By R. Arokkh. Webster University. 2018.

The nurse-in-charge is responsible for all patients on their unit safe anafranil 25mg, even if some responsibilities are devolved to team/area sub-managers generic anafranil 10 mg without prescription. Following handover buy anafranil 25mg amex, the nurse- in-charge should visit each patient to make their own assessment, identify the needs of each bedside nurse, and pass on any relevant additional information/expectations. Sufficient time should be allowed for bedside nurses to take individual handovers, complete their own safety checks and make their own patient assessment; seeking information before bedside nurses can fully assimilate it can create stress for the nurse without providing the manager with full information. Looking through each patient’s notes gives bedside nurses time to complete their initial assessment and checks, while giving managers information that may have been missed in handover (relevant points should then be passed on to the bedside nurse). The nurse-in-charge should ensure that imminent shifts are adequately covered by checking staff numbers and initiating the booking of any additional staff required. Many agencies provide their main service during office hours, and so planning should include all shifts until the agency’s next ‘working’ period; on-call services may be able to provide emergency cover, but they often have few remaining staff to allocate. However, this can cause a conflict of roles between their responsibility to the unit as a whole (as manager) and individual responsibility to their patient; it also limits their availability to other members of staff. Instead, it may be reasonable to allocate two patients to one member of staff; the appropriateness or otherwise of assuming direct patient care necessarily remains an individual decision, based on resources available and remembering that the nurse-in- charge remains accountable for whatever decision is made. Managers need to maintain clinical skills and credibility; with career progression and increasing management duties, staff may need to identify shifts when they assume direct patient care without unit management responsibilities. Staff morale Managers are responsible for enabling others to achieve their work goals, and so need to motivate and communicate (Drucker 1974). Nursing demands a high level of cognitive, affective and psychomotor skills, and the ability of staff to realise their potential is affected by their morale. Maintaining staff and unit morale is therefore an important management skill; loyal staff are more likely to support managers during crises. It follows that managers need good interpersonal skills and respect for, as well as of, their staff. If aware of unsatisfactory practices, they should approach staff constructively, identifying why staff are acting that way (rationale, knowledge base), treating the incident as a developmental learning opportunity rather than a belittling and humiliating experience for the junior nurse (or possibly the manager); if patient safety is compromised, managers may need to act before any discussion. Delayed, compromised or missed breaks often cause dissatisfaction, so that ensuring the smooth (and safe) organisation of breaks for staff is an important duty of managers. Organising break relief varies between units and shifts; where units have a system that works and is familiar to staff, this should be followed. Managers may need to assume some direct patient responsibilities to cover breaks; this can also provide them with valuable opportunities to assess patients and the nurse’s skills and needs. However, possible conflicts with managerial duties (see above) should be considered, especially if providing relief in inaccessible areas (e. When situations are particularly stressful, managers may be able to support staff by offering additional ‘stress breaks’, making themselves (and other experienced staff) available when necessary, and by acknowledging the stress of the situation. Managers who are unable to offer ideal support to staff can still build team rapport and loyalty by acknowledging the stress of others. Opinions vary about staff consuming tea and coffee at bedsides; concerns usually include infection and professionalism. Ideally, staff should take breaks (at least every four hours) away from their workspace, but busy shifts (especially 12-hour shifts) may prevent this. If full breaks cannot be taken, providing refreshments at the bedside (this task could be delegated) may help staff to function safely, and also maintain morale. Anything brought into the bedspace may introduce infection, but, on the other hand, stressed nurses are more likely to work inefficiently, possibly skipping more important infection control measures (e. What is ‘unprofessional’ is a value judgement, but professional images may be less important than meeting the basic physiological needs of staff. Relatives, and patients who are able, may also be offered refreshments, and anecdotal experience suggests that they do not mind, or feel any less confidence in, nurses drinking at bedsides. Staff who are needing a break are likely to function inefficiently, give less empathy to others and be more difficult to motivate. This ideal is not always achieved, but if managers consider unit, patient or staff safety is compromised through inadequate staffing (or any other problem they are unable to resolve), they should inform senior managers, who have (higher) responsibility for the unit. During the shift The manager who has established mechanisms for staff to work effectively has achieved their most important role, but throughout the remainder of the shift managers should ensure that the unit continues to run smoothly, solving problems as they occur and providing a resource (knowledge, experience) for, and support to, more junior staff. Intensive care nursing 460 Staff need to have confidence in their manager; while managers usually have more experience and knowledge than their staff, each member of staff has potential to contribute knowledge, experience or values, and managers should be prepared to learn from, as well as guide and teach, their staff. Staff also need to feel that they can approach their manager, so that managers should show positive attitudes and remain accessible (this includes spending most of their time in the main patient-care area). If the medical review of patients does not involve bedside nurses, managers often become the links between medical and nursing staff. Similarly, information to and from other hospital departments, or telephone messages from family members, are often ciphered through the nurse-in-charge. This decision includes imminent shifts dependency of patients already on the unit skills of staff available The manager is professionally accountable for decisions about nursing management on the unit, but if faced with coercion or moral blackmail may need considerable skills in assertiveness. Good managers may inspire loyalty in their staff, but being in charge can isolate managers from other support mechanisms. Managers also need their breaks: a stressed manager is less likely to be able to support their staff.

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Establish a nurse–patient relationship head anafranil 75 mg low cost, used to test reflexes and determine tissue b buy anafranil 25mg fast delivery. Gather data about the patient’s general health density status cheap anafranil 25 mg without prescription, integrating physiologic, psychological, 3. Ophthalmoscope: Lighted instrument used for assessment will be done by the nurse, that body visualization of interior structures of the eye structures will be examined, and that such b. Have patient put on ing external ear canal and tympanic membrane a gown and empty bladder. Nasal speculum: Instrument that allows visualiza- should be mutually agreed on and should not tion of lower and middle turbinates of the nose interfere with meals or daily routines. Vaginal speculum: Two-bladed instrument used patient should be as free of pain as possible, to examine vaginal canal and cervix and the room should be quiet and private. Inspection: Process of deliberate, purposeful Body size, color, shape, position, observations performed in a symmetry, norms, and deviations systematic manner. Percussion: The act of striking an object against Location, shape, size, and density another object to produce a sound. Auscultation: The act of listening to sound Lung and bowel sounds; heart and produced in the body, using vascular sounds. Duration—short, medium, or long to 15 cm in front of the bridge of the patient’s 7. Ask the patient to first look at the forefin- an indentation may remain after the pressure is ger, then at a distant object, then the forefinger released. Dehydration: Pick up the skin in a fold; when patient looks at the finger and dilates when dehydration exists, normal elasticity and he/she looks at a distant object. Weber: Hold the tuning fork at its base and strike ahead, bring the penlight from side of patient’s it against the palm of the opposite hand so that face, and shine the light on one of the pupils. Place the base of the fork on Observe pupil’s reaction; normally it will the center of the top of the patient’s head; ask constrict. Normal find- and observe the other eye—normally it too will ings: sound is heard in both ears or in midline. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Equipment: Vials of aromatic substances, visual acuity chart, penlight, sharp object, cotton balls, Multiple Response Questions vials of solution to test taste, tuning fork, tongue 1. Never induce vomiting; contact physician or poi- perform a focused assessment of Billy’s allergies and son control center. Neonates and infants: mother who smokes; providing first aid in camp situations mother who drinks alcohol 4. School-aged child: accidents, fire Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Developmental considerations: A teenager who The mother should be informed about safety for drinks and drives is at risk for accidents; an toddlers, and a plan should be devised to help her adult who is under stress at work is at risk for childproof her home. Lifestyle: A person who lives in a high-crime covers; moving medications, cleaners, poisonous neighborhood is at risk for violence; a person plants, and so on to higher levels; and keeping who has a dangerous job is at risk for accidents. Do you have soft pillows or thick blankets in changes may cause a person to stumble, lose your infant’s crib? Risk for Injury related to refusal to use child with normal communication and may result in safety seat a patient who is insensitive to alarms, horns, b. Limitation in knowledge: A mother who does child left unattended in bathtub not know how to childproof her home puts her d. Risk for Trauma related to history of previous toddler at risk for accidents; an elderly person falls who does not know how to use her walker is at e. Screening programs for vision and hearing or stress, certain medications, aphasia, and lan- b. Limitation in psychosocial state: Depression the patient, the type of restraint and time it was may result in confusion and disorientation, applied, pertinent nursing assessments, and regular accompanied by reduced awareness of environ- intervals when restraints were removed. The nurse completes the safety event report imme- sible for a reduced level of concentration. Nursing history: The nurse must be alert for any recording the occurrence of the accident and its history of falls because a person with a history effect on the patient in the medical record. Assistive devices report should objectively describe the circumstances should be noted. A history of drug or alcohol of the accident and provide details concerning the abuse should also be noted. Physical assessment: Nurses need to assess the ment of the patient after the event. Accident-prone behavior: Some people seem to motion or needs the use of his hands to push up be more likely than others to have accidents. Once standing, ask the patient setting in which the patient is at risk for injury, to keep his eyes open and stand as still as possible.

Foul smelling discharge due to short chain fatty acid products of anaerobic metabolism generic 50mg anafranil with mastercard. Fatty acid production Treatment: Antimicrobials + Surgery Clindamycin Metronidazole Cefotetan 262 Cefoxitin Piperacillin Penicillin 2 purchase anafranil 25mg mastercard. Source of infection: Tuberculous patients Route of infection: Respiratory- Inhalation of droplet nuclei Ingestion of infected milk Disease: Pulmonary and extrapulmonary tuberculosis The disease generally manifests with low-grade persistent fever purchase anafranil 75mg on line, night sweating, significant weight loss, fatigue and generalized weakness. Used for observing colony morphology, susceptibility testing, and as selective media 2. Lowenstein-Jensen medium It is the ordinary selective media for tubercle bacilli Raised, dry, cream colored colonies of tubercle bacilli after 3-6 wks of incubation 264 3. Pasteurization of milk and milk products Mycobacterium leprae Characteristics: • Typical acid-fast bacilli, arranged in singly, parallel bundles or in globular masses. Foot pads of mice Armadillos Clinical features: Incubation period is months to years. Clinical triads: Anaesthetic skin patches 266 Peripheral neuritis Presence of acid-fast bacilli from skin lesion Two major types of leprosy 1. Comparison of the two types of leprosy Characteristics Lepromatous leprosy Tuberculoid leprosy 1. Usually positive Laboratory diagnosis: Specimen: Skin scrapings from the ear lobe. Non-viable bacilli stain poorly and unevenly as fragmented, beaded and granular red bacilli. When dry, hold fold of skin tightly between the thumb and forefinger until it becomes pale. Using the sterile blade, make a small cut through the skin surface, 5mm long and 2-3mm deep, where the bacteria is be found. Make a small circular smear of the tissue juice (Cover the cut with a small dressing). Wipe the back of the slide clean, and place in a draining rack for the smears to air-dry (protect from direct sun light). Most are soil saprophytes, but some are human pathogens responsible to cause actinomycosis nocardiosis and actinomycetoma. Large group of gram positive bacilli with a tendency to form chains and filaments. Endogenous members of the bacterial flora in the mouth and lower gastrointestinal tract Actinomycosis Chronic suppurative and granulomatous infection with interconnecting sinus tracts that contain sulfur granules Etiology: Actinomyces israeli Actinomyces naeslundii Characteristics:. Gram positive, facultative anaerobe substrate filaments that grow in co2 enriched condition Pathogenesis and clinical features:. Infection is initiated by trauma that introduces these endogenous bacteria into the mucosa 1. Cervico facial actinomycosis 270 Fluctuant mass with draining fistula in jaw area, and may extend to involve bone and lymphnodes in the head and neck 2. Thoracic actinomycosis Resemle subacute pulmonary infection with extension to chest wall and ribs 3. Abdominal actinomycosis May be secondary to ruptured appendix or ulcer with extensive involvement of abdominal organs Lab. Diagnosis: Specimen: Tissue, pus, sputum Smear: Gram-positive filaments with lobulated sulfur granules Culture: Thioglycolate broth or blood agar incubated anaerobically or co2 enriched condition Biochemical reacrion: Catalase positive/negative Treatment: Penicillin Clindamycin + Surgery Erythromycin Nocardiosis Etiology: Nocardia asteroides complex N. Aerobic gram positive, partially aci fast bacilli Pathogenesis and cloinical features: Route of transmission: Inhalation Usual presentation is subacute or chronic pulmonary infection with dissemination to the brain and skin Lab. Spirochete consist of protoplasmic cylinder bounded by a cell wall and outer membrane. There is an axial filament or endoflagella between the cell wall and outer membrane. Not cultured in artificial media, in fertilized eggs and tissue culture, but the saprophytic Reiter strain grows in anaerobic culture. Remain viable in the blood or plasma store at 4 c at least for 24 hrs (transmitted via blood transfusion) Antigenic structure:. Primary stage: Hard chancre: Clean-based, non-tender, indurated genital ulcer with inguinal lymphadenopathy. Secondary stage: Manifests with generalized maculopapular rash condylomata lata and white patches 274 in the mouth. There may be syphilitic meningitis, nephritis, periostitis, hepatitis and retinitis. Primary and secondary syphilis are rich in spirochete from the site of the lesion and patients are highly infectious. Early latent stage: Relapse of symptoms and signs occur, and patients are infectious. Tertiary stage: Manifesting with gumma(granulomatous lesion) in bone, skin and liver; meningovascular syphilis, syphilitic paresis, tabes dorsalis, syphilitic aortitis and aortic aneurysm. One third of cases seems spontaneously cured during primary and secondary syphilis but no clear evidence 2.

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In the United States discount 50mg anafranil amex, child protective services best estimates indicate that there are approximately eight hundred thousand annual cases of child maltreatment order 50 mg anafranil mastercard. Childhood exposure to abuse discount 10mg anafranil otc, neglect, and parental violence has been associated with risky behaviors, smoking, using illicit drugs, and overeating. Te efects of alcohol, drugs, poor nutrition, and physical trauma are well documented in the professional and lay literature. Assault of the pregnant women can result in a wide range of emotional and physical trauma, includ- ing the potential for injuries that result in death (homicide), perinatal death, low-birth-weight live births, and preterm delivery. In some cases of women reporting being in an abusive relationship, abuse might actually decrease during preg- nancy. A study of dating violence among students in grades 7 to 12 found that physical and psychological violence was 12 and 20%, respectively. Students with poorer grades (mostly Ds and Fs), blacks, non-Hispanics, and students from the northeastern United States were at greatest risk for dating violence and victimization. Te report indicates that: • Approximately one-third of female murder victims were killed by an intimate. Homicides may also result in the murderer taking his or her own life following the violent act that resulted in the death of the intimate partner. It has been reported that 74% of all murder-suicides involved an intimate partner. Of these reported cases, 96% were females killed by their intimate partner, with 75% of these cases occurring within the home. Estimates indicate that the annual medical expense associated with domestic violence is at least $3 billion to $5 billion. Also, businesses are reported to lose another $100 million in lost wages, sick leave, absenteeism, and loss of productivity. Te risk for facial injury was much higher among the domestic violence victims than was seen in other mechanisms of injury. Head injuries were also more common in women victims of intimate partner violence. One published study indicates that 85% of intimate partner violence victims were found to have injuries on more than one area of the body. Te most common sites for injury were the eye, side of the face, throat and neck, upper and lower arms, upper and lower legs, mouth, outside of the hand, back, and scalp. Of importance to dentists, 79% of the injuries were in areas clearly visible (injuries to the head and hands). Abuse knows no age group limitations and is seen in persons of all ages from the very young through the very old (Figures 15. Like other forms of abuse, physical abuse of an elderly individual can appear in many diferent patterns. Other signs are traumatic hair and tooth loss, rope or strap marks indicating physical restraint, multicolored bruises indicating injuries at various stages of healing, and injuries suggesting heal- ing “by secondary intention” (possibly indicating inappropriate or delayed presentation for care). Te National Committee for the Prevention of Elder Abuse also reports that some of the indicators of elder abuse can include: • Injuries that are unexplained or are implausible • Family members providing diferent explanations of how injuries were sustained • A history of similar injuries or numerous hospitalizations, or both • Victims brought to diferent medical facilities for treatment to pre- vent medical practitioners from observing a pattern of abuse • Delay between onset of injury and seeking medical care Many of these indicators are very similar to those signs and symptoms of abuse/neglect seen in younger populations. Zeitler reported that approximately 30% of known elder abuse cases presented with neck and facial injuries. Many of the inju- ries associated with inficted trauma are seen in the maxillofacial complex. Because of the injury locations, oral health care providers may be the frst to have the opportunity to diagnose and treat the victims of nonaccidental (inficted) trauma. Plans should be in place in each oral health care facility whereby intervention can appropri- ately begin on behalf of the suspected victim of violent behavior. Without intervention, the assaults may increase, leading to serious sequelae, including death by homicide. Preventing intimate partner violence, sexual violence and child maltreatment, 1–7. Partner vio- lence among adolescents in opposite-sex romatic relationships: Findings from the National Longitudinal Study of Adolescent Health. A comparison of facial fractures in victims of motor vehicle accidents and battered women. Injuries due to domestic violence against women: Sites on the body, types of injury and the methods of infiction. What distinguishes unintentional injuries from injuries due to intimate part- ner violence: A study in Greek ambulatory settings. Inevitably, the opinion 379 380 Forensic dentistry expressed in a forensic dental case is likely to lead to testimony. Tis chapter will guide the reader through the legal and court systems of the American justice system, explain the need for, and the use of, the expert witness in legal proceedings, and conclude with a review of several case law examples in which forensic dental testimony played an important role. First and foremost, it is an adversarial system in which opposing parties enjoy representation by attorneys who advocate for their client’s position. Te heart of the advocate’s representation is his or her duty to investigate fully the cir- cumstances and events surrounding the legal action coupled with the ability to subject the opposing side’s witnesses to a vigorous cross-examination, allowing the testimony of the witness to be thoroughly tested in front of the trier of fact—judge—or jury.

Most authorities agree that an individual’s as cortical activities related to a state of sleep–wake cycle is fully developed by what alertness anafranil 10 mg on-line. Nap frequently during the day to make up person to remain awake for long periods for the lost sleep at night cheap anafranil 25 mg on-line. Respirations are irregular and sometimes She is scheduled for an exploratory laparotomy interspersed with apnea anafranil 25mg cheap. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. An average of 5 to 7 hours of sleep is gener- he/she could not sleep during the night. Which of the following statements accurately describe factors that affect sleep patterns? Which of the following describe the influences breathing between snoring intervals. Patients with restless arm syndrome cannot lie still and experience unpleasant crawling a. Place the following stages of a sleep cycle in interventions for patients experiencing insom- the order in which they would normally occur. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Which two systems in the brainstem are quality of sleep believed to work together to control the cyclic nature of sleep? Marked muscle contraction that results in the jerking of one or both legs during sleep 2. Match the sleep disorder listed in Part A with its appropriate definition listed in Part B. Constitutes about 5% of sleep Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. List the average amount of sleep required for True False the following age groups. Older adults: time, he/she will return to sleep again by starting at the point in the cycle where 3. Exercise that occurs within a 2-hour interval before normal bedtime stimulates sleep. The administration of a larger mid-afternoon dose of asthma medication may prevent i. True False Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Maher, age 28, consumes four in a sleep history when a sleep disturbance is alcoholic drinks when watching television noted. After eliminating the alcohol from her diet, she complains of waking after a short period and not being able to fall back to sleep. Eichorn, age 45, has two teenage sons confirm that a patient is getting sufficient rest who are often out late at night. She cannot to provide energy for the day’s activities or val- get to sleep until they are both home idate the existence of a sleep disturbance that safely, and even then she continues to is decreasing the quantity or quality of sleep. Describe how you would prepare a restful environment for a home healthcare patient b. List three measures a nurse can take to help falling asleep, but the noise of the hospital alleviate a patient’s sleep problem. Loper, a 74-year-old patient in a long- ask a patient to assess for the following sleep term care facility, is bored during the day factors. Quality of sleep: that he is sleepy all the time but cannot sleep when he lies down after work. Number and duration of naps: Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Interview several friends or relatives to find out what they do to prepare for a restful night’s sleep. Nature of a sleep disturbance: man who has recently been admitted to a long-term care facility. Onset of a disturbance: don’t fall asleep until after midnight and then I’m up twice to go to the bathroom and have a lot of trouble falling back to sleep. Causes of a disturbance: ter has mentioned to the nurse that her father spends a lot of time napping during the day. What intellectual, technical, interpersonal, factors on the ward that would contribute to a and/or ethical/legal competencies are most patient’s sleep deficit. Develop a sleep teaching tool that explains the typical sleep patterns and requirements for patients of all ages (infants to older adults).

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Stress and illness onset and progression Stress causes changes in both sympathetic activation (e proven 50mg anafranil. 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 generic anafranil 50 mg without a prescription. These changes may increase the chances of heart disease cheap anafranil 25mg without prescription, 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. They argued that the body’s physiological systems constantly fluctuate as the individual responds and recovers from stress, a state of allostasis, and that as time progresses recovery is less and less complete and the body is left increasingly depleted. Therefore if exposed to a new stressor the person is more likely to become ill if their allostatic load is quite high. 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 emphasize how some people remain healthy even stressors occur (e. Stress resistance includes adaptive coping strategies, certain personality characteristic and social support. This perspective provides a scientific basis for the ‘mind over matter’, ‘think yourself well’ and ‘positive thinking, positive health’ approaches to life. The immune system The role of the immune system is to distinguish between the body and its invaders and to attack and protect the body from anything that is considered foreign. When the immune system works well the body is pro- tected and infections and illnesses are kept at bay.