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Lung infections can result in pneumonia buy venlor 75 mg otc anxiety symptoms for months, infec- mediators does not occur when IgE alone binds to the tion of the lining of the lung (empyema) or constriction of the basophils or mast cells venlor 75mg visa anxiety symptoms jumpy. In females discount venlor online amex anxiety free stress release formula, The release of the mediators triggers the physiological pelvic infections can inflame the lining of the uterus reactions. Mouth infections can involve the root canals or diameter) and fluid can pass across the blood vessel wall more gums (gingivitis). Because the immune system is sensitized to the partic- lead to brain and spinal cord infections. Infection of the skin, ular allergen, and because of the potent effect of mediators, the via bites and other routes of entry, causes open sores on the development of symptoms can be sudden and severe. An example is that massive and tion called anaphylactic shock can ensue, in which the body’s potentially lethal tissue degradation, which is known as necro- physiology is so altered that failure of functions such as the tizing fascitis, and which is caused by group A b-hemolytic circulatory system and breathing can occur. Finally, infection of the bloodstream (bac- those who are susceptible, a bee sting, administration of a teremia) can prelude the infection of the heart (endocarditis). Those who are allergic to bee stings often carry medica- visible, on both the appearance and smell of the infected area. Most of the bacteria responsible for infection are susceptible Anaphylaxis occurs with equal frequency in males and to one or more antibiotics. No racial predisposition towards anaphylaxis is ever, since the bacteria are often growing slowly and since known. The exact number of cases is unknown, because many antibiotics rely on bacterial growth to exert their lethal effect. However, at least 100 people die annually in removal of the affected tissue is an option to prevent the the United States from anaphylactic shock. Amputation of limbs is a frequent means of dealing with necrotizing fascitis, an infection that is See also Allergies; Immunoglobulins and immunoglobulin inside of tissue (and so protected from antibiotics and the deficiency syndromes 17 Animal models of infection WORLD OF MICROBIOLOGY AND IMMUNOLOGY Drawing depicting Louis Pasteur (right) using an animal model. Such work would not Animal models of infection have been possible without the use of animals. The use of various animals as models for microbiological Subsequent to Pasteur, the use of animal models for a infections has been a fundamental part of infectious disease myriad of bacterial and viral diseases has led to the production research for more than a century. Now, techniques of genetic of vaccines to diseases such as diphtheria, rabies, tuberculo- alteration and manipulation have made possible the design of sis, poliomyelitis, measles, and rubella. Animal models are also used to screen candidate drugs animals so as to be specifically applicable to the study of a for their performance in eliminating the infection of concern myriad of diseases. While some The intent for the use of animals as models of disease is of this work may be amenable to study using cells grown on to establish an infection that mimics that seen in the species of in the laboratory, and by the use of sophisticated computer concern, usually humans. By duplicating the infection, the rea- models that can make predictions about the effect of a treat- sons for the establishment of the infection can be researched. Development of a vaccine to the particular A key to developing an animal model is the selection of infection is an example of the successful use of animals in an animal whose physiology, reaction to an infection, and the infectious disease research. The study of an infection that bears caused by bacterial infection grow from animals studies by no resemblance to that found in a human would be fruitless, Louis Pasteur in the mid-nineteenth century. The use of ani- in terms of developing treatment strategies for the human mals as models of cholera and anthrax enabled Pasteur to condition. Accounts by the Huns during their development of animal models that are specifically tailored sweep across Eurasia in 80 A. One example is the so-called nude mouse, their horse and cattle attributed to anthrax. These animals, which derives its name from the fact that it has no hair. Indeed, mice lack a thymus, and so are immunodeficient in a number loss to European livestock in the eighteenth and nineteenth of ways. Use of nude mice has been very useful in the study centuries stimulated the search for a cure. In 1876, Robert of immunodeficiency diseases in humans, such as acquired Koch identified the causative agent of anthrax. As well, this animal model The use of anthrax as a weapon is not a new phenome- lends itself to the study of opportunistic bacterial infections, non. In ancient times, diseased bodies were used to poison which typically occur in humans whose immune systems are wells, and were catapulted into cities under siege. In World War II, Japanese and animals have proven to be useful in infectious disease German prisoners were subjects of medical research, includ- research. These animals include the rabbit, rat, guinea pig, pig, ing their susceptibility to anthrax. Britain actually produced five million anthrax cakes at tives to humans. Thus, for example, mouse models exist in which exposure to the natural reservoirs of the microorganism; live- the activity of certain genes has been curtailed. The involvement of the gene acquired by workers engaged in shearing sheep, for example. Cutaneous anthrax refers to the entry of the organism through The data from animal models provides a means of indi- a cut in the skin. Gastrointestinal anthrax occurs when the cating the potential of a treatment. With prompt treatment, the cutaneous form is provides a guide towards establishing the optimal treatment in often cured. In other words, the animal model can help screen and lethal in 25–75% of people who contract it. Inhalation anthrax eliminate the undesirable treatments, narrowing the successful is almost always fatal. Further study, involving The inhalation form of anthrax can occur because of the humans, is always necessary before something such as a vac- changing state of the organism. Such human studies are a large “vegetative” cell, which undergoes cycles of growth subject to rigorous control. Or, the bacterium can wait out the nutritionally The use of animals in research has long been a con- bad times by forming a spore and becoming dormant. As well, in most institutions, an growth and reproduction the spore resuscitates and active life evaluation committee must approve the use of animals. Only research can be accomplished in some other way than through 8,000 spores, hardly enough to cover a snowflake, are suffi- the use of living animals, then approval for the animal study is cient to cause the pulmonary disease when they resuscitate in typically denied. The dangers of an airborne release of anthrax spores is See also AIDS, recent advances in research and treatment; well known. British open-air testing of anthrax weapons in Giardia and giardiasis; Immunodeficiency 1941 on Gruinard Island in Scotland rendered the island unin- habitable for five decades. In 1979, an accidental release of a minute quantity of anthrax spores occurred at a bioweapons ANIMALCULES • see HISTORY OF MICROBIOLOGY facility near the Russian city of Sverdlovsk. Sheep and cattle up to 50 AAnthrax NTHRAX kilometers downwind became ill. Three components of Bacillus anthracis are the cause Anthrax refers to a pulmonary disease that is caused by the of anthrax. First, the bacterium can form a capsule around bacterium Bacillus anthracis.
In medical schools cheap venlor online american express anxiety and panic attacks, most groups are expected to deal with a substantial amount of content cheap 75mg venlor with amex anxiety scale 0-10. However buy cheap venlor 75mg line anxiety symptoms muscle weakness, you will also wish to use the small group approach to develop the higher intellectual skills of your students and even to influence their attitudes. In order to achieve these various purposes you will need considerable skills in managing the group and a clear plan so that discussion will proceed in an orderly fashion towards its conclusion. MANAGING A SMALL GROUP Small group teaching is considerably more challenging to manage than a conventional lecture because you must take account of the students’ behaviour, personalities and the emotional aspects of being in a group. To achieve success with a small group you must also have a clear under- standing of how a group operates and how it develops. You have particular responsibilities as the initial leader of the group but your role will vary considerably both within a session and from session to session. For instance, if you adopt an autocratic or authoritarian style of leadership (not an uncommon one among medical teachers) you may well have a lot of purposeful activity but there will be a limited amount of spontaneous participation. You should pre- ferably adopt a more co-operative role where you demonstrate an expectation that the students will take responsibility for initiating discussion, providing informa- tion, asking questions, challenging statements, asking for clarification and so on. A successful group is one that can proceed purposefully without the need for constant intervention by the teacher. This is hard for most teachers to accept but is very rewarding if one recognises that this independence is one of the key goals of small group teaching and is more important than satisfying one’s own need to be deferred to as teacher and content expert. These are factors relating to the task of the group and factors relating to the maintenance of the group. In addition there must be a concern for the needs of each student within the group. The tasks of the group: clear definition of tasks is something that must be high on the agenda of the first meeting. The reason for the small group sessions and their purpose in the course must be explained. In addition, you should initiate a discussion about how you wish the group to operate, what degree of preparation you expect between group meetings, what role you intend to adopt, what roles you expect the students to assume and so on. Because such details may be quickly forgotten it is desirable to provide the students with a handout. Ideally it is one that is open, trustful and supportive rather than closed, suspicious, defensive and competitive. It is important to establish that the responsibility for group maintenance rests with the students as well as with the teacher. The firm but pleasant handling of the loquacious or dominating students early in the session or the encouragement of the quiet student are obvious examples of what can be achieved to produce the required environment for effective group discussion. The successfully managed group will meet the criteria shown in Figure 3. A structured approach to tasks and to the allocation of the time available is a useful tool for you to consider. An example of such a structured discussion session is illustrated in Figure 3. Note that the structure lays out what is to be discussed and how much time is budgeted. Such a scheme is not intended to encourageundue rigidity or inflexibility, but to clarify purposes and tasks. This may seem to be a trivial matter, but it is one which creates considerable uncertainty for students. You need to be alert to how time is being spent and whether time for one part of the plan can be transferred to an unexpected and important issue that arises during discussion. Another structure, not commonly used in medical educa- tion, is illustrated in Figure 3. From an individual task, the student progresses through a series of small groups of steadily increasing size. There are special advantages in using this structure which are worth noting: it does not depend on prior student preparation for its success; the initial individual work brings all students to approximately the same level before 45 discussion begins; and it ensures that everyone partici- pates, at least in the preliminary stages. INTRODUCING STIMULUS MATERIALS A very useful means of getting discussion going in groups is to use what is generally known as ‘stimulus material’. We have seen how this was done in the snowballing group structure described previously. It is limited only by your imagination and the objectives of your course. Here are a few examples: A short multiple-choice test (ambiguous items work well in small groups). X-rays, photographs, slides, specimens, real objects, charts, diagrams, statistical data). A journal article or other written material (an interesting example is provided by Moore where he used extracts from literary works to help students understand the broader cultural, philosophical, ethical and personal issues of being a doctor. Examples of sources of these extracts included Solzhenitsyn’s Cancer Ward and Virginia Woolf’s On Being III). ALTERNATIVE SMALL GROUP DISCUSSION TECHNIQUES As with any other aspect of teaching it is helpful to understand several techniques in order to introduce variety or to suit a particular situation. Such techniques include: One-to-one discussion Buzz groups Brainstorming Role playing Evaluation discussion 46 1. One-to one discussion This is a very effective technique which can be used with a group of almost any size. It is particularly useful as an ‘ice- breaker’ when the group first meets, and is valuable for enhancing listening skills. It can also be used to discuss controversial or ethical issues when forceful individuals with strong opinions need to be prevented from dominat- ing the discussion (Figure 3. Buzz groups These are particularly helpful to encourage maximum participation at one time. It is therefore especially useful when groups are large, if too many people are trying to contribute at once or, alternatively, if shyness is inhibiting several students (Figure 3. Brainstorming This is a technique that you should consider when you wish to encourage broad and creative thinking about a problem. It is also valuable when highly critical group members (including perhaps yourself? If used frequently, it trains students to think up ideas before they are dismissed or criticised. The key to successful brainstorming is to separate the generation of ideas, or possible solutions to a problem, from the evaluation of these ideas or solutions (Figure 3. It is valuable in teaching interpersonal and communication skills, particularly in areas with a high emotional content. It has been found to be helpful in changing perceptions and in developing empathy.
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