Sistrurus miliarius

Number of Pages: 2Integrative BiologyGeological Science

Lesson 01

Introductionhttps://scholar.csl.edu/deaf_pah_large_catechism/1000/thumbnail.jp

Transoral robotic surgery for the treatment of oropharyngeal squamous cell carcinoma

Squamous cell carcinoma (SCC) of the oropharynx affects nearly 50,000 individuals in the United States each year, and, with the rising incidence of the human papillomavirus (HPV), the number of patients diagnosed with SCC is expected to continue to grow (American Cancer Society 2018; Coughlan and Frick 2012). Oropharyngeal squamous cell carcinoma (OPSCC) has traditionally been treated with wide surgical extirpation often involving removal of portions of the oral cavity, pharynx, and jaw; this kind of surgery can be disfiguring and has been associated with significant post-operative complications (Brickman and Gross 2014). In the late 20th century, clinicians began favoring the use of chemoradiation therapy instead of surgery in an effort to spare patients the morbidity associated with surgical techniques at the time (Mercante et al. 2015). While chemoradiation offers excellent survival for patients with SCC, this therapeutic strategy has been observed to have its own debilitating post-treatment side effects (Hamilton and Paleri 2017). An important advancement in the management of OPSCC occurred about 20 years ago with the advent of transoral robotic surgery (TORS), a surgical technique that uses a robotic system to operate through the natural opening of the mouth. Proponents of TORS suggest that the technology improves on conventional surgery and may provide patients with functional outcomes superior to those seen with chemoradiation with no sacrifice in survival (Yeh et al. 2015; Hay et al. 2017). This review investigates the validity of the concept that TORS has significant advantages in the modern-day treatment of OPSCC. This report includes three components. First, the TORS technology, its advantages, and its drawbacks are explained. Second, relevant medical literature is reviewed to provide an understanding of the rationale for utilizing TORS in the treatment of OPSCC. Review and analysis of published reports show that TORS can provide patients with excellent post-operative function, good quality of life, and acceptable survival rates. Notable exceptions include patients with advanced disease. Third, this review discusses future studies that will better inform caregivers about the utility of TORS in the treatment of OPSCC. TORS is a relatively new technology that seems to offer the possibility of helping to improve the lives of patients with OPSCC

Practice Smiling

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The United States Draft United Nations Convention on the International Sea-Bed Area and the Accomodation of Ocean Uses

The United States Draft Sea-Bed Convention is a dynamic application of the principle of true accommodation in the broadest sense. It addresses the need to regulate in a fair and orderly fashion the exploitation of sea-bed resources while meeting the needs of other ocean uses by means of mutual accommodation provisions

Administrative Law - Federal Communications Commission - Responsible Representatives of the Listening Public Granted Standing to Intervene at FCC Hearings. Office of Communications of the United Church of Christ v. FCC (D.C. Cir. 1966).

T Section 404.6 permits the arrest and prosecution of every person who, by acts or conduct, intends to cause a riot under circumstances where the probabilities that he will succeed are imminent. By allowing the police to arrest such a person or persons, the section intends to nip the riot-rose in the bud and thereby preserve the public peace. Through an analysis of legislative history, case history, and recent opinions of the Supreme Court, the writers will endeavor to support the proposition that private correspondence between consenting parties, whether obscene or not, is outside to scope of the obscenity statute

Structural Models of Comorbid Anxiety and Depression in a Primary-Care Older Adult Sample: Effect of Medical Illness Severity, Threat, Chronicity, and Progressiveness on Model Fit

Recent research suggests that anxiety disorders may be more common in later life than previously thought. Among other factors, the presence of comorbid mood disorders and medical illness confounds accurate assessment and diagnosis of these conditions in the elderly. There have been few studies, however, examining the structural relationships between anxiety and depression with older-adult samples, and even fewer have considered the effect of medical illness on these relationships. This study examined three established structural models of anxiety and depression, using a clinical sample of older adults seeking treatment in a primary-care setting (N = 2,163). It was hypothesized that the presence of comorbid medical illness would act as a moderating variable in evaluating the fitness of these models. Results indicated that a hierarchical model represented the most parsimonious fit to the full sample. Tests of factorial invariance revealed variance in model fit as a function of illness severity and threat, and as a function of illness chronicity and progressiveness. Specifically, the relationship of somatic symptoms to anxiety varied by combined severity/threat, as well as by chronicity/progressiveness. These findings support previous conceptualizations of the relationship between anxiety and depression. Implications of these results for taxonomy, assessment, and intervention are discussed

Examining Treatment Acceptability of an Eight-Week Mindfulness-Based Stress Reduction Protocol

The goal of this study is to examine whether levels of perceived stress, experiential avoidance, personality traits including openness to experience and agreeableness, and demographic variables will predict the treatment acceptability (indicated by responses on the Treatment Acceptability and Adherence Scale) of an eight-week Mindfulness-Based Stress Reduction (MBSR) program. This study collected data in the Spring of 2019. The final number of participants in the study was 116 (40 females, 76 males, Mage = 36, age range: 22-69 years). Participants completed measures including the Perceived Stress Scale (PSS), Acceptance and Action Questionnaire-II (AAQ-II), the agreeableness and openness to Experience domains from the International Personality Item Pool-Neuroticism Extraversion Openness scale (IPIP-NEO-60), and the Treatment Acceptability and Adherence Scale (TAAS). Participants also responded to an open-response question regarding what influenced their rating of the mindfulness protocol. This study examined three hypotheses. The first looked at how level of education and age were related to participants’ ratings of treatment acceptability (measured by the TAAS) of an eight-week MBSR protocol. The second looked at how gender and ethnicity related to participants’ ratings of the mindfulness protocol. The third looked at how performance on the PSS, AAQ-II, and IPIP-NEO-60 affected participants’ ratings of the mindfulness protocol. Results from this study indicated that, based on the sample, factors related to personality, perceived stress, and levels of acceptance significantly predict how acceptable an individual will rate an eight-week MBSR protocol. Additional findings from reviewing the open-response question indicated that the length of the protocol influenced individual’s ratings on both the high and low end of the TAAS. The biggest barrier that clinicians will likely face with clients in an MB intervention will be the amount of time involved in completing such a program. Highlighting the benefits of this type of treatment along with explaining to clients the rationale behind the length of time required for such a program will be useful