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The lymph system heart attack lyrics 007 buy 75mg plavix overnight delivery, on the other hand arrhythmia and palpitation effective plavix 75mg, requires movement and exercise to make lymph fow heart attack in women buy generic plavix 75mg line. The movements we make during our everyday activities involve the expansion and contraction of the various muscles in our bodies blood pressure variation order generic plavix from india. These muscle movements in turn serve to massage and squeeze the tissues around them blood pressure chart guidelines plavix 75 mg line, forcing excess fuid out of the tissues and into the smallest lymph vessels prehypertension coffee order plavix. The process is similar to what happens when you squeeze and release a sponge underwater. Squeezing a wet sponge drives water out through the pores and from the network of channels within the sponge. Releasing the sponge under water then absorbs water back into the sponge where it stays until the sponge is next squeezed. The larger lymph vessels further along the lymph system have special muscle cells built into their walls. As one section contracts, the lymph is pumped through the open valve into the next section, with the valve prevent ing reverse fow so that the lymph always moves in one direction, much like lock gates on a canal, which ensure the water can only fow one way. Lymphoedema occurs when the lymph system fails: lymph vessels can get blocked or close down at some point along the drainage route; valves can fail allowing the lymph to fow backwards, towards the tissues; and the ability of the lymph vessels to contract can fail, in which case lymph is not pumped towards and beyond the glands. Any impairment to the lymph drainage system causes the fuid to back up and collect within the tissues instead of draining away. As we will see in the next chapter, one of the most immediate and obvious symptoms of lymphoedema is therefore swelling, but there are many more potential symptoms and complications. There are many reasons why it might fail (see Chapter 4) but the end result is generally the same: a build-up of fuid in the tissues causing chronic swelling with thickened skin. Similarly, if there is an impairment to the lymph glands in your right groin area, this could lead to problems in the adjoining side of the lower abdomen below the belly button, or anywhere along your right leg. In this case, due to the infuence of gravity, you would be most likely to experience swelling in the foot, ankle and lower leg. Lymphoedema most commonly occurs in the arm or leg, but it can appear in other parts of the body as well. This is because these areas of the body have lymph drainage on both sides, so there would have to be a problem on both sides to cause lymphoedema to occur. For example, lymphoedema of the foot could result from impaired drainage within the small lymph capillaries of the foot; from a failure of the main lymph vessels of the leg to pump properly; or from obstruction in the groin. It can develop in diferent ways, but generally starts as mild, reversible swelling, that may go away at frst, but at some point will become more permanent. In practice this swelling might mean that the rings on your fngers start to feel tight, your face and tummy become bloated, or your ankles begin to balloon. This swelling can then in turn cause further symptoms such as heaviness, aching and a general discomfort. Oedema can often occur during pregnancy, before a period or sometimes in the heat (due to a redistribution of fuid). In fact, to make diagnosis more complicated, all cases of oedema involve the lymph system because oedema occurs when blood vessels under the skin release more fuid into the tissues than the lymph vessels can drain away. The diference between oedema and lymphoedema is that oedema afects the lymph system, whereas lymphoedema is caused by a fault in the lymph system and involves a build-up of lymph rather than just fuid. Since lymph contains other elements including waste products and immune cells, the swelling produced by lymphoedema tends to have a more solid texture to it. The fuid in oedema, on the other hand, can be displaced by pressure, and so indents, or pits, very easily if a fnger is pressed on the skin. A good example of pitting is the indentation left by pressure from the rim of a sock. This can be tested to some extent by pressing a fngertip frmly on the skin surface for twenty seconds (assuming it is not painful). The surface of the skin can also develop a warty complexion and can start to look like the bark of a tree or elephant hide. There is some evidence to suggest that these deposits can partly be explained by a failure of lymph drainage within the cells of the arterial walls. The lymph system is also important for maintaining a healthy body fuid balance, which means that any impairment could possibly contribute to raised blood pressure. There is also a strong association between lymphoedema and obesity (see Chapter 4) and this associ ation is known to work in both directions: obesity is the biggest risk factor for lymphoedema but lymphoedema can also cause obesity. On other occasions we feel unwell and feverish with aching and headache, which are signs the immune system has had to go into overdrive to fght the infection. However, that area becomes very susceptible to infections, which are difcult to eradicate and can keep coming back. It can cause profound illness with high temperatures and low blood pressure, with the accompanying threat of damage to vital organs. This is one of the reasons skin care is so important in managing lymphoedema (see page 95), although there are other ways the harmful bacteria can enter the body. It remains unprov en but it is more than likely that in some cases, because of the weakened immune system, the infection is never properly eradi cated. Antibiotics used to treat infection are intended to aid your immune system, so if your immune response is impaired, they are not always efective. This would explain why some patients with lymphoedema and recurrent cellulitis fnd that they can bring on an attack just by getting overtired, overstressed or by over-exercising. Attacks can come on without warning, sometimes mild, sometimes severe, with no rhyme or reason as to why one attack might be more debilitating than another. This element of unpredictability can be extremely unsettling and discourages people from making plans for holidays or long-distance travel in case infection strikes. A signifcant proportion of those patients will have lymphoedema, but many may not yet have a diagnosis. He had noticed that his ankles would swell on fights; the longer the fight the worse the swelling. He knew it was fuid because he could make an indentation by pressing his thumb into his shin. The swell ing did not hurt, and if he elevated his legs and wore fight socks on trips, he could just about control it. He thought he had the fu but then realised his right leg was painful, bright red and hot to the touch. After fve days on a drip having intravenous antibiotics and then a further two-week course of antibiotics he made a full recovery. Although he did not feel as ill as he had during the frst attack and did not have to spend time in hospital, he was forced to take three weeks off work. After ten days on a drip he was allowed home on oral antibiotics but remained concerned that the leg still hurt and was red. Returning to work a month later, he almost immediately suffered another attack of cellulitis, the fourth, in the same leg. Multiple, repeat infections have resulted in further damage to lymph vessels and severe staining of the skin. Furthermore, without diagnosing the condition and addressing the underlying lymph drainage problem, the swelling and infection will only get worse: the greater the swell ing the more likely it is that an infection will take hold, and every episode of infection can cause further damage to lymph vessels, so making the lymphoedema worse. Persistent or recurrent swelling in the feet, ankles or legs suggests a lymph problem, and should be checked out. The lymphoedema affected not only both of her legs but also the lower abdomen and external genitalia. The pres sure of the lymph fuid within the skin of the genitals led to small blisters which would then leak lymph, making her feel as if she had wet herself. Not long after developing lymphoedema, she started to suffer from bouts of cellulitis. The severity of the attacks would vary but she frequently had to be admitted to hospi tal to be treated for septicaemia. Her swelling got worse as did the leaking of lymph fuid, and her overall health deteriorated, both physically and psychologically. She was a police offcer but gradually became unable to stay on her feet all day or chase criminals on the street. Sadly she was forced into early retirement on medical grounds from a job she loved at the age of forty-fve. After that, the attacks of cellulitis were not as frequent or severe, but they still did not stop altogether. Her legs remained huge and heavy, making it diffcult to walk any distance or fnd clothes to ft. Despite Sarah receiving excellent care, the vicious cycle of relent less swelling and attacks of infection could not be broken. Because she had one huge leg, and most of the swelling was found to be fat related to the lymphoedema, she was funded to have liposuction to reduce its size. This did not cure her lymphoedema and she still had to wear compression garments night and day to control the remaining fuid, but the relentless recurrent attacks of cellulitis fnally ceased, also ending her fear of them, and her quality of life improved enormously. Cellulitis is possibly the worst side efect of lymphoedema, and we need to better understand what causes such frequent bouts so that we can improve both treatment and prevention. When the condition occurs without any warning, with no known interference to the lymph system from an outside source, it is called primary lymphoedema. In these cases, it is assumed that the lymph system has failed to form properly in the frst place so that it therefore possesses a structural or functional weakness. If there is an identifable cause arising outside the lymph system interfering with lymph drainage, for example the removal of lymph glands in cancer treatment, this is called secondary lymphoedema. For patients whose lymphoedema has started without identifable damage to lymph drainage it is likely there has been some pre-existing, presumed genetic, weakness of the lymph system, which efectively programmes it to fail. This genetic trait might be inherited from parents, particularly if there is a history of the condition in the family.

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Also recorded from Lake Biwa [Fisheries Management Division of the Shiga Prefecture Agriculture and Fisheries Department 2007] blood pressure of 80/50 purchase plavix with paypal. Found in Ban Hang Khone arrhythmia grand rounds buy generic plavix online, a village on an island in the middle of the mainstream Mekong River just below the Great Khone Waterfalls in Khong District arteria vertebral buy 75mg plavix with mastercard, Champasak Province [Baird 1998] arrhythmia nclex discount 75mg plavix mastercard. Two strains exists: German carp introduced from India and Israeli/mirror carp from Israel blood pressure jadakiss lyrics purchase 75 mg plavix with visa. The common and Chinese carps were introduced during the early history of Singapore arrhythmia burlington ma cheap 75mg plavix with amex. They formed the basis for an important aquaculture after 1945, but rising land values have now rendered this activity uneconomic and it has declined considerably in recent years probably due to predation on juveniles by Parachromis managuensis [B. Transported from the Amu Darya into the Murgab in 1894, from Murgab to Tedgen in 1952. It has been widely introduced around the country: Kara Kum channel, Lake Sarykamysh, the Murgab, salty Lake Yaskhan (the western Uzboi), and other water bodies. Known from the Italian peninsula and islands [Bianco and Ketmaier 2001; Bianco 2014], and recorded from Ombrone, Albegna and Fiora [Bianco and Ketmaier 2001]. They are also found in several Victorian and South Australian coastal streams [Fisheries and Wildlife Division, Victorian Ministry for Conservation 1976] and from Lake Frome in the arid region of South Australia [Kailola et al. European carp were introduced in Tasmania in 1960 or 1961 [Fisheries and Wildlife Division, Victorian Ministry for Conservation 1976], but have since been eradicated there [Kailola et al. It is only since the most recent introduction in 1959-60 that European carp have become widespread, establishing populations in many areas within the Murray-Darling River system. No natural reproduction; dependent on continous [sic] stocking with one or two years old fish. It is listed as present in containment facilities in Republic of the Congo, Ecuador, Saudi Arabia, and Tajikistan. Means of Introduction Outside the United States From Froese and Pauly (2018a): It is introduced from Uganda to Kenya in 1969 for aquaculture [Seegers et al. Stocked in various small private dams with no records of escapee populations (Pers. When the Rio Grande de Mindanao flooded, the fish escaped and established in the Pulangi and its tributaries between Dulauan and Fort Pikit. It has escaped from aquaculture facilities and has now widely established self sustaining populations [Bogutskaya and Naseka 2002b]. The importation of carp was probably because of the desire of some of the colonists to imitate a European environment in Victoria. The Acclimatisation Society of Victoria (1861) which was established from the short-lived Zoological Society of Victoria (1857) aimed to offer salmon, trout, carp and other fish for anglers (Gillbank 1980, in Koehn Brumley & Gehrke 2000). It has been introduced as a food fish, into temperate freshwaters, throughout the world. Diagnosed from other cyprinid species in Europe by having the following characters: 2 pairs of barbels; dorsal fin with 15-20branched rays; caudal fin deeply emarginate [Kottelat and Freyhof 2007]. Pharyngeal teeth 1, 1, 3:3, 1,1, robust, molar-like with crown flattened or somewhat furrowed. Last simple anal ray bony and serrated posteriorly; 4 barbels; 17-20 branched dorsal rays; body grey to bronze [Kottelat 2001]. Hardy and tolerant of a wide variety of conditions but generally favor large water bodies with slow flowing or standing water and soft bottom sediments. River regulation and hybridization with domesticated stocks, East Asian congeners and their hybrids have caused continuous decline of wild populations [Kottelat and Freyhof 2007]. Reproductive success is restricted to years when the water level starts rising in May and when high temperatures and flooding of terrestrial vegetation last for a long period during May and June" [Kottelat and Freyhof 2007]. Young are probably preyed upon by northern pike, muskellunge, and largemouth bass. Pflieger (1975) noted that the common carp tends to concentrate in large numbers where cannery or slaughter-house wastes are emptied into streams. The common carp have shown to be an important seed dispersal vector for aquatic plants (VonBank 2018). The common carp is very active when feeding and its movements often disturb sediments and increase turbidity, causing serious problems in some regions especially where the species is abundant. The species also retards the growth of submerged aquatic vegetation by feeding on and uprooting plants (King and Hunt 1967). Found in 2 out of 6 live fish markets near the Lakes Erie and Ontario [Rixon et al. In Victoria in 1971 special licenses were issued to fishers for European carp in rivers normally closed to fishing. They worked the rivers in the Murray River valley [Fisheries and Wildlife Division, Victorian Ministry for Conservation 1976]. Low catches have seen electro fishing activities cease there in recent years [Hume et al. In the Gippsland Lakes, European carp are taken using electro-fishing gear, beach seines and gillnets. Catches for the State fluctuated widely between 1964-65 and 1983-84, peaking at 487 t in 1975-76 and 464 t in 1979-80. For the same period, 66% of the European carp catch came from the Gippsland Lakes. Fish Commission documented the early years of common carp propagation and stocking in the United States. It is also important as ornamental/aquarium fish, particularly if subspecies are considered (koi) (Rixon et al. Froese and Pauly (2018b) list Acanthocephalus alabamensis, Argulus foliaceus, Arugulus carpionis, Aspidogaster dectis, A. Common carp populations function as ecosystem engineers by regulating bottom-up and top-down processes. Ecosystem effects imposed by common carp may be greater than those caused by other native benthivores and occur even at relatively low common carp densities, with increases in undesirable ecosystem effects with increases in common carp biomass (Parkos et al. Ecosystem engineering by common carp can transform lakes from clear to turbid water, with ecosystem-wide consequences (Scheffer, 1998; Haas et al. The addition of common carp produced a system with highly turbid, nutrient-rich water, few aquatic macrophytes, low numbers of macroinvertebrate predators, many zooplankton grazers, and abundant phytoplankton. Even though some effects of common carp were stronger at a high biomass of fish, in general, the influence of common carp on aquatic systems was strong at both low and high fish abundance and distinct from the effects of a native benthic fish. Populations collected from Lake Gariep had shorter maturation and generation times as well as had faster growth performance compared to other populations in Europe. This emphasizes the potential of the species to rapidly colonize and dominate new freshwater systems [Winker et al. Bellrichard (1996) found that alterations in macrophyte biomass are due more to direct effects of common carp. It stirs up the bottom during feeding, resulting in increased siltation and turbidity (Lee 20 et al. This feeding behavior also destroys rooted aquatic plants that provide habitat for native fish species and food for waterfowl (Dentler 1993). Bonneau and Scarnecchia (2015) found that carp eradication and exclusion from reservoir tributaries allowed for increased benthic invertebrate community diversity and abundance, and the return of submerged aquatic vegetation. For this reason, it may be responsible for the decline of the razorback sucker Xyrauchen texanus in the Colorado River basin (Taylor et al. In another case, Miller and Beckman (1996) documented white sturgeon Acipenser transmontanus eggs in the stomachs of common carp in the Columbia River. In California, carp have been implicated in the decrease in water clarity in Clear Lake, Lake County, and in the gradual disappearance of native fishes (Moyle 1976). McCarraher and Gregory (1970) wrote that in 1894 there was documentation that Sacramento perch Archoplites interruptus were becoming more scarce because carp was destroying their spawning grounds. Laird and Page (1996) stated that common carp may compete with ecologically similar species such as carpsuckers and buffalos. Because this species has been present in many areas since the first surveys, its impacts on many of the native fishes are difficult to determine. Once established in a water body, common carp is difficult and expensive to eliminate. On every continent where it has been introduced it has reduced water quality and degraded aquatic habitats (McCrimmon 1968, Roberts et al. Modification of nutrient regime: Carp increase nutrients in the water column in two ways: by sediment resuspension and by excretion (Lamarra 1975, Brabrand et al. Carp provide an important source of protein in some third world countries (FishBase 2009). For instance, following the installation of a carp barrier at Cootes Paradise Marsh (Lake Ontario), average turbidity was reduced by 40% in open water and 60% in vegetated areas, although further implications for plants and wildlife were difficult to assess due to variation in environmental conditions (Lougheed et al. The authors found that small densities of common carp (<30 kg/ha) did not have significant effects on vegetation or waterfowl, but a subsequent increase to over 250 kg/ha was strongly correlated with a decrease in vegetative cover from its original value of 94% to just 17% (Bajer et al. The authors suggested a threshold of 100 kg/ha past which common carp exert extensive ecological damage to shallow lakes (Bajer et al. For instance, in Mexico, populations of a native crayfish (Cambarellus montezumae) notably decreased with increasing carp density (Hinojosa-Garro and Zambrano 2004). Miller and Crowl (2006) executed research in a eutrophic lake involving in situ observations of C. They documented both direct and indirect effects of common carp on overall species composition, abundance, and plant species diversity. Cyprinus carpio also appeared to have indirect effects on macroinvertebrate community composition (Miller and Crowl 2006). A similar experiment set up enclosures within experimental ponds and noted that higher biomasses of C. In comparison, channel catfish (Ictalurus punctatus), a native benthivore, affected phosphorus concentration and zooplankton communities, but had no significant effect on turbidity, macroinvertebrates, macrophytes, or suspended solids (Parkos et al. In a biomanipulative experiment, Schrage and Downing (2004) removed >75% of the C. In comparison to the adjacent reference site, they found that 22 the removal of common carp had cascading effects, including an increase in water quality related to decreased suspended solid and phytoplankton biomass. The major limiting factor on maximum phytoplankton biomass appeared to switch from phosphorous abundance to zooplankton abundance, as suspended inorganic sediment settled to the bottom (Schrage and Downing 2004). The authors found that density of common carp was positively related to nutrient concentrations in the water column, suspended solids, and chlorophyll a concentrations. Furthermore, carp density was negatively related to dissolved oxygen concentrations, photic depth, and submersed macrophyte density (Badiou and Goldsborough 2010). These findings support the hypothesis that common carp may facilitate phytoplankton growth via increased nutrient loading in the water. Nevertheless, significant reduction in submersed macrophyte biomass was not observed, possibly because turbidity was relatively limited and the euphotic zone continued to span the entire water column at all carp densities (Badious and Goldsborough 2010). Their results also suggested that suspension of solids increases as the colonized water body decreases in size, possibly due to a limited prey populations and increased forage activity by common carp. In this system, common carp populations were estimated to resuspend 37 to 361 kg of sediment per day, relative to pre-stocked conditions (Badiou and Goldsborough 2010). King and Hunt (1967) used carp exclosures in a lake marsh and found a significantly higher weight of plant species inside the exclosures. At carp densities less than 300 lb/acre (336 kg/ha), plant growth was most affected in early and late summer but, at higher carp densities, plants were adversely affected throughout the growing season. Robel (1961) stocked enclosures with known numbers of carp in a Utah marsh and compared the amount of vegetation and turbidity levels with empty control enclosures. Vegetative productivity in control 23 enclosures was not different from that in enclosures with less than 200 lbs carp/acre (224 kg/ha) but was significantly higher than in enclosures with over 400 lb carp/acre (448 kg/ha). Carp densities of 200 kg/ha in two Minnesota ponds were sufficient to increase the amount of chlorophyll a, net community production, and community respiration. From in situ experiments, Lamarra concluded that these increases were caused by the rapid recycling of nutrients, especially phosphorus, by carp. Locations in southern Florida 2) were not used as source points for the climate match. Locations in southern Florida 3) were not used as source points for the climate match. Cyprinus carpio is considered to not be established in Florida outside of the panhandle area (Nico et al. The High, Medium, and Low Climate match Categories are based on the following table: Climate 6: Proportion of Climate Match (Sum of Climate Scores 6-10) / (Sum of total Climate Scores) Category 0. No further information is needed to evaluate the negative impacts the species is having where introduced. Cyprinus carpio is used for aquaculture, commercial, subsistence, and sport fisheries, aquaria, and bait, which has promoted its spread. There are many morphological variations of this species, including the ornamental mirror carp and koi. This species is now established in many locations worldwide, including the United States. Within the United States, only Alaska has not had a documented introduction of this species, and the species has established in all other states. The primary impacts of this species are habitat modification and reduction of the abundance of macrophytes and macroinvertebrates. When foraging for benthic organisms, this species uproots macrophytes and disturbs sediments.

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I found that going to the gym and running a lot and eating the right food not only made me feel so much better about myself but actually helped with the swelling of my leg blood pressure 140100 buy discount plavix 75mg online. A faulty lymph system afecting the digestive tract is considered rare but may occur more often than realised blood pressure medication lip plavix 75mg with amex. It is difcult to diagnose and would probably not be considered at all if it were not for the presence of lymphoedema blood pressure medication hydrochlorothiazide order plavix with a mastercard. However blood pressure pulse rate plavix 75 mg overnight delivery, there is another type of lymphoedema that most people have never heard of blood pressure below normal purchase discount plavix on line, but that afects millions of people around the world: flariasis blood pressure chart easy to read plavix 75mg for sale. There are W two main causes in particular: lymphatic flariasis and podoconiosis, both recognised by the World Health Organisation as neglected tropical diseases. Here he describes the very diferent challenges presented by lymphoedema when it is caused by lymphatic flariasis: Lymphatic flariasis is an infection caused by a mosquito: an infected mosquito bites a human and deposits micro scopic larvae (microflaria) into the skin. The larvae migrate to the nearest lymph vessel in the unsuspecting human, and then on to the bigger lymph vessels close to the lymph glands where they mature into adult worms. They mate and form worm nests, which physically block the fow of lymph within the vessel, and so lymphoedema starts. People are only affected by flariasis in regions with infected mosquitos and that means a tropical country. Arguably India has more cases of lymphoedema than any other country on the planet because of the high numbers of cases of lymphatic flariasis. As well as swelling, the disease also causes frequent fevers as the body fghts the worm infection. Eventually the fevers cease, when the worms die, but by then the lymph system has likely been permanently damaged. With each episode of infection the swelling gets worse, often reaching gigantic proportions. In one case we saw Mr Muhammed Shaban, a twenty year-old plumber from Thana, Mumbai. He had flarial lymphoedema of both lower limbs, which developed over four years before he accessed any treatment. The swelling had started with an episode of high fever and gradually oedema extended up one leg, reaching his thigh. He then had an injury resulting in a chronic wound on his leg, which did not respond to conventional treat ments and started to emit a foul smell. Sometime later he experienced multiple bouts of fever and abscesses formed in his groin. Over the next four months he started getting severe knee-joint pain, which affected his mobility. A nurse counsellor explained lymphatic flariasis to him and his mother as the cause of all his problems, and what he could expect from the programme of treatment. The patient, his mother and other family members who attended were instructed on how to continue care once he was back home. His treatment lasted twenty-one days, by which time the ulcers were healed, the odour had gone and the swelling was markedly reduced. He continued his treatment at home with little assis tance from his family members. He was able to attend his second follow up at the outpatient clinic without a walk ing stick as his leg was much smaller and less heavy. He returned to his job as a plumber part time and once again was earning his living on his own. The clinic started in 1999 and started to develop new treat ments integrating Indian Ayurvedic practices with Western methods. There is limited public funding for medical care in India so the clinic not only provided the treatment for Muhammed but also raised the sponsorship to cover 90 per cent of his treatment costs. Each camp has a patient education class, a skincare demonstration and a yoga and exercise class. Skin disease is very common in India because of the heat and poorer living conditions and sanitation, which means a much higher risk of cellulitis in lymphoedema, hence why skin care is so important. Patients and their families are taught to wash the skin twice a day with soap and water. For more intensive clean ing, soaking solutions made from boiling fne powders of particular medicine plants are used. Massage with herbal oil is taught to encourage lymph drainage, but any very infected skin areas may be treated with modern drugs. A treatment programme that employs locally available supervisors and simple technology that is easy to admin ister and teach has been successful. Lymphatic flariasis can be eliminated through preven tive chemotherapy with single doses of two medicines for people living in areas where the infection is present. There is still a lot of work to do, particularly in India, to eradicate this neglected tropical disease, but even if new cases are prevented those already affected with flarial lymphoedema will be around for many years to come. It afects people mainly in tropical and sub-tropical regions, and has occurred in ffteen countries across Africa, Central America and Asia. Dr Claire Fuller, Chair of the International Foundation for Dermatology, is a consultant dermatologist who has developed a research interest in tropical dermatology and in particular podoconiosis. It occurs mainly in farmers living in the tropical highlands such as Ethiopia, who work their land barefoot. It is thought that the mineral particles contained in these fertile soils pass through the skin and into the lymph vessels. It is further evidence of why skin and foot care are so important in both preventing and treating lymphoedema. Once the condition has developed, the person is more susceptible to bacterial infections and episodes of fever, as happens with all forms of lymphoedema. The Mossy Foot clinic in Soddo, Ethiopia, treats peo ple suffering from the condition, and that is where I met Bethsaida. The swelling of her legs had worsened over those years, especially after every acute attack, which was accompanied by fever and increased swelling. Patients suffering from these attacks are completely incapacitated and bed-ridden for a few days. During an early infection Bethsaida had taken a course of antibiotics but she could ill-afford the cost of these and so during subsequent epi sodes simply had to wait for the fu-like symptoms to sub side without medication. By the time she attended the clinic, she was suffering acute attacks twice a month; they seemed to be triggered when she was getting the produce ready from the family small holding for market day. Even between episodes she had heavy, large, swollen legs, too big to be able to wear shoes, ugly to look at and studded with skin lumps. Podoconiosis can be completely prevented if individ uals with the genetic risk avoid frequent barefoot contact with the soil. A simple regimen of washing the skin of the feet and lower legs daily, mois turising the skin once it has been carefully dried, donning socks (or if possible compression stockings) and then shoes can have a signifcant beneft. Shoes not only protect the foot from further exposure to the harmful soil but also limit the swelling of the feet during the day. A podo agent is a pre vious patient who uses the knowledge they have gained through their own experiences to help others who need treatment. She was delighted to support the clinics and gave back a day per week of her time to wel come new patients and encourage them to participate in the treatment that had transformed her life so dramatically three years earlier. Root explained the basics of the simple treatment, showing Bethsaida how to wash the leg and foot, to dry the skin carefully, especially between the toes, and to apply a greasy moisturiser to the skin of the lower leg, foot and toes. Once this had soaked in, Bethsaida was given a pair of clean socks and then some shoes that had been selected to ft her swollen and misshapen foot. Podoconiosis is not only an uncomfortable illness, it is also massively stigmatising. Before attending the clinic, Bethsaida was no longer permitted to eat at the same time as her family as they found the smell so hard to cope with. The risk of being seen also prevented those affected from being able to join social gatherings. Fortunately there is a positive end to this story; some of the treatment programmes have really focused on com munity education and myth debunking. On my last visit to the area, strangers would approach the project team in public places and show their legs to see if they might have early podoconiosis. At another clinic I attended, I was introduced to Aykale, another podo agent, and shoemaker, who helps out her local community and has seen a huge difference in atti tudes. She told us she started to get symptoms when she was about twenty; her mother and brother also had podo. Her father had left the family when her mother developed symptoms soon after Aykale was born. The family were taken in by a local church, which provided food and shelter for them. She realised she was very lucky to have this support but aspired to a better, independent life. Coming from a podo family, she had been too embar rassed to attend school and so had no formal education. Once her symptoms had started she also knew she had little chance of ever being married as no one wanted a podo patient as a life partner. She started to try to make a living by collecting and selling avocados, but the selling days usually triggered a painful acute attack with fever, resulting in incapacitation for several days so she had so stop. She then heard about the Mossy Foot projects and started to come to her area clinic. Some time later, having improved even further, she was no longer having any acute attacks and her skin texture had virtually returned to normal. She trained as a shoemaker to help make the bespoke shoes needed for the new patients with enlarged feet and limbs. She became so fast at making the shoes, she usually completed her weekly quota (set by her employers, the Podoconiosis Project) by Thursday. She could then spend Friday and Saturday running her own stall in the market, making, mending and cleaning shoes, so enabling her to supplement her income. She also saved enough money to be able to rent a small room in which she could live safely and support her mother. The message from a fellow patient sharing the impact of successful treatment on her life is very powerful, and can encourage others to seek help and make a positive change in their lives. Sometimes all it takes are small steps to make all the diference in transforming the lives of suferers of flariasis and podoconiosis.

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According to the Cannon-Bard theory hypertension treatment jnc 7 buy plavix australia, certain experiences activate the thalamus blood pressure chart home use purchase 75mg plavix mastercard, and the thal amus sends messages to the cortex and to the other body organs - arrhythmia purchase generic plavix line. Thus blood pressure over 60 cheap 75 mg plavix overnight delivery, when we use the word emotion pulse pressure of 20 generic plavix 75 mg overnight delivery, we are referring to the simultaneous burst of activity in the brain and gut reactions blood pressure 4020 discount 75 mg plavix otc. Later, more sophisticated experiments showed that the thalamus is not involved in emotional experience, but the hypothalamus is. Cannon also emphasized the importance of physiological arousal in many different emotions. He was the first to describe the fight-or-flight reaction of the sympathetic nervous system that prepares us for an emer gency. Cognitive Theories Cognitive theorists believe that bodily changes and thinking work together to produce emotions. This, How does the Cannon in turn, depends on labeling the physical arousal with an emotion to Bard theory differ from the James-Lange theory The Schachter-Singer Experiment Stanley Schachter and Jerome Singer designed an experiment to explore this theory (1962). They told all their Chapter 12 / Motivation and Emotion 333 participants they were testing the effects of a vitamin on eyesight. The informed group was told that the injec tion would make their hearts race and their bodies Lie Detection tremble (which was true). The misinformed group was Throughout time, people have tried to told that the injection would make them numb. A control group tem, including blood pressure, heart rate, received a neutral injection that did not and breathing rate. Like the third group, these under the assumption that people feel ner participants were not given any information about pos vous when they lie, so their physiological sible side effects. How effective After the injection, each participant was taken to a are polygraphs There they found anoth become nervous when questioned and so er person who was actually part of the experiment. The Guilty-Knowledge test, though, is a participants thought the accomplice had had the same modified version of the polygraph test. As this happened, the accomplice applied the questions that could be threatening only to second independent variable. For half the participants he someone who knows the unpublicized facts got happier and happier, eventually shooting the ques of the crime. However, those from the second and third groups, who either had an incorrect idea or no idea about the side effects, joined in with the accomplice. Internal components of emotion (such as those adrenaline produces) affect a person differently, depending on his or her interpretation or perception of the social situation. When people cannot explain their physical reactions, they take cues from their environment. Yet when people knew that their hearts were beating faster because of the shot, they did not feel Reading Check particularly happy or angry. Critics of this theory point out that you do not need to first experience physiological arousal to feel an emotion. When you go to use your computer and see that all of your files have been destroyed, you get angry, and then your body reacts with anger. Critics also say that you use processes other than environ mental cues to interpret your emotions. Why would the body not James-Lange Theory develop a homeostatic mechanism to control the effects of extreme emo You experience physiological changes. Facial Feedback Theory the opponent-process theory states the muscles in your face move to form an expression. State A, the internal force is labeled Schachter-Singer Experiment State B (see Figure 12. An afternoon in the park was glorious, and doing homework assignments together is fun and easy. The opponent-process theory would indicate that with this person you were subjected to State A, which aroused your emotions, but no State B had developed. Your years together had produced a strong countering State B, which occurred any time you were in the presence of your beloved. It kept your emotions near neutral and allowed you to get on with your daily activities. Yet now Chapter 12 / Motivation and Emotion 335 that your spouse is gone, you are left with only the Figure 12. Have you ever had the when the stimulus for one emotion is removed, misfortune of watching one of your grandparents you feel the opposite emotion. According to lose the partner to whom he or she was deeply this theory, what happens when the experi devoted The significance of this theory is that if the State A event is a terrifying one, such as your first parachute jump, it still predicts what will happen. Experienced jumpers know that how they pack their chutes is crucial, how they coordi nate during the fall is important, and it is important that they know how to land. In fact, other emotion researchers believe that emotion may play an important role in our survival as human beings and in our ability to achieve goals, precisely because it spurs us to action. It will probably be many years before we under stand all the complex ways in which the two interact in human behavior. Application Activity Create a self-test to evaluate the presence and intensity of an emotion. Recall Information What does it mean create a checklist that includes the following: when psychologists say that certain People tell you that you need to calm down. Motivation refers to the physical and mental Chapter Vocabulary factors that cause us to act in a specific way at a specific time. Theories of Some psychologists believe emotions derive from emotion propose that physical changes, while others believe that emo emotions result from tions result from mental processes. Which theory of motivation suggests that all human motives are extensions of basic biologi Self-Check Quiz cal needs Explain the difference between extrinsic motiva Self-Check Quizzes to prepare for the Chapter Test. An internal condition that orients an individual toward a specific goal is a(n). Evaluating Information Try going without voked by real or imagined objects or events that bread in your meals for several days a week. The result an individual is trying to achieve tion would best explain why some people through his or her motivated behavior is a(n) engage in high-risk activities, such as sky-diving, also known as a reinforcer. Which of the two do you sends signals to tell you when you have had think is the stronger motivator Synthesizing Information What factors might and physiological factors that cause people to account for overeating at holiday dinners, such act a certain way at a certain time. A lack of something desirable or useful is a(n) to the following statement: Men feel fewer emo. Theories of Motivation Choose one of the fol Use the Internet to find the latest lowing theories of motivation: the drive research about motivation. Sum reduction theory, the incentive theory, or the marize your findings in a short paper, comparing the cognitive theory. Emotions With a partner or as a group, select Psychology Journal 10 emotions to express. Then play a variation of Analyze the list of concerns and aspirations charades, with one person attempting to con you wrote in your journal. What emotions are harder to convey In other words, classify the items in terms of than others Are there consistent differences in fundamental needs, psychological needs, and interpretation between individuals In your journal, write a important do you think context (the social situ rationale for classifying the individual items as ation in which the facial expression occurs) is in you did. Building Skills Interpreting a Chart In an exper Changes in Heart Rate and Skin Temperature for Six Emotions iment run by Paul Ekman, actors Specific Change in Heart Rate Changes in Skin were hired to assume specific Emotion (beats/min. Practice and assess key social See the Skills Handbook, page 628, for an studies skills with Glencoe Skillbuilder explanation of interpreting charts. Chapter 12 / Motivation and Emotion 339 Contents Chapter 13 Psychological Testing Chapter 14 Theories of Personality A range of personalities hroughout time people have proposed different T theories to explain the development of human personality. In the seventeenth century, Thomas Hobbes argued that all humans are inherently selfish. In the eighteenth century, Jean-Jacques Rousseau claimed that humans are basically good. Psychology Journal Suppose you were asked to select the best person to be your teacher from among a group of applicants. He often responded to my asking for clarification by going into great detail while explaining a particular kind of question. I wondered if my score would be comparable to that of another person who was tested by someone who was not so generous about clarifying items. One virtue of stan dardized tests is that they can provide comparable data about many indi viduals. Further, Chapter 13 / Psychological Testing 343 psychologists can use some tests to help people understand things about themselves more clearly. One of the great dangers of testing is that we tend to forget that tests are merely tools for measuring and predicting human behavior. The fairness and usefulness of a test depend on reliability, validity, and standardization. First, if a person retakes the test or takes a similar test within a short time after the first testing, does he or she receive approximately the same score If, for example, you take a mechanical aptitude test three times in the space of six months and score 65 in January, a perfect score of 90 in March, and 70 in June, then the test is unreliable because it does not produce a measurement that is stable over time. The second measure of reliability is whether the test yields the same results when scored at different times by different people.

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