Category: Transportation

9 Tips for Rewiring the Anxious Brain | Cognitive Behavioral Tools

https://www.youtube.com/watch?v=SHksvBpVSkk
Unlimited CEUs are available for $59 at AllCEUs.com/Anxiety-CEU hey there everybody and welcome to this  presentation on nine tips to rewire your   anxious brain i’m your host dr dawn elise snipes  in this presentation we’re going to start by  
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understanding a little bit more about what  anxiety is then we’ll talk about the influence   of experience and the stress response and we’ll  finish up by identifying those rewiring strategies anxiety is an emotional label we apply  to a particular set of physical reactions  
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like rapid breathing and increased heart rate  that can be triggered by a variety of things   phys physical stress like exercise can trigger  the hpa axis which is our stress response system   threat can also trigger the hpa axis  our cognitions or our thoughts can also  
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trigger this physiological reaction if we  tell ourselves there’s a impending danger   then it’s going to trigger that fight-or-flight  reaction relationship dynamics are another example   of something that can trigger a stress response  if someone starts interacting with you in a way  
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that reminds you of an unpleasant interaction in  the past it’ll trigger that memory and your brain   may respond with activating that stress response  system anxiety is an emotion it is there to help   protect us the fight-or-flight system the anger  and anxiety are designed to give us energy to  
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tell us that there might be a threat not that  there is a threat so this fight or flight system   is designed to help us survive it’s designed like  a fire alarm to alert us to the fact that there   might be a problem and i know i already said that  but it bears repeating anxiety is a feeling which  
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may or may not be based on accurate facts feelings  are not facts feelings tell us to check the facts when you experience something that causes anxiety  your brain encodes it as a threat so think about   if you are walking down the street and an  aggressive dog just runs up to the fence and  
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starts barking like crazy well if that’s your  first experience with a dog or if you felt too   threatened then your brain is going to encode  that and it’s going to make it really prominent   high winds are another example that i’ll use  throughout this presentation we live on a farm  
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and we’ve had occasions where the winds have  gotten so high that is not that it has knocked   down significant portions of our fence which not  only is inconvenient but it means the animals can   escape and it is not a cheap endeavor in order to  repair the fence so whenever we have high winds  
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there’s a part of me that may get a  little bit anxious that oh my gosh   i hope it doesn’t blow down the fence so we’ll  talk about how i’ve dealt with that over the years   it’s important to remember that in order to  protect us your brain gives more weight or  
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more prominently displays information about  threats so instead of remembering the 15   nice dogs that you’ve met in your life it’s  going to remind you of that one aggressive dog   or instead of remembering the 50 times that we had  a storm come through that there was no damage my  
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brain as soon as the wind starts picking up goes  to that one time well actually three times but   whatever those few times that the fence blew down  so probability is that nothing bad is going to   happen but my brain focuses on those distressful  events because it’s trying to keep me safe
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when your brain perceives a threat based on  prior experience or lack of experience so if   you’ve never encountered a situation  many times that’s going to trigger a   feeling of anxiety in you because your brain’s  like i’ve got no data i don’t know what to expect  
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so it could be bad it could be good but let’s just  err on the side of caution and be a little anxious   so it triggers the hpa axis which causes your  body to drop dump adrenaline we know that that’s   stimulating norepinephrine and glutamate those are  also stimulating and all of those things um work  
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together as well as uh your thyroid causing  blood sugar to be dumped into the system to   create that feeling of anxiety when we are anxious  when our fight-or-flight system has kicked off   i mentioned earlier our heart rate increases our  breathing increases our gi tract says you know  
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it’s not the time to rest and digest so let’s  clear out the system so a lot of times we get   stomach cramps or an uncomfortable feeling in  our belly all of that is just a normal reaction   to our body getting prepared in case we need  to fight or flee but we assume that since we’re  
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feeling that way then there must be a problem and  we’ll talk about emotional reasoning in a minute   when we have this physical  reaction we start feeling   anxious thoughts about our ability to keep  ourselves safe and to cope with the situation  
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can really affect whether it spirals and gets  worse into a panic attack or we’re able to cope   with it so if we start feeling anxious and we  believe that oh my gosh i’m feeling anxious this   is going to be out of control i’m going to feel  overwhelmed i’m powerless over these feelings  
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then we’re going to have increased anxiety which  is going to cause more adrenaline more glutamate   more blood sugar to be dumped because our our  body’s going ooh there must be a big problem   if our feel thoughts on the other hand are  that of safety curiosity and empowerment  
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i’m looking around i recognize that i’m pretty  safe and i think i can handle whatever life   throws at me okay so let me get curious i wonder  why i’m feeling pinky right now i wonder why i’m   feeling anxious right now so let me explore it  so i can figure out how to handle it that’s the  
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empowerment part well when we approach a situation  like that then it promotes functional responding   we can assess the situation accurately and  decide is this something i need to address   or can i turn on that rest and digest  and down regulate my stress response
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all right easier said than done so  when we talk about rewiring the brain   it’s important to start out with mindfulness and  i know we talk about mindfulness a lot but it’s so   important when you’re on autopilot then your brain  is just pulling from data that it already has  
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and not taking into account anything in the  present mindfulness encourages us to become   aware of things we become mindful of what  i call our pacer triggers for anxiety that   means our physical triggers for anxiety when  i feel a particular way for example if you’ve  
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got health anxiety then maybe if you have start  having pain that triggers anxiety in you okay   write it down what other physical sensations may  trigger anxiety in you maybe when your blood sugar   starts to get low you start to get really shaky  and you can’t necessarily differentiate that from  
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a panic attack so you assume that if you’re shaky  it must mean a panic attack so write down shaky   that’s a trigger for anxiety um some people  tend to be more anxious in certain situations   when they have certain feelings if they feel  angry that also may trigger their anxiety in other  
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videos we’ve talked about that as dirty discomfort  because we rarely have one isolated feeling   so if we get angry we may feel anxious that people  are going to get angry with us because we got   angry or if we feel depressed it may trigger our  anxiety that we’re never going to feel any better  
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so what feelings what affects trigger your anxiety  and then cognitive what thoughts trigger your   anxiety when you’re having an anxious moment  what are you telling yourself and sometimes   you may not be aware of these right now so the  first part of rewiring your brain is starting  
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to become mindful and become aware when i’m  feeling anxious what am i telling myself   when i’m feeling anxious what in the  environment might be triggering my anxiety   in the book the body keeps the score but um vessel  vander kulk talks about how a lot of times when  
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we’ve experienced trauma we may re-experience  it not as a thought so much as a reaction   so if there are stimuli in the environment  sites smart smells sounds in the environment   that remind you of a past trauma it may trigger  your anxiety and you may have that anxious  
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reaction and you don’t know where it’s coming from  it’s like oh i really don’t like how i’m feeling   and i don’t know why i’m feeling anxiety i’m  looking around and objectively everything’s fine   so it’ll be important to be aware of triggers  in your environment and start becoming aware of  
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things that trigger reactions from the past so you  can process that and recognize in the present are   you safe and and not even necessarily related to  trauma i remember one of the places i worked was   the walls were kind of this pukey blue green color  and it felt very institutional and it felt very  
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depressing and overly rigid and it  felt uncomfortable to be in there and   i couldn’t exactly tell you why and  to this day i can’t exactly tell you   why that color paint and the um environment  in that particular building triggered that  
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feeling but it did and i recognized that  when i started when i see that color   it triggers a emotional reaction in me it’s  not anxiety but people may have similar   reactions when they see particular colors  or environments and relationally what people  
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or interpersonal behaviors trigger anxiety in you  maybe particular people that you’ve interacted   with may trigger anxiety but also people that  look like those people can trigger anxiety in   you and it’s important to note that it could  be that they look physically like that person  
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or it could be that they are in a similar  role so maybe all doctors trigger your anxiety it’s important as you become more aware of  your triggers to also encourage yourself   to open your mind and become aware of  facts in context in the present moment  
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so i notice that when i’m in  this environment i feel icky facts in context in the present moment is  there something going on that is distressful   or is it triggering a reaction from the past you  know there are two completely different things
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another important step is what i call reducing  stress sensitivity if your body machine   is hyperactive hyper vigilant then you may tend to  respond with anxiety more easily or more strongly   than if it’s not so what can we do in order  to create a sense of safety and empowerment  
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well part of it is sleep when you are sleep  deprived your hpa axis becomes more active   which means and remember your hpa  axis is your stress response system   when that system is more active then you  are more likely to respond with more anxiety  
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think about it when you’re sleep deprived is  it just as easy to deal with life on life’s   terms or do things stress you out more easily  i mean i think most of us have the answer there   good quality sleep is important also with that  recognize some of your natural rhythms in the  
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morning there is the cortisol awakening response  and that is when your cortisol your stress hormone   and other uh hormones as well as your blood sugar  tend to be high your body is saying hey wake up   get ready for the day that is your body’s  um awakening response it’s not anxiety it’s  
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not designed to make you feel stressed out it’s  designed theoretically to make you feel excited   but sometimes we label it  differently sometimes our system is overly eager and it secretes too much cortisol  and it’s important to to take a look at that  
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so if you wake up in the morning and the first  thing is you feel anxious get curious examine   what thoughts am i having that  are contributing to this anxiety   what physical sensations did i not sleep well you  know what might be contributing to this besides  
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something that’s actually threatening so sleep  is important pain management is important when   we’re in pain that triggers that stress response  system to stay more active the primitive parts   of our brain say hey if we’re in pain that means  we’re vulnerable which means we are in more danger  
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from that hungry lion that might be chasing us  manage pain you may not be able to eliminate   it completely but be aware that pain may increase  your anxiety just because it triggers the hpa axis   pain may also trigger your anxiety because of  health anxiety and that’s a different video  
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but being aware of that and  managing your pain can be helpful   nutrition is important if you’re eating a  lot of simple sugars then your blood sugar   is doing this and that can contribute to feelings  of anxiety and jitteriness same thing with if  
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you drink a lot of coffee you can have surges  and crashes that can feel uh very anxiety like   getting enough protein throughout the  day to keep your blood sugar stable   can be really really helpful and paying attention  to insulin resistance is also important uh  
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when we become more insulin resistant  than our body has more difficulty   managing our blood sugar to grossly  oversimplify it some people have found that dietary changes can help with their anxiety  additionally making sure that you’re getting  
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a relatively healthy diet so your body can make  the neuro chemicals it needs to like gaba in order   to moderate your anxiety can be important and  then reducing minimizing eliminating if possible   stimulants if you’re already anxious then adding  stimulants is just turning up the volume of that  
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stress response system it’s giving it more energy  environmentally create safety in your environment   in your house in your car in your workspace so  you’re not hyper vigilant so you’re not on edge   a lot of the time turn down any unnecessary  sources of distress and develop a safety plan to  
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identify aspects within your control to respond to  common threats if x happens then i will so going   back to the aggressive dog if the aggressive dog  charges me i will respond with pepper spray you   know maybe i have pepper spray that keeps me  safe when i’m on my when when i’m on my runs  
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or if we get a bad storm and it does blow the  fence down then i will call my neighbor and i have   t posts that i can use in order to put the fence  back up so i have a plan that helps me feel   safer so i know that if this bad thing happens  i’m not saying that it will but if it happens  
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i can cope with it it’s not going  to have catastrophic consequences many people with anxiety get caught  in the emotional reasoning trap   i feel anxious therefore something bad must  be getting ready to happen emotional reasoning  
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causes you to seek out and focus on information  that confirms your feelings it’s not necessarily   confirming the facts it confirms your feelings  and it dismisses contradictory information if you   wake up and you’re having feeling anxious and you  say oh something bad’s going to happen today it’s  
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it’s going to be an awful day then you’re going  to pay attention and you’re going to notice the   bad things that happen and you’re not going to pay  attention or notice as as much of the good things another example i feel anxious about this test  therefore i am going to fail so the person starts  
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looking for confirmatory information they’re  taking the test and every time they get to a   question they don’t know they’re just like see  i knew i was going to fail and they can actually   create a confirmation bias they tell themselves  enough that they’re going to fail that they  
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actually do fail or i feel vulnerable and  anxious in this relationship therefore this   person must intend to abandon me so i feel anxious  maybe based on prior abandonment experiences therefore i’m going to look for any clue anything  this person may do that may indicate that they’re  
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getting ready to abandon me now i don’t know  for certain whether that’s what their behavior   actually means but i’m assuming based on other  people’s behaviors that that that’s what’s   going on here so there’s we’re not talking  about facts we’re talking about assumptions
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examine your relationship with anxiety  and i know that sounds really weird   but anxiety is there to protect you think  about how it has protected you in the past   and in what ways is this current anxiety maybe  
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dysfunctional but trying to protect you in  in the present you know it’s sort of that um   hyperactive or overprotective uh friend  that wants to make sure that you stay safe   how are you different now than you were in  the past what was dangerous or overwhelming or  
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whatever in the past uh things that caused you  anxiety in the past how are you different how can   you handle them differently how are you safer and  more empowered or how is the situation different   now in the past than in the past maybe in past  situations people that you dealt with were unkind  
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or caused you distress in some way how are these  people in the present different than those people sometimes that people find it helpful to treat  anxiety like a nervous friend think of piglet   from winnie the pooh and set good boundaries if  your nervous friend tells you that there might  
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be a problem and they’re really anxious about  something okay thank you for alerting me i’ll   check it out just because they feel anxious  doesn’t mean you need to take the information   thank them for letting you know and  then figure out for yourself what you  
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think and what your perception of the situation  is then be willing to explain to them why they   don’t need to be anxious in your perception or  why you don’t feel like you need to be anxious   so thank you for letting me know however these are  the actual facts in the situation as i see them  
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how are you safe and empowered if they persist if  your your anxious friend persists in saying no you   need to be anxious you need to be anxious you can  also set boundaries and tell them to go home you   know and that’s where those cognitive boundaries  come in if you treat anxiety as something separate  
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from you as a person or an entity separate from  you then you can more easily set boundaries it’s   hard to set boundaries with yourself sometimes  consider what are you afraid will happen   if you don’t dwell on anxiety all the time  if you’re not constantly scanning for the  
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next shoe to drop what are you afraid will happen  think back to times when you haven’t been anxious   moments hours even not necessarily days or weeks  but moments or hours when you haven’t been anxious   has something bad happened a lot of people  are afraid if they let go of their anxiety  
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then they’re going to be caught unawares by  something bad but think about it times when   you haven’t been hyper vigilant over anxious  when you’ve actually felt calm for a moment   did something bad happen and catch you unawares  a lot of times you’re going to be able to say no
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so rewiring the brain develop distress  tolerance tools for emotional regulation   when you are in your fight-or-flight  mode your cognition is impaired you’re   not going to be able to effectively  evaluate the situation and alter  
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your your brain’s shortcuts alter your brain’s  understanding of the situation when you’re in   fight or flight your brain is focused on just that  fight or flee not let’s check it out in order to   get into the place where you can effectively  evaluate what’s going on and potentially  
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rewire what’s going on you need to be able to  get into what linehan called your wise mind   using distress tolerance tools like  distress tolerant thoughts telling yourself   that you won’t be consumed by anxiety or  that you are able to handle this situation  
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activities like slow breathing breathe in for  four hold for four exhale for four hold for four   so that’s what we call square breathing or  engaging in relaxation activities or even exercise   i know that’s the opposite but sometimes when  your fight or flight system is revved and dumping  
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energy some people find that the best way to  manage that is to actually start moving their body   in sync with their heart so if their heart is  beating fast then they start moving and then when   they stop moving their heart naturally decreases  they kind of get it recalibrated or re-synced  
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between their their physiological  reaction and what their body is doing   guided imagery can be helpful as well as  sensations like sounds and smells and even   things that you feel like splashing cold water on  your face and i have lots of videos on distress  
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tolerance tools on the youtube channel so  i’m not going to go into that a lot here   but it’s important to find tools that work  for you so you can get into your wise mind   and engage in using some of the following tools
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when you’re confronted with a stressful  situation and you manually override your   stress response you use those distress  tolerance schools tools then your brain   actually says hmm wonder what’s going on here  i guess maybe i might not need to be nervous  
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about this i’m not sure you manually  override it you get into your wise mind   you can start adjusting the beliefs and  your brain also associates that anxiety   formerly anxiety provoking situation with  low amounts of physiological distress
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fcp is another technique that i really like   once you’re into your wise mind examine the  facts in the present context i feel anxious   okay that’s a fact i’m mindfully aware that i  feel anxious what thoughts are contributing to my  
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feeling of anxiety what are the facts for  and against those thoughts in this context   at this time not when i was eight not last  week not three weeks from now but right now   in this context at this time what are the facts  for and against my belief that there is a threat  
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what else might be contributing to my feeling  of anxiety did i have a little too much coffee   in the past few hours is my blood sugar  low am i under chronic stress so you know   i already was like that pressure cooker that  was at max capacity and this one thing that  
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came at me normally wouldn’t bother me but  it’s just i don’t know how to deal with it   i don’t know that i have any more energy to deal  with it so i feel overwhelmed and i feel anxious   or as i mentioned earlier are there sensory  triggers around me right now that might be  
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contributing to my feeling of anxiety there’s  no actual facts there’s no actual threat in the   environment but there’s sensory stimuli that are  triggering reactions based on prior experiences c stands for what’s within your control  we’ve already evaluated the facts we’ve  
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identified what may be contributing to  what’s going on and if there’s a threat   what’s within your control what  can you do to address the situation   and if you do what’s within your control if  you do what you’re empowered to do what is the  
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probability of the worst case scenario what is the  probability that catastrophe is going to happen   i have teenagers older children now and one  example can be letting them go out and drive   by themselves when they go out in the car by  themselves i feel anxious yes i do what thoughts  
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are contributing to it they could get into a wreck  what are the facts for and against those thoughts   they have a license they are in a safe  vehicle so even if they do get into a wreck   it’s probably not going to be catastrophic  my daughter is a very good driver and
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she’s been driving for years and never had an  accident so therefore um what are the facts   supporting my feeling my anxiety you know it do i  have information that says yeah it’s pretty likely   that she’s going to get into into an accident no  i don’t have that information so what is within  
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my control with her driving with the exception  of taking away her keys not a lot therefore uh   i have to rely on her being smart and i cannot  control other drivers and i cannot control her   when she is out driving i did my best leading up  to this to make sure that she was a safe driver  
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and and again what is the probability of  the worst case scenario the probability   of her getting into a catastrophic  car accident probably pretty small   she doesn’t drive on the interstates uh we  live in a very small town so there’s not a  
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whole lot of traffic you know probability  of the worst case scenario is pretty slim another technique that can help in rewiring  is rewriting cognitions or your thoughts in   your core beliefs and i emphasize re-write and  rethinking about it is one thing but if you  
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actually hand write it not type it hand write it  it solidifies the new memory or the restructured   memory in a different way than if you just  think it or even if you type it or talk about it when you start feeling anxious  write down what you’re thinking  
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and then write down a restructured version or  a more accurate version of what you’re thinking   um all or nothing thinking this happens every time  every time there’s a storm the fence blows down   every time i get into a relationship i get  abandoned those are all or nothing thoughts  
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so what are the exceptions write down the  exceptions to the rule um mental filtering   and that is when you focus only on the negative  so again you want to look for the positives   i’m always getting in trouble at work or at school  or my child is always getting in trouble at school  
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look for the exceptions okay maybe they’ve  gotten in trouble a lot but not always so what’s   different during the times when they’re  not getting in trouble personalization   you know people don’t like me because i’m a  bad person or people are going to abandon me  
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because i’m not lovable what are some alternate  explanations you know maybe it’s because they’ve   got stuff going on now that doesn’t necessarily  mean you’re not going to get abandoned   by a person but if you personalize it if you think  it’s about you then you expect that henceforth  
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and forevermore everybody’s going to abandon  you because you’re the one that’s not lovable   if you look at the big picture find alternate  explanations why something may have happened   yes it’s unfortunate and you’ve got to  grieve that loss but you can also recognize
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that that doesn’t always have to happen  magnification of the negative or minimization of   the positive look at the facts assuming or jumping  to conclusions without all of the information   or mind reading get the facts you don’t know  what somebody’s thinking if you’re anxious if  
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you feel anxious that somebody’s angry with you  instead of assuming that you’re interpreting their   nonverbals correctly or their mood correctly  and it’s about you ask them get the facts   and availability is another thing that  contributes to anxiety we tend to remember and  
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react based on the things that are either  most recent or most emotionally charged so   plane crashes for example we hear about plane  crashes on the news and those are devastating   those are very emotionally charged when we hear  about it we feel awful for those people and we  
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may empathize and think how awful it would be to  be in that plane crash we don’t think about the   20 000 flights that took off that day that landed  successfully so it’s important to get the facts   if you start thinking flying is dangerous what  are the facts how many planes actually crash um  
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driving you know how many cars actually crash how  many people you know actually have problems it’s   important to if there’s something that’s making  you anxious if there’s something you’re afraid of   get all of the facts about it snakes for example  you know when i was growing up a lot of people  
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talked about how snakes were dangerous  and in my mind that’s all i heard   snakes are dangerous therefore all snakes  must be dangerous and that’s a false premise   when i started doing the research i learned  that yes there are six snakes in tennessee  
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that are dangerous but there are literally  hundreds of other species that are not   so looking at the availability of  information i needed to broaden   my awareness of the whole picture not just  the sliver of information that i was presented
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rewiring and retraining can also be done through  experience the first step is to be willing to   be open to the experience and challenge our  inaccurate beliefs which means i’ve got to be   able to look at the snake or whatever it is that’s  causing me anxiety use my distress tolerance  
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skills to get into my wise mind and then examine  the accuracy of my facts in the current context   data collection can also be helpful write  it down again handwrite whenever possible   how often does this actually  happen how likely is it to happen  
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does it happen literally every single  time so start keeping notes for the   storms i started keeping notes how frequently do  we have storms and how frequently during those   storms does my fence get blown down and the  preponderance of the time it didn’t happen uh  
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so it’s important to get data to understand  how often does this happen versus how often   does it feel like it happens what are other  possible outcomes and how often do they happen   so let’s take relationships and abandonment  for example move away from the fence
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how what are other possible  outcomes i get into a relationship   and it works out how often does that happen when how often does it happen that people get into  not necessarily just me that other people get into  
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relationships that they get abandoned that other  people get into relationships and it works out   it’s important to recognize that how frequently you could expect something to  happen and how accurate are your expectations  
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do you expect a gale-force wind and it’s only  a gentle breeze do you expect to fail a test   and okay you get a b minus what  were your expectations going into it   rewiring can also be done through guided imagery  envision yourself successfully navigating  
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a concern that that you’re having going to  the doctor or asking somebody out on a date or   your kid going out driving and coming home safely  envision the positive scenario envision the   positive solution envision prior times when you’ve  experienced something similar and it’s gone okay  
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remind yourself of other times when it’s gone  okay see that happening and repetition repeating   to yourself the distress tolerant thoughts  and those more accurate cognitions are really   helpful at reducing anxiety so instead of saying  everybody is dangerous or nobody is trustworthy  
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repeating to yourself that some people are  untrustworthy and some people are trustworthy repetition repeating it to yourself over  and over again and stopping using the um   extreme or thoughts or the thoughts with the  cognitive distortions that trigger your anxiety  
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can help you approach a situation and  feel more in control and empowered your brain learns from experience and uses  those experiences to help you predict the future   information from past experiences often only  provides part of the picture that is what happened  
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in the past it doesn’t take into consideration  what’s going on right now when in fight or flight   cognition is impaired and prior information is  often unable to be modified to include new data   so if you expect something to be distressful and  you maintain your anxiety even if the situation  
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ended up being no big deal your brain isn’t going  to process that because you were in that anxiety   haze if you will rewiring the brain requires  learning tools to calm the stress response   then identifying new information that may help  you feel safer more empowered that’s based in  
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facts in the present context integrating that  new information training the brain to have new   expectations i’ve mentioned in other videos that  when i was very very little i had a bad experience   with a nurse giving me a shot and from then on  i was terrified of needles and i talked about  
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it with my doctor one time when i was much much  older and she said i’m gonna give you the shot   trust me it’s not going to hurt and every  fiber of my being said oh she’s lying   but i did trust her and i was willing to be open  to a new experience and sure enough she gave  
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me the shot and it didn’t hurt so now i go into  the doctor’s office different doctor now um and   i don’t automatically expect it to be painful  or distressful because i know that it i can get   shots without having it be be awful so i’ve  trained my brain to have new expectations  
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now there are certain phlebotomists for  example that you may go to and you may   know from experience that they have difficulty  finding a vein so your anxiety may go up when you   see that particular phlebotomist whereas if you  see a different one who gets the vein every time  
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you may not have any anxiety at all and in that  way you’ve trained your brain to be more selective   and not expect that every time you get your  blood drawn it’s going to be a painful situation   the brain’s desire for survival may cause  it to cling to the distressful expectations  
00:44:22
until it is proven wrong multiple  times you can’t just have this fear   and then have an experience that contradicts that  fear and your brain goes oh i was wrong never mind   your brain’s automatic response is to say maybe  that was just an exception let’s see if it happens  
00:44:44
again and so it may take several repetitions of  something several times experiencing something   or doing something like get public speaking  or asking somebody out on a date before it   doesn’t trigger the extreme anxiety response  so it takes practice what you want to look for  
00:45:07
is a reduction in the intensity of the anxiety  each time you repeat it now see if you feel   it feels a little bit easier each time i hope this  has given you a few tools to consider exploring in   rewiring your brain basically what you’re trying  to do is reprogram your brain by providing it  
Source : Youtube

Fertility Preservation in Women and Men With Hodgkin Lymphoma

Lymphoma is a cancer of lymphocytes, the cells that are part of the human immune system. The disease was first described in 1832 and can start anywhere lymphocytes are found (lymph nodes, spleen, bone marrow, or digestive tracts). Two types are recognized; Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). The American Cancer Society estimates that approximately 3800 women and 4600 men will be diagnosed with HL in 2010. The majority of those diagnosed with HL are children and young adults (age 15 to 40 years). Modern treatment carries high survival rates. (>80%). HD, however, by virtue of the disease itself or its treatment poses considerable risk to fertility in women and men, especially if it recurs after treatment.When HD is suspected usually because of enlarged lymph nodes or other symptoms such as a fever, weight loss, or night sweating, a biopsy of lymph nodes is required for the diagnosis. Biopsy require special stains (CD15, CD 30) for proteins on the surface of the characteristic cell. Once confirmed certain imaging studies (especially PET scan) to detect the extent of the disease.
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 Hi, I was able to get a store https://shopzpresso.club/top-nutrition-101/ it is connected to or affiliated to my WordPress blog Top Nutrition Expert (com) it would be nice if you would stop by to give it a look so I could get a review https://g.page/r/CdaKFyal4iKqEAg/reviewChemotherapy for Hodgkin Lymphoma; combination chemotherapy is used either ABVD, BEACOPP, or MOPP-ABV. Each of the letters represents one medication. The combination of drugs is used for several cycles usually 3 to 6. This is the principal treatment for HL.Radiation therapy using an external beam is sometimes combined with chemotherapy. Radiation is usually localized to the area of the body that harbors enlarged lymph nodes.Hematopoietic stem cell transplantation (HSCT). This treatment is used for resistant HL or HL that recurred after successful treatment in the past (relapse). This treatment requires 1. very high dose of chemotherapy and possibly total body radiation then 2. transplantation of the mother cells of the bone marrow that produce our blood cells. The sources of these cells could be the person himself (autologous) a donor person (allogenic).Effects of Hodgkin Lymphoma and treatment on future fertility. It has been shown that men and women attempting conception after treatment for HL had lower chances of becoming pregnant than the general population (Aisner 1993).Men: There is evidence to suggest that HL itself can affect sperm production in 50 to 70% of boys and men, probably due to the disturbance of the immune cells. Chemotherapy also can be harmful to sperm production. Alkylating agents especially cyclophosphamide can cause prolonged or permanent azospermia (no sperm production). The other agents may have a reversible effect with some prospects of recovery after months to years. The final effect of chemotherapy is difficult to predict and is related to the type of regimen and doses used. For example, the old MOPP regimen for 6 or more cycles results in a very high rate of azospermia while the newer ABVD regimen usually causes reversible azospermia.HSCT entails the use of a high dose of alkylating agents and sometimes radiation. It commonly results in prolonged azospermia. HL or its treatment may also affect sperm quality (sperm shape and motility) in addition to concentration. Suppression of sperm production in the testes using a group of medication called gonadotropin-releasing hormone agonists (GnRHa) has been suggested but there is no proof that they protect the gonads from the effects of treatment in men and women. The testes should be shielded from the radiation field whenever possible.Women: Chemotherapy for HL can result in a reduction of ovarian reserve and may reduce future fertility depending on the medication used, dose, frequency, intensity, age, and associated radiation treatment. Multiple studies suggested that the risk of loss of fertility is related to 1. Age > 30 years (or > 25years with high dose therapy) 2. Type of chemotherapy. MOPP was associated with loss of fertility than ABVD and BEACOPP. 3. Dose and frequency of chemotherapy. Dose escalation BEACOPP used in more advanced HL was associated more with ovarian failure. 4. Exposure of the ovaries to radiation. In a large study about 20% of women experienced menopause. In another study, about 40% of women were able to conceive after treatment. In general published literature is not accurate in reporting fertility potential because they used menses as their endpoint. Resumption of menses after chemotherapy does not accurately reflect fertility potential. The high dose of chemotherapy used prior to HSCT is associated with ovarian failure in the vast majority of women and girls.Options for the preservation of fertility in men. 1. Sperm cryopreservation: This is a widely available and safe option in adults. One or multiple sperm samples are obtained and frozen for later use. After remission, the sample is thawed and used for intrauterine insemination or in vitro fertilization. If IVF is used a single sperm is injected directly into a partner oocyte (ICSI) and the rest of the sperm is refrozen. ICSI is a very powerful tool that can compensate for lower quality sperm encountered in men with HL. In prepubertal boys, sperm may be found in the ejaculate as early as 12 years. Asking prepubertal boys to produce a sperm sample may carry some ethical consideration. The majority of cancer patients are interested in knowing their options about the preservation of genetic parenthood in the future. In spite of that, only about one-quarter freeze their sperm, mainly because of a lack of information about sperm freezing (Schover et al 2002). A survey of over 700 oncologists indicated that less than half offer this option to their patients diagnosed with cancer. 2. Surgical sperm retrieval (TESE). Testicular sperm extraction is a surgical procedure where a small amount of tissue is harvested directly from the testes to obtain sperm. It is used in men with azospermia before starting treatment. The specimen is frozen for future use with IVF-ICSI. This is a common procedure in adults and has been reported in prepubertal boys. 3. Testicular stem cell freezing; either within testicular biopsy or separated cells. This is an experimental method with no reported human pregnancy. It is considered for prepubertal boys. The cells or tissue is later transplanted back for sperm production.Options for the preservation of fertility in women.1. Embryo freezing. This technology is widely available and suitable for women with a partner (or accepting donor sperm) and treatment can be delayed for 3 weeks. It requires stimulation of the ovaries and egg retrieval (an outpatient procedure under sedation). Embryos can be frozen for a long time and transferred after remission when fertility is desired.

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2. Egg freezing. Used in women with no partner and declining the use of donor sperm. It also requires ovarian stimulation and a treatment delay for 3 weeks. It’s generally less successful than embryo freezing, although the use of the vitrification method can yield comparable results to embryo freezing.3. Ovarian tissue freezing. This method is experimental. It’s used in prepubertal girls or in women that need to start treatment urgently and do not have the time to undergo ovarian stimulation. Its also considered in women or girls before undergoing HSCT since it is associated with a very high rate of ovarian failure. One ovary is harvested usually using minimally access surgery (laparoscopy). The patient is discharged the same day and can start treatment immediately. The ovary is processed so that the outer part (2mm thin) is isolated and frozen. The inner part of the ovary (does not bear eggs) is submitted for pathological examination. After remission, the ovary is transplanted back in the abdomen or under the skin.Women and men diagnosed with Hodgkin Lymphoma experience a high chance of cure. Counseling about fertility issues before treatment can enable them to preserve their sperm, eggs, or embryos for future use after treatment.

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Separation anxiety in dogs describes a condition in which a dog exhibits distress and behavior problems when separated from its handler. Separation anxiety typically manifests within 30 minutes of departure of the handler. It is not fully understood why some dogs suffer from separation anxiety and others do not. The behavior may be secondary to an underlying medical condition. With chronic stressors in the dog’s lives, impairments can occur on their physiological health. Increased stress in the animal alters their hormone levels and thus decreases the animals’ immunity to various health problems. A visit to the veterinarian is always recommended if a dog’s behavior changes suddenly.see more at WikipediaCheck More at http://workout.vydio-x.com/

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Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. An old concept, the meaning of hypochondria has repeatedly changed. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of the body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they or others have, or are about to be diagnosed with, a serious illness. Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, their concerns are far in excess of what is appropriate for the level of disease. Many hypochondriacs focus on a particular symptom as the catalyst of their worrying, such as gastrointestinal problems, palpitations, or muscle fatigue. To qualify for the diagnosis of hypochondria the symptoms must have been experienced for at least 6 months. The DSM-IV-TR defines this disorder, “Hypochondriasis”, as a somatoform disorder and one study has shown it to affect about 3% of the visitors to primary care settings. The 2013 DSM-5 replaced the diagnosis of hypochondriasis with the diagnosis of somatic symptom disorder and illness anxiety disorder. Hypochondria is often characterized by fears that minor bodily or mental symptoms may indicate a serious illness, constant self-examination and self-diagnosis, and a preoccupation with one’s body. Many individuals with hypochondriasis express doubt and disbelief in the doctors’ diagnosis and report that doctors’ reassurance about the absence of a serious medical condition is unconvincing or short-lasting. Additionally, many hypochondriacs experience elevated blood pressure, stress, and anxiety in the presence of doctors or while occupying a medical facility, a condition known as “white coat syndrome”. Many hypochondriacs require constant reassurance, either from doctors, family, or friends, and the disorder can become a debilitating challenge for the individual with hypochondriasis, as well as their family and friends. Some hypochondriacal individuals completely avoid any reminder of illness, whereas others frequently visit medical facilities, sometimes obsessively. Some sufferers may never speak about it.see more at WikipediaCheck More at http://youtube.effectsofanxiety.net/ebook/

Panic! at the Disco

Panic! at the Disco is an American pop rock band from Las Vegas, Nevada, formed in 2004 by childhood friends Brendon Urie, Ryan Ross, Spencer Smith, and Brent Wilson. Since 2015, singer Urie has been the only official member of the band, with drummer Dan Pawlovich, bassist Nicole Row, and guitarist Mike Naran accompanying him on tour. Panic! at the Disco recorded their first demos while they were in high school. Shortly after, the band recorded and released their debut studio album, A Fever You Can’t Sweat Out (2005). Popularized by the second single, “I Write Sins Not Tragedies”, the album was certified triple platinum in the US. In 2006, founding bassist Brent Wilson was fired from the band during an extensive world tour and subsequently replaced by Jon Walker. Influenced by 1960s rock bands the Beatles, the Zombies and the Beach Boys, and preceded by the single “Nine in the Afternoon”, the band’s second studio album, Pretty. Odd. (2008), marked a significant departure from the sound of the band’s debut. Ross and Walker, who favored the band’s new direction, departed because Urie and Smith wanted to make further changes to the band’s style. The duo subsequently formed a new band, the Young Veins, leaving Urie and Smith as the sole remaining members of Panic! at the Disco. Continuing as a duo, Urie and Smith released a new single, “New Perspective”, for the movie Jennifer’s Body, and recruited bassist Dallon Weekes and guitarist Ian Crawford as touring musicians for live performances. Weekes was later inducted into the band’s lineup as a full-time member in 2010. The band’s third studio album, Vices & Virtues (2011), was recorded solely by Urie and Smith in 2010, produced by John Feldmann and Butch Walker. Crawford departed once the tour cycle for Vices & Virtues ended in 2012. As a three-piece, Urie, Smith, and Weekes recorded and released the band’s fourth studio album, Too Weird to Live, Too Rare to Die!, in 2013. Prior to the release of the album, Smith unofficially left the band due to health and drug-related issues, leaving Urie and Weekes as the remaining members. The duo recruited guitarist Kenneth Harris and drummer Dan Pawlovich as touring musicians for live performances. In 2015, Smith officially left the band after not performing live with the band since his departure in 2013. Shortly thereafter, Weekes reverted to being a touring member once again, leaving Urie as the only member of the official lineup. In April 2015, “Hallelujah” was released as the first single from Panic! at the Disco’s fifth studio album, Death of a Bachelor (2016). In December 2017, Weekes officially announced his departure from the band. He was replaced in March 2018 by Nicole Row. Later that same month, the band released “Say Amen (Saturday Night)”, the lead single from their sixth studio album, Pray for the Wicked (2018), which was released in June. In September 2018, Harris was dismissed following multiple allegations of sexual misconduct and was replaced in October by Mike Naran.see more at WikipediaCheck More at http://personal.effectsofanxiety.net/

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Stress, either physiological or biological, is an organism’s response to a stressor such as an environmental condition. Stress is the body’s method of reacting to a condition such as a threat, challenge or physical and psychological barrier. Stimuli that alter an organism’s environment are responded to by multiple systems in the body. In humans and most mammals, the autonomic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis are the two major systems that respond to stress. The sympathoadrenal medullary (SAM) axis may activate the fight-or-flight response through the sympathetic nervous system, which dedicates energy to more relevant bodily systems to the acute adaptation to stress, while the parasympathetic nervous system returns the body to homeostasis. The second major physiological stress, the HPA axis regulates the release of cortisol, which influences many bodily functions such as metabolic, psychological and immunological functions. The SAM and HPA axes are regulated by several brain regions, including the limbic system, prefrontal cortex, amygdala, hypothalamus, and stria terminals. Through these mechanisms, stress can alter memory functions, reward, immune function, metabolism and susceptibility to diseases. Definitions of stress differ. One system suggests there are five types of stress labeled “acute time-limited stressors”, “brief naturalistic stressors”, “stressful event sequences”, “chronic stressors”, and “distant stressors”. An acute time-limited stressor involves a short-term challenge, while a brief natural stressor involves an event that is normal but nevertheless challenging. A stressful event sequence is a stressor that occurs and then continues to yield stress into the immediate future. A chronic stressor involves exposure to a long-term stressor, and a distant stressor is a stressor that is not immediate.see more at WikipediaCheck More at https://engageshops.com/novelty_inc

Private Jet Burger King Mukbang 🍔 Trying The Impossible Whopper

What’s up everybody welcome back to my channel hi how are you guys no today I am so excited because first of all actually show you guys what time it is it’s in the morning hi oh my god okay so Good Morning America excuse me I’m sorry y’all no makeup on except some lip gloss but I’m excited because we’re off to Grand Rapids Michigan me Nathan his brother Zach who also films for our channel with Christian hi we have all five dogs going with us and we are so hungry we’re famished we’re dying so we thought why not do a mukbang eating show we haven’t done one in a while literally I I always usually do them with Trisha but we haven’t seen each other in a while the bitches on tour so I’m like Nate let’s do an eating show now Zach’s vegetarian and he goes you guys burger king has what is it Christian impossible oh the impossible burger impossible cut me okay so um we’re gonna order a bunch of food we’re gonna eat on the plane and we’re gonna try to get all five dogs on the jet as calmly as possible but you know it’s a circus in this family so we have a lot going on when we’re in Michigan we have a huge meet-and-greet at Alta to celebrate my morphe collab and we’re there to visit our house you guys know that we invest in a lot of real estate and hi Michigan we’re coming for you so I’m really hungry so let’s get the hell outta here and get to eating it is on the verge of dying so we took a leg it in oh my god so this is the charging station come on Electric and if you’ve never seen a Tesla car just hidden in here and you can let me in there we go alright so we’re gonna let it charge where it’s not to take another car Burger King don’t try me we’re on the way oh my god there’s a little bit of traffic right now I’m so hungry I think last night we got a little too stone and Oh Christian we’re about to die I haven’t been to Burger King in a minute I’m obsessed with you know me you guys cheeseburger playing french fries blah blah blah I love the Hershey pies there they have Wario Cheesecake we have so many good pies bitch I love a good pie so could you all hurry up bitches hungry so we’re just gonna have to order as much food as possible obviously we’ve got some vegetarian Christian yes I don’t know why I asked that so you and Zach are so we’re just gonna get you guys some food we’re gonna get me an eight some food and yeah we’ll be back a little bit oh wow this is a really nice one you better get it Burger King I think we just pull up Christian is there valet mmm maybe not this early oh okay okay oh look it frozen coke oh my god that’s like a drug dealers drinking okay frozen Fanta sign me up oh my god you guys they have free Wi-Fi here that is so special okay Oh they have use at a lot of places now I have to actually talk to a human being so let’s go try that they make it weird I’ll try it hi there how are you all right so what is the best thing you have for vegetarians you have the impossible burger yeah okay can I get it how many Christian two of us go crazy angry buh let’s get three basic is that who lives for it yeah it’s a great possible record Emil oh they’re just a sandwiches and then let’s get some ham bacon sausage platter one of those that’s so amazing like watching to make our plans and then let me get the French toast sticks with extra stare at three yeah yeah right anywhere else let’s do the sausage waffle sandwich it wise meal I’m no just sandwich sounds so good with the cinnamony they’re back thank you like God okay bye let me get to that to her she one twigs okay and then let me get a small frozen coast or that of theory yes I’d like McDonald’s and this shit actually works here yeah I got a five pack okay that doesn’t mean let’s get a medium hashbrown yeah one beggin egg cheese croissant now I get to go free oh right what was our total our total was fifty nine dollars and fifty two fans you better work that’s not bad for Burger King like five dollars let me be really honest usually get like a cheeseburger and a Hershey pie that’s it but they have so many new things here so I get so excited for like food and snacks alright so once we get the food we’re gonna go back to the house really quickly while the food’s still hot grab all the dogs get into a sprinter head to the Chet and get to eating so we’ll see you all a little bit alright Burger King thank you so much all right we are here at the airport and the dogs are all ready to get on I suppose go are you guys we’re in the jet and everyone is secure we have our Burger King over here get some desserts even cupcakes everything so as soon as we are up in the air and it’s safe we will begin eating she was living alright we’re about to take off little man e-mini all right you guys well we’re here yep all right da Vinci’s it needs a lab he doesn’t he’s a little nervous all the other dogs are just chilling but we have all of our food here we got a lot of stuff locked back we got you the impossible uh uh actually matches your hair by the way the crazy all right so let’s just pull out all the food Nate oh we got napkins jumbo whoppers the pancake okay now normally you guys we have dog etiquette our dogs were never allowed on our laps while we eat Finch is a little nervous so we’re gonna let up today sorry I do will let it slide what is this sunglow whipped butter Wow okay work interesting interesting all right and you guys we got some dessert there’s anyone shocked that I got a Hershey by not shocked at all maybe I got you a Twix all right check it out in other issue bye okay oh my god I was crazy look at this shit I went in all right we even got the I don’t know that is these fucking french toast sticks yeah oh my god I need to eat this shit right now okay let’s try them and we got a little scare Todd’s I tatertot it’s like childhood boo those are probably one of my favorite things ever yeah it’s been so long there’s so good look at the cinema news I’m dying oh where are those oh wow where is the glaze where is the frosting y’all oh my god imagine there’s not a stain Oh bitch I wouldn’t lend you this flight right now right so the impossible burger is vegetarian I don’t even know what’s in it does anyone know Christian you’ve had it once right I don’t know what’s sort of felt like I get impossible burger all right so you’ve never had it no obviously Zach’s a real vegetarian you know they don’t do pickles me neither well we’re sitting here guys I’m gonna start on the Hershey by we all know I like desserts first it’s like ripping open a FedEx package good or bad Ziza is it basic as are you living for it how many tastes like an impossible burger so I mean oh yeah come on whopper I have a real whopper here for you to case you need a reminder I mean it doesn’t please taste like it until you hit the impossible burger and then obviously it don’t taste like meat so right but is it a good like you know I’ve had vegetarian food I’ve had no my god I’m gonna say this so wrong I’m into both so I don’t it doesn’t like yeah we know you’re into both maybe okay it’s actually get it right here it’s gave me the camera right like you should have someone who’s actually vegetarian right is actually the real vegetarian look at that just we’re like really on brand where’s that sponsorship all right first impressions yeah is it better than their breakfast one that’s pretty good that’s very related okay all right you into it nate? you want some real me I mean don’t matter to me I’m down for any time yeah I’ll try the meat it’s not the real one how are you guys I’m gonna get it fist into my belly huh good morning and by the way this frozen coke everything all right the frozen coke a plus I will say that yeah should I try that you know I’ve learned to like sweets at breakfast food but let me do one fight come on give that shit on there though oh just a pickle me oh my god just looking at pickles make me sick let me just do this no everyone watching this knows I like everything plain I can I couldn’t eat that we should’ve got a plane one for me I flopped Oh oh my god all right that will now absolutely not look it’s so good take the corner bite oh my god no ketchup I’ll try this I just wanna taste the Patti Oh literally hey hot less damage I like grilled meat I really just want whipped cream so you thought it was okay that was pretty good yeah okay okay name we have set of minis you want to try those I don’t know if I can do all that sweets that I got you a fish sandwich I guess I don’t remember ordering that do you guys I know order that you did that’s someone else’s food you just know I’m good we got stead of minis we have another possible Berber Christians new whopper that’s a croissant that’s a croissant is that what you want that one I mean I love a croissant oh man oh whoa whoa whoa look at this I’ve never seen a patty like this before it’s like a waffle it’s like a Gucci wicker basket oh this is crazy it smells mom I’m not gonna mind yeah yep Oh I’m not mad at it as me I was gonna say try this never mind interesting Christian did you want to try anything on the table I’ll try some – insults oh they’re a little cold though that’s fine like my heart but give it away yeah you might want to heat him up I tried one if I wanna eat it up I’m pretty good best supporting role in a meal babe look I smell everything before you did I’ve been waiting this whole flight for one bite of this mother mine but we all know I’m the slowest eater if you don’t know I had a soffit of surgery was it this year or last year oh my god I mean early this year yeah maybe well so I chew very slow you want to know why I’ll put the link down below I know you nurses first a baby but Nate’s trainer is gonna try and kill me I don’t watches they’ll watch is 8 please oh my god he still watches oh so good I don’t really get enough of these a scientist I look at Nate killing me just a nostalgia I can’t like from what what is that honey chicken this no this french toast 600 what Christian I do have one of those as a kid you’re missing out all right I’m gonna finish off this last french toast bite my Bobby look at the Vinci I know blood all right I think the dogs need something they’re not having to BK right now they’re DaVinci one tree and let’s treat and once a little treat to my babies want a treat look it drum a little to do Street delicious delicious drama oh it took it we’ll then meet in my lap it’d be but you’re a big boy you’re ten years of spin or yeah go quietly hi baby he’s ready for one more drama gets another one let’s just see one that one do okay all jokes aside a lot of people ask what we feed our dogs when treats we used Stella and Chewy’s is such a good brand all organic ingredients are the best no filler and weirdness because our dogs do not eat that smoothie no bad stuff on the market did you do need one more dude oh I’m carnivore crunches all right I’m definitely still a little hungry the flight attendant said that she has some snacks and stuff for us let’s check it out watermelon juice cupcakes basically my favorite thing I mean that sounds delicious okay so let’s get rid of his Burger King and be right back all right we’re back we’re in Hawaii no we’re not we want a little more food a little bit maybe on the healthier side yeah so we got cupcakes and some crazy colored fruit appear cupcakes yellow Carol you guys liked I have never seen a yellow carrot before purple the cauliflower whoa do we try it right now yes we do whoa it tastes healthier than like a basic vigil orange carry on that really does I don’t know long experience with many bitches no no wow that’s rare what a melon juice Itzik surveyance so fresh Wow super fresh amazing watermelon juice is one of my favorite things on the planet it’s basil smells Sonia wash it down so yeah I mean Oh Lord look at the dragon fruit though this looks so yummy yeah that’s right I got it I got it I had it I was gonna try the Kiwi it’s about the same the Kiwi looks really yummy oh it’s so fresh oh my god pretty damn good oh yeah chill Kiwi are you gonna try the edible flowers name I have to so alleged that you can eat these I don’t know what they are why are they edible I say my supermarkets I have to go with the yellow one for obvious reasons for very obvious reasons I’m so sorry who’s this hopes that cream cheese I love cream cheese my stomach is like what are you doing to me she loves me she loves me the days for real meeting flowers no big deal it’s Cho it’s all better I have not heating the flowers it’s a little bitter don’t do that I don’t know about all that I do Oh the strawberry looks heaven well I’m gonna sit over here and eat my flowers oh yeah I’m eating so fresh it’s time to spend the time with the dogs we’re gonna go play with them and do a little jet tour and then we can’t wait to be in Grand Rapids dude he’s so cute you guys divas ten years old he is such a warrior hug thank you look he’s looking at the camera like excuse me I will say this though it’s really crazy this is the first trip that we’ve taken with all the dogs retirement isn’t here with us so definitely mr.Law me too not to be all sad it’s kind of crazy here yes it is definitely they sing her a lot recipes it’s crazy and we’re not being in my lap I know she’ll always be able to big brothers to keep it all the little ones ruin he’s on guard that’s right nothing bad she’s doing a lot better now he was a little nervous when we first started the the flight but I think he’s doing good I good drama she’s still care for ages like I’m bored do we get to my house now she’s like I wanna run around the woods dad yeah drama loves the woods we’re gonna have so much fun in Michigan maybe my favorite time of the day and all the babies are sleeping now it’s time for me to just sit back take a little nap before we land because bitch you know I work a lot way too much over here on the camera cute all right good night everyone see all right you guys we are about to land it’s time to sign up and go enjoy some time with our family we having crazy week ahead of us of filming content and so thank you so much for watching today’s video and we’ll see you on the next one bye guys

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Apple Check-out 2 Analysis: Constantly Breathe

– 2016 has-been annual of comfortable predictability for Apple. Many present iPhones 7 ended up being truly anything we anticipated from organization, and the changed Apple look for wont give numerous lumps typically. Truly, oahu may be the most readily useful practical notice can be achieved to aquire the iPhone, just as before. (upbeat paths) beauty things initial: if you liked initial Apple consider, you will most certainly like Series 2. the appearance could be the identical curved rectangle with prominent digital top and squared-off system, a let down in the event that you was in fact making an assortment on Apple to trigger the circular view ranks, but I need to state i wish to offer business credit which will make an incredible system.

That is simply mesmerizing offered some seen as some these view issues, also it’s over 2 times due to the fact brilliant since preliminary Apple demand. Increasing towards casing, the placement gray alternative is a welcome addition into economic condition alternative this existing twelve months. Demonstrably, here is the aluminum Apple consider, maybe not the metallic Hermès or porcelain big difference. I did so therefore so-so therefore consequently discover artificial songs business this present every year, but that women and men think appears cool, though it keeps onto mixture for a long time after a swim. Which will be at huge improvements this present year: without splash-proofing, discover 50 meter water-resistance, shield this on for restrooms you’ll need. There might be demonstrably a for secure this method, consequently you merely won’t splash text your exes, and, be it a lot of fun typical dried-up down, you can test my preferred gathering strategy: spin ideal, although view creates a tone which in turn triggers item from presenter begin getting talk upon it merely as right before. They’ve been generally, each one-year I recognize another Apple see or Samsung gear, and annual im reminded just how uncomfortable its to chat on a wristwatch.

You probably have shed after an instantaneous. The presenter stays less noisy whenever I would like, but, if you should be in a quiet destination, it certainly works entirely. We became astonished merely the number of We liked due to this, positively. And all sorts of types of types of forms of kinds of forms of types of types of forms of three callers we chatted to claimed we cause great. Don’t require could notify we might been making use of a wristwatch, which amazed me-too. You still need be affixed with an iPhone or a wifi destination to-do organization with numerous the scene’s functions. There isn’t any cellular url below, but i need to state we no time before matter that resistant concerning Apple see, like I need to state I must say I usually do not for my day-to-day wearable, the Moto 360. In my view, helpful watches but shine really since second shows about practical helpful mobiles, this is actually the way we end in the many using the Apple see; examining notifications as they possibly can be around, replying in regular message, and remembering to breathe.

Simply joking. We disabled it after each and every time. In the event that you dig it, cool, nonetheless it seems because of this needed, like a move Samsung might made a protracted timeframe straight back, disguising an exceptionally slim, niche application as some kind of core improvement. I will be unsure. Inhale features one essential purpose. It calls appearance closely on re-positioning of Apple browse as a health and physical fitness friend, that might be perhaps not emphasized as acutely whenever you look at the first generation. Serenity’s assessment at iMore gets the thin on routines.

My consumption was at truth from the unusual power stroll about city, but, as a periodic outdoorsman, we must state that women and dudes liked the inclusion of stand-alone GPS for examining a hike or a kayak travel. And Apple health is but a pleasure succeed alongside, from quick enjoyable of doing the teams toward reasonable “remain up-and enhance” prompt.

Those notifications, like every the, do feel a light tap through epidermis. Apple’s Taptic motor but can make another useful view’s vibration comprehending old. 2-3 weeks ago requires the scene have-been contextually smarter. We got numerous these “remain up-and get” recommendations while working a vehicle, which, you know, is stupid. If you think about the pc software aspect, many programs, of improved for watchOS 3, are generally speedier, as soon as you work utilising the initial boot. We choose just what few they could be created for the scene, additionally. This procedure remains a lot more technical than possibly it is standard, but it really is extremely simpler than earlier versions. The most truly effective features was indeed surely attaining rapidly jobs through vocals control with Siri, and purchasing coffee without taking out my phone. Old constraint to meet your requirements Apple browse veterans, likely, but this newb has reached truth impressed. In the course of time, battery power life: if you’ve got the scene like I must state I have to say i truly do, alongside more expensive 42 millimeter massive distinction, you may assists its two total times between expenses, consequently includes utilising the view as a sleep monitor instantaneously, that men and women’ve made a practice of.

Consider as a result of this should improve it to 3, or four, times in addition to rapidly you top up once again, after we performed so-so before we setup many programs. Make certain that you possess that charger for you personally on roadway trips, and, by-the-way, for spending Apple’s after scene, i am but extremely dissatisfied that discover a continuing obtain outstanding cradle and it also. That investing, $369 or maybe more, make myself believe individuals is meant to-be lots happy conserving a Benjamin and attaining a string 1, and production degree of the Apple have a look at, these days retired. Truly, i might most likely get a Pebble, because 90percent of my usage example is notifications. I would personally state, if you most likely require the full-on waterproofing or split GPS, should you spring the Series 2, but, if you, might be getting one difference of the greatest of good use view there was clearly obviously demonstrably about iPhone, and, truthfully, among best practical watches, proportions. We saw you since Casio.

Start making a selection back inside my report concerning this animal, and subscribe on YouTube, making certain you merely can’t miss so much more Mr. cellphone. On a short while later purpose, thank-you for witnessing, and remain cellular, my connections. (reasonable tracks).

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Social Determinants of health (summit 1)

Alright, the manner in which you you shouldn’t be getting included if you are through pupil symposium these days? Really, David, my friend towards task, discovered on regarding this on the internet and kinds of concept we was not most likely having hold about of ethics assistance without a doubt furthermore for task consequently we believed that this may be a fantastic replacement system it if most likely feasible have more individuals notice and move on to comprehend the typical person with average skills determinants of health. Alright, consequently is it possible to immediately describe for myself exacltly what the duty is primarily about? In A Positive Way. For that reason David and I also in addition additionally furthermore besides additionally furthermore besides are 2nd one year wellness pupils consequently we in addition’re of a credit card applicatoin frequently “generating backlinks” – its a certificate in intercontinental health expenditures safety and a good amount of exactly what it targets is 1st determinant of medical insurance and simply exactly what fundamentally by this may be undoubtedly which type of culminate collectively to go you if you’re through infirmary.

That’s the reason we have been utilizing regarding the understanding, we is talking about your housing standing, whether or only perhaps not you are used. And there’s some products which type of interrelate alongside numerous cases are often kinds of a lot more crucial in health impacts after that, concern, if perhaps you are cared for on infirmary. Exactly what especially we developed is analysis competent in the original determinants of health you would do before continuing inside doctor’s business for checkup while afterwards definition medical practitioner would evaluate these numerous issues in several places and recognize numerous components of need you may have to be honest in all honesty here after analysis works very well and attached with sources if you have the location, especially numerous programs you could possibly supply to help to enhance your total medical care insurance coverage and total have in fact the reality is undoubtedly really undoubtedly truly definitely better wellness outcomes. Which each is you today tangled up in working within task? Appropriate, consequently we types of built on each day Making backlinks gents and ladies including both men and women inside our education curriculum. Most of us appeared collectively and developed the difficulties based around unique determinants of medical care insurance safety and David and I also in addition also furthermore besides in addition more over furthermore besides develop these. Consequently we besides worked alongside Dr. Ryan Miley, it is simply the creator personal determinants of medical insurance and plenty of another trainers particularly Accountability unit inside organization of medicine.

Consequently is standard of among secrets founder. We have been today at this time as a result of solutions of switch to it is essential to have this implemented if you were to think in regards to the infirmary which will oftimes be around after few times which we commence to wear it and examine its effectiveness and magnificence of change it out out away to raised healthier specific requirements the customers. Just how can its comprehension informed your personal future aspirations or work goals? Really, the main information we performed definitely medicine regularly recognition discover essential in many susceptible communities inside our province alongside our nation to generate some considered to be the non-public determinants of health care expenditures costs protection plus go through the whole aspect of health in customers so having included applying this.

And reveals its my aspirations possibly recently made myself recognize my goal are usually recognize a vocation in family members medication or pediatric medication assure im in a position develop that longitudinal dedication with my clients, to raised assist these to with their particular total health eventually. How works this kinda taught you things that mayn’t recognize within a frequent training curriculum comprehension? This is the reason ,, I would in reality really definitely declare that getting included making use of this and Making oneway backlinks as an entire relocated method maybe not classroom just what with trading six-weeks in a northern spot and six-weeks in an internationally place, could the very fact is still want specific determinants of health care expenditures insurance policy and it’ll make you recognize exactly how appropriate a written report and a project and a recognition for problems can be purchased day-to-day life plus in persistent attention.

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Consciousness/Awareness And Religious Mastery Answers From Akashic States.