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By Q. Copper. Central Bible College. 2019.

Dennis Carlson for his invaluable technical and moral support for the completion of this work buy flavoxate 200 mg amex. We also extend our appreciation to those individuals who reviewed this lecture note in different teaching institutions for the materialization of this lecture note generic 200 mg flavoxate free shipping. Identify the chemical meanses of sterilization and disinfection, and their effect on bacterial cell 6. It considers the microscopic forms of life and deals about their reproduction, physiology, and participation in the process of nature, helpful and harmful relationship with other living things, and significance in science and industry. Hippocratus, father of medicine, observed that ill health resulted due to changes in air, winds, water, climate, food, nature of soil and habits of people. Although Leeuwenhoek was not concerned about the origin of micro-organism; many other scientists were searching for an explanation for spontaneous appearance of living things from decaying meat, stagnating ponds, fermenting grains and infected wounds. Theory of Biogenesis 2 Theory of Abiogenesis deals with the theory of spontaneous generation; stating that living things originated from non-living things. He observed spontaneous existence of fishes from dried ponds, when the pond was filled with rain. Francesco Redi (1626-1697): He is the scientist who first tried to set an experiment to disprove spontaneous generation. He designed a large curved flask (Pasteur goose neck flask) and placed a sterile growth broth medium. Air freely moved through the tube; but dust particles were trapped in the curved portion of flask. Therefore Pasteur proved that micro-organisms entered to substrates through the air and micro-organisms did not evolve spontaneously. Discovery of streptococci The germ theory of disease The complete establishment of the germ theory of disease depended on the work of a German scientist, Robert Koch (1843- 1910). Koch’s postulates Koch’s postulates: proof of germ theory of disease A micro-organism can be accepted as a causative agent of an infectious disease only if the following conditions are satisfied. The micro-organism should be found in every case of the disease and under conditions which explain the pathological changes and clinical features. It should be possible to isolate the causative agent in pure culture from the lesion. When such pure culture is inoculated into appropriate laboratory animal, the lesion of the disease should be reproduced. It should be possible to reisolate the bacterium in pure culture from the lesion produced in the experimental animal. It has not been possible to fulfil every one of Koch’s postulates, but by adhering to them as closely as possible, serious errors have been prevented. Some microbes are very difficult or impossible to grow in vitro(in the laboratory) in artificial media. Certain diseases develop only when an opportunistic pathogen invades immunocompromised host. Classification is the assignment of organisms (species) into anorganised scheme of naming. The establishment of criteria for identifying organisms & assignment to groups (what belongs where) 5 2. At what level of diversity should a single species be split in to two or more species? Species) are more similar to each other than are members of higher level taxa (eg. Thus once you know that two individuals are member of the same taxon, you can inter certain similarities between the two organisms. Strain is the level below the species b) Two members of the same strain are more similar to each other than either is to an individual that is a member of a different strain, even if all three organisms are members of the same species Bacterial species - A bacterial species is defined by the similarities found among its members. Properties such as biochemical reactions, chemical composition, cellular structures, genetic characteristics, and immunological features are used in defining a bacterial species. Identifying a species and determining its limits presents the most challenging aspects of biological classification for any type of organism. Monera ( the prokaryotes) Kingdom of Monera Three categories: - Eubacteria Are our common, everyday bacteria, some of which are disease – causing; also the taxon from which mitochondria originated. Distinctively, however, the members of Kingdom Protista are all eukaryotic while the mebers of kingdom Monera are all prokaryotic. Some members of protista are multicellular, however Kingdom protista represents a grab bag, essentially the place where the species are classified when they are not classified as either fungi, animals or plants. Kingdom Fungi Unlike pprotists, the eukaryotic fungi are typically non – aquatic species. They traditionally are nutrients absorbers plus have additional distinctive features. The domain system contains three members 9 ¾ Eukaryotes ( domain Eukarya ) ¾ Eubacteria ( domain Bacteria) ¾ Archaebacteria ( domain Archaea) Viral classification Classification of viruses is not nearly as well developed as the classification of cellular organisms.

In a walking meditation you use the physical movement of your body as the object of your concentration and mindfulness buy flavoxate 200mg online. This is an excellent alternative to sitting in meditation purchase flavoxate 200 mg otc, as in a sitting posture sometimes fatigue sets in when your body is still for a long time. Slowly lift one leg, feeling how the muscles contract and how your whole body changes as it’s balancing in response to this action. Slowly move your raised leg to take a step and mindfully note 120 • Mindfulness Medication the second when your raised heel makes contact with the ground. Begin to add your weight to the step and slowly feel the changes in your body as this new balance is accommodated. Continue to slowly take steps across the room while trying to notice every little aspect of your body as it moves through the steps. Feel the sensations of movement and the point of contact between your feet and the ground. Look for how the sensations are constantly changing as a way of maintaining your uninterrupted attention and interest. When you reach the other end of the room, turn and repeat the process as you continue to walk back and forth. In a modification of the above process, you can bring your awareness to the intent to move that is present, before you actually move your body. Before any movement, or speech is carried out, your mind creates the intent to perform it in your consciousness. If you bring your attention to what happens before you speak or move, you can hear the words before they are spoken, and experience the urge to move before any movement occurs. Try to bring your awareness to the intent to move, before you take each step of your walking meditation. You can also try to coordinate the movement of the breath with the movement of the body. For example with an inhalation you lift one leg and with an exhalation you then place the foot on the ground. You can discover whatever rhythm of breathing, coordinated with movement, works best for you. This is a way to maintain your concentration on your breathing by using physical movement to help support your focus. As a formal practice you can set aside five to ten minutes a day, or longer, for a walking meditation. Whenever you’re walking somewhere in your daily life, try to bring your attention, mindfully to the act of walking. Meditation: Sitting in Stillness • 121 Meditation Pitfalls, Hurdles, Trips and Traps Physical Discomfort It’s not uncommon for you to experience some physical discomfort, even minor pain, when first starting to meditate. This may reflect a release of stored tension within your body that only becomes evident as you slow your mind down. It may indicate that your muscles are a bit tight and are simply not used to sitting in the posture you’ve chosen. Practice stretching exercises for your hips, such as the Butterfly exercise discussed in the Sitting Posture section of this chapter. When discomfort, pain or itching first starts, use it as the object of your concentration. Instead of calling it pain, try to think of what you’re feeling as just another physical sensation. If the pain begins to be overwhelming, or is becoming significant, it’s perfectly okay to move, but try to move in a slow and mindful way. Sleepiness If you really feel lethargic and sleepy during meditation this may reflect that you’re actually sleep deprived. Getting more sleep is essential and is yet another way to improve your response to everyday stress. Just as a young child is grouchy and emotional when tired, so are you, but you probably hide it a little better. If you find yourself nodding off during your meditation, initially check that you’re holding your spine in an upright but relaxed position. Make sure that your head is not bending forward as your chin tries to sneak toward your chest. Often, when you become tired, 122 • Mindfulness Medication your posture is not maintained and this is the first clue that you’re beginning to get fatigued. Another option, that I’ve already mentioned, is the Walking Meditation, wherein you keep your attention on your breath as you slowly walk around the room. You can give yourself a quick wakeup anytime by grasping your ear lobe and giving it a good squeeze. Try meditating at a different time of day when you’re not as vulnerable to fatigue. If none of these suggestions seem to work for you, then maybe you’re just really tired and you need some rest. Try catching a nap during the day and recognize that there will be some days when you’re just plain tired.

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All other routes of characteristics/Terapeutic drug monitoring/2 administration require absorption through cells order 200 mg flavoxate mastercard, 7 200 mg flavoxate otc. Te phrase “first-pass hepatic metabolism” and this process reduces the bioavailable fraction. One hundred percent of a drug is excreted by can be calculated by dividing the peak blood the liver concentration after oral administration by the peak B. C Drugs given orally enter the blood via the portal circulation, reducing bioavailability circulation and are transported directly to the liver. Te drug must be metabolized in the liver to an Some drugs are excreted by the liver, and a fraction active form will be lost by hepatic excretion before the drug Chemistry/Apply knowledge of fundamental biological reaches the general circulation. An example is characteristics/Terapeutic drug monitoring/2 propranolol, a β-blocker that reduces heart rate and hypertension. Dose per hour = clearance (milligrams per hour) × average concentration at steady state ÷ f 8. Dose per day = fraction absorbed – fraction bring the drug level up to the desired therapeutic excreted range, a maintenance dose must be given at C. Dose = fraction absorbed × (1/protein-bound consistent intervals to maintain the blood drug level fraction) at the desired concentration. Dose per day = half-life × log Vd (volume determined by multiplying the clearance per hour distribution) by the desired average steady-state concentration, Chemistry/Calculate/Terapeutic drug monitoring/2 then dividing by f (bioavailable fraction). Which statement is true regarding the volume Answers to Questions 9–13 distribution (Vd) of a drug? B The Vd of a drug represents the dilution of the drug divided by the dose given after it has been distributed in the body. Vd is the theoretical volume in liters into which used to estimate the peak drug blood level expected the drug distributes after a loading dose is given. Te higher the Vd, the lower the dose needed to equals the dose multiplied by f ÷ Vd. The Vd can be reach the desired blood level of drug calculated by dividing the dose, Xo, by the initial D. Te Vd is the principal determinant of the dosing plasma drug concentration, Co, (Vd = Xo/Co) or by interval dividing the clearance rate by K, the elimination rate constant (K = 0. The Chemistry/Apply knowledge of fundamental biological greater the Vd, the higher the dose that will be characteristics/Terapeutic drug monitoring/2 needed to achieve the desired blood concentration 10. The V is the principal determinant of the d statement about drug clearance is true? It is directly related to half-life between the amount of drug eliminated per hour D. For drugs following linear Chemistry/Apply knowledge of fundamental biological kinetics, clearance equals the elimination rate divided characteristics/Terapeutic drug monitoring/2 by the drug concentration in blood. Which statement about steady-state drug levels (in milligrams per hour) and f are known, the dose per is true? Clearance is inversely amount excreted related to the drug’s half-life and is accomplished B. Constant intravenous infusion will give the same distribution and elimination rates are constant. Peak and trough levels are the dose-response curve characteristics of intermittent dosing regimens. The Chemistry/Apply knowledge of fundamental biological steady state is reached when drug in the next dose is characteristics/Terapeutic drug monitoring/2 sufficient only to replace the drug eliminated since the last dose. If too small a peak–trough difference is seen for a drug half-lives because blood levels will have reached drug given orally, then: 97% of steady state. Dose interval should be increased concentration of the drug, and increasing the dose D. Dose per day and time between doses should be will increase the peak concentration of the drug, decreased resulting in a greater peak–trough difference. The Chemistry/Select course of action/Terapeutic drug peak–trough ratio is usually adjusted to 2 with the monitoring/3 dose interval set to equal the drug half-life. If the peak level is appropriate but the trough level fall within the therapeutic range. Decreasing the dosing per day interval will raise the trough level so that it is B. Not be changed, but dose per day increased level is affected by the drug clearance rate. Be shortened, but dose per day not changed clearance increases, then trough level decreases. If the steady-state drug level is too high, the best Answers to Questions 14–19 course of action is to: A.

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It negative stereotypes discourages them from entering treatment and effective skills for and media stories buy 200 mg flavoxate. It cre- Managers and staff ates a barrier for those trying to access other working with the members should parts of the health care system discount flavoxate 200mg visa. A striking develop effective skills example is the failure of many medical practi- for working with the media. It prevents new treat patients with respect and pay attention programs from opening when community oppo- to the terms they use. It can affect a programís inter- treatmentî should be avoided because it incor- nal operations. Terms such as ìdirtyî and ìcleanî in gram services with a punitive or counterthera- reference to drug-test specimens should be peutic demeanor. The consensus panel the programís public representatives and easy hopes that this publication will advance high- targets for complaints from the community. Lorem ipsum dolorEmergence of Opioid Addiction assit Opioid addiction has affected different population groups and socio- a Significant economic classes in the United States at different times. Societyís Problem and theSed do response has changed along with changes in the groups or classes most Roots ofeiusmod affected, shifts in social and political attitudes toward opioid addiction, Controversy and the accumulation of more and better information about its causes Ut enim and treatments (Musto 1999). Regulatory History Em ergence of Opioid Addiction as a Significant Problem and the Roots of Controversy Many of todayís substances of abuse including the opioidsóprimarily opium, morphine, heroin, and some prescription opioidsógained their early popularity as curatives provided by physicians, pharmacists, and others in the healing professions or as ingredients in commercial prod- ucts ranging from pain elixirs and cough suppressants to beverages. These products usually delivered the benefits for which they were used, at least initially, such as pain relief, increased physical and mental ener- gy (or ìrefreshmentî), and reduced anxiety. For example, opioids were often the best available substances to relieve pain on Civil W ar battle- fields. Unfortunately, the uncontrolled use of opioids either for pre- scribed and advertised benefits or for nonmedicinal effects leads to 11 increased tolerance and addiction. Recog- persons were opioid addicted in the United nition of this prob- States (Brecher and Editors 1972; Courtwright to alleviate acute lem has spurred a 2001; Courtwright et al. Doctors usually prescribed This debate centers more opioids for these patients, and sanatori- on two different ums were established for questionable ìcuresî views: (1) opioid addiction is a generally incur- of the resulting addictions. The chronic nature able disease that requires long-term mainte- of opioid addiction soon became evident, how- nance with medication; or (2) opioid addiction ever, because many people who entered sanato- stems from weak will, lack of morals, other riums for a cure relapsed to addictive opioid psychodynamic factors, or an environmentally use after discharge. In Eugene OíNeillís autobi- determined predilection that is rectified by ographical drama ìLong Dayís Journey Into criminalization of uncontrolled use and distri- Night,î for example, his father refuses to bution and measures promoting abstinence. Addiction By the end of the 19th century, doctors became Opioid addiction first emerged as a serious more cautious in prescribing morphine and problem in this country during and after the other opioids, and the prevalence of opioid Civil W ar, when opioids were prescribed widely addiction decreased. Small groups still prac- to alleviate acute and chronic pain, other types ticed opium smoking, but most Americans of discomfort, and stress. Although a smaller regarded it as socially irresponsible and pattern of nonmedical opioid use continued as immoral. It is noteworthy, however, that well, mainly opium smoking among Chinese heroin, introduced in 1898 as a cough suppres- immigrants and members of the Caucasian sant, also began to be misused for its euphoric ìundergroundî (e. By the late 19th of the hypodermic technique of drug adminis- century, probably two-thirds of those addicted tration, which gained popularity between 1910 to opioids (including opium, morphine, and and 1920, had a profound effect on opioid use laudanum) were middle- and upper-class W hite and addiction in the 20th century and beyond women, a fact Brecher and the Editors of (Courtwright 2001). Courtwright (2001) from crowded cities, Hispanics and African- portrays most users of opioids of this period as Americans moved into areas with preexisting young men in their 20s: ìdown-and-outsî of opioid abuse problems, and the more suscepti- recent-immigrant European stock who were ble people in these groups acquired the disorder crowded into tenements and ghettos and (Courtwright 2001; Courtwright et al. The initial treatment response in the early 20th society appeared to view with disdain and fear century continued to involve the prescriptive the poor W hite, Asian, African-American, and administration of short-acting opioids. By the Hispanic people with addiction disorders who 1920s, morphine was prescribed or dispensed lived in the inner-city ghettos (Courtwright et in numerous municipal treatment programs al. Brecher and the Editors of Consumer Reports Addictive use of opium, cocaine, and heroin, (1972) point out that, by the mid-1960s, the along with drug-related crime, especially in number of middle-class young W hite Americans poor urban communities, increasingly con- using heroin was on the rise, as was addiction- cerned social, religious, and political leaders. From one-fourth (Brecher and Editors rated; negative attitudes toward and discrimi- 1972) to one-half (Courtwright 2001) of nation against new immigrants probably col- American enlisted men in Vietnam were ored views of addiction. Immigrants and others believed to have used or become addicted to who trafficked in and abused drugs were heroin; however, W hite (1998) points out that viewed as a threat. As detailed below, societyís the feared epidemic of heroin addiction among response was to turn from rudimentary forms returning veterans did not materialize fully. He of treatment to law enforcement (Brecher and concludes, ìVietnam demonstrated that a pat- Editors 1972; Courtwright 2001; Courtwright et tern of drug use could emerge in response to a al. For more on trends in the 1920s and particular environment and that spontaneous 1930s, see ìEarly treatment effortsî below. Although this number represented a opioid-addicted population to drop to a historic 66-percent increase over the estimated number low of about 20,000. Once smuggling resumed of late 19th-century Americans with opioid after the war, the population that had used addiction, the per capita rate was much less opioids resumed the habit.

Have you ever Ubeen in an airplane when turbulence caused a sudden dip of the plane as well as your stomach? Or watched in slow motion as another car careened across the road sliding in your direction? How about noticing someone wearing dark clothing cheap 200 mg flavoxate mastercard, who’s nervously glancing around 200mg flavoxate with visa, sweating, and carrying a large bag at a ticket counter? Do you get a bit jumpy in a strange city in the dark, not sure which way to go, with no one around, when a group of quiet young men suddenly appear on the corner? This chapter is about true feelings of stark terror and the emotional after- math of being terrified. First, we take a look at your personal risks — just how safe you are and how you can improve your odds. Then we discuss methods you can use to prepare or help yourself in the event that something terrifying happens to you. Finally, we talk about acceptance, a path to calmness and serenity in the face of an uncertain world. Evaluating Your Actual, Personal Risks Chapter 15 discusses the fact that the risk of experiencing natural disasters is quite low for most people. Billions of dollars are justifiably spent battling terrorist activities, and according to a 2005 report in Globalization and Health, you’re 5,700 times more likely to die from tobacco use than an attack of terrorism. Similarly, the journal Injury Prevention noted in 2005 that you’re 390 times more likely to die from a motor vehicle accident than from terrorism. For example, around 3 million (about 1 percent) of all Americans will be involved in a serious motor vehicle accident in any given year. For those who sign up to serve and protect our country through the military, the risk of injury in combat varies greatly over time and also depends on the particular war. However, for someone in a combat zone, the risk of death pales in comparison to the chances that the person will experience serious injury or witness acts of severe violence to others — and then struggle emo- tionally afterward. People find themselves having intrusive images of the event(s) and often work hard to avoid reminders of it. The following section reviews what you can do to reduce your risks of experiencing trauma. Maximizing Your Preparedness No matter what your risks for experiencing violence, we advise taking reason- able precautions to keep yourself safe. The key is making active deci- sions about what seems reasonable and then trying to let your worry go because you’ve done what makes sense. If, instead, you listen to the anxious, obsessional part of your mind, you’ll never stop spending time preparing — and needlessly upset your life in the process. Taking charge of personal safety Chapter 15 lists important preparatory steps you can take in possible anticipa- tion of natural disasters. Those same items apply to being prepared for terror- ism and other violent situations. In addition, we recommend you consider a few more actions: ✓ Always have a stash of cash on hand. Duct tape can fix a lot of things in a pinch and also serve to prevent windows from shattering. Always keep at least a three-day supply of food and water for each household member. Avoiding unnecessary risks The best way to minimize your risk of experiencing or witnessing violence is to avoid taking unnecessary risks. People don’t ask to be victims of crime, ter- rorism, or accidents, and you can’t prevent such events from ever occurring. We suggest the following, fully realizing that some of these may sound a little obvious. But because people often don’t follow these suggestions, here they are: ✓ Wear seatbelts; need we say more? State Department lists areas deemed unsafe for travel because of terrorism or other known risks at http://travel. Dealing with Trauma We hope you’re never a victim of nor a witness to severe violence, but we know it’s a real possibility. So if you’ve recently been a victim, you may be experiencing some serious signs of anxiety or distress. And the first thing we’re going to tell you is that, unless your symptoms are quite severe and interfering greatly with your life, don’t seek out mental-health treatment right away! That’s because, in many cases, your mind’s own natu- ral healing process will suffice. For example, a single debriefing session often takes place after exposure to a traumatic event. In such a session, people are given basic information about trauma and its potential effects and are then encouraged to talk about how they’re coping with it. But such a session may actually increase the risk of emotional symp- toms occurring or continuing.