The frontostriatal pathway connects the medial prefrontal cortex, which deals with self-knowledge, to the ventral striatum, which deals with feelings of motivation and reward. Stronger anatomical pathways are correlated with higher long-term self-esteem, while stronger functional connectivity is correlated with higher short-term self-esteem. Criticism and controversy
The American psychologist Albert Ellis criticized on numerous occasions the concept of self-esteem as essentially self-defeating and ultimately destructive. Although acknowledging the human propensity and tendency to ego rating as innate, he has critiqued the philosophy of self-esteem as unrealistic, illogical and self- and socially destructive – often doing more harm than good. Questioning the foundations and usefulness of generalized ego strength, he has claimed that self-esteem is based on arbitrary definitional premises, and overgeneralized, perfectionistic and grandiose thinking. Acknowledging that rating and valuing behaviors and characteristics is functional and even necessary, he sees rating and valuing human beings totality and total selves as irrational and unethical. The healthier alternative to self-esteem according to him is unconditional self-acceptance and unconditional other-acceptance. Rational Emotive Behavior Therapy is a psychotherapy based on this approach. "There seem to be only two clearly demonstrated benefits of high self-esteem....First, it increases initiative, probably because it lends confidence. People with high self-esteem are more willing to act on their beliefs, to stand up for what they believe in, to approach others, to risk new undertakings. (This unfortunately includes being extra willing to do stupid or destructive things, even when everyone else advises against them.
ERCP or MRCP with secretin allow precise delineation of the anatomical structure and in particular a good visualization of pancreatic ducts, as well as a careful analysis of pancreatic secretion into the duodenum lumen. Treatment
In neonates, treatment for relief of obstruction usually is bypassing the obstructed segment of duodenum by duodeno-jejunostomy. In adults, due to the minor duodenal mobility, the approach is laparoscopic gastrojejunostomy or duodenojejunostomy. References


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