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Fake v. Real

The question of the difference between real vs. fake breasts has become common in celebrity media. The quality of the surgery results in much of the difference between real looking and fake looking breasts. A poor boob job can introduce an unnatural looks. Breast implants are silicone rubber sacs filled with either saline solution or silicone, which increase the size of the breasts. Saline implants are the most commonly used form of implants in the United States. Implants come in different sizes, shapes and textures and a surgeon may place them under or over the chest muscles. Breast implants often sit higher on the chest than real breasts, and they appear fuller and rounder on top than real breasts. Breast implants often have a noticeable gap between the breasts, while real breasts tend to be closer together. Real breasts also fill out more at the bottom and not at the top. When in motion, breast implants often do not move much and will appear to keep their round shape, whereas real breasts will jiggle, bounce or shift depending on movement. There is mostly fat in real breast tissues and is therefore soft, whereas breast implants are more firm and less pliable. Silicone breast implants are generally softer than saline implants because they are made of a thick, gel-like substance that feels similar to fat. Saline implants feel more like muscle instead of fat. When women with breast implants do not wear bras, their breasts tend to stay firm and round. Natural breasts will hang lower and will not jut out much without a bra. Real breasts are mostly fat, which gives them a jiggle quality, if breasts look more like solid muscle, they may fake. One often can identify if breasts are fake by comparing them to the rest of the body. Although there is the rare woman who has a hot body and unusually large natural breasts, more than a few women make the mistake of going too large and getting very big fake breasts. Fortunately, these women are easy to spot: if she has the body of a dancer and breasts like a porn star. Check breast shape and alignment with her movement. Fake breast do not follow body movements as well. Many people associate breast implants with a large cup size, such as a D or DD. However, many women who opt for breast implants choose more natural-looking sizes such as a C or B cup. It can be harder to determine whether a woman has natural or implants at these sizes. In addition, padded bras create a similar effect to breast implants by lifting the breasts and making them appear larger. It can be hard to tell the difference between real breasts and implants when a woman wears a bra.

Nails

Nail care is more than the proper maintenance of the fingernails and toenails. A nail is a horn-like envelope covering the dorsal aspect of the terminal phalanges of fingers and toes. The nail is made of a hard protein called keratin. Nails can dry out, just like skin. They can also peel, break, and become infected. The nail protects the ends of the fingers and toes from trauma and helps pick up small objects. Care of the fingernails and toenails is important. Poor nail care causes problems. Recommendations for maintaining nail health include: keeping nails clean and dry in order to keep bacteria and other infectious organisms from collecting under the nails; cutting nails straight across with only slight rounding at the tip; using a fine-textured file to keep nails shaped and free of snags; and avoiding nail-biting. Nail changes, swelling and pain can signal serious problems that may require a physician and medical nail care. Medical nail care includes preventing and treating diseases. Nail diseases are distinct from diseases of the skin. Although nails are a skin appendage, they have their own signs and symptoms, which can relate to other medical conditions. Nail conditions that show signs of infection or inflammation require medical assistance beyond a beauty parlor. Deformity or diseases of the nails are onychosis. Onychia is an inflammation of the nail folds of the nail with formation of pus and shedding of the nail. Onychia results from the introduction of microscopic pathogens through small wounds. The medical term for ingrown nails is onychocryptosis. Ingrown nails can affect the fingers and the toes. With this condition, the nail cuts into one or both sides of the nail bed, resulting in inflammation and possibly infection. The relative rarity of this condition in the fingers suggests that pressure from the ground or shoe against the toe is a prime cause. The movements involved in walking or other physical disturbances can contribute to the problem. Mild onychocryptosis in the absence of infection is treatable by trimming and rounding the nail. In more advanced cases including infection, doctors perform matrixectomy by surgically excising the in growing portion of the nail down to its bony origin and thermally or chemically cauterizing the matrix to prevent recurrence. The best results are by cauterizing the matrix with phenol.

Offender Relapse

Because addiction is a chronic disease, drug relapses and returns to treatment are common features of the path to recovery, so treatment should extend over a long period of time and across multiple episodes of care. Individuals with the most severe problems can participate in treatment and achieve positive outcomes.

Rewards and Sanctions in Offender Treatment

The systematic application of behavioral management principles that underscore reward and punishment can help individuals reduce drug use and criminal behavior. Rewards and sanctions change behavior when they follow targeted behavior, swiftly and fairly. It is important to recognize and force progress toward abstinent behavior. Rewarding positively toward responsible, behavior is more effective in producing abstinent behavior. Long term positive change is better than punishing negative behavior. Nonmonetary rewards such as social recognition can be as effective as monetary rewards. A graduated range of rewards given for meeting predetermined goals can be an effective strategy.
In recovery treatments in the community, contingency management strategies use incentives or rewards, like vouchers or bus tokens, to reinforce abstinence measured by negative drug tests or to shape progress toward other treatment goals, such as program session attendance or compliance with medication regimens. Contingency management is most effective when the contingent reward closely follows the behavior monitored. Graduated sanctions, which invoke less punitive responses for early and less serious noncompliance and increasingly severe sanctions for more serious or continuing problems, are effective tools in conjunction with drug testing. The effective use of graduated sanctions involves consistent, predictable and clear responses to noncompliant behavior.

Drug Testing

Drug testing can determine when an individual is having difficulties with recovery. The first response to drug use is clinical and detected through urinalysis and results in an increase in treatment intensity or a change to an alternative treatment. This often requires coordination between the criminal justice staff and the treatment provider. A more intensive treatment approach should not be a sanction, but rather a routine progression in healthcare practice when a treatment appears less effective than expected.
Behavioral contracting can employ both rewards and sanctions. A behavioral contract is an explicit agreement between the participant and the treatment provider or criminal justice monitor or among all three. A behavioral contract specifies proscribed behaviors and associated sanctions, as well as positive goals and rewards for success. Behavioral contracting can instill a sense of procedural justice because both the necessary steps toward progress and the sanctions for violating the contract are specific and understood in advance.

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