What is a Mild Brain Injury?

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By Michael Howard, Ph.D.

The Mild Traumatic Brain Injury (MTBI) Working Group of the CDC (Center for Disease Control) in Atlanta has defined MTBI as an injury to the head resulting from blunt trauma or acceleration or deceleration forces with one or more of the following conditions:

  • transient confusion, disorientation, or impaired consciousness.
  • dysfunction of memory around the time of injury.
  • loss of consciousness lasting less than 30 minutes.

Mild traumatic brain injury is also called concussion.  Traumatic brain injury results when the neurons inside the brain are damaged from acceleration-deceleration forces during impact.  When the head is struck or moved violently, the gel-like brain is rapidly displaced or concussed back and forth within the skull.  The brain is distorted in shape and the fragile, thread-like neuron cells inside the brain can be stretched, torn, or traumatized by the mechanical forces.

Typically, the long axon of the neuron is most susceptible to injury.  The phenomenon is called axonal shearing.  This type of traumatic injury can result in the neuron’s death or temporary loss of function.  When, by head trauma, a number of neurons is disabled in such a manner, disruption or alteration of brain functions can occur.  This is the major mechanism behind MTBI.

Traumatic brain injury can result in the skull being broken or fractured (penetrating head injury) or the skull remaining intact (closed head injury).  In MTBI, closed-head injuries are by far the most common.  It is not necessary for the head to be physically struck to result in mild traumatic brain injury.  Violent back-and-forth movement of the head, called whiplash, can also result in neuronal damage.  The MTBI that is due to proximity to a blast explosion that many soldiers and others in Iraq have sustained is another example of an MTBI occurring without the head being physically struck.

WHAT ARE THE SYMPTOMS OF A MILD BRAIN INJURY?

It is common for individuals to have immediate symptoms of brain impairment after a mild traumatic brain injury.  These symptoms can be physical, cognitive, and behavioral in nature and can occur in any combination. They typically last up to a few weeks.  Although there is no “typical” MTBI patient, headaches, dizziness, insomnia, and intermittent confusion are commonly seen in the first days or weeks after the injury.  These symptoms are most severe immediately after the injury.

Over the few days or weeks following the injury, the symptoms should diminish in number and intensity.  Whether or not an individual will have symptoms persisting beyond the first few weeks or months is very difficult to predict and may depend on a number of factors, including the presence of co-existing conditions like depression, anxiety, chronic pain, prior head traumas, or involvement in personal-injury litigation.

Celebrate the Brain

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fondue-709713_640Thanksgiving and the many holidays that follow are joyful times to be with family and friends.  Holiday cheer, a positive emotion, can also provide the brain with healthful hormones and neurochemicals that improve brain function.

Family traditions boost enjoyment of holiday gatherings.  In a recent series of studies in the Journal of the Association for Consumer Research, subjects described the customs they followed — along with those of their families — during holidays.  These activities were rated as enjoyable, personal experiences that enhanced bondings with family members.  In fact, simply recalling past traditions can put a warm glow on holiday gatherings and support creative thinking.

Memories of childhood or lost loved ones often surface at celebrations.  The bittersweet feeling of nostalgia can elevate mood and mental outlook.  A recent study published in the journal, Emotion, reported that nostalgia boosts a sense of connection to the past, creating a social web that extends across people and time.  This “self-continuity” energizes the brain.  So, pull out an old photo album and spend some time revisiting your past this season.

When listing New Year’s resolutions, resolve to keep friendships alive throughout the year.  The benefits of supportive relationships are numerous.  Research published online in the Journal of Epidemiology and Community Health (2016), stated that individuals who have greater levels of social support enjoy better psychological health and mental functioning.  The reduction of chronic stress and the stimulation associated with meaningful social interaction are strongly linked to improved resilience and reduced risk of anxiety and depression.  There is also a lower likelihood of cognitive decline.

The highlight of any holiday is food, often deeply entwined with tradition, but possibly devoid of brain-healthy choices.  Compromises that allow both brain-healthy and traditionally-happy fare, including desserts, can solve this dilemma.  First, shift the spotlight from rich food to lighter fare by serving salad as the first course.  Go heavy on the greens, colored veggies, and crunchy bits of apples or pears.  Second, make a healthy vegetable side dish the co-star of the main course.  Third, regarding the turkey, think outside the bread box with offerings such as wild-rice stuffing, augmented with vegetables and dried cranberries.  Lastly, the first bite of dessert, thoughtfully consumed, always gets rated as the best.

Enjoy the fabulous taste of that bite!  Then, empower your mind with oxygen — by taking a mindful walk — to complete the celebration of your brain.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

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And The Winner Is…….The Grape!

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Nature introduced our ancestors to the first sampling of wine about 10 million years ago. As fruit ripened and fell to the earth, a natural process of decomposition occurred.

Microbes in the soil turned fruit sugar into a simpler component, ethyl alcohol.  Some curious, hungry ancestor, eating the decaying fruit, probably rejected the taste, but loved the altered state of mind.  A sophisticated version of nature’s process, called fermentation, was perfected, producing wines that delight the palate as well as the mind.

My  grandmother lived in rural Manitoba, Canada, and made her own wine from wild berries picked in late summer.  Her doctor recommended a glass of wine each night for good sleep and longevity.  In her generation, that glass was small, holding a mere four ounces.  Although today’s wine goblet may be enormous in size, the recommended intake of wine remains 4-6 ounces per day.  At high doses, the alcoholic content of wine may be both addictive and toxic to the brain.  An alternative choice is nonalcoholic wine.

Fermentation of the grape produces any array of chemical changes.  In addition to the conversion of sugar to alcohol, compounds in the grape’s skin and pulp are released, creating more than color, aroma, and a distinctive taste.  Vitamins, minerals, and an array of other nutrients are released into the liquid brew.  One of the heart-healthy plant chemicals concentrated in wine is the antioxidant resveratrol.  How does the content of resveratrol in wine compare with that in grapes or grape juice?

Resveratrol contributes color to grapes.  Red, purple, and black grapes are better sources of the chemical than white or green grapes.  Secondly, there is more resveratrol in the skin of the grape than in the pulp.  Fermentation releases the resveratrol from the grape’s skin into the liquid.  Thus, for the same weight or volume, red wine generally has more resveratrol than dark grapes or its juice.  Keep in mind that the fresh grape is an excellent choice, perhaps better than grape juice or wine.  For variety, peanuts, pistachios, cocoa, blueberries, and cranberries are good sources of resveratrol.

If you want more resveratrol in your diet, get it from food or wine, not from pills. Whole food or a glass of your favorite wine contains nutrients that work with this super antioxidant (resveratrol) for more healthful years.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

Belly Fat and Movement

Posted on Posted in Continuing Education, Nutrition, Psychology, Seminars, Webinars

By Laura Pawlak, PhD, RD emeritus

Today, unlike any time in U.S. history, body fat is accumulating pointedly in the belly.  In addition to calorie restriction, what practice is required to decrease belly fat?  Move about.

Losing the unwanted pounds gained during the holidays is a struggle for everyone. Keeping it off is even more difficult.  What’s the best way to maintain a lower weight, once achieved?  Move about.

Scientist study the brain, searching for ways to keep it vital over the extra decades we now live. What is considered the most important lifestyle factor to retain cognition throughout life?  Move about.

More Americans are diagnosed with depression and anxiety than anywhere else in the world.  What habit can aid in balancing mood?  Move about.

Researchers agree that the most important natural way to bring about good health is movement.  During activity, muscles release anti-inflammatory proteins that act as a natural protection against disease.  In spite of the proof that moving is as vital as sleep, food, or water, less than 25 percent of the nation exercises.

Perhaps part of the problem lies in the mistaken vision of exercise as fitness training, often too tough for most mortals. Boutique gyms continue to augment the difficulty of their programs to retain the hardiest of their hard-core members.  While a few exercisers may enjoy the endorphin “high” produced by the physical demand of these classes, the average member is soon discouraged and disappears in about three months.

At the opposite end of the spectrum is the typical worksite, where the employee exercise program might be limited to moving one’s fingers on a computer all day. Scientific evidence clearly shows that sitting for long periods of time heightens the risk of dementia, diabetes, depression, and, of course, obesity.

Now imagine that your workplace offers a program that can lift your mood and combat lethargy without reducing focus or attention — and even dull hunger and cravings.  What’s the strategy?  Stand up and walk for five minutes every hour during the workday.  Whether you are hired, fired, or retired, this movement schedule is a healthy approach to limiting sedentary behavior every day.

Does a simple sit/walk program eliminate the need for strength training, stretching, and near-daily moderate exercise?  No, but it’s wise to begin an active lifestyle with the easiest step.  Devote five minutes of every sedentary hour to walking.

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Binge Eating Disorder

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fat-foods-binge-eatingBy Nikita Katz, MD, PhD

Binge eating disorder is an illness that resembles bulimia nervosa.  Like bulimia, the disorder is characterized by episodes of uncontrolled eating or binging—occurring, on average, at least once a week for three months, according to DSM-5.  However, binge eating disorder differs from bulimia because its sufferers do not purge their bodies of excess food.

Individuals with binge eating disorder feel that they lose control of themselves when eating. While they commonly eat fewer meals than people without eating disorders.  When they do eat, they eat rapidly, consuming large quantities of food and do not stop until they are uncomfortably full.  When binging, they typically do so alone because they feel embarrassed by how much they are eating, and they tend to feel disgusted with themselves, depressed, or very guilty afterward.  Usually, they have more difficulty losing weight and keeping it off than do people with other serious weight problems. Most people with the disorder are obese and have a history of weight fluctuations.

Binge eating disorder is found in about two percent of the general population—more often in women than men.  Recent research shows that binge eating disorder occurs in about 30 percent of people participating in medically supervised weight-control programs.

Because people with binge eating disorder are usually overweight, they are prone to the serious medical problems associated with obesity, such as high cholesterol, high blood pressure, and diabetes. Obese individuals also have a higher risk for gallbladder disease, heart disease, and some types of cancer. Research at the National Institutes of Health and elsewhere has shown that individuals with binge eating disorder have high rates of co-occurring psychiatric illnesses, especially depression.

Cognitive behavioral therapy and interpersonal therapy are the treatments found to produce the greatest degree of remission in patients with binge eating disorder.  Also, there can be improvements in specific eating-disorder psychopathology, associated psychiatric problems such as depression and psychosocial functioning.

Epidemiology of Eating Disorders

Estimates of the incidence or prevalence of eating disorders vary depending on the sampling and assessment methods.

  • Eating disorders have generally been recognized as affecting a narrow population of Caucasian adolescent or adult young women from developed Western countries.  In recent years, data are steadily accumulating to document that:
  • The prevalence of anorexia nervosa and bulimia nervosa in children and younger adolescents is unknown.
  • Approximately 0.5–1 percent of adolescents suffer from anorexia nervosa and 1–5 percent suffer from bulimia nervosa. Female college students are at highest risk of the latter.
  • An estimated 85 percent of eating disorders have their onset during adolescence.
  • Estimates of the lifetime prevalence of bulimia nervosa among women have ranged from 1.1 to 4.2 percent. Some studies suggest that the prevalence of bulimia nervosa in the United States may have decreased slightly in recent years.
  • The reported lifetime prevalence of anorexia nervosa among women has ranged from 0.5 percent for narrowly defined to 4 percent for more broadly defined anorexia nervosa.
  • Estimates of the male-female prevalence ratio range from 1:5 to 1:10 (although 19-30 percent of younger patient populations with anorexia nervosa are male).
  • An estimated five million Americans suffer from eating disorders at any given time, including approximately 5 percent of women and <1 percent of men with either anorexia nervosa, bulimia nervosa, or binge eating disorder.
    • eating disorders have become more common in pre-pubertal children and women in middle and late adulthood in such countries
    • ethnic and racial minority groups in these countries are vulnerable to eating disorders, and
    • there is nothing uniquely “Western” about eating disorders, which are a global health problem.

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Avoiding Holiday Weight Gain

Posted on Posted in Continuing Education, Homestudy, Psychology, Seminars

pumpkin-pie-520655_640Turkey, stuffing, mashed potatoes, gravy, sweet potato casserole, cranberry sauce, more mashed potatoes, pumpkin pie, pecan pie, cherry pie, triple chocolate cheesecake, cookies, fudge, fruitcake. Okay, pass on the fruitcake. Is it any wonder why the vast majority of exercise equipment is sold in the month of January? This year, with a little foresight and planning, things could be different.

Prevention has always been preferable to cure. A few weeks of “preventive dieting” is not a bad way to avoid the shock and horror of stepping on the scale in January. It need not be as stringent as clear liquids and lettuce from Thanksgiving to New Year’s. That would be cruel and unusual punishment. However, a few, simple, common sense measures really can make a significant difference:

  • Have a healthy breakfast with some protein and whole grains. People who routinely eat breakfast (not a crème-filled doughnut) consume an average of two hundred calories less per day than people who skip breakfast.
  • Try not to drink calories. Avoid sugary beverages such as sodas, sweetened tea, lemonade, juice drinks. Diet sodas may be tempting, but they can actually cause an increase in appetite.
  • Cut back on alcohol for several weeks. Save the wine or cocktails for the really special meals. Alcohol consumption generally increases significantly from Thanksgiving through New Year’s. Unfortunately, alcohol is loaded with empty calories and can slow metabolic rate. It also disrupts normal sleep architecture.
  • Preserve and protect sleep. Multiple studies now confirm that sleep deprivation in both children and adults is associated with weight gain. There is no mystery. Even one night of inadequate sleep can adversely affect numerous hormones, including cortisol, thyroid, growth hormone, leptin, and ghrelin. Metabolic rate can drop and appetite increases. The result is weight gain. Ease up on the late nights and parties.
  • Aim for 30 minutes of exercise every day. There’s no need to wait for January 2. The benefits of exercise are legion. Apart from the improvement in conditioning, strength, and flexibility, exercise is a terrific way to cope with holiday stress, improve sleep quality, and possibly escape annoying relatives for a while.
  • Have a light, high-protein snack before heading off to a party. Working all day, skipping dinner, and arriving at a party in a state of semi-starvation is a recipe for overindulgence. Some yogurt, a little cottage cheese, or a small bowl of cereal before leaving the house can boost self-control in the face of tempting treats.
  • Downsize plates, bowls, glasses, and mugs. Most people will eat whatever food is presented on a plate, whether it’s 10 inches or 6 inches. Use small luncheon plates or salad plates at home for every meal. This is a great strategy for year-round weight control.
  • Split dessert with a friend even at the “big event” meals. TUMS will not be required as the after-dinner mint.

Avoiding holiday weight gain is not the impossible dream. It’s entirely possible with a little planning and discipline. Besides, no one will really miss all that fruitcake.

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Managing Holiday Stress

Posted on Posted in Continuing Education, Homestudy, Nutrition, Psychology

They’re coming: Thanksgiving; Hanukkah; Christmas; and New Year. Weeks of potential, nonstop stress are right around the corner. And, all of that is followed by seemingly endless bills, three or four months of miserable weather, and tax season. What could be better? Medically speaking, all of this can lead to a perfect storm of illness. Too much stress and too little sleep can set the stage for everything from colds, flu, and pneumonia, to hypertension, heart disease, and diabetes out of control. The discussion about holiday stress aggravating anxiety and depression could fill a book.

The reality is difficult to deny. During this wonderful but weird time, millions of people will go places they really don’t want to go. They will do things they really don’t want to do. And, in many cases, they will visit people they don’t even like. This is not necessary. Too many activities, too much chaos, noise, and stress, not to mention too many calories and too little sleep, combine to create a physiologic disaster. Before the madness begins, a few principles of prevention may help:

  • Minimize caffeine and alcohol. Alcohol is loaded with empty calories and will disrupt normal sleep architecture.
  • Avoid holiday exhaustion. It’s okay to decline invitations. Try not to go out two nights in a row and schedule some quiet time instead.
  • Make time for exercise. It will help dissipate stress, boost energy, and facilitate better sleep.
  • Avoid unrealistic expectations. Don’t try to recreate a Norman Rockwell scene. It puts too much pressure on everyone.
  •  Aim for a few lovely memories—not a credit card extravaganza. Overspending is a major contributor to holiday stress.
  • Be prepared to overlook a lot. Everyone has annoying relatives. We can’t control what they say or do, but we can control our response to it. Don’t let a thoughtless remark ruin the day for everyone.

In short, managing holiday stress involves a healthy dose of common sense. Don’t overeat, overindulge, overreact, or overspend. Do try to have a healthy routine with a little less food, a lot less chaos, and for more rest. That’s a good plan for any time of the year.webinarsSeminars-CTA

 

History of Meditation

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology

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By Barbara Sternberg, Ph.D.

The earliest roots of meditation go back too far to trace with full confidence. We do know, however, that the practice of meditation was refined in the temples, caves, and monasteries of the East and Near East.  Meditation has found its way to the West in the past century. In slightly different form, meditation also appears in the Judeo-Christian tradition.

Meditation dates back to our earliest ancestors, who stared in wonder at the sky as they waited for hours to hunt for prey.  Perhaps these ancestors waited while communal fires burned. Our ancestors had plenty of time on their hands.  Because meditation entails a shift from thinking and doing to just “being,” these ancestors were probably able to meditate during the course of many of their days.

Long before the arrival of Buddha in the East, or the great Indian yogis, shamans — people with alleged access to what is good and evil — living in hunter-gatherer cultures all over the world used meditative techniques to enter altered states of consciousness known as trances. Focusing their minds using simple rhythms and chants, and sometimes employing hallucinogenic substances, these shamans traveled to the “spirit world” and returned with wisdom, healing abilities, magic abilities, and spirit blessings to bestow on their people.

Cave paintings dating back at least 15,000 years show figures lying on the ground in poses of meditative absorption. Scholars have determined that these were shamans in a trance state asking the spirits for a successful hunt. Other cave pictures showed shamans transformed into animals and taking on the animals’ magical powers.

Although shamanism has declined considerably, there are still world cultures that utilize shamans as healers, guides for the dead, and intermediaries between humans and spirits. Recent years have shown an upsurge of interest in shamanism, due in some part to the writings of Carlos Castaneda, Michael Harner, and Joseph Campbell.

But perhaps meditation’s deepest roots can be traced to India, where sadhus (traveling holy men and women) and yogis have practiced meditation in one form or another for more than 5,000 years. It was in India that meditation first flourished, and it is from India that meditation later traveled and spread to distant parts of the globe.

The earliest Indian scriptures, the Vedas, don’t have a word for meditation but described what are now known to be meditative rituals requiring great concentration. Over time, these practices evolved into a type of prayerful meditation that entailed the use of breath control with devotional focus on the Divine. From these earliest roots, three of India’s best-known meditative traditions blossomed:  yoga; Buddhism; and tantra (a range of religious traditions).

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Seasonal Affective Disorder

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By Nikita Katz, MD, PhD

Seasonal affective disorder (SAD), also known as winter depression and winter blues, is a type of mood disorder that is typically caused by low light levels. SAD generally begins in the fall and worsens during the winter months.  The rarer, reverse seasonal affective disorder (summer blues, summer depression) begins in the spring and worsens in the in the summer.

SAD is generally found more frequently in people who live in latitudes far north or south of the equator (for example, one percent in Florida; four percent in Washington, D.C.; 10 percent in Alaska).  Some patients experience a serious mood change when the seasons change. They may sleep too much, have little energy, and crave sweets and starchy foods. They may also feel depressed. Although symptoms may be severe, they generally resolve over several months.

SAD can be a serious disorder that may require hospitalization. There is a potential risk of suicide among some individuals experiencing SAD. The symptoms of SAD mimic those of clinical depression or dysthymia. The prevalence of SAD in the adult American population has been estimated at between 1.5 percent in Florida and about nine percent in the northern US.  Overall, 6.1 percent of the US population is affected by SAD. Subsyndromal seasonal affective disorder is a milder form of SAD estimated to affect 14.3 percent of the American population.

Seasonal affective disorder is more common in women than men and in people between the ages of 15 and 55 years. The risk of developing SAD for the first time decreases with age. People who have a close relative with SAD are also at greater risk.

CAUSES

There is strong evidence that SAD is caused by a lack of available sunlight. Decreased exposure to sunlight may have an effect on the body’s biological clock, which regulates mood, sleep, and hormone production. Exposure to light may reset the biological clock. Melatonin and serotonin synthesis may be altered in individuals with SAD. Exposure to light appears to correct both neurotransmitter deficits and changes in the biological clock.

SYMPTOMS

Symptoms of SAD include difficulty waking up in the morning, a tendency to oversleep, to overeat, and to crave carbohydrate-rich foods, often leading to weight gain. Other symptoms include a lack of energy, difficulty concentrating on completing tasks, and withdrawal from friends, family, and social activities. Individuals with SAD are characterized by depression, pessimism, and a lack of pleasure in usual activities. Symptoms of SAD can include heightened anxiety as well as depression. For most people with SAD, symptoms start in September or October and end in April or May  and tend to occur at the same time every year.

TREATMENT

There are several treatment options for classic SAD. Bright-light treatment uses a specially designed lamp (or light box) — with an intense “full spectrum” or blue light at doses of 2,500 to 10,000 lux. The patient sits at a prescribed distance, usually 30 to 60 cm, in front of the box with eyes open but not staring at the light source for 30 to 60 minutes. Many individuals use the light box in the morning, and there is evidence that morning light is superior to evening light  although people may respond to evening light as well. One study found that up to 69 percent of patients find the treatment inconvenient, and as many as 19 percent stop use because of this.

There is evidence that dawn simulation is effective as well. In some studies, this has been found to be 83 percent more effective than other bright-light therapies. Most studies have found light therapies to work well — for several weeks — as seasonal treatment until greater amounts of natural light are available.

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Animal Companionship

Posted on Posted in Brain Science, Continuing Education, Homestudy, Psychology

girl-1561943_640By Barbara Sternberg, Ph.D

Our pets occupy a special place in our lives and our hearts partly because they love us no matter who we are. Successful or not, rich or poor, young or old, our pets not only don’t care, but remain constant as our own human fortunes ebb and flow.

We see this constancy in the way our pets greet us after we return from an absence. A pet’s greeting is always exuberant, as if they are welcoming home a long-lost, beloved family member. The pet makes no demands on us (other than to return its greeting and maybe get scratched) and harbors no ill feelings over having been left behind. This happy homecoming replenishes us and helps us feel that life is safe, that everything is as we left it, and that we have not changed.

When humans face serious trials—illness, loss of a job, the disabilities of aging— affection from a pet becomes even more important. The pet’s continued affection shows us that the essence of the person has remained unchanged. For this reason, pets can be of enormous value in the treatment of depressed or chronically ill individuals, as well as the institutionalized elderly.

Playing with a pet—a game of catch, or friendly roughhousing, has a kind of constancy to it because pet play does not involve true competition. Even a game of tug-of-war is played in fun — for the pleasure of both participants. Typical pet games, once learned, stay constant, just as the animal does. Playing games with our pets is reassuring and provides a break from life’s burdens. One of the great pleasures of pets—whether we are playing with them or just watching them—is their appeal and their ability to make us smile and laugh. Laughter is therapeutic, and our pets are able to induce it with great regularity.

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