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By: John Alexander Bartlett, MD

  • Professor of Medicine
  • Director of the AIDS Research and Treatment Center
  • Research Professor of Global Health
  • Professor in the School of Nursing
  • Affiliate of the Duke Initiative for Science & Society
  • Member of the Duke Cancer Institute


The return of a natural ecosystem after agricultural activities is also a well-documented secondary succession process diet for gastritis patients discount protonix 40 mg otc. A sequence of the community present at three successive times at the same location is depicted gastritis diet 3-2-1 cheap protonix 40 mg with amex. Ecologists measure characteristics of populations: size gastritis dogs generic protonix 40 mg mastercard, density gastritis icd 9 purchase protonix 20 mg overnight delivery, and distribution pattern. Life tables are useful to calculate life expectancies of individual population members. Survivorship curves show the number of individuals surviving at each age interval plotted versus time. When resources become limiting, populations follow a logistic growth curve in which population size will level off at the carrying capacity. Populations are regulated by a variety of density-dependent and density-independent factors. Lifehistory characteristics, such as age at first reproduction or numbers of offspring, are characteristics that evolve in populations just as anatomy or behavior can evolve over time. The model of r- and Kselection suggests that characters, and possibly suites of characters, may evolve adaptations to population stability near the carrying capacity (K-selection) or rapid population growth and collapse (rselection). Species will exhibit adaptations somewhere on a continuum between these two extremes. Humans have increased their carrying capacity through technology, urbanization, and harnessing the energy of fossil fuels. Many organisms have developed defenses against predation and herbivory, including mechanical defenses, warning coloration, and mimicry. Two species cannot exist indefinitely in the same habitat competing directly for the same resources. Species may form symbiotic relationships such as commensalism, mutualism, or parasitism. Communities respond to environmental disturbances by succession: the predictable appearance of different types of plant species, until a stable community structure is established. The number of seal deaths would increase, but the number of births would also increase, so the population size would remain the same. Which of the following methods will provide information to an ecologist about both the size and density of a population Which of the following is best at showing the life expectancy of an individual within a population Which of the following is not a way that humans have increased the carrying capacity of the environment The first species to live on new land, such as that formed from volcanic lava, are called. A symbiotic relationship where both of the co-existing species benefit from the interaction is called. When an invasive species alters the community structure it is introduced to, what can the consequence be Give an example of how density-dependent and density-independent factors might interact. Describe the age structures in rapidly growing countries, slowly growing countries, and countries with zero population growth. Describe the potential effects when a keystone species is removed from a community. The ecosystem comprises all the biotic components (living things) and abiotic components (non-living things) in a particular geographic area. Ecosystem biologists study how nutrients and energy are stored and moved among organisms and the surrounding atmosphere, soil, and water. Wild lupine and Karner blue butterflies live in an oak-pine barren habitat in portions of Indiana, Michigan, Minnesota, Wisconsin, and New York (Figure 20. This habitat is characterized by natural disturbance in the form of fire and nutrient-poor soils that are low in nitrogen-important factors in the distribution of the plants that live in this habitat.

Also called field of vision visualisation / vI ulaI zeI()n/ chronic gastritis weight loss discount protonix 20mg visa, visualization noun 1 gastritis zdravljenje purchase protonix 40mg on line. Also called retinol visualisation visually impaired visually impaired person visual purple vitae vital vital capacity vital centre vital organs vital signs vital statistics vitamin Vitamin A balamin Vitamin B complex / vItmIn bi km pleks / noun a group of vitamins such as folic acid gastritis diet treatment inflammation order protonix 40mg visa, riboflavine and thiamine Vitamin C / vItmIn si / noun a vitamin which is soluble in water and is found in fresh fruit gastritis diet vs regular buy protonix 40mg with visa, especially oranges and lemons, raw vegetables and liver. Also called ascorbic acid Vitamin D / vItmIn di / noun a vitamin which is soluble in fat and is found in butter, eggs and fish. Vitamin E / vItmIn i / noun a vitamin found in vegetables, vegetable oils, eggs and wholemeal bread Vitamin K / vItmIn keI/ noun a vitamin found in green vegetables such as spinach and cabbage, and which helps the clotting of blood and is needed to activate prothrombin vitelline sac /vI telaIn s k/ noun a sac attached to an embryo, where the blood cells first form vitellus /vI tels/ noun the yolk of an egg (ovum) vitiligo / vIti laI / noun a condition in which white patches appear on the skin. Also called leucoderma vitrectomy /vI trektmi/ noun a surgical operation to remove some or all of the vitreous humour of the eye vitreous / vItris/ adjective 1. Carotene (the yellow substance in carrots) is a precursor of Vitamin A, which accounts for the saying that eating carrots helps you to see in the dark. Zimmer frame wall /w l/ noun the side part of an organ or a passage in the body An ulcer formed in the wall of the duodenum. Wheezing is often found in people with asthma and is also associated with bronchitis and heart disease. They can result in brain damage leading to speech and learning disabilities, paralysis, seizures, blindness and hearing loss. Also called leucocyte white commissure / waIt kmIsj/ noun part of the white matter in the spinal cord near the central canal white corpuscle / waIt k p s()l/ noun same as white blood cell white finger /waIt fI / noun a condition in which a finger has a mottled discoloured appearance because its blood vessels are damaged. Widal reaction /vi d l rI kn/, Widal test /vi d l test/ noun a test to detect typhoid Widal reaction window / wInd/ noun a small opening in the ear windpipe / wIndpaIp/ noun same as trachea wiring / waIrI/ noun 1. Also called third molar witch hazel / wIt heIz()l/ noun a lotion made from the bark of a tree, used to check bleeding and harden inflamed tissue and bruises. Also called hepatolenticular degener- other terms referring to the womb, see words beginning with hyster-, hystero-, metr-, metro-, uter-, utero-. Also called flatulence to break wind to bring up gas from the stomach, or to let gas escape from the anus windburn / wIndb n/ noun redness and inflammation of the skin caused by exposure to harsh wind windburn ation [Described 1912. World Health Organization / w ld hel naI zeI()n/ noun an organisation, part of the United Nations, which aims to improve health in the world. Also called ensiform cartilage, xixiphoid process phisternum X-linked / eks lIkt/ adjective relating to the genes situated on the X chromosome X-linked disease / eks lIkt dI zi z/ noun a genetic disorder caused by a mutation on the X chromosome which only appears in males. X-rays are used in diagnosis in radiography, and in treating disease by radiotherapy. They grow faster than normal, and their final height is approximately 7cm above average. X-ray screening / eks reI skri nI/ noun a method of gathering information about the X-ray photograph X-ray screening nal organs opaque so that they will show up on the film. In the case of stomach X-rays, people take a barium meal before being photographed (contrast radiography); in other cases, such as kidney X-rays, radioactive substances are injected into the bloodstream or into the organ itself. X-rays are used not only in radiography for diagnosis but as a treatment in radiotherapy as rapidly dividing cells such as cancer cells are most affected. Excessive exposure to X-rays, either as a person being treated, or as a radiographer, can cause radiation sickness. X-ray imaging / eks reI ImId I/ noun the X-ray imaging Y yawn /j n/ noun a reflex action when tired or sleepy, in which the mouth is opened wide and after a deep intake of air, the breath exhaled slowly His yawns made everyone feel sleepy. Symptoms include fever with raspberry-like swellings on the skin, followed in later stages by bone malformation. A deep Z-shaped incision is made to relieve tension in the area of a scar, or to change the direction of a scar. Also called zygoma zygomatic bone / zaI m tIk bn/ noun a bone which forms the prominent part of the cheek and the lower part of the eye socket.

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Numerator: Denominator: Rationale Number of children < 5 years failing to gastritis diet quotes purchase protonix 20 mg gain weight Number of children < 5 years weighed Calculation Failure to lymphocytic gastritis symptoms treatment generic 40mg protonix otc gain weight gastritis tums protonix 20 mg fast delivery, even for one month gastritis menu protonix 20 mg low cost, indicates early nutritional problem or an acute illness and is the most sensitive indicator of the nutritional well being of individual children or whole communities. Each weight is recorded on the Road to Health card, and the register if weight gain is absent. The nutrition register, Tick register, Child health register are less reliable because of potential double counting. Children coming back for rehabilitation are often entered more than once in a month. Any individual child not gaining weight needs to be put on an "at risk" register and followed closely, with support to the mother both at home and in the clinic. Communities with more than 5 - 7% of children not gaining weight need special nutrition remedial action and nutrition promoting activities in the community. Nutrition is classically a field for sample surveys and sentinel site investigation, as routine growth monitoring is seldom accurately done. However, mothers of children who are not gaining weight should be reminded to use iodised salt in the home, provide vegetables eggs and meat to assure adequate micronutrients. Perhaps at present there is a severe food crisis in the area, or mothers need additional support in regards to understanding basic nutritional needs for a family and specifically children. Name Definition Calculation Severe malnutrition rate (new cases) the proportion of children who are weighed who are newly found to be suffering from Kwashiorkor, Marasmus or have weight under 60% of expected weight for age. Numerator: Denominator: Number of children < 5 years with new severe malnutrition Children under Five weighed Rationale Severe malnutrition is a failure of preventive services and is the tip of the iceberg representing the larger pool of malnutrition in the community. Most children with severe malnutrition do not come to the health services and die at home. Severe malnutrition can be measured by age group to find out which age suffers most from this problem. The percentage of all children in the target area under one year who have received the full series of primary immunisation prior to reaching age one year. Number of children reaching 1 year of age in the catchment area for the same period of recording as used in the numerator (month, quarter, year to date, calendar year) Use the same period of time for both numerator and denominator. Denominator: Rationale Immunisation coverage compares the number of fully immunised children to the number of children under one year old. This indicator is a wide-ranging measure of nursing skills, clinic management skills, transport management, community participation, cold chain and effectiveness of health education. Counting of children who come back to the clinic after they have previously been fully immunised at your clinic or elsewhere causes incorrect coverage rates. Data source Common problems Graphs Cumulative Immunisation coverage graph shows the numbers fully immunised each month, added to the previous months to show the total year to date. Communities with low coverage need to be identified and special efforts made to immunise them. If your coverage is > 100%, check population figures, make sure children are not being counted twice and investigate outsiders coming into your area. Cold chain performance can be measured by plotting % days the refrigerator is outside the normal range. Health District: Child Health: Children Fully Immunised Jan - Sept 99 Provincial target 7% per month 70. In order to Fully Immunised at least 80% of Children before they turn one year old, on average some 7% of the children need to be immunised every month.

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The restricting type includes people who rarely engage in binge eating or purging gastritis liquid diet 20 mg protonix sale. In contrast gastritis loss of appetite cheap 20mg protonix visa, the binge eating/ purging type is defined by regular binge eating and purging during the course of the disorder gastritis diet book buy 40 mg protonix visa. The validity of the subtypes is questionable gastritis foods buy 20mg protonix overnight delivery, however, as they do not differ in terms of comorbidity, recovery, relapse, or mortality (Wonderlich et al. Moreover, an eight-year longitudinal study found that 62 percent of the former restrictors met diagnostic criteria for binge eating/ purging, and only 12 percent of the restrictors had never regularly engaged in binge eating or purging (Eddy et al. Bulimia Nervosa Bulimia nervosa is defined by five symptoms described earlier (see Table 10. The purging type regularly uses self-induced vomiting, laxatives, diuretics, or enemas. The nonpurging type instead attempts to compensate for binge eating only with fasting or excessive exercise. Recurrent inappropriate compensatory behavior in order to prevent weight gain, such as self-induced vomiting; misuse of laxatives, diuretics, enemas, or other medications; fasting; or excessive exercise. The binge eating and inappropriate compensatory behaviors both occur, on average, at least twice a week for 3 months. Specify Type Purging type: During the current episode, the person has regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. Nonpurging type: During the current episode, the person has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas. Diagnosis of Eating Disorders 257 Frequency of Eating Disorders Estimates of the epidemiology of anorexia and bulimia vary, but both disorders appear to have increased in frequency since the 1960s and 1970s. Anorexia is far more common among certain groups, however, particularly young women, where the incidence still may be increasing (Keel, 2010). Anorexia nervosa also occurs among males, but most estimates indicate the disorder is about 10 times more common among women than men. Establishing the exact prevalence in males is difficult, because only a few cases are identified even in large national surveys (Hudson et al. Changes in the frequency of bulimia nervosa are difficult to document, however, because the diagnostic term was introduced only in 1979. A cohort is a group that shares some feature in common, for example, year of birth; thus, cohort effects are differences that distinguish one cohort from another. The lifetime prevalence of bulimia nervosa was far greater among the women born after 1960 than it was for those born before 1950. The risk for women born between 1950 and 1959 was intermediate between the two (Kendler et al. Binge Eating Disorder and Obesity There is debate about whether other eating problems should be considered eating disorders. Binge eating disorder, episodes of binge eating but without compensatory behavior, is one possible new diagnosis. Accumulating evidence supports binge eating disorder as a reliable diagnosis distinct from other eating disorders in terms of demographics, correlates, and treatment (Allison & Lundgren, 2010). Binge eating is associated with a number of psychological and physical difficulties (Hudson et al. Among these problems is obesity, excess body fat corresponding with being 20 percent above expected weight. A cutoff of 40 percent above normal is a rough marker of being severely overweight (Brownell, 1995). Calling obesity a "mental disorder" is controversial, especially given its high prevalence in the United States and throughout the world.


  • https://www.researchgate.net/journal/Pediatric-Rheumatology-1546-0096/publication/297892846_Biologic_agents_in_juvenile_spondyloarthropathies/links/5fc4c905299bf104cf951e53/Biologic-agents-in-juvenile-spondyloarthropathies.pdf
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  • https://www.bsee.gov/sites/bsee.gov/files/tap-technical-assessment-program//001aa.pdf
  • https://www.worldgastroenterology.org/UserFiles/file/guidelines/diverticular-disease-english-2007.pdf