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They relaxed‖; ―I get upset anger discount 75 mg elavil overnight delivery treatment for nerve pain in dogs, anxiety purchase genuine elavil on line pain treatment in shingles, or depression; may have trouble thinking clearly buy discount elavil online pain treatment center richmond ky, easily‖; ―I am easily sometimes called “emotional making decisions, and coping effectively Neuroticism disturbed‖ instability‖ with stress. The Big Five dimensions seem to be cross-cultural, because the same five factors have been identified in participants in [12] China, Japan, Italy, Hungary, Turkey, and many other countries (Triandis & Suh, 2002). For instance, a pattern of high conscientiousness, low neuroticism, and high agreeableness predicts successful job performance [13] (Tett, Jackson, & Rothstein, 1991). The Big Five factors are also increasingly being used in helping researchers understand the dimensions of psychological disorders such as [15] anxiety and depression (Oldham, 2010; Saulsman & Page, 2004). Rather than studying hundreds of traits, researchers can focus on only five underlying dimensions. The Big Five may also capture other dimensions that have been of interest to psychologists. For instance, the trait dimension of need for achievement relates to the Big Five variable of conscientiousness, and self-esteem relates to low neuroticism. On the other hand, the Big Five factors do not seem to capture all the important dimensions of personality. For instance, the Big Five does not capture moral behavior, although this variable is important in many theories of personality. And there is evidence that the Big Five factors are not exactly the same across all cultures (Cheung & Leung, [16] 1998). Situational Influences on Personality One challenge to the trait approach to personality is that traits may not be as stable as we think they are. When we say that Malik is friendly, we mean that Malik is friendly today and will be friendly tomorrow and even next week. But what if Malik were found to behave in a friendly way with his family members but to be unfriendly with his fellow classmates? In one relevant study, [18] Hartshorne, May, Maller, & Shuttleworth (1928) examined the correlations among various behavioral indicators of honesty in children. They also enticed children to behave either honestly or dishonestly in different situations, for instance, by making it easy or difficult for them to steal and cheat. And similar low correlations were found in adults on other measures, [19] including dependency, friendliness, and conscientiousness (Bem & Allen, 1974). One possibility is that the natural tendency for people to see traits in others leads us to believe that people have stable personalities when they really do not. In short, perhaps traits are more in the heads of the people who are doing the judging than they are in the behaviors of the people being observed. The fact that people tend to use human personality traits, such as the Big Five, to judge animals in the same way that they use these traits to judge humans is consistent with this idea (Gosling, [20] 2001). And this idea also fits with research showing that people use their knowledge representation (schemas) about people to help them interpret the world around them and that [21] these schemas color their judgments of others‘ personalities (Fiske & Taylor, 2007). Research has also shown that people tend to see more traits in other people than they do in themselves. First, think about a person you know—your mom, your roommate, or a classmate—and choose which of the three responses on each of the four lines best describes him or her. Intense Calm Depends on the situation [22] Richard Nisbett and his colleagues (Nisbett, Caputo, Legant, & Marecek, 1973) had college students complete this same task for themselves, for their best friend, for their father, and for the (at the time well-known) newscaster Walter Cronkite. These results also suggest that people may perceive more consistent traits in others than they should. Nisbett, Caputo, Legant, and Marecek (1973) found that participants checked off a trait term (such as ―energetic‖ or ―talkative‖) rather than ―depends on the situation‖ less often when asked to describe themselves than when asked to describe others. Imagine that you had completed a personality test and the psychologist administering the measure gave you this description of your personality: You have a great need for other people to like and admire you. You have a great deal of unused capacity, which you have not turned to your advantage. While you have some personality weaknesses, you are generally able to compensate for them. Disciplined and self-controlled outside, you tend to be worrisome and insecure inside. At times you have serious doubts as to whether you have made the right decision or done the right thing. You probably do criticize yourself at least sometimes, and you probably do sometimes worry about things. The problem is that you would most likely have found some truth in a personality description that was the opposite. You frequently stand up for your own opinions even if it means that others may judge you negatively. You sometimes confide in others that you are concerned or worried, but inside you maintain discipline and self-control. You generally believe that you have made the right decision and done the right thing. The Barnum effect refers to the observation that people tend to believe in descriptions of their personality that supposedly are descriptive of them but could in fact describe almost anyone. The Barnum effect helps us understand why many people believe in astrology, horoscopes, fortune- telling, palm reading, tarot card reading, and even some personality tests. People are likely to accept descriptions of their personality if they think that they have been written for them, even Attributed to Charles Stangor Saylor. A second way that psychologists responded to Mischel‘s findings was by searching even more carefully for the existence of traits. One insight was that the relationship between a trait and a behavior is less than perfect because people can express their traits in different ways (Mischel & [24] Shoda, 2008). People high in extraversion, for instance, may become teachers, salesmen, actors, or even criminals. Although the behaviors are very different, they nevertheless all fit with the meaning of the underlying trait. Psychologists also found that, because people do behave differently in different situations, personality will only predict behavior when the behaviors are aggregated or averaged across different situations. We might not be able to use the personality trait of openness to experience to determine what Saul will do on Friday night, but we can use it to predict what he will do over the next year in a variety of situations. When many measurements of behavior are combined, there is much clearer evidence for the stability of traits and for the effects of traits on behavior (Roberts [25] & DelVecchio, 2000; Srivastava, John, Gosling, & Potter, 2003). Taken together, these findings make a very important point about personality, which is that it not only comes from inside us but is also shaped by the situations that we are exposed to. Personality is derived from our interactions with and observations of others, from our interpretations of those interactions and observations, and from our choices of which social situations we prefer to enter [26] or avoid (Bandura, 1986). Skinner explain personality entirely in terms of the environmental influences that the person has experienced. Because we are profoundly influenced by the situations that we are exposed to, our behavior does change from situation to situation, making personality less stable than we might expect. And yet personality does matter—we can, in many cases, use personality measures to predict behavior across situations.

Therefore according to this model order elavil with amex treatment pain base thumb, negative moods are the internal stressors cheap elavil 10mg with visa back pain treatment nerve block, or the consequence of an external stressor purchase elavil 10mg pain medication for dogs arthritis, which cause alcohol consumption due to the expected outcome of the alcohol. For example, if an individual feels tense or anxious (their internal state) as a result of an exam (the external stressor) and believes that alcohol will reduce this tension (the expected outcome), they may drink alcohol to improve their mood. This theory has been supported by some evidence of the relationship between negative mood and drinking behaviour (Violanti et al. Further- more, it has been suggested that medical students’ lifestyle and the occurrence of problem drinking may be related to the stress they experience (Wolf and Kissling 1984). In one study, this theory was tested experimentally and the health-related behaviours of medical students were evaluated both before and during a stressful examination period. The results showed that the students reported a deterioration in mood in terms of anx- iety and depression and changes in their behaviour in terms of decreases in exercise and food intake (Ogden and Mtandabari 1997). The authors concluded that acute exposure to stress resulted in negative changes in those behaviours that had only a minimal influence on the students’ ability to perform satisfactorily. Obviously chronic stress may have more damaging effects on longer-term changes in behaviour. Eating Diet can influence health either through changes in body weight or via the over or under consumption of specific dietary components (see Chapter 6). Most research has focused on the individual difference model and has examined whether either naturally occurring stress or laboratory- induced stress causes changes in eating in specific individuals. Therefore, gender, weight and levels of dieting (see Chapter 6) seem to be important predictors of a link between stress and eating. Their results showed a direct associ- ation between increased daily hassles and increased snacking but showed no differences according to either gender or dieting. Such inconsistencies in the literature have been described by Stone and Brownell (1994) as the ‘stress eating paradox’ to describe how at times stress causes overeating and in others it causes undereating without any clear pattern emerging. Exercise Exercise has been linked to health in term of its impact on body weight and via its beneficial effects on coronary heart disease (see Chapter 7). Accidents Accidents are a very common and rarely studied cause of injury or mortality. Research has also examined the effects of stress on accidents and correlational research suggests that individuals who experience high levels of stress show a greater tendency to perform behaviours that increase their chances of becoming injured (Wiebe and McCallum 1986). Further, Johnson (1986) has also suggested that stress increases accidents at home, at work and in the car. If this is the case then the stress following illness also has implications for the health of individuals. Such stress may influence individuals’ behaviour in terms of their likelihood to seek help, their compliance with interventions and medical recommendations, and also adopting healthy lifestyles. Therefore, stress may cause behaviour changes, which are related to the health status of the individual. Research indicates that stress causes physiological changes that have implications for promoting both the onset of illness and its progression. Stress and illness onset and progression Stress causes changes in both sympathetic activation (e. Sympathetic activation: The prolonged production of adrenalin and noradrenalin can result in: s blood clot formation; s increased blood pressure; s increased heart rate; s irregular heart beats; s fat deposits; s plaque formation; and s immuno suppression. These changes may increase the chances of heart disease, kidney disease and leave the body open to infection. These changes may increase the chances of infection, psychiatric problems and losses in memory and concentration. These physiological changes can be further understood in terms of Johnston’s chronic and acute model of the stress illness link (Johnston 2002). This results in ongoing wear and tear and the slower process of atherosclerosis and damage to the cardiovascular system. Acute stress operates primarily through changes in sympathetic activation with changes in heart rate and blood pressure. This can contribute to atherosclerosis and kidney disease but is also related to sudden changes such as heart attacks. So far the behavioural and physiological pathways have been presented as separate and discrete. Stress may cause changes in behaviours such as smoking and diet which impact upon health by changing the individual’s physiology. Likewise, stress may cause physiological changes such as raised blood pressure but this is often most apparent in those that also exhibit particularly unhealthy behaviours (Johnston 1989). Therefore, in reality, stress is linked to illness via a complex interaction between behavioural and physiological factors. Further, Johnston (1989) argued that these factors are multi- plicative, indicating that the more factors that are changed by stress the greater the chance that stress will lead to illness. To some extent this is due to the role of variables such as coping, control, personality and social support which are described in detail later on. However, research indicates that this variability is also due to individual differences in stress reactivity, stress recovery, the allostatic load and stress resistance. Stress reactivity Some individuals show a stronger physiological response to stress than others which is known as their level of ‘cardiovascular reactivity’ or ‘stress reactivity’. This means that when given the same level of stressor and regardless of their self perceived stress some people show greater sympathetic activation than others (e. Research suggests that greater stress reactivity may make people more susceptible to stress-related illnesses. For example, individuals with both hypertension and heart disease have higher levels of stress reactivity (e. However, these studies used a cross sectional design which raises the problem of causality. The results showed that stress and illness were not linked in the children with low reactivity but that those with higher reactivity showed more illness if they had experienced more stress. Everson and col- leagues (1997) also assessed baseline stress reactivity and explored cardiac health using echo cardiography at follow-up. The results showed that higher stress reactivity at base- line was predictive of arteriol deterioration after four years. In addition, stress reactivity has been suggested as the physiological mechanism behind the impact of coronary prone behaviours on the heart (Harbin 1989; Suarez et al. This doesn’t mean that individuals who show greater responses to stress are more likely to become ill. However, some people recover more quickly than others and some research indicates that this rate of recovery may relate to a susceptibility to stress-related illness. This is reflected in Seyle’s (1956) notion of ‘exhaustion’ and the general wear and tear caused by stress. Some research has focused particularly on changes in cortisol production suggesting that slower recovery from raised cortisol levels could be related to immune function and a susceptibility to infection and illness (e. Allostatic load McEwan and Stellar (1993) described the concept ‘allostatic load’ to reflect the wear and tear on the body which accumulates over time after exposure to repeated or chronic stress.

Positive result revert to negative with in 6- 18 months of effective therapy of syphilitic infection Principle: Antigen and antibody (Reagin) reaction results in clumping after aggitation order 25mg elavil with mastercard pain treatment with antidepressants. It can give quantitative results discount elavil online master card advanced pain treatment center ohio, and valuable in establishing a diagnosis and in evaluating effect of treatment 2 buy cheap elavil 25mg online blue sky pain treatment center/health services. Complement fixation test: Wasserman test; Kolmer test Principle: Reagin-containing sera (mixture of IgM and IgA) fix complement in the presence of “cardiolipin-cholestrol-lecithin complex” antigen. Add diluted serum containing antibody to the sensitized gelatin particle in a microdilution tray. Positive result when agglutination occurs Treatment: Penicillin Tetracycline Erythromycin Control measures: Treatment of cases and screen contacts Practice safe sex with condoms Health education 278 2. Tightly coiled, thin, flexible spiraled spirochetes forming one polared hooked ends. Grow best in semisolid (Fletcher’s or Stuart’s) media under O aerobic condition at 28-30 c. Fatty acid oxidation is major source of energy Antigenic structure: Lipopolysaccharide: Determine the specificity of human immune response to the organism and serologic classification of leptospirae Pathogenesis and clinical features: Essentially zoonotic infection and humans are accidental host Source of infection is contaminated foood and water with leprospia spp. Obligate intracellular pleomorphic gram-negative coccobacilli occurring in single, pairs, short rods and filaments. Antigenic structure: Group-specific antigens Species-specific antigens Clinical Features: Clinical illness is due to the invasion and multiplication of rickettsiae in the endothelial cells of small blood vessels. It manifests with fever, headache, malaise, skin rash and enlargement of liver and spleen. Hosts and vectors of the medically important rickettsiae Organism Disease Hosts Vectors 1. It causes epidemic or louse-borne typhus and the milder recrudescence form, Brill-Zinser disease. Clinical Features: It is transmitted by self-inoculation of the organism by scratching after bite by infected louse(Pediculous humanus corporis and pediculous humanus capitis). The illness manifests with sudden onset of fever, headache, malaise, prostration and skin rash. Epidemics of the disease are associated with overcrowding, cold weather, lack of washing facilities and fuel, famine and war. The disease is milder than louse-borne typhus and occurs in those individuals living or working in highly rat-infested area. Laboratory diagnosis: Specimen: Serum for serological tests The serological tests to diagnose typhus are: 1. The smallest living micro-organism capable of free living in nature self-replicating on laboratory media. Highly pleomorphic due to absence of rigid cell wall, instead bounded by a triple-layered “unit membrane”. Have enzyme systems and make their own proteins, lipids, nucleic acids and vitamins. The elementary body is reorganized into reticulate body in the host cell which is specifically adapted for intracellular growth. The reticulate body grows and divides many times to form inclusions in the host cell cytoplasm. With in 24-48 hours of developmental cycle, the reticulate bodies rearrange them selves into infective elementary bodies and released after host cell rupture. Antigenic structure: Group-specific antigen Species-specific antigen Chlamydia trachomatis. Appearance in giemsa’s stain Elementary body -------- Purple Reticulate body---------- Blue Host cell cytoplasm----- Blue. Appearance in iodine stain Brown inclusions in host cell cytoplasm because of glycogen matrix surrounding the particle. Incubation period is 3-10 days Route of transmission is through indirect contact like eye-to- eye by infected fingers or sharing towels. It manifests as a chronic keratoconjunctivitis producing scarring and deformity of the eyelids, corneal vascularization and opacities which may lead to blindness. Laboratory diagnosis: Specimen: Conjunctival scraping from upper tarsal conjunctivae. Culture: Mac coy cells or embryonated eggs Serology: Immunofluorescent tests Treatment: Erythromycin Tetracycline Control measures:. Females------ Urethritis Cervicitis Pelvic inflamatory diseases If complicated in females, it causes infertility and ectopic pregnancy. Neonatal inclusion conjunctivitis and neonatal pneumonia Transmission is during passage through the infected birth canal. Laboratorydiagnosis: Specimen: Endocervical scraping Culture: mac coy cells Serology: Enzyme immunoassay for group-specific antigen. On the basis of their life habits, microorganism is classified as saprophytes or parasites. Saprophytes : Mode of life of free-living organisms which obtain their nourishment from soil and water. Commensalism: The ability to live on the external or internal surface of the body with out causing disease. Invasiveness of micro-organism A high degree of bacterial invasiveness is usually associated with severe infection. Mode of release from bacteria Excreted by released on bacterial death 295 living cell (Integral part of cell wall) 4. Collagenase: Degrade collagen, which is major protein of fibrous connective tissue. Hyaluronidase: (Early spreading factor) hydrolyzes hyaluronidic acid, which is the ground substance of connective tissue. Lecithinase: Splits lecithin of cell membrane into phosphorylcholine and glycerides. Many layered impermeable barrier to invasion of the tissues by microorganisms from the environment. Lysozyme: An enzyme which lyses the mucopeptide (peptidoglycan) of the Gram-positive bacteria. Respiratory secretion: Traps bacteria and constantly moves them upward propelled by cilia on the cells of the epithelium. Phagocytosis: The process by which microorganisms are ingested and destrrroyed by phagocytic cells. Act as an early defense against infection and are the “pus cells” seen in the exudate from acute infection. Produced in the bone marrow and found in blood stream as monocyte and in tissue as fixed macrophage. Phagolysosome: Fusion ofphagosome and lysozyme (bag of hydrolytic and proteolytic enzymes found in phagocytic cells). Specific defense mechanisms There are two main mechanisms by which the host mounts a specific immune response against bacterial infection.