1951) as well as among the nonhuman primates (Table 1.2). Polyandry (a long-term relationship between one female and several males) is exceptional, but it has been recorded for people in parts of northern India, and also in some...

Case Vignette

The effects of stress on an officer's physical and emotional health are well documented. Problems include an increased risk of alcohol drug abuse, is-chemic heart disease, marital problems, excessively aggressive conduct, premature retirement, disability, and possibly an elevated suicide risk (Davey et al. 2000 Hem et al. 2001 Neylan et al. 2002 Richmond et al. 1998 Tuchsen et al. 1996), although recent data have raised some questions about suicide risk (Marzuk et al. 2002). Police are repeatedly exposed to critical incidents. This exposure predisposes them to the development of acute stress disorder and posttraumatic stress disorder (Carlier et al. 1997 Kopel and Friedman 1997 Rivard et al. 2002 Sims and Sims 1998 Stephens and Miller 1998). Given the stressful nature of law enforcement, performance can become impaired as a consequence of any combination of personal, biological, or work-related factors. These factors can include exposure to trauma, ineffective coping strategies,...

Hugo Bovill

Essential Oils Palm Map

Market information, as provided by the processor, is essential to developing long-term relationships. To enable the producer to understand market pricing, he should appreciate that when receiving more enquiries for an oil, it is likely that the price is moving upward and it is by these signs of demand that he can establish that there are potential shortages in the market (Figure 20.6).

The Road to Truth

Lovejoy (1981) posited that monogamy is an ancient trait among hominids. However, many conflicting views have been expressed as to whether human ancestors had monogamous, polygynous, or multi-partner-mating systems. Cross-cultural anthropological evidence shows that the majority of recent human populations include polygyny, as well as monogamy within their mating system (Ford and Beach 1951 Murdock 1981). The phenomenon of romantic love is a human universal, as is the propensity for men and women to engage in long-term relationships, and to raise their children together. As David Buss has put it

Case Vignette 2

Financial problems and had received an eviction notice. The couple's marital problems had escalated. Mrs. J had confided that she was thinking about asking for a trial separation. Earlier on the day of the dispute, Mr. J had asked Mr. H to recommend an attorney so that Mr. J could get his affairs in order. Mr. J was a Desert Storm veteran and had several guns in the home.

Desired Outcomes

Pression, loss of self-esteem, poor self-image, and marital discord. The primary goal of therapy is achievement of erections suitable for intercourse and improvement in patient quality of life. Additionally, the ideal therapy should have minimal side effects, be convenient to administer, have a quick onset of action, and have few or no drug

Marriage Rescue

Marriage Rescue

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