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By: David Bruce Bartlett, PhD

  • Assistant Professor in Medicine
  • Member of the Duke Cancer Institute
  • Member of Duke Molecular Physiology Institute

https://medicine.duke.edu/faculty/david-bruce-bartlett-phd

Recent decisions in the United States gastritis diet zinc cheap 300mg ranitidine free shipping, including the phasing out of chimpanzees in research by the National Institutes of Health and the pending closure of the 1Department * To whom correspondence should be addressed gastritis diet гугл ranitidine 150 mg low price. Page 2 New England Primate Research Center chronic gastritis reflux esophagitis order ranitidine 150 mg free shipping, illustrate to gastritis kronik aktif adalah order ranitidine 300 mg line us the critical importance of conveying why continued research with primates is needed. Here we review key areas in biomedicine where primate models have been, and continue to be, essential for advancing fundamental knowledge in biomedical and biological research. The appropriateness of various animal models depends upon not only the species but also the ways in which the models are used. In particular, the model needs to parallel not only the clinical and biological features but also the behavioral repertoires of interest. While rodents are, and will continue to be, extremely valuable models for biomedical research, rodents do not always accurately model human behavioral and biological response [Seok et al. The evolutionary distance between rodents and humans [human-mouse-rat ancestor ~87 mya; [Springer et al. Old World monkeys (rhesus macaques, baboons, vervet monkeys) and New World monkeys (marmosets, squirrel monkeys, titi monkeys, capuchin monkeys) are used frequently; prosimians and Great Apes (chimpanzees) are also used, though less frequently (see Figure 1). Ethical considerations in the use of primates in biomedical research the ability of all animals to feel pain and experience stress means that researchers have a moral obligation to conduct research in a manner that reduces negative effects and does not unnecessarily cause stress or suffering. A being has moral standing if its interests must be given consideration Am J Primatol. If an individual has moral standing, then the individual has a valid interest in the moral norm, and they count in a moral sense. Thus, having moral standing restricts the permissible range of conduct toward these beings. Properties that are frequently taken into account when considering questions of moral standing include being sentient, rational, and a self-conscious agent. However, the growing recognition by researchers, veterinarians and other biomedical professionals that ethical issues such as these are important and relevant to primate research has led to specific changes in the way such research is conducted and regulated. This has been an important stimulus leading to concrete, practical, and enforceable changes in the procedures and standards required, including legal restrictions and government policies that are tied to research funding. Fifty years ago, there was little formal oversight on the use of animals in research. While most research was done with appropriate concern for the health and welfare of the animal subjects, this was not always the case and a series of regulations and laws were thus enacted to ensure proper methods and housing conditions. One of the changes that most clearly reflects the changing attitudes, and also has immediate daily impact on the primates maintained in research colonies, is a series of regulations regarding the psychological well-being of the animals. The rules apply whether or not any particular animal is actually being used in a research project1. This reflects the broad acceptance of the idea that researchers and veterinarians have a responsibility to attend to the psychological needs of the animals as well as nutritional and environmental needs. Page 4 In all research institutions, investigators must convince a set of independent experts that the work they propose to do is justified and will be performed appropriately. These committees (Institutional Animal Care and Use Committees), which are mandated by Federal law, function separately from the research team and the funding agencies and have the right and obligation to restrict or stop any primate research that the committee considers unnecessary, inappropriately designed or inadequately justified given the effects on the study subjects. These committees must include non-scientists and representatives of the community (lay members), to ensure that community standards for ethics are followed. Most (> 95%) behavioral and biomedical research with nonhuman primates either does not involve pain, or the pain is alleviated with analgesic or anesthetic drugs2. Pain causes stress, and researchers understand that stressed animals present different biological responses which may affect the results of the study. Animal suffering and use are minimized in line with the 3Rs principle of Russell and Burch [1959]: replacement, reduction, and refinement. As such, efforts are made to enhance psychological wellbeing through social housing, addressing the specific social and development needs of infants and aged individuals, and providing environmental enrichment. Some have argued that human rather than nonhuman primates are the more appropriate, and ethically preferable, subjects for biomedical research. However, we should be reminded that it is essential for the protection of humans that prior research be conducted on animals. Page 5 model (which we illustrate below for specific research areas; see Table 1) as well as potential costs and benefits of the research. As long as we believe that a human life is more valuable than a fish, fly, mouse, or primate, some experiments will be performed on animals before exposing humans to risk. The summaries focus almost exclusively on studies performed in captivity; we recognize, however, that important information in some of these topical areas has been obtained from field studies as well [Emery Thompson, 2013; Fedurek and Slocombe, 2011; Tung et al.

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Special consideration of engaging the laity actively in communal celebrations is also included chronic atrophic gastritis definition buy ranitidine 150 mg line. Worship that Changes Lives: Multidisciplinary and Congregational Perspectives on Spiritual Transformation diet during gastritis attack cheap 300mg ranitidine with visa. Cultural developments and psychological insights are highlighted gastritis diet гугол cheap ranitidine 150 mg on-line, seeking to gastritis beans discount ranitidine 150 mg on-line accent the role of worship in shaping spirituality. He explores such important questions as: What is the relationship between worship and belief What is the relationship between corporate worship and the formation of Christian persons and communities What is the relationship between worship and our knowledge of ourselves, our world, and God How might our attention to the reform and renewal of worship and sacramental practice provide a framework for theological, evangelical, and sacramental renewal Transforming our Days: Spirituality, Community and Liturgy in a Technological Culture. Ten of the eleven essays address forms of Christian prayer (one considers Sufi prayer in Indonesia), with most focused on aspects of congregational life and prayer. Three essays address Pentecostal/charismatic expressions of prayer, two examine the prayer of young people, two consider prayer requests (one in an English cathedral setting and another in a hospital setting) and one concerns the Amish. The social context, motivations and interpretations of prayer are of special interest to the authors. Webber Institute for Worship Studies Chapters examine the sacraments of baptism and Eucharist, prayer and spiritual disciplines. Includes daily prayer, scripture readings based on the lectionary, additional reflections, and more models for spiritual retreats. Includes additional reflections for each week and models that could be adapted for spiritual retreats. Suggestions for mediating on this prayer of Christ in order to experience it more fully are found throughout the book. Two essays provide a context for understanding the relationship between theology and literature, five essays analyze the works of significant literary figures (such as Aquinas, Dante, Shakespeare, and Wallace Stevens), and seven essays examine poetry, inspiration, and faith in a more focused approach. The power of poetry to assist religious imagination, devotional contemplation, and mystical experiences are of special interest. Five essays consider theoretical ways of understanding how poetry can enhance the life of prayer. Eight essays provide case studies of both premodern and 20th century poetry sources and the impact that they have had on the prayers of the faithful. He seeks to accent the ways in which sacred readings in liturgical actions serve to facilitate conversation between God and humanity, conversation that potentially transforms us in and through Christ. Thomas Nelson, 2009 [Published in the Ancient Practices Series, McKnight discusses a variety of ways in which fasting can help us to achieve spiritual insights through wise use of an ancient material discipline. He does not seek to pursue a historical or theological analysis in this brief work, but desires to inspire more creative prayer among the faithful. Pray, Praise, and Give Thanks: A Collection of Litanies, Laments, and Thanksgivings at Font and Table. Models for intercessional prayers are provided, along with examples of thoughtful prayers of lament, thanksgivings for baptism and remembering baptism, and Eucharistic prayers. The prayers correspond to theological themes of the church year and are accompanied, at times, by brief reflections and/or biblical passages. Webber Institute for Worship Studies resource could provide inspiration for individuals or congregations to pray with renewed theological understanding and grace. Approved for use in the Episcopal Church, fresh expressions may inspire worship celebrations across Christian traditions. Stevenson considers the contributions of biblical and theological scholars, from the Patristic period to the modern era, in his book. The Westminster Collection of Christian Prayers: Over 1,500 Prayers Arranged by Theme. The liturgical year and other occasions for celebration both find ample representation in this useful guide.

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Most patients with acute sinusitis do not require antibiotic treatment gastritis nsaids purchase 300mg ranitidine with visa, because approximately 98% of acute sinusitis cases are caused by a viral infection and resolve in 10-14 days without treatment gastritis diet 6 days buy 300mg ranitidine with visa. For some patients with sinusitis gastritis diet хентай generic ranitidine 300 mg free shipping, antibiotics might be appropriate gastritis diet гороскоп ranitidine 150 mg low cost, such as those patients taking drugs that reduce the effectiveness of the immune system, those with prolonged, severe symptoms, or those with worsening symptoms. Antibiotics can cause many side effects and have potentially severe complications, and these risks usually outweigh the benefits of their use for sinusitis. In addition, inappropriate antibiotic use for sinusitis can contribute to the development of antibiotic-resistant infections and contributes to avoidable health care costs. Kidney stones can cause severe pain (called renal colic) and nausea, which can usually be relieved with medication. Most stones pass spontaneously in the urine in a few days, though kidney stones often do recur. The task force received over 200 individual suggestions, which were grouped into a set of strategies. A technical expert panel, including representatives from all aspects of emergency medicine practice, reviewed and prioritized the recommendations using a modified Delphi technique. The panel prioritized the strategies using multiple rounds of voting based on contribution to cost reduction, benefit to patients and actionability by emergency physicians. A literature review including data on cost was assembled for the highest-rated strategies. Strategies were further refined and a final list of strategies that received majority support of the panelists was created. Five of these were ultimately selected by the Board of Directors to be included in Choosing Wisely. A Delphi panel of emergency physicians was convened and the list was winnowed using the Delphi process to the top twelve. To be included in the top twelve, there must be research to demonstrate cost effectiveness and improvement of patient care if implemented with reason, caution and explanation to the patient. Also of importance was the consideration that the recommendations would be or are also in concert with some of the other specialties participating in the Choosing Wisely campaign. Clinical policy: neuroimaging and decision-making in adult mild traumatic brain injury in the acute setting. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals. Appropriateness of use of indwelling urinary catheters in patients admitted to the medical service. The association between indwelling urinary catheter use in the elderly and urinary tract infection in acute care. Overutilization of indwelling urinary catheters and the development of nosocomial urinary tract infections. Inappropriate use of urinary catheters in elderly patients at a midwestern community teaching hospital. Reducing cost at the end of life by initiating transfer to inpatient hospice in the emergency department. Half of older Americans seen in emergency department in last month of life; most admitted to hospital, and many die there. Management of pediatric skin abscesses in pediatric, general academic and community emergency departments. Randomized, controlled trial of antibiotics in the management of community-acquired skin abscesses in the pediatric patient. National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary. The role of oral ondanestron in children with vomiting as a result of acute gastritis/gastroenteritis who have failed oral rehydration therapy: a randomized controlled trial. Oral versus intravenous rehydration for treating dehydration due to gastroenteritis in children. Diagnostic patterns and temporal trends in the evaluation of adult patients hospitalized with syncope.

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References:

  • https://www.wsha.org/wp-content/uploads/Second-Stage-Labor-WA-KSimpson-Handout.pdf
  • https://www.who.int/ceh/publications/leadguidance.pdf
  • https://www.web.fordham.edu/download/downloads/id/1491/types_of_anxiety_disorders.pdf
  • https://www.law.georgetown.edu/poverty-journal/wp-content/uploads/sites/25/2018/05/25-2-Inconceivable.pdf