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Aging milestonesChanges in old age depends on attitude as much as person to person. In young old age some changes begin to take place in a person’s appearance. Wrinkles, warts, age spots begin to form on the body. Hair begins to thin or becomes grey and even height lessens because the bone density decreases. While in ‘old‘ old age these changes are already permanent. Men might look distinguished if in good health, but women all look grandmotherly. In ‘young’ old age, cells begin to decay and muscle mass declines and immunity is no longer as strong as it used to be. People lose energy as the age progresses.  ‘Old’ old age brings in a lot of physical decline, profound changes in appearance and motor abilities, as also in sensation. Skin gets less elastic and becomes thin and blood vessels can break under the skin. The senses also begin to become dull. Eye lenses get affected and color perception and reading ability becomes very low. Hearing loss may lead to paranoia and ‘old’ old age people begin to think everyone is plotting against them because they can’t hear properly about what others are saying. Sense of smell also declines, but the taste remains almost intact. In ‘young’ old age, reflexes also slow down and so do the motor abilities. By the time they reach ‘old‘ old age most adults find that their response time has become quite reduced. This can be seen most in driving situations where it is difficult for ‘old‘ old aged adults to operate their vehicles as they have poor spontaneous responses. The ‘young’ old adults do not lose as much of their motor abilities as the ‘old‘ old adults, especially when holding small things like needles and pins. Of course, there are changes in sexuality and there may be a decline in the ability to have sex as men may not have an erection and women become dry due to lack of female hormones. Cognitive decline in 40% to 60% of older adults can be arrested with remedial training. Despite all the changes, most people even in their 70s remain comparatively active if they do not suffer any illness. Mental, physical, and social activity is necessary to maintain the quality of life. Old people begin to withdraw from work and other important roles and allow the younger people to take over. They are a lot happier as is also advised in Vedic literature as vridhashram. While activities are important, disengagement is equally important. Memory loss becomes aggravated and other cognitive abilities begin to decline and there are many ‘old‘ old adults who get Alzheimer’s and lose the ability to look after themselves. Old people also dwell on questions of death and sometimes go through a phase of denial and then anger that they have so little time left. Acceptance of death comes, but after a struggle and the idea of losing the family saddens them. Old people require support in their declining years as they begin to lose their faculties.
Absent father, violent kids!When children are growing up, they undergo a lot of hormonal changes and have varying emotional requirements. If these requirements are not fulfilled by the presence of both parents, they can develop into violent adults. Single parenting for a mother, is extremely difficult; it is simply impossible for her to fill the void left behind by an absent father. When a couple cannot live under the same roof due to major differences, they separate or get divorced. However, the requirements of the children remains the same; they still need the care and love of their mother and the support and guidance of their father, to grow up without any complications or insecurities. Children usually look up to their father as a symbol of strength and security and in his absence, they might not receive the same support and may feel inadequate and insecure. If during their childhood kids do not get the support and security that only a father can provide, they might bottle up the feelings inside; and these feelings usually explode when they grow into violent adults. A Father's Absence is Critical Due to whatever reasons, if the father is not present in the family during the most important growing periods of the kids, they have more chances of turning to crime and drugs, than the children who have a father by their side. According to a research conducted by the Research Institute of the McGill University Health Center located in Quebec, a father's absence, especially during the child's prime growing period, can lead to behavioral problems when they grow into adults. The research was carried out on mice raised only by their mothers and showed that the mice that were brought up in the absence of their fathers, were  abnormal and aggressive in their social interactions. Gabriella Gobbi, who is an author and a senior associate professor at the McGill University - Faculty of Medicine, says that even though the experiment was carried out on mice, the findings are highly relevant to the behavior of humans, under similar circumstances. Role of Fathers and Fatherhood Another research carried out by Dr. David Popenoe, a renowned sociologist, throws light on the role of fatherhood and fathers. According to Popenoe, fathers should not be treated as mere second adults in the family. Fathers, who are more involved in their family, have a certain positive impact on the children, which no other person is capable of. Fatherhood is an important responsibility and the presence of fathers in a family, directly influences the well-being of the growing children. In the absence of fathers, mothers may try their level best to provide their children with the right kind of upbringing and education. However, they might fail to give the kids the support and strength that only a father can provide. Due to this, children fail to face the challenges of life head on and are unable to handle their problems with an open mind. When a lot of emotions get bottled up inside, in most cases, they find their release in the form of violence. Sometimes, children also lack the right kind of guidance in their growing years and mothers fail to handle their changing emotional requirements, due to which these kids become increasingly frustrated and violent as they grow up.  
Making babies, the best way!Some couples get pregnant easily. But many couples have to wait months before the baby is conceived. There are several factors that affect conception right from fertility to the position during intercourse. Some believe that positions have nothing to do with conceiving a child. This is not true. Some positions are ideal to help the sperm meet the ovum. Let's see what some of these positions are. Missionary position:The best position for getting pregnant fast is the missionary position.Here the man is lying on top of the woman allowing for the deepest possible penetration, making it possible for the sperm to get deposited closest to the cervix. It is also the most common and comfortable position preferred by couples. Raise your hips high: Your hips have a lot to do in helping you get pregnant. Raise your hips high during sex by placing a pillow below you. This helps to expose the female cervix to as much semen as the male can release. Doggy position: Considered to be the most erotic and pleasurable position,this rear-entry position where the man enters the woman from behind is also recommended for increasing the chances of getting pregnant. In this position too, the sperm is deposited closest to the cervix, thereby increasing the chances of conception. Side-by-side: You can also try having intercourse while lying side by side. This position, likewise, causes the most exposure of the cervix to the male sperm. While these positions certainly improve your chances of getting pregnant, there is no guarantee that you will conceive. The most important thing is to enjoy this special time and have fun with your partner. So keep enjoying and keep trying!
Hairy tale: Hirsutism in womenThe condition is called Hirsutism where women grow coarse hair just like males on the face, chest or elsewhere. The primary cause for Hirsutism is hormonal imbalances by the over stimulation or excess production of male hormones (present in minute quantities in females too). The thickness of hair that grows largely depends on our genes and at times Hirsutism in women may be just a hereditary trait rather than an imbalance. Self care and medication can take of it in such a case. Idiopathic Hirsutism is a type of this condition where there is no possible cause for the male type hair growth. These women have regular menstrual cycles and no Androgen excesses, yet they have Hisrutism. Hirsutism with excessive bodily and facial hair, usually in a male pattern, in women may be present in normal adults as an expression of an ethnic characteristic or may develop in children or adults as the result of androgen excess due to tumors, or of non-androgenetic or other drugs. Hirsutism can make its appearance at menopause or soon after as there are a lot of hormonal changes that occur in the female body, and in certain cases women grow hair even on the lip, nipples, abdomen and upper shoulders. And just as men go bald there can also be a receding hairline and baldness in women accompanied by a deepening of the voice and enlargement of the clitoris. If the hair growth occurs at puberty then a doctor's evaluation is most essential as it could be more than just Hirsutism.
Is circumcision a healthy ritual?Religious rituals and practices have been carried out since ancient times. Circumcision is a religious ritual that involves surgical removal of the prepuce of the human penis. Prepuce is the foreskin of the penis and during the procedure; the person performing the ritual opens, inspects and separates it from the glans. The process is painful and hence local or topical anesthesia is used to reduce physiological stress and pain. Circumcision is performed for religious as well as personal reasons and many times recommended medically for prophylactic or therapeutic reasons as well. Today's medical science makes use of this treatment for treating chronic urinary tract infections, refractory balanoposthitis and pathological phimosis. Circumcision is performed as ritual in many parts of the world. However, it is also recommended medically as protection against HIV infection. Circumcision-Is it Legal and Ethical? In the world over, the ritual or practice of circumcision is carried out on all types of people from neonatal stage to adulthood. While no significant risks have been noticed due to the practice of this ritual, rather some modest health benefits have come to the fore. The World Health Organization has recommended circumcision for male infants in parts of Africa where the children are more vulnerable to urinary tract infections. However, no other medical organization in the world has supported or banned the procedure. Over past few years, legal and ethical questions have been making rounds and many believe that consent should be taken before carrying out neonatal circumcision. HIV and Circumcision Benefits A Cochrane meta-analysis conducted in 2009 on sexually active African men have revealed that the ritual of circumcision reduces the risk rate of HIV infection by 38 to 66 percent among heterosexual men in a period of 24 months. That is why WHO has recommended circumcision in sub-Saharan African areas having high rates of HIV infection as a part of the comprehensive HIV program. Moreover, this process is more cost-effective as compared to other treatments and preventive measures recommended for HIV. Circumcision reduces the risk rate of HSV-2 infections and oncogenic HPV prevalence along with the risk of penile cancer and UTIs. Until now, there have been no concluding reports on the protective effects circumcision offers against other types of sexually transmitted infections. Circumcision is also recommended medically to children suffering from pathological phimosis and refractory balanoposthitis. Contraindications The literature worldwide review conducted in 2010 reveals that around 1.5 percent of the newborns face median complication when the process of circumcision is performed by trained medical providers. Only 6 percent children face severe complications with the common complications being infection, bleeding or removal of too little or too much of foreskin. However, the process does not cause any negative impact on the sexual functioning of an individual. Contraindications due to circumcision are also cited in infants having genital structure abnormalities right from the birth such as misplaced urethral opening, ambiguous genitalia or chordae. In such cases, the foreskin may require reconstruction through surgery.  It is contraindicated in premature babies and clinically unstable infants and it should also be avoided in children with family history of hemophilia (bleeding disorders). In such patients, it is important that the blood should be checked for its coagulation properties before attempting the procedure.
Stress - Even kids cannot escape!Often when we feel overwhelmed with stress, we go back in the past and reflect. We miss our golden days of childhood.We think of those days with fondness, miss the free and carefree times. We feel like becoming kids again. But the truth is that at no age are we free of stress and worries. It is just that with time, we move on to newer situations and every new stressor seems worse than the previous one. Children stress out too, some more than the others. Stressors Simple things like a test in school, a Physical Training class or poem recital could mean a lot of stress for the little ones. The desire to meet the expectations of parents or teachers also creates tremendous pressure on the children. They are eager to do well at all the times and the smallest failures can upset these kids immensely. Peer groups are difficult to manage. In childhood, the social maturity is not sufficiently developed to handle day-to-day conflicts. Trivial fights or comments from classmates and friends can lead to a long-lasting impact on the vulnerable minds. They get easily influenced by their friends. Elder siblings also play a major role. Some act as mentors, some as bullies. Some cause damage unknowingly, some are plain indifferent. Life is full of new things and childhood is a fast-track learning lesson. Every other day, there is something new a child has to do. Meet a new kid, learn a new subject, try to dodge a ball differently or ride a bicycle without side wheels; there is too much to learn. These cause anxiety and may make the child nervous. Performance pressures, technology, precocity, media influences, etc. are some of the other factors that add to the stress in childhood. Signs Watch out for subtle changes in moods and behaviour. With adults, it is easier to identify the stress and hence rectify it. But with children, it is quite a challenge. Most of the children are themselves unaware of the stress they are facing, they don't understand why they are feeling sad or angry or fearful. They are just not at ease. Inordinate crying or screaming is a common sign. Being withdrawn, aloof and quiet is another way by which kids express their tensions. Physical signs can be seen in basic physiological changes - in sleep patterns (oversleeping or inability to sleep), eating habits (not eating or eating too much), frequent aches and pains, especially digestion disturbances and headaches, etc. Managing childhood stress Pay attention to your child. Listen to what he/she is saying, but also try to listen to what he/she is not saying in words, although only in action. Help the kids open up to you, spend quality time with them and talk to them about everything under the sun. Be well connected with their school teachers and parents of their closest friends. If the need be, please don't hesitate to reach out and seek professional help from psychologists and child counsellors. "One of the luckiest things that can happen to you in life is, I think, to have a happy childhood." - Agatha Christie  
Be positive. Here's howAs someone so very rightly said, "We are the sum total of our thoughts". So the more positive thoughts you have, or are capable of thinking, the more positive will be the outcome of your life journey. Here are a few tips to think more positively and empower yourself: Have a daily positive thinking routine. Generally the time when you are just waking up, i.e., the half awake state, is best for you to start feeding positive thoughts about yourself. The mind is more accepting of suggestion at that time. You can just feed your brain with happy and positive thoughts about your situation and what you hope to achieve for yourself and your family. Creative positive visualization is another great method of positive thinking. At a set time, just picture your life in the way you want it to go. This is different from daydreaming. Creative visualization gears you up for action while daydreaming remains just wishful thinking. If you have difficulty in certain areas of your life, say at work or with your relationship, visualize a positive outcome. This will engage your mind in thinking of various action plans to get about that positive result. Positive affirmations are a great way of reminding yourself that all is well. Have patience with yourself as your mind will probably not even believe half the things that you are affirming. That's what affirmations are all about.They are statements that you feed your mind about what you are and what you can achieve. Positive affirmations can help you reprogram your mind to what your heart really desires. Let go. Feel that delicious sense of surrender as you just indulge in mentally letting go of things. As a busy person you probably end up trying to control the outcomes of every situation and feel bad when things don't go the way you expect them to. Remember things can go wrong from time to time. Like you, life is also not perfect, so why expect perfection from others? Learn to let go of that emotional baggage that you are carrying. The weight of the world needn't rest on your shoulders. Collective consciousness is where you should try to tap into. Think of situations where things can go horribly wrong for someone else. Send out a silent prayer for those unfortunate people in this world. Chances are that your prayers just might help some stranger badly in need of a prayer or two. This can only come back to you manifold. Help someone else become a positive person. This can only reaffirm your faith in positive thinking. Positive energy is what everyone naturally seeks and we can for sometime blame our friends or family for being a negative influence on our lives. This line of thinking will get you nowhere. Instead think what's the next best option? Think of how you can convert negative energy or experiences into positive ones. Initially you might meet with resistance, but remember if you are positive then positivity is yours for keeps.
5 tips to reduce your salt intakeSalt is an inevitable part of our food, but added salt has harmful effects on the body. The list of benefits in reducing sodium/salt intake in our diet runs long, ranging from lower blood pressure, in turn leading to reduced risks of heart disease, obesity, and diseases of the kidney. The daily sodium intake of an individual should not exceed 1500-2300 mg per day (a table spoon of salt approximately), and this needs to be maintained in the salt added to our food, including the processed food and drinks we buy. Sodium, an indispensable component of our diet, is consumed in excess by most of us. Follow the tips, as mentioned below, to curb your daily salt intake. Avoid added salt. Do not add salt to already cooked food while eating. Keep a diary and make a list of foods with salt in them that you eat daily. Do not forget to add pickles, spices, papads, salted biscuits, and salted nuts. All of these are highly loaded with salt. Next time you go shopping read the labels. Choose low-salt options-sauces, crackers, khakhra, instead of papad. Make an attempt to eat less canned and processed foods. Choose fresh fruits and vegetables over processed food. Eat less bread. Each bread slice has about 250 mg of sodium. Do not mistake bread to be healthy. Next time, keep this in mind when you go out to eat pizza. Pizza base is like bread. While cooking food, make it a point to add salt only towards the end in the recipe. This way you will need to add lesser salt. Sodium content of some foods Bread (one slice) - 250mg Cheese pizza: 450 - 1200mg Tomato soup: 350 - 1000mg Potato chips: 100 - 150mg
5 Muscle building smoothiesProtein is highly important for muscle building as it repairs the muscles and help in their rapid recovery after a workout. That is why most of the trainers recommend taking protein smoothies after workouts. Generally, banana and peanut butter alternatively, are used to add the protein content to the smoothies. Apart from these, Chocolate is a hot favourite as well. But if these do get boring, here are some smoothie ideas, only for you. Hot Cocoa (bed-time and post workout) Ingredients: 1-cup milk (fat-free), 1 scoop whey protein chocolate, 1 packet Swiss Miss Diet hot Cocoa and ½-cup cottage cheese (low fat). Recipe Heat the milk and just when it gets to the boiling point, blend it in the blender with the protein, cottage cheese and cocoa until smooth. Ensure that the mixture has mixed well. This protein smoothie can be taken just before bedtime as well, because the cottage cheese contains slow digesting proteins that are great for overnight muscle repairing. Each glass of the Hot Cocoa smoothie contains: Calories-275 Protein-44 gms Carbs-20 gms Fat-1 gm Fiber-0gm Root Beer Float (post-workout) Ingredients: 1 scoop vanilla flavored whey protein, ½ cup vanilla yoghurt (fat free(, 1 scoop vanilla casein protein and 1 ½ cup root beer Recipe In a bowl mix all the protein powders into the yogurt slowly and stir well to avoid clumps. Now, pour the root beer in a large beer glass and add this mixture of yoghurt carefully, without stirring. Since the root beer starts carbonation process, the shake becomes quite frothy without having to use a blender for mixing. Each large glass of the Root Beer Float smoothie contains: Calories-443 Protein-48gms Carbs-61 gms Fat-1 gm Fiber-1 gm Post workout or pre-workout smoothies provide the necessary protein to the body that contributes in rapid muscle recovery and growth. Peach Cobbler (pre-workout) Ingredients: 1-cup water, ½ can of sliced peaches with juice, 1 scoop vanilla whey and 1 packet Quakers Instant Oatmeal (lower sugar maple and brown sugar) Recipe Mix all the ingredients in a blender and serve. Use an immersion blender for this one, to get a finely mixed smoothie. Each glass of the Peach Cobbler smoothie contains: Calories-305 Protein-24 gms Carbs-49 gms Fat- 2 gms Fiber-3 gms Orange Creamsicle (pre-workout) Ingredients: 1-cup orange juice, ½ cup fat-free yoghurt (vanilla flavor) and 1 scoop vanilla whey protein Recipe Mix all the ingredients in the blender and enjoy your smoothie. Ensure that you use real orange juice and not the flavored orange drinks for this one to get the desired result. One glass of the Orange Creamsicle smoothie contains: Calories-280 Protein-27gms Carbs-43 gms Fat-1 gm Fiber-2 gms Chocolate Almond Brownie (pre workout or early morning) Ingredients: 1 cup milk (fat-free), ¼ cup almonds (chopped), ½ Clif brownie bar (chocolate flavor-chopped finely) and 1 scoop of chocolate flavored whey protein Recipe Mix the milk and the flavored protein in the blender and serve with almonds and Clif bar topping. Use a spoon as you will be eating as well as drinking the shake, because the almonds and the bar chips can settle to the bottom. One glass of this Chocolate Almond Brownie smoothie contains: Calories -457 Protein-39 gms Carbs-41 gms Fat-17 gms Fiber-8 gms
A guide to earwax impactionBiologically, the earwax which builds up over time moves through the ear canal from movement caused by chewing or other jaw motions. It is also extricated through the inside-out motion of the skin of the ear canal - it reaches the outer ear and peels away. The cerumen is produced in the outer regions of the ear and not in the inner recesses. Earwax impaction refers to the condition where the ear wax builds up to such an extent or in such a manner that it causes discomfort to the entire body. In many cases, earwax impaction occurs when patients use cotton swabs or safety pins to clean their ears, only causing the wax to drop deeper into the ears. The main symptoms of earwax impaction include difficulty in hearing, faintness, ache in the ear, foul smell in the ear region, ringing or sound in the ear (also known as tinnitus), a sensation of fullness in the ear, and lastly, discharge from the affected ear. The most vulnerable groups for this condition include those who use hearing aids or ear plugs, elderly people, and those who insert cotton swabs or other items into their ears, as well as those who have an odd ear shape which could negatively affect the discharge of the earwax and those suffering from development incapacities. Did you know that one of the most common methods used by people to clear excessive earwax is ear candling where a candle (in shape of a cone) is placed inside the ear canal and set alight to warm up and remove the wax? This is one of the most dangerous methods causing burns, worsened blocks, and damaged eardrums; this should be clearly avoided. The diagnosis of this condition can be done by an ear specialist using an instrument called otoscope. Earwax impaction is treated in many ways. While at home, you could try to clean the outer region of the ear by wiping with a cloth, the physician could irrigate or syringe the ear to wash out the ear canal with saline. This procedure is generally done once the wax has been softened by the use of cerumenolytic solutions aimed at dissolving the wax like mineral oil, peroxide-based ear drops, and hydrogen peroxide. Physicians also use special instruments to remove the built-up earwax like forceps, cerumen spoon, and suction tool. The best way to prevent cerumen impaction is by not inserting anything into the ears to clean it up. Cotton swabs should only be used in the outer part of the ear. In case you feel that the buildup is regular, then you can fix an annual appointment with your physician for cerumen removal.
Winter - When your heart feels the cold too!As per a study in America, 193.6 people of every 10000 people die of a heart disease every year. 53% of the heart attacks occur in the winter months. Heart diseases have a seasonal trend as found by medical research recently. A team of medical researchers recently conducted a survey which saw 10,000 participants between the ages 35 to 80 from around seven European countries. The study was conducted to see if there is any seasonal variation in the presentation of heart diseases. The participants were measured on the parameters of blood pressure, waist circumference, body mass index, blood glucose levels and blood lipid levels. The parameters were later adjusted for sex, age and smoking. The results revealed that the incidence of heart disease shows an upward trend in the winter month [Jan to Feb] as compared to the summer months [June-Aug]. The researchers accept that there is no logical explanation to these findings. A plausible cause being the fact that the eating habits change in winter. One tends to eat more which in turn increases the cholesterol levels leading to heart diseases. Several other theories are being put forth. According to one, during the winter months the body undergoes hormonal imbalance. The day and night variation in the hormone levels, especially that of cortisol varies. This results in a lower threshold for heart attacks. Yet another theory says that the cold temperature tends to constrict the arteries narrowing the blood flow to the heart tissue and this result in a heart attack. On the basis of this study, scientists advise that more attention is to be paid to heart health during the winters.
Is sex linked to self esteem?Man is a curious creature, full of quirks and contradictions. Sexual intercourse, something that most people consider an intimate and private experience, is spoken about in hushed tones and often, with some discomfort. We don't reveal or talk about our sexual desires, as readily we discuss our salary packages or food habits. This is quite ironic seeing how sex is an important gauge for a person's self esteem and also an indicator of his/her social desirability. The very thing that we do under covers, we somehow choose to "keep under cover". The Link between Sex and Self Esteem: Self esteem is an important factor that determines the mental & physical well-being of an individual. All of us have a craving to be understood, liked and appreciated; and these form the equivalent of our basic needs on the inverted pyramid- Food, clothing and shelter. For a human being to flourish and prosper, consumable food, without the mental food of appreciation, is not enough; and sexual intercourse or an intimacy with the opposite sex, is one way of validating that need. Sex therefore, ceases to be just a physical need instilled by nature for the perpetuation of the species, but goes into the larger emotional cum psychological dimension of self actualization and realization. Though some of us might be embarrassed to broach the topic of 'whether or not we are getting enough', the truth is that every human seeks to achieve his sexual potential, even while he or she might, not be aware of it. Most of us have the ability to get the foods matching our taste preferences onto our plates, but with sex, this could be a little difficult, since sex, is a complex subject with a lot of social, moral and religious links. The truth is evident in the number of marriages (the very cornerstones of civil society) that fail on the basis of sexual compatibility, either by setting unrealistic sexual expectations or by not owning up to, or even identifying, one's sexual needs. This has repercussions on the psyche and self-esteem of a person, and this is especially true in the case of men in particular, as they may feel completely inferior for not being able to attract a sexual partner matching his desires. In some people, this also leads to a case of self-loathing, for having sexual needs which a partner doesn't understand, or much worse, needs which are considered taboo and sinful (Homosexuality, Anal Sex, Group Sex, Fetishes, etc.) These complex emotions can wreak  havoc on a person's self-esteem, by creating severe internal conflicts and serious self-doubts. Now socially, sex can either liberate a person, or hold him prisoner. At times, the unfulfilled needs may get repressed and banished to the shadows, only to be played out later, in the form of sexual adventurism and crime. Just one look at the sexual crimes in our society today, and we can clearly understand just how healthy our collective self esteem is! The very society that frowns upon prostitution, is actually responsible for creating it, though everybody would like to pretend otherwise. The crux of the matter is that "sex" and "self esteem" are closely related; and one should not shy away from addressing any issues one might face regarding one's sexuality. Physical love is necessary for the survival of a relationship and one needs to make time and efforts to successfully create one's own sexual space. The positive effects of a good sex life can be seen in an increased work productivity, fewer illnesses and an increase in one's overall efficiency. Some people are haunted by sexual guilt and confusion and when they keep it all locked up, they suffer from unexplained physical pains and feel 'down in the dumps' mentally. Another problem with appreciation from the opposite sex, is the addiction to  external validation. Some people feel utterly worthless until they receive positive feedback about their looks or abilities on a regular basis. This can be downright devastating, as in these cases, there is a great dependence on external factors for one to feel good. While no one denies the "feel good factor" of sexual appreciation, it is up to each one of us, to decide just how much of control one must be giving to external factors, to determine our personal self-esteem. The appreciation may be theirs, but the esteem is entirely of the self and only the self can decide how much of appreciation and sex is enough.
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