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Parturition, associated as it is with many biologic disturbances such as the effects of pain, drugs, eclampsia, hemorrhage, infection, and an abrupt hormonal adjustment, is frequently associated with a disturbance of mood Obstetricians have repeatedly observed that the woman may feel extraordinarily well immediately postpartum, only to lapse in the following days into a weepy, depressed state in which she may be distressed by lack of feeling for her newborn infant Usually this lasts for only a few days ( postpartum blues ), being quelled by the return home, responsibility for the infant, nursing, etc In some patients the depressive symptoms persist for months (see later) The period after childbirth is also one in which there is a strong disposition to psychosis Opinion varies as to whether there is a special puerperal psychosis.

The console tree now displays additional containers that were not displayed before. These containers include LostAndFound, System, and Microsoft Exchange System Objects (Figure 10.1). The first two containers are for Windows 2000 in general; the Exchange container contains hidden public folders and the System Mailbox. Several new tabs are added to Properties Sheets of objects displayed in ADUC. Two of these tabs are added to all objects in ADUC, namely an Object tab giving the fully qualified domain name of the object within AD, and a Security tab displaying the permissions currently

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One thing that tends to be overlooked in all of the predictions is exactly how the individual user is likely to react to the new technology Just as the design of a WAP application is vital to its perceived usefulness to the user, leaving the user out of the equation of technology advances can be very expensive in terms of wasted research time and dollars The question to ask is, Would I use this, if it were available now The mobile phone offers a simple example Many car accidents occur because the driver is using a mobile phone, and therefore does not have both hands properly on the steering wheel to fully control the car This is well known, and legislation now exists in some countries to prohibit the use of a mobile phone without a hands-free kit.

Take one of the 2-cell AA battery holders and drill a hole with a 5/32-inch bit, 5/8 of an inch from the edge of the holder without the battery clip connectors, as shown in Figure 5.17. Do this for all six of the 2-cell AA battery holders. Secure part E in place with a 6/32-inch 1/2-inch machine screw and locking nut so that the bent part of piece E is to the left side of the battery pack, as shown in Figure 5.18. Do this for five of the holders. For the other holder that remains, secure part E in place so that the bent tab is oriented to the right. When this battery holder is connected to the tail section, it will be fastened differently than the rest. Now that all of the individual mechanical pieces have been constructed, we will build the tail and head sections and then put it all together.

Most psychiatrists believe that the psychotic break that may occur at this time is either a confusionaldelirious state or a schizophreniform or depressive psychosis, and that these illnesses do not differ from those occurring at other times in life As mentioned in the previous chapter, some authors have questioned the existence of a special depressive illness that is linked to the postpartum period, an opinion that is not supported by our clinical experience (see Brockington) Additionally, there occurs a postpartum psychosis that cannot be categorized in this way Usually it has its onset between 48 and 72 h after a delivery that may have been complicated by excessive bleeding or infection The patient alternates between periods of noisy hyperactivity and of mutism and inactivity She is disoriented and incapable of thinking clearly The baby is sometimes rejected as not belonging to her (instances of infanticide are not unknown).

(a) (b) (c) (d)

Although the illness has some features of delirium, it may merge with a schizophrenic or depressive type of psychosis that persists for months Boyd found in a series of such cases that about 40 percent were predominantly affective, 20 percent schizophreniform, and the remainder self-limited confusional psychoses of the type previously described In some patients, a typical depressive illness has followed each of several pregnancies, disabling the patient for weeks to months at a time Some women with manic-depressive disease have had their early depressive attacks only after delivery Also, as consultants to hospitals for women and babies, we had observed a number.

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The McGraw Hill Companies, 2010

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