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The differential memory accessibility account is more likely when the person engages in extensive substantive processing such as full and open search in memory breast cancer freebies purchase clomiphene australia, which presumes a certain level of involvement menstruation 10 days bleeding discount clomiphene 25 mg overnight delivery. The mood-as-information account is more likely when the person engages in heuristic processing womanlog pregnancy 100 mg clomiphene mastercard, which is more common under conditions of low involvement womens health 2014 covers 50 mg clomiphene with amex. Consistent with this proposition, it has been found that positive moods have two separate effects in persuasion (Batra & Stayman, 1990; Petty, Schumann, Richman, & Strathman, 1993). Under conditions favoring low elaboration, positive moods have direct assimilative effects on attitudes-a finding consistent with a mood-as-information process. Under conditions favoring high elaboration, the assimilative effects of positive moods on attitudes appear to be mediated by the valence of target-related thoughts during message exposure-a finding consistent with a differential memory accessibility explanation. Within the mood-as-information account, there is still uncertainty as to the exact locus of the process. In conventional interpretations of the process, feelings are assumed to enter judgments during the formal evaluation stage (Schwarz & Clore, 1988, 1996). However, recent findings suggest that the informative influence of incidental feelings may take place earlier in the process, during an initial appraisal of the object (Yeung & Wyer, 2004). Moderators of congruency effects of incidental affective states Factors that increase the reliance on integral feelings in evaluations generally also increase the influence of incidental affect on evaluations. Incidental moods are generally found to have stronger assimilative influences on evaluations when motivation to process information is low. However, recent studies suggest that higher levels of motivation and ability to process information do not necessarily result in a monotonic decrease of the influence of incidental mood on evaluations. The relationship may sometimes be curvilinear, with stronger influence of incidental mood under moderate levels of motivation and ability (Albarracin & Kumkale, 2003). This is because when motivation and ability to process information are very high, people are likely to recognize that their feelings are incidental and therefore irrelevant for the judgment at hand. There is also consistent evidence that incidental affective states have stronger affect-congruent influences on evaluations when other bases of evaluation are ambiguous. Consistent with the principle of representativeness mentioned earlier, incidental affective states tend to be more influential when their actual source is not salient (Gorn, Goldberg, & Basu, 1993; Raghunathan, Pham, & Corfman, 2006; Schwarz & Clore, 1983; Siemer & Reisenzein, 1998). This is because, when the actual source of the affective state is salient, people recognize that the affective state is unrelated to . Further evidence of a representativeness interpretation of this contingency comes from the finding that, even when their actual source is salient, incidental affective states may still influence objectively unrelated judgments and decisions provided that there is a superficial domain similarity between the judgment or decision and the salient origin of the affective state (Raghunathan, Pham, & Corfman, 2006). Inferences of representativeness, we know, are very sensitive to surface similarity (Gilovich, 1981). Also consistent with the logic of affect-as-information is the findings that, even when people do not recognize that their feelings are truly incidental-that is, even when they assume that their feelings are representative-they do not seem to use them unless they perceive their feelings to be a relevant basis for a specific judgment or decision-a contingency known as the relevance principle (Pham, 1998). For example, people are more influenced by their mood when making decisions guided by experiential motives, such as assessing a movie for an evening out, than when making decisions guided by instrumental motives. As a result, they are typically more influenced by their moods in decisions involving hedonic products than in decisions involving utilitarian products (Adaval, 2001; Yeung & Wyer, 2004). In addition, incidental affective states have been found to be more influential when people make decisions for themselves as opposed to for someone else (Raghunathan & Pham, 1999). Avnet and Pham (2007) recently suggested the idea and found evidence that the reliance on feelings in judgments and decisions may involve a meta-cognitive stage in which people assess whether they should use their feelings in a given judgment or decision, and found evidence consistent with this proposition. This meta-cognitive assessment appears to require significant cognitive resources; when resources are insufficient, incidental and integral feelings influence judgments and decisions more indiscriminately. The dual-process, meta-cognitive model proposed by Avnet and Pham (2007) appears to account for a wide variety of findings about the moderators of incidental and integral affect in judgments and decisions. Evaluations based on nonconstructive processes, such as the retrieval of prior attitudes, are less amenable to affect infusion. For example, Fedorikhin and Cole (2004) found that respondents exposed to a mood-inducing video prior to being exposed to a commercial were more influenced by their mood in their evaluation of the advertised product than were respondents exposed to the mood-inducing video after viewing the same commercial and forming an initial evaluation of the product. This is presumably because respondents in the mood-before condition had to form their product evaluations "from scratch," which required constructive processing, whereas respondents in the mood-after condition could simply retrieve their previously-formed initial evaluations. More generally, Srull (1987) showed, in a very compelling series of studies, that mood congruent evaluation effects generally require that the incidental mood be experienced at the same time the evaluation is constructed.

Its spectrum is broad and includes Aspergillus and Candida species pregnancy questions hotline buy clomiphene canada, Blastomyces dermatitidis (which causes North American blastomycosis) pregnancy care order clomiphene canada, Histoplasma capsulatum (which causes histoplasmosis) menstrual cramps 7 months pregnant cheap 50 mg clomiphene visa, Cryptococcus neoformans (which causes cryptococcosis) womens health lynchburg va discount clomiphene generic, Coccidioides immitis (which causes coccidioidomycosis) and Sporotrichum schenckii (which causes sporotrichosis). Amphotericin is insoluble in water, but can be complexed to bile salts to give an unstable colloid which can be administered intravenously. Amphotericin B is normally given as an intravenous infusion given over four to six hours. Several liposomal or lipid/colloidal complex amphotericin preparations have now been formulated, and are less toxic (particularly less nephrotoxic), but more expensive than the standard formulation. Liposomal amphotericin is reserved for patients who experience unacceptable adverse effects from regular amphotericin or in whom nephrotoxicity needs to be minimized. Topical amphotericin lozenges or suspension are used for oral or pharyngeal candidiasis. Nystatin works in the same way as amphotericin B, but its greater toxicity precludes systemic use. Its indications are limited to cutaneous/mucocutaneous and intestinal infections, especially those caused by Candida species. Little or no nystatin is absorbed systemically from the oropharynx or gastrointestinal tract, and resistance does not develop during therapy. Cutaneous infections are treated with ointment and vaginitis is treated by suppositories. Adverse effects Nystatin can cause nausea and diarrhoea when large doses are administered orally. Available for topical (nystatin and amphotericin) treatment of common mucocutaneous fungal infections. Amphotericin is used intravenously for deep-seated and severe fungal infections. Intravenous amphotericin is toxic, causing fever, chills, hypotension during infusion, nephrotoxicity, electrolyte abnormalities and transient bone marrow suppression. Systemic toxicity (especially nephrotoxicity) of amphotericin is reduced by using the liposomal/ lipid/micellar formulations. Amphotericin combined with 5-flucytosine may be used in severe infections and immunosuppressed patients. Mechanism of action Amphotericin is a polyene macrolide with a hydroxylated hydrophilic surface on one side of the molecule and an unsaturated conjugated lipophilic surface on the other. Some imidazoles are also used systemically, although they have limited efficacy and significant toxicity. Adverse effects these include: נfever, chills, headache, nausea, vomiting, and hypotension during intravenous infusion. It results from vasoconstriction and tubular damage leading to acute renal impairment and sometimes renal tubular acidosis. Mechanism of action of azoles (imidazoles and triazoles) Imidazoles competitively inhibit lanosterol 14-demethylase (a fungal cytochrome-haem P450 enzyme), which is a major enzyme in the pathway that synthesizes ergosterol from squalene. This disrupts the acyl chains of fungal membrane phospholipids, increasing membrane fluidity and causing membrane leakage and dysfunction of membrane-bound enzymes. The imidazoles have considerable specificity/affinity for fungal cytochrome-haem P450 enzymes. Pharmacokinetics Poor gastro-intestinal absorption necessitates intravenous administration for systemic infections. It is still used to treat metastatic prostate cancer and adrenocortical carcinoma (see Chapter 48). Breast milk concentrations are similar to those in plasma and fluconazole should not be used by nursing mothers. Pharmacokinetics Fluconazole is well absorbed after oral administration and is widely distributed throughout the body. About 80% is excreted by the kidney and dose reduction is required in renal failure. The fluconazole mean elimination t1/2 is 30 hours in patients with normal renal function. It is active against many Candida species, Cryptococcus neoformans and Histoplasma capsulatum. However, Aspergillus species are resistant and resistant Candida species are problematic in immunocompromised patients. Fluconazole is used clinically to treat superficial Candida infections and oesophageal Candida, for the acute therapy of disseminated Candida, systemic therapy for blastomycosis and histoplasmosis, for dermatophytic fungal infections and, in low doses, for prophylaxis in neutropenic and immunocompromised patients.

These effects occur in part because the information to which people are exposed becomes dissociated from its source breast cancer young women purchase clomiphene 100 mg amex. If this is so women's health center of santa cruz discount 50 mg clomiphene, the information could have an effect on beliefs even when it is identified as invalid at the time it is first received menstrual reg generic 100mg clomiphene fast delivery. Participants were exposed to statements about commercial products either one pregnancy old wives tales gender buy genuine clomiphene on-line, two, or three times, in each case accompanied by an indication that the statement was not true. Participants, a short time after exposure to the statements, were less likely to believe the statements were true if they had been exposed to them three times than if they had been exposed to them only once. After a 3-day delay, however, older participants were more likely to believe the statements in the former case. Based on an earlier formulation of belief organization by McGuire (1960), Wyer and Hartwick (1980) proposed a conceptualization of conditional inference processes that recognize this possibility. That is, people who are asked to report their belief in a conclusion, C, search memory for an antecedent, A, that has implications for it, and estimate the likelihood that C would be true if A is or is not true. If these conditional beliefs differ, they average their implications, weighting each by their belief that A is and is not true, respectively. If the beliefs are in units of probability, this inference can be captured by the equation: P(C) = P(A)P(C/A) + P(~A)P(C/~A), [1] where P(C) is the belief that C is true, P(A) and P(~A) are beliefs that A is and is not true, respectively, and P(C/A) and P(C/~A) are conditional beliefs that C is true if A is and is not true, respectively. If P(~A) = 1 ͠P(A), the effect of a communication changes beliefs in A by the amount P(A) should theoretically induce a change in beliefs in C, P(C), that is predictable from the equation: P(C) = P(A)[P(C/A) ͠P(C/~A)]. The relevance of this conceptualization in the present context derives from its implication that people who estimate their belief in a proposition do not conduct an exhaustive search of memory for knowledge that has implications for its validity. Rather, they identify and use the fi rst relevant "informational" proposition (A) that comes to mind. Therefore, when more than one such proposition exists in memory, the one that is most quickly and easily accessible is used. To give a specific example, the belief that drinking coffee is desirable (C) should be stronger if the proposition "Drinking coffee makes you alert" happens to be accessible in memory than if "Coffee gives you insomnia" is more accessible. Equation 1 can be a diagnostic tool for determining whether a particular proposition is used as a basis for beliefs in any given instance. That is, the equation should describe the relations among a set of beliefs associated with propositions A and C if A has been used as a basis for reporting beliefs in C than if it has not (Wyer, 1970; Wyer & Hartwick, 1980, 1984). The effectiveness of advertisements could potentially be diagnosed in terms of this conceptualization. First, the commercial might have been ineffective in changing beliefs that X has more energizing ingredients; that is, P(A) = 0. However, consumers might have typically think about other judgmental criteria than A at the time they report their purchase intentions, as reflected in a discrepancy between obtained and predicted values of P(C). The third possibility raises an additional implication of the model that was initially proposed by McGuire (1960) and confirmed empirically by Rosen and Wyer (1972). That is, syllogistically related beliefs may sometimes be inconsistent because they have not recently been thought about in relation to one another. However, asking people to report these beliefs in temporal proximity may call attention to their inconsistency and, therefore, may stimulate attempts to eliminate it. As a result, the beliefs may become more consistent if they are reported again at a later point in time. This "Socratic" effect was demonstrated in consumer research by Kardes, Cronley, Pontes, and Houghton (2001), who also applied the model in diagnosing the influence of multiple sets of syllogistically related arguments and their impact on resistance to persuasion. Nevertheless, the processes that underlie these two types of estimates can differ. The different strategies that people use to compute the incidence of an event, and the conditions in which they are applied, have been investigated by Menon (1993; Menon, Raghubir, & Schwarz,1995). When an event occurs regularly (as in eating breakfast, or tooth-brushing), for example, people are likely to estimate its incidence within a given time period by simply extrapolating, based on general knowledge of its frequency of occurrence over the course of a day or week. When an event occurs irregularly, however, people are more likely to search memory for specific instances of the event or attribute being judged. Rather, people may base their judgment on how easily these instances come to mind. This tendency, which was referred to by Tversky and Kahneman (1973) as the availability heuristic, may be a manifestation of a more general tendency to treat conditional rules of inference as biconditionals (Wyer & Srull, 1989). Thus, because people believe that things that occur frequently are likely to come to mind easily, they infer that things that come to mind easily are likely to occur frequently. As a result, objectively irrelevant factors that influence the accessibility of instances in memory can have an impact on frequency estimates.

Four streams of context effect literature are reviewed breast cancer events 2014 clomiphene 50 mg on line, including the choice set menopause guidelines generic 50 mg clomiphene with mastercard, reference points pregnancy quotes cheap clomiphene 25mg overnight delivery, price image women's health gov faq birth control methods quality 50 mg clomiphene, and consumer information vs. Choice Set Consider the following choice problem: A customer need to choose between two six-pack cola, product A is priced at $1. The customer is having a hard time comparing the two products and making the price-quality tradeoff, so she delays the purchase and goes to another store. The new product C is obviously worse than and dominated by product A, but not by product B. One prediction from a number of consumer choice models including Luce model of choice (1959) is that C would take disproportionally more market share from a similar product A rather than a dissimilar B, called similarity hypothesis. A second prediction of the Luce model would be that adding a new alternative cannot increase the probability of choosing a member of the original set, called regularity condition. Here both similarity hypothesis and regularity condition can be violated by addition of an asymmetrically dominated alternative C. The story behind this problem is that the context of choice has been altered by adding of a new alternative. The addition of a low-quality product makes the 20 point quality difference between A and B less important, a manifestation of range strategy. Huber, Payne, and Puto (1982) had shown with their experiments that the range strategy could increase an average of 13% of market share for the target product, while a range-frequency strategy had a net gain of 8%. This is achieved by adding another price level thus drawing more attention to the price dimension. The addition of a new price might also spread the psychological distance of the price advantage the target has over its competitor. In support of the range theory, Janiszewski and Lichtenstein (1999) showed that the range of prices a consumer evoked when evaluating a market price could have an independent influence on the judged attractiveness of the market price. Variance in the width of the evoked price range affected judgment of price-attractiveness in the absence of any variance in the internal preferential price. Niedrich, Sharma, and Wedell (2001) provided evidence that range-frequency theory accounted for reference price effects that the other theories could not, suggesting that consumers compared the target price against specific members of the category rather than the category prototype. Their experiment indicated that range and frequency effects can be moderated by the stimulus presentation condition. Consumers placed greater weight on extreme prices anchoring the range for internal reference prices than for external reference prices. Tradeoff contrast refers that the preference for an alternative is enhanced or hindered depending on whether the tradeoffs within the choice set are favorable or unfavorable to that option. Extremeness aversion claims that the attractiveness of an option is increased if it is an intermediate one in the choice set and is diminished if it is an extreme one. It is found that tradeoff contrasts are not limited to local context, or the context defined by the offered set itself. People also compare an option with relevant alternatives they have encountered in the past, or background contrast. For instance, subjects exposed to the background where the cost of computer memory is high would be more likely to select the computer with bigger memory. Both tradeoff contrast and extremeness aversion are expected to have less impact under situations where consumers have well-established preferences. Simonson and Tversky (1992) had further conducted a series of studies revealing that context effects were both common and robust. Framing effect and context effect, which are hard to interpret from the value maximization perspective, are easier to understand if we assume that various frames and contexts highlight certain aspects of the options, thus bringing forth different reasons to guide decision. Back to the three-product problem, the presence of C helps the decision maker to break the tie and builds up an argument for choosing A over B. Reference Points Both internal and external reference prices can serve as context of evaluation. Although perceptions of ordinary product prices were not affected by the presence or type of reference price, the subjects did have lower estimates of ordinary prices in the sale context. Adaval and Monroe (2002) showed that the context in which a product was seen influenced the internal standard that consumers used to judge both this and other products. This effect of the initial context even carried over to a new product encountered two days later. Existence of price promotion, either from the target brand itself or from competing brands, often provides reference points when consumer makes price estimation.

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