St. Augustine Humane Society

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By: Q. Iomar, M.A., M.D., M.P.H.

Program Director, Loma Linda University School of Medicine

Its study and practice encompass the basic and clinical sciences including biology of the normal pulp anxiety symptoms jittery purchase 37.5 mg venlafaxine amex, the etiology anxiety kids discount venlafaxine 75mg with amex, diagnosis anxiety symptoms racing heart 150 mg venlafaxine with mastercard, prevention and treatment of diseases and injuries of the pulp and associated peri-radicular conditions anxiety attack symptoms quiz purchase 75 mg venlafaxine otc. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. Orofacial Pain is the proposed specialty of dentistry which includes the assessment, diagnosis and treatment of patients with orofacial pain and dysfunction disorders, oromotor and jaw behavior disorders, orofacial sleep disorders, head and neck pain, as well as pursuit of knowledge of the underlying pathophysiology and mechanisms. Furthermore, Orofacial Pain does not include diagnosis and management of conditions that are included in the scope of practice for any existing dental specialties including surgical treatment of the temporomandibular joint, surgery of the trigeminal nerve, correction of malocclusions, treatment of pulpitis, dentinal hypersensitivity, burning mouth, anxiety and acute pain related to operative procedures, or diagnosis or treatment of oral soft tissue pain. It also does not include skills of prosthodontic or restorative dentistry, orthodontics, any oral surgery procedure, endodontic procedures, periodontal surgery or treatment, or diagnosis or treatment of soft tissue lesions with exception of diagnosis and treatment of temporomandibular disorders. Orofacial Pain also does not include acute pain control and sedation and does not overlap with Dental Anesthesiology. It also does not include treatment of pain from pulpitis, pulpal disease or dental hypersensitivity there is no overlap with Endodontics. Since the field does not include pain from gingival, periodontal or other soft tissue disease, there is no overlap with Periodontics. Since Orofacial Pain does include restorative dental treatments, there is no overlap with Prosthodontics. Since the field does not include pain from 3rd molars and other teeth, surgical treatment of temporomandibular disorders or nerve injuries, or acute pain and anxiety from dental surgical or operative procedures, there is no overlap with oral and maxillofacial surgery and dental anesthesiology. Since the field does not include pain from soft tissue lesions or burning mouth, there is no overlap with Oral Pathology. Since the field does not include orthodontic or orthopedic movement of teeth, there is no overlap with Orthodontics. Since the field does not include care of dental needs for children, there is no overlap with Pediatric dentistry. In conclusion, with regard to definition of each specialty, there is clear evidence that there is no actual or perceived overlap between the field of Orofacial Pain and any existing specialty. A comparison of the practice patterns between dentists in the community with those dentists practicing in field of Orofacial Pain also provide clear evidence that there is no perceived overlap in clinical practice with any existing specialty. Figure 2 shows that when asked "do you treat or refer patients with these orofacial pain disorders? As most dentists know, patients with orofacial pain disorders are often time-consuming and frustrating for current dental specialists so they have little interest in providing care for them. These patients may have behavioral, psychosocial, and addiction issues, require sophisticated multi-and inter-disciplinary treatment, and generate services that are typically submitted through medical insurance with different diagnosis codes, procedure codes, and health plan contracts than the rest of dentistry. These patients can be a burden on dental practices and, thus, explains why many of these patients are shuffled from one dentist to another and why the vast majority of general dentists and dental specialists choose to refer versus treat these patients. The advanced knowledge and skills in these documents includes no reference to orofacial pain disorders and minimal reference to temporomandibular disorders. Table 6 lists a summary of the results of a comparison of 2019 curriculum standards for advanced education program in the clinical dental specialties with that of advanced knowledge and skills required in diagnosis and management of orofacial pain disorders that are included in the field of Orofacial Pain (2). As noted in the Table 5, the existing dental specialties do not reference these conditions except for surgery or care for non-complex splint treatment for temporomandibular disorders. The 2019 accreditation standards for each of the recognized specialties make no reference to the advanced 43 knowledge and skills required for diagnosis and management of orofacial pain disorders with the exceptions noted in this section. Curriculum guidelines for Orofacial Pain advanced education program require a minimum of full-time skills training of two years for graduate, or post-doctoral study in the field of Orofacial pain. Knowledge must be brought to a medical competency standard to permit treatment as well as diagnosis for multiple pain conditions and to qualify the graduate to work in a multidisciplinary medical and dental community. Most of the established dental specialties have been required to move to a three-year curriculum because of the amount of skill training in their own disciplines. The International Association for the Study of Pain has published a set of required skills for pain treatment facilities laying down the requirements for a multidisciplinary pain center.

The final portion of this section then recapitulates the events of the creation in reverse order: Creation begun with a declaration of the first words concerning the creation (lines 97-117) the sky is in suspense and the earth is submerged in water (lines 118-136) the creation is to be under the direction of Its Heart Sky (lines 137-192) the creation of all things begun (lines 193-201) the creation of earth (lines 202-232) the creation of mountains (lines 233-255) the division of the waters into branches (lines 256-258) "Merely divided then existed waters anxiety medication list safe venlafaxine 75 mg," (line 259) "Then were revealed great mountains anxiety journal order 37.5mg venlafaxine fast delivery. Envelope Parallelism: the repetition of parallel elements at the beginning and end of a long stanza or section of poetry ms symptoms anxiety zone proven 75mg venlafaxine. This has the effect of tying together the introduction and conclusion of a passage to set it apart from that which precedes and follows it anxiety 504 plan buy generic venlafaxine 37.5 mg line. The section is then concluded with a parallel enveloping couplet in lines 51575158: these therefore their names Their wives. Merismus: the expression of a broad concept by a pair of complementary elements which are narrower in meaning. Lines 338-339 use "deer-birds" to describe all wild animals, while lines 748-749 use "dogsturkeys" to describe all domesticated animals. Emblematic Parallelism: the use of simile to compare elements, often with the use of words such as "like" or "as. Combination of Parallel Arrangements: the use of two or more types of parallelism in a single strophe. Monocolon: An isolated line which does not parallel any associated line, thus standing on its own. Because monocolons are relatively rare within the Popol Vuh, they are all the more powerful when they do occur. In general they are used when the author desires to give extra emphasis to a passage. While the parallel couplet is the standard poetic form in the Popol Vuh, it is by no means the only one. Tedlock recognized this in his work with highland Maya literature: "To measure all Mayan texts by the single standard of the couplet is to miss the very essence of Mayan verse rhythms, which move in twos, and sometimes threes, and once in a while arch over to produce a four" (D. The following are examples of the various strophic types in terms of length found within the Popol Vuh: 1. Parallel Couplets (Bicolon): By far the most common strophic length in the Popol Vuh is the couplet, consisting of two parallel lines. I am giving my wax candle, my stake toward the legs arms of God at the rising of the sun, at the setting of the sun Sachaj la numac Tiox. One interesting phenomenon which appears frequently within longer series of parallel lines is "gapping," in which an expected word or clause is omitted in one line, although it is implied by the parallelism of the series. Longer parallel series: the following is an example of a parallel sextet in lines 464-469: Merely it would come undone, Xa chiyojomanik, 42 Merely crumbled, Merely sodden, Merely mushy, Merely fallen apart, Merely as well it would dissolve. Recognition of the presence of parallelism in a given text helps to focus attention on what the authors feel is important. By pairing each thought with complementary ones, the authors are able to develop their ideas with greater clarity. They may compare elements, contrast them, elaborate upon their significance, or add layers of meaning which would not otherwise be obvious. The words of the Popol Vuh were not arranged into sentences and paragraphs as in modern literature. Parallelism is a common mnemonic device used in many ancient cultures to help narrators remember the flow and direction of their tale. This is particularly true of the chiastic type of parallelism, which may give order to large sections of a story. It also gives the listener an opportunity to hear a recapitulation in reverse order of what had been said, while reminding him of the central themes that are of special importance. The presence of parallelism in the Popol Vuh is also a tremendous, though unintended, boon to modern translators. By comparing an ambiguous word or passage with its associated line, its general meaning is often clarified. This is especially important when interpreting a word which has more than one possible meaning, or which is poorly transcribed through scribal error. We can see how he organized his thoughts as he took pen or brush in hand to set them down in permanent form. Far from being the random musings of an unlearned storyteller, the Popol Vuh can be appreciated as the eloquent creation of a master poet with a sophisticated literary heritage. For the most part, the letters used were based on those standardized by the Franciscan priest Francisco de la Parra in 1545. Variant spellings of words occur throughout the manuscript and glottalized sounds in particular are haphazardly distinguished at best.

The Grandmother thus rushed back to her home and said to the maiden: "This is but a sign that you are in truth my daughter-in-law anxiety 2016 buy venlafaxine cheap. I will surely watch your deeds anxiety 9 year old son 37.5 mg venlafaxine fast delivery, for they that are to be my grandchildren are enchanted already anxiety worse in morning generic venlafaxine 75 mg otc," the maiden was told anxiety shortness of breath order venlafaxine 75 mg line. The Grandmother did not see it when they were born, for these two arose320 suddenly. They arose in the mountains, but when they were taken into the house they did not sleep: "Take them away and abandon them, for truly shrill are their mouths," said the Grandmother. This was done by One Batz and One Chouen, for they would have had them die there on the anthill and on the thornbush. This treatment of the twin sons of One Hunahpu and Lady Blood is a serious breach of highland Maya attitudes toward children, particularly infants. Infants and small 126 Thus at first their younger brothers were not accepted in the house. They had passed through great affliction and misfortune, and thus they had become great. They were not only flautists and singers, but they had also become writers and carvers. For they knew of the circumstances of their birth, and certainly they were ingenious. In their hearts, they knew everything from the first, even before their younger brothers were created. The abuses325 born in their hearts merely fell upon their own backs and nothing came of them. Whenever possible babies accompany their mothers, who carry them on their backs everywhere as they go about their work. Toddlers and small children are cared for solicitously by their older siblings who also carry them about wherever they go. This attitude is so pervasive in highland Maya society that it is difficult to believe that it would have been otherwise at the time the Popol Vuh was composed. It is likely that the "treachery" of One Batz and One Chouen toward their half-brothers would have been recognized as sufficient grounds for the punishment they later received when they were turned into monkeys. It is significant in this regard that monkeys were earlier described as descendents of the wooden people who "did not possess their hearts nor their minds," "walked without purpose," "did not remember Heart of Sky," and "were not capable of understanding" (pp. It was the cold and dry hearts of the wooden people that had led to their ultimate destruction. In modern usage it suggests something that festers and spreads, such as an abscess, gangrene, or smallpox. When meals were prepared for them, One Batz and One Chouen would eat it all before they returned. They tolerated it, for they knew their own nature, and this was a light by which they could see. Thus when they returned each day, One Batz and One Chouen would take away their birds and eat them. But if I go before them with my sins still upon me, and quarreling with my wife or relatives, then I shall die at once, before my enemy, for the justice which I ask for him will fall upon me" (Bunzel 1952, 376). Basseta writes it is to be "discounted, ignored, displeased, dissatisfied" as well as to be "perverted, corrupted. Bunzel noted that the calm that prevails in all households is somewhat superficial, often hiding bitterness and discord with a "smooth surface of respectful courtesy" (Bunzel 1952, 12). Particularly among older family members, there is often an atmosphere of intense rivalry and mistrust. Thus one of her collaborators who was preparing for a ceremony told her: "It is better that I go out of the house before I am provoked to retort. For I am asking justice before the spirits, and if I do anything, they will immediately drag me out of this life" (Ibid.

If herbivorous fish anxiety symptoms lingering generic 75mg venlafaxine free shipping, such as damselfish anxiety symptoms jaw buy venlafaxine with a visa, are overfished or removed from coral reefs anxiety 1-10 rating scale discount 37.5mg venlafaxine visa, algae can quickly overgrow the corals and block them from receiving the sunlight that they need for photosynthesis anxiety symptoms social purchase genuine venlafaxine on line. Introduce the terms primary producers, primary consumers (herbivores), secondary consumers (carnivores and omnivores), and decomposers. Handout copies of the Coral Reef Color Page and have students identify and label each of the organisms by common name and role in the marine food web. Consider having the groups divide up the work and present their results to the class. Have students diagram their own marine food chain using a representative organism from the color page. Discuss the importance of predation and protection on survival in the coral reef ecosystem. Describe different protective strategies used by organisms on the reefs and their adaptive importance. Using the Coral Reef Color Page, have students form small groups and discuss the protective strategies utilized by as many of the organism as they can. Have each group pick their favorite relationship or adaptive strategy and have them present a short role playing skit to the class. It is bright yellow with a blue streak on its body and a "fake eye" on its tail to confuse any predators that try to attack. The predator thinks that it is aiming for the head when in reality it is aiming for the tail, enabling the butterflyfish to dart forward and escape. Clown Triggerfish: the clown triggerfish is marked with large white polka dots which help to break up its outline and camouflage it against the reef. The clown triggerfish attacks small reef animals, such as fish that hide in the sand and sea urchins, by blowing streams of water out its mouth to uncover or overturn its prey. Hard Coral: Hard corals build reefs by secreting a hard external limestone skeleton. During the daytime, the coral polyp retracts into its limestone base for protection from hungry fish but at night it comes out to feed on floating plankton. Nudibranch: the nudibranch feeds on the tentacles of sea anemones but does not trigger their stinging cells (called nematocysts). Pufferfish: Pufferfish protect themselves by drawing water into their abdomen to inflate themselves to more than twice their normal size thereby making it difficult for predators to swallow them. They also have large protruding eyes that can see in all directions enabling them to spot predators quickly. Pufferfish produce a powerful poison called tetraodontoxin which discourages predators from eating them. Stonefish: the stonefish uses more than one method for protection: camouflage to blend in with its environment, and lethal poison in its dorsal spine to avoid being eaten. Have the class break up into small groups and prepare a short poem, role playing presentation, or artistic representation about the importance of symbiosis on the coral reef. As an extension have each student prepare a research essay describing a symbiotic relationship and its evolutionary and ecological importance to the organisms involved. These algal cells provide the coral with food through the process of photosynthesis in which zooxanthallae cells use sunlight to convert the carbon dioxide and water in the polyp tissue into oxygen and carbohydrates. The oxygen is used by the polyp for respiration and the carbohydrates are used for energy to build its limestone skeleton. In return, the polyp provides the zooxanthallae with nutrients, protection, a place to live, and carbon dioxide, a by-product of respiration which is vital for photosynthesis. Sea anemone and clownfish: the clownfish has a symbiotic relationship with its partner, the sea anemone. In return, the clownfish, being extremely territorial, drives off any fish that try to prey on the anemone. The clownfish also drops bits of food among the tentacles which the anemone can eat. Cleaner wrasse and fish being cleaned: the cleaner wrasse cleans debris and parasites off of larger fish which keeps the larger fish healthy and gives the cleaner wrasse nourishment and protection. The fish being cleaned will allow it to move freely about its gills and mouth without trying to eat it. In some places fish actually line up for this service, forming cleaning stations along the reef. Lettuce coral primary producer (zooxanthallae), and secondary consumer - omnivore (polyps) (page 1-2) 3.

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Tomfohr anxiety coach cheap venlafaxine 37.5mg on-line, Pung anxiety cat buy generic venlafaxine on line, Mills anxiety pill 027 purchase venlafaxine from india, and Edwards (2015) conducted a study with 130 healthy college students to understand the association between trait mindfulness and physiological reactivity anxiety symptoms - urgency and frequent urination buy venlafaxine master card. Brown, Weinstein, and Creswell (2012) have also enhanced our understanding by conducting a study with 44 healthy college students to examine whether trait mindfulness can buffer from the negative impact of stress by investigating cortisol and negative affective responses to a social stress task. They found that cortisol response to a social evaluative threat task was inversely associated with trait mindfulness such that individuals with high mindfulness show less cortisol response. This evidence provides limited support for the idea that trait mindfulness may attenuate the physiological responses to stress. As a result, it may affect more biological responses and may lead to a more maladaptive pain experience. Given the fact that young and healthy students with limited pain experience participated in the study, cognitive stress appraisals prior to a cold pressor pain induction may be different from cognitive stress appraisals during the cold pressor recovery period. A more integrative understanding of the association between variables known to exacerbate the chronic pain experience may help in the development of more effective psychological and multidisciplinary treatment. It is also to examine how mindfulness as a trait disposition influences these relations. Hypothesis 2: Pain catastrophizing will be positively associated with Threat Appraisal 1, Threat Appraisal 2, and the magnitude of change in threat appraisals. Pain Catastrophizing will be positively associated with cardiovascular and cortisol reactivity. Hypothesis 4: Trait mindfulness will be inversely associated with Threat Appraisal 1 as well as Threat Appraisal 2. Hypothesis 6: the association between Threat Appraisals and pain catastrophizing and outcomes of physiological reactivity and pain experience, found from the hypothesis 5, will be significantly different between individuals with high trait mindfulness and those with low trait mindfulness. There were initially total 134 participants who gave consent for their participations to the study and completed a demographics questionnaire (Appendix A). Of those 134 participants, 26 participants were excluded based on exclusion criteria (see below). Students voluntarily selected a study to participate for course credit from the provided list of the available research studies on campus. Participants were excluded from the entire study if they had not eaten a meal in the last four hours, had not drunk any water or any liquid in the last two hours, or had consumed alcohol within 12 hours of the study. Participants were excluded from the entire study if they any medical disorders. Participants who have an implanted medical device, an open cut or sore on their non-dominant hand, or are pregnant were excluded from the entire study. Part ways through the study, data collection methods were modified to have the study sessions only in the afternoon. Participants were excluded from the data analysis if they had not been awake more than three hours and a half. In addition, participants were excluded from the data analysis if they had an average systolic blood pressure at rest was equal or greater than 160 mm Hg. Research Design A correlational design was conducted examining the relations between the variables of interest. A cold pressor apparatus consisted of Igloo 38-gallon ice cooler divided into two compartments by a mesh net. In addition, the height and weight of each participant was measured by a researcher using a wall-mounted ruler and a professional medical scale. Pain threshold was measured by the time (seconds using a digital stopwatch) when participants reported the first time they felt the pain. Pain tolerance was measured by the length of time in seconds that the participants kept their hand in the cold water. The second pain ratings by a Likert scale of 0-10 (0 being "no pain" and 10 being "the worst pain you can imagine") were measured immediately after participants removed their hand from the cold water. Participants provided their salivary samples via passive drool method, which involves in pooling saliva in their mouth and drooling through a straw into a clear 14-mL polypropylene cryovial tube.