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By H. Rhobar. Georgetown College. 2018.

Stress reactivity is thought to be dispositional and may either be genetic or a result of prenatal or childhood experiences buy discount pletal 100mg on-line. However 50mg pletal for sale, there is great variability in the rate of recovery both between individuals as some people recover more quickly than others and within the same individual across the lifespan pletal 100 mg online. Allostatic load: Stress recovery is linked with allostatic load which was described by McEwan and Stellar (1993) generic 50 mg pletal overnight delivery. They argued that the body’s physiological systems constantly fluctuate as the individual responds and recovers from stress purchase 50 mg pletal, a state of allostasis, and that as time progresses recovery is less and less complete and the body is left increasingly depleted. Stress resistance: To reflect the observation that not all individuals react to stressors in the same way, researchers developed the concept of stress resistance to empha- size how some people remain healthy even when stressors occur (e. Stress resistance includes adaptive coping strategies, certain personality characteristic and social support. Stress reactivity, stress recovery, allostatic load and stress resistance all influence an individual’s reaction to a stressor. Laboratory setting Many stress researchers use the acute stress paradigm to assess stress reactivity and the stress response. This involves taking people into the laboratory and asking them either to complete a stressful task such as an intelligence test, a mathematical task, giving a public talk or watching a horror film or exposing them to an unpleasant event such as a loud noise, white light or a puff of air in the eye. The acute stress paradigm has enabled researchers to study gender differences in stress reactivity, the interrelationship between acute and chronic stress, the role of personality in the stress response and the impact of exercise on mediating stress related changes (e. Naturalistic setting Some researchers study stress in a more naturalistic environment. Naturalistic research also examines the impact of ongoing stressors such as work-related stress, normal ‘daily hassles’, poverty or marriage conflicts. These types of studies have provided important information on how people react to both acute and chronic stress in their everyday lives. Costs and benefits of different settings Both laboratory and naturalistic settings have their costs and benefits: 1. The degree of stressor delivered in the laboratory setting can be controlled so that differences in stress response can be attributed to aspects of the individual rather than to the stressor itself. Researchers can artificially manipulate aspects of the stressor in the laboratory to examine corresponding changes in physiological and psychological measures. Laboratory researchers can artificially manipulate mediating variables such as control and the presence or absence of social support to assess their impact on the stress response. The laboratory is an artificial environment which may produce a stress response which does not reflect that triggered by a more natural environment. Naturalistic settings allow researchers to study real stress and how people really cope with it. However, there are many other uncontrolled variables which the researcher needs to measure in order to control for it in the analysis. Physiological measures Physiological measures are mostly used in the laboratory as they involve participants being attached to monitors or having fluid samples taken. However, some ambulatory machines have been developed which can be attached to people as they carry on with their normal activities. They can also take blood, urine or saliva samples to test for changes in catecholamine and cortisol production. Self-report measures Researchers use a range of self-report measures to assess both chronic and acute stress. Self- report measures have been used to describe the impact of environmental factors on stress whereby stress is seen as the outcome variable (i. They have also been used to explore the impact of stress on the individual’s health status whereby stress in seen as the input variable (i. Costs and benefits of different measures Physiological and self-report measures of stress are used in the main to complement each other. The former reflects a more physiological emphasis and the latter a more psycho- logical perspective. A researcher who has a greater interest in physiology might argue that physiological measures are more central to stress research, whilst another researcher who believes that experience is more important might favour self-report. Most stress researchers measure both physiological and psychological aspects of stress and study how these two components interact. However, in general the different types of measures have the following costs and benefits: 1. Physiological measures are more objective and less effected by the participant’s wish to give a desirable response or the researcher’s wish to see a particular result. Self-report measures reflect the individual’s experience of stress rather than just what their body is doing.

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Psychoanalytical Theory: The psychoanalytic approach defines a paraphiliac as one who has failed the normal developmental process toward heterosexual adjustment (Sadock & Sadock purchase 50 mg pletal visa, 2007) cheap pletal 50 mg amex. This occurs when the indi- vidual fails to resolve the Oedipal crisis and identifies with the parent of the opposite gender cheap pletal 100mg on line. This creates in- tense anxiety pletal 100mg with amex, which leads the individual to seek sexual gratification in ways that provide a “safe substitution” for the parent (Becker & Johnson proven pletal 100mg, 2008). Sexual arousal from being humiliated, beaten, bound, or otherwise made to suffer (through fantasy, self-infliction, or by a sexual partner). Sexual arousal by inflicting psychological or physical suffering on another individual (either consenting or nonconsenting). Sexual arousal from observing unsuspecting people either naked or engaged in sexual activity. Masturbation often accompanies the activities described when they are performed solitarily. Male Orgasmic Disorder (Retarded Ejaculation): With this disorder, the man is unable to ejaculate, even though he has a firm erection and has had more than adequate stimulation. The severity of the problem may range from only occasional problems ejaculating to a history of never having experienced an orgasm. Vaginismus: Vaginismus is characterized by an involun- tary constriction of the outer third of the vagina, which prevents penile insertion and intercourse. Sexual and Gender Identity Disorders ● 205 Predisposing Factors to Sexual Dysfunctions 1. Sexual Desire Disorders: In men, these disorders have been linked to low levels of serum testosterone and to elevated levels of serum prolactin. Evidence also exists that suggests a relationship between serum testosterone and increased female libido. Various medications, such as antihypertensives, antipsychotics, antidepressants, anxio- lytics, and anticonvulsants, as well as chronic use of drugs such as alcohol and cocaine, have also been implicated in sexual desire disorders. Sexual Arousal Disorders: These may occur in response to decreased estrogen levels in postmenopausal women. Medications such as antihistamines and cholinergic blockers may produce similar results. Erectile dysfunc- tions in men may be attributed to arteriosclerosis, dia- betes, temporal lobe epilepsy, multiple sclerosis, some medications (antihypertensives, antidepressants, tran- quilizers), spinal cord injury, pelvic surgery, and chronic use of alcohol. Orgasmic Disorders: In women these may be attributed to some medical conditions (hypothyroidism, diabetes, and depression) and certain medications (antihyperten- sives, antidepressants). Medical conditions that may in- terfere with male orgasm include genitourinary surgery (e. Various medications have also been implicated, including antihypertensives, antidepressants, and antipsychotics. Sexual Pain Disorders: In women these can be caused by disorders of the vaginal entrance, irritation or damage to the clitoris, vaginal or pelvic infections, endometrio- sis, tumors, or cysts. Painful intercourse in men may be attributed to penile infections, phimosis, urinary tract infections, or prostate problems. Sexual Desire Disorders: Phillips (2000) has identified a number of individual and relationship factors that may contribute to hypoactive sexual desire disorder. Individual causes include religious orthodoxy; sexual identity con- flicts; past sexual abuse; financial, family, or job problems; depression; and aging-related concerns (e. Among the relationship causes are interpersonal conflicts; current physical, verbal, or sexual abuse; extramarital affairs; and desire or practices differ- ent from partner. Sexual Arousal Disorders: In the female these may be attributed to doubts, fears, guilt, anxiety, shame, con- flict, embarrassment, tension, disgust, resentment, grief, anger toward the partner, and puritanical or moralistic upbringing. A history of sexual abuse may also be an im- portant etiologic factor (Leiblum, 1999). The etiology of male erectile disorder may be related to chronic stress, anxiety, or depression. Early developmental factors that promote feelings of inadequacy and a sense of being un- loving or unlovable may also result in impotence. Orgasmic Disorders: A number of factors have been im- plicated in the etiology of female orgasm disorders.

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She was a daughter 100 mg pletal with mastercard, sister purchase pletal 100 mg visa, wife order pletal 100mg online, mother pletal 100 mg without prescription, friend generic pletal 50mg, Levine was born in Chicago and was raised with educator, administrator, student of humanities, a sister and a brother with whom she shared a close, scholar, enabler, and confidante. She thinks that this ‘holistic’ in favor of ‘organismic,’ largely because the might have been why she had such a great interest term ‘holistic’ had been appropriated by pseudosci- in nursing. Levine’s mother was a strong woman entists endowing it with the mythology of tran- who kept the home filled with love and warmth. I used ‘holism’ in the second edition She was very supportive of Levine’s choice to be a in 1973 because I realized it was too important to nurse. I believed that it was nursing as I did” (Levine, 1988b) because she was the proper description of the way the internal envi- devoted to caring for her father when he was ill. Being in nursing school was a new expe- and yet books do have a life all their own. They gather rience for her; she called it a “great adventure” life from the use to which they are put, and when they (Levine, 1988b). She received her diploma from succeed in communicating among many individuals Cook County in 1944. She later received her bach- in many places, then their intent is most truly served. She was a civilian nurse at the (1969b) provided a model to teach medical surgical Gardiner General Hospital, director of nursing at nursing and created a dialogue among colleagues Drexel Home in Chicago, clinical instructor at about the plan itself. The text has continued to cre- Bryan Memorial Hospital in Lincoln, Nebraska, ate dialogue about the art and science of nursing and administrative supervisor at University of with ongoing research serving as a testament to its Chicago Clinics and Henry Ford Hospital in value (Delmore, 2003; Mefford, 1999). She was a visiting professor Levine’s original reason for writing the book was to at Tel Aviv University in Israel and Recanti School find a way to teach the foundations of nursing that of Nursing at Ben Gurion University of the Negev would focus on nursing and was organized in such in Beer Sheeva, Israel. She was professor emeritus a way that nursing students would learn the skill as in Medical Surgical Nursing, University of Chicago, well as the rationale for the skill. She felt that nursing Tau International, from which she received the research was generally ignored. Her intent was to Elizabeth Russell Belford Award as distinguished bring practice and research together to establish educator. The first chapter of her text was entitled, Introducing the Theory “Introduction to Patient Centered Nursing Care,” a model of care delivery that is now acclaimed to be F. Davis Company published the first edition of the answer to cost-effective delivery of health-care Myra Levine’s textbook Introduction to Clinical services today. She believed that patient-centered Nursing in 1969 and the second and last editions in care was “individualized nursing care” (Levine, 1973. The nursing care chapters in her text focus on nurs- Her way of organizing the material was a shift ing care of the patient with: from teaching nursing based on the disease model. She “borrowed” information from other disciplines while retaining the basic structure of nursing in the model (Levine, 1988a). As she continued to write about her model, she integrated information from other sciences and increasingly cited personal experiences as evidence of her work’s validity. The following is a list of the influences in the development of her philosophy of nursing and the Conservation Model. Levine indicated that Florence Nightingale, through her focus on observation (Nightingale, 1859) provided great attention to energy conservation and recognized the need for structural integrity. Levine relates Nightingale’s discussion of social integrity to Nightingale’s concern for sanitation, which she says implies an interaction between the person and the environment. Irene Beland influenced Levine’s thinking about nursing as a compassionate art and rigid intellectual pursuit (Levine, 1988b). Levine also credited Beland (1971) for the theory of specific causation and multiple factors. Feynman (1965) provided support for Levine’s position that conservation was a natural law, arguing that the development of theory cannot deny the importance of natural law (Levine, 1973). Bernard (1957) is recognized for his contribution in the identification of the interdependence of bodily func- tions (Levine, 1973). Levine (1973) emphasized the dynamic nature of the internal milieu,using Waddington’s (1968) term “home- ophoresis. Use of Bates’s (1967) formulation of the external environment as having three levels of factors (perceptual, operational, and conceptual), challenging the integrity of the individual, helped to emphasize the complexity of the environment. The description of illness is based on Wolf’s (1961) description of disease as adaptation to noxious envi- ronmental forces. Selye’s (1956) definition of “stress” is included in Levine’s (1989c) description of her organismic stress response as “being recorded over time and...

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He or she may be asked to analyze the information and at a later date be called to testify as to what possibly caused them buy 100mg pletal mastercard. Te initial investigative procedures buy generic pletal 100 mg on-line, if properly performed purchase pletal 50 mg line, can be of great help in preventing or minimizing errors in interpretation buy cheap pletal 100 mg online. Te appropriate hand- ling of these three responsibilities of case management in the beginning of a bitemark case may well prove valuable as the case progresses through the criminal justice system purchase 50mg pletal overnight delivery. Te dental profle determined at the time the bite is analyzed could turn out to be among the most important articles of evidence and certainly may help to eliminate suspects. Te dental profle has been used to support “probable cause” for the authorities to secure a court order or search warrant. As discussed previously, in an ideal world, the odontologist will collect and analyze the evidence from a patterned injury and will have the oppor- tunity to conduct his or her investigation from crime scene through court presentation. Ofen the odontologist, especially if he or she is asked to review a case by the defense, will have only photographs and evidence collected by others with which to work. Rarely will 342 Forensic dentistry he or she be provided scene photographs, and ofen only the images of the pat- terned injury from police or morgue photographs. It bears repeating that it is imperative that the forensic odontologist strongly request scene photographs and transcripts of the statements from the victim, medical care providers, pathologists, medical examiners, and eyewitnesses whenever possible. He or she should know the history and the circumstances of the event in order to be able to complete the most accurate analysis of the evidence and formulate the most accurate opinion. Analysis of a patterned injury without all of the information greatly increases the possibility of errors. Bitemarks are unique items of physical evidence that should be handled diferently from other forensic evidence. Bitemarks are items of physical evidence that have unique forensic value with the potential to include and exclude. Even though there may be voluntary consent, a written, signed consent by the subject is strongly advised. Te subject may be a victim who bit a perpetrator of a crime or a suspected biter in a crime, usually a rape, assault, or homicide. It is extremely important that the investigators, police, prosecutors, or crime scene technicians know in advance of the potential of a person changing his or her teeth if made aware that there is a possibility that teeth can be associated to a bitemark. Consequently, the subject (suspected biter) should be “kept in the dark” until such time as steps to legally collect dental information have been satisfed. A suspect in a violent crime, especially in a homicide, will not be inclined to give dental evidence voluntarily. Te legal process begins with probable cause, and here the dental profle of the biter from the bitemark or bite wound may assist police, pros- ecutors, and judges to satisfy the legal requirement to obtain a warrant or court order to obtain the dental evidence. A search warrant is most ofen used for the search of the physical prop- erty of a suspect, such as his house, car, or computer, but can also be used to obtain dental evidence in a bitemark case. A search warrant has certain advantages over the court order to obtain dental evidence. With a search warrant the suspect and his or her defense attorneys are not necessarily made Bitemarks 343 aware of the evidence collection in advance. Also, during examination based upon a search warrant of the body of the suspect, the defense counsel will not be present. Te police and prosecutor will draw up the warrant and present it to the judge for his signature. Te warrant will outline the details of the crime and the areas of probable cause, circumstantial or otherwise, that may link the suspect to the crime. Te execution of the warrant usually takes place at a location that has a medical or dental facility, but may be done at any location the authorities deem appropriate. He may refuse to open his mouth, object to the taking of biological samples, and resist being photographed. It must contain language that will allow the taking of the required evidence with the use of “reasonable force. Despite the efectiveness of search warrants, the majority of bitemark evidence is obtained following the issuance of a court order.

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