Lopid
Walter E. Pofahl II MD, FACS
- Associate Professor, Department of Surgery
- Chief, Division of Advanced
- Laparoscopic, Gastrointestinal, and Endocrine Surgery, Brody School of Medicine,
- East Carolina University
- Chief, General Surgery, Pitt County Memorial Hospital,
- Greenville, North Carolina
Support? to eat is an attempt to regain control of her body in defi? ive care by clinicians and family is probably the most ance of parental control medicine hat lodge 300mg lopid mastercard. Cognitive behavioral therapy symptoms ulcerative colitis generic 300mg lopid overnight delivery, inhabit an "adult body" may also represent a rejection of intensive psychotherapy treatment zygomycetes order lopid 300 mg mastercard, and family therapy may be tried medications known to cause weight gain purchase discount lopid on line. Marked depression or anxiety may be ever, clinical trial results have been disappointing. Bradycardia, hypo? Adolescents and young adults with otherwise unex? tension, and hypothermia may be present in severe cases. Parotid enlargement All patients with diagnosed anorexia nervosa should be and edema may also occur. When to Admit Laboratory findings are variable but may include anemia, Signs of hypovolemia, major electrolyte disorders, and leukopenia, electrolyte abnormalities, and elevations of severe protein-energy malnutrition. A longitudinal investigation of mortality in anorexia nervosa and bulimia nervosa. Cognitive Behavioural Therapy for Other medical or psychiatric illnesses that can account for anorexia nervosa: a systematic review. Position of the American Dietetic Association: intense fear ofbecoming obese, disturbance ofbody image, nutrition intervention in the treatment of eating disorders. Cardiovascular complications of anorexia nervosa: the differential diagnosis includes endocrine and met? a systematic review. Epidemiology, course, and outcome of eating disorders (eg, Crohn disease and gluten enteropathy); disorders. Quality of life in anorexia nervosa: a review of the phoma); and rare central nervous system disorders (eg, literature. When to Refer All patientswith diagnosedbulimia should be co-managed with a psychiatrist. Recurrent inappropriate compensation to prevent bulimia nervosa-purging subtype or to binge eating disorder? General Considerations and atypical bulimic nervosa: effectiveness in clinical settings. It is more difcult to detect than anorexia, and some studies have estimated that the prevalence may be as high as 19% in college-aged women. Early symptoms of anorexia, muscle cramps, par? quantities of easily ingested high-calorie foods, usually in esthesias, irritability. Advanced syndromes of high output heart failure day for a few days; others report regular and persistent pat? ("wet beriberi"), peripheral nerve disorders, and terns ofbinge eating. Binging is usually followed by vomit? Wernicke-Korsakoff syndrome ("dry beriberi"). General Considerations fluctuate but generally are within 20% of desirable weights. Some patients with bulimia nervosa also have a crytic Most thiamine deficiency in the United States is due to form of anorexia nervosa with significant weight loss and chronic alcoholism, with poor dietary intake of thiamine amenorrhea. Family and psychological issues are generally and impaired thiamine absorption, metabolism, and stor? similar to those of patients with anorexia nervosa. Thiamine deficiency is also associated with malab? patients, however, have a higher incidence of premorbid sorption, dialysis, and other causes of chronic obesity, greater use of cathartics and diuretics, and more protein-calorie undernutrition. Menstruation is usually be precipitated in patients with marginal thiamine status preserved. Clinical Findings can result in poor dentition, pharyngitis, esophagitis, aspi? Early manifestations of thiamine deficiency include ration, and electrolyte abnormalities. Advanced deficiency primarily affects the cardiovascular Constipation and hemorrhoids are common. Treatment panied by severe physical exertion and high carbohydrate Treatment ofbulimia nervosa requires supportive care and intake. Individual, group, family, and behavioral panied by inactivity and low calorie intake. Antidepressant medications Wet beriberi is characterized by marked peripheral may be helpful. Although death from buli? dyspnea, tachycardia, cardiomegaly, and pulmonary and mia is rare, the long-term psychiatric prognosis in severe peripheral edema, with warm extremities mimicking bulimia is worse than that in anorexia nervosa. The legs are affected more sis, angular stomatitis, glossitis, seborrheic dermatitis, than the arms. Central nervous system involvement results weakness, corneal vascularization, and anemia. Korsakoff syndrome includes Riboflavin defciency can be confirmed by measuring the amnesia, confabulation, and impaired learning. Urinary ribofavin In most instances, the clinical response to empiric thia? excretion and serum levels of plasma and red cell flavins mine therapy is used to support a diagnosis of thiamine can also be measured. The most commonly used biochemical tests measure erythrocyte transketolase activity and urinary. A transketolase activity coefficient Ribofavin defciency is usually treated empirically when greater than 15-20% suggests thiamine defciency. It is easily treated with fo ods such as meat, fish, and dairyproducts orwith oral prepara. Administration of 5-15mg/day until Thiamine deficiency is treated with large parenteral doses of clinical findings are resolved is usually adequate. Fify to 100 mg/day is administered intravenously vin can also be given parenterally, but it is poorly soluble in for the first few days, followed by daily oral doses of 5-10 aqueous solutions. All patients should simultaneously receive thera? peutic doses of other water-soluble vitamins. Inadequate ribofavin intake and anemia risk in a Chinese population: five-year follow up of the Jiangsu Nutri? tion Study. Wernicke encephalopathy insubjects undergo? ing restrictive weight loss surgery: a systematic review of lit? Niacin is a generic term for nicotinic acid andother deriva? erature data. Micronutrient intakes and potential inadequa? cies of community-dwelling older adults: a systematic review. Beriberi disease: is it still present in the United the major fo od sources of niacin are protein foods con? States? Clinical Findings ciency is more commonly due to alcoholism and nutri? Ribofavin deficiency almost always occurs incombination ent-drug interactions. A challenging diferential mide (the form of niacin usually used to treat niacin defi? diagnosis in burn injuries. A number of inborn errors of metabolism and pellagra: dermatitis, diarrhea, and dementia. The dermati? other pyridoxine-responsive syndromes, particularly pyri? this is symmetric, involving sun-exposed areas. Skin lesions doxine-responsive anemia, are not clearly due to vitamin are dark, dry, and scaling. The dementia begins with deficiency but commonly respond to high doses of the insomnia, irritability, and apathy and progresses to confu? vitamin. Patients with common variable immunodef? sion, memory loss, hallucinations, and psychosis. Diagnosis to those of other B vitamin defciencies, including mouth In early deficiency, diagnosis requires a high index of sus? soreness, glossitis, cheilosis, weakness, and irritability. Severe deficiency can result in peripheral neuropathy, ane? Niacin metabolites, particularly N-methylnicotinamide, mia, and seizures. Low levels suggest niacin tionship of low vitamin B6 levels and a variety of clinical deficiency but may also be found in patients with general? conditions including cardiovascular diseases, infamma? ized under-nutrition. Niacin deficiency can be effectively treated with oral nia? cin, usually given as nicotinamide (10-150 mg/day). These include cutaneous fushing taking medications that interfere with pyridoxine metabo? (partially prevented by pretreatment with aspirin, 81-325 lism (such as isoniazid) may need doses as high as 50-100 mg/day, and use of extended-release preparations) and mg/day orally to prevent vitamin B6 deficiency. Elevation of liver enzymes, hyperglyce? particularly true for patients who are more likely to have mia, and gout are less common untoward effects. Effects metabolism and pyridoxine-responsive syndromes often of extended-release niacin with laropiprant in high-risk require doses up to 600 mg/day orally.
Nonsteroidal anti-inflammatory Drug Use and Colorectal Polyps in the Prostate treatment for depression cheap lopid 300 mg with mastercard, Lung medicine x 2016 buy lopid 300mg visa, Colorectal symptoms 7 days after conception generic 300mg lopid, and Ovarian Cancer Screening Trial symptoms 0f a mini stroke buy lopid 300 mg on line. The submucosal cushion does not improve the histologic evaluation of adenomatous colon polyps resected by snare polypectomy. Prevalence and variable detection of proximal colon serrated polyps during screening colonoscopy. Single-ballon colonoscopy versus repeat standard colonoscopy for previous incomplete colonoscopy: a randomized, controlled trial. Bowel preparation with split-dose polyethylene glycol before colonoscopy: a meta-analysis of randomized controlled trials. Association of adherence to life style recommendations and risk of colorectal cancer: A prospective Danish cohort study. Serious complications within 30 days of screeing and surveillance colonoscopy are uncommon. Hereditary nonpolyposis colorectal cancer (Lynch Syndrome): criteria for identification and management. Endoscopic trimodal imaging detects colonic neoplasia as well as standard video enscopy. Likelihood of missed and recurrent adenomas in the proximal versus the distal colon. Race and colorectal cancer disparities: health-care utilization vs different cancer susceptibilities. Interval fecal immunochemical testing in a colonoscopic surveillance program speeds detection of colorectal neoplasia. Bowel cleansing for colonoscopy: prospective randomized assessment of efficacy and of induced mucosal abnormality with three preparation agents. Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post operative infectious complications in colorectal cancer surgery a double-blind study. Polyp recurrence after endoscopic mucosal resection of sessile and flat colonic adenomas. Effective bowel cleansing before colonoscopy: a randomized study of split-dosage versus non-split dosage regimens of high-volume versus low-volume polyethylene glycol solutions. Lower albumin levels in African Americans at colon cancer diagnosis; a potential explanation for outcome disparities between groups? A randomized, double-blind trial of succinylated gelatin submucosal injection for endoscopic resection of large sessile polyp of the colon. Endoscopic mucosal resection outcomes and prediction of submucosal cancer from advanced colonic mucosal neoplasia. Colonic work-up after incomplete colonoscopy: significant new findings during follow-up. Long-term outcomes of endoscopic submucosal dissection for colorectal epithelial neoplasms. Adverse events associated with use of the three major types of osmotically acting cathartics. Racial/ethnic differences in colorectal cancer risk: the multiethnic cohort study. Molecular mechanisms for chemoprevention of colorectal cancer by natural dietary compounds. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. Colorectal cancers detected after colonoscopy frequently result from missed lesions. Pancolonic chromoendoscopy with indigo carmine versus standard colonoscopy for detection of neoplastic lesions: a randomized two-centre trial. Warm water infusion versus air insufflation for unsedated colonoscopy: a randomized controlled trial. A back-to-back comparison of white light video endoscopy with autofluorescence endoscopy for adenoma detection in high-risk subjects. American College of Gastroenterology Action Plan for Colorectal Cancer Prevention. American College of Gastroenterology guidelines for colorectal cancer screening 2008. Guidelines for colonoscopy surveillance after cancer resection: A consensus update by the American Cancer Society and the U. Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomized trials. Colonoscopy and optical biopsy: bridging technological advances to clinical practice. A prospective, multicenter study of 1111 colorectal endoscopic submucosal dissections (with video). In vivo diagnosis and classification of colorectal neoplasia by chromoendoscopy-guided confocal laser endomicroscopy. Proximal and Large Hyperplastic and Nondysplastic Serrated Polyps Detected by Colonoscopy Are Associated With Neoplasia. American Journal of Physiology Gastrointestinal and Liver Physiology 2010;299: G807-G820. Rate and Predictors of Early/Missed Colorectal Cancers After Colonoscopy in Manitoba: A Population-Based Study. The reduction in colorectal cancer mortality after colonoscopy varies by site of the cancer. Development and validation of a novel patient educational booklet to enhance colonoscopy preparation. Effect of evidence based risk information on informed choice? in colorectal cancer screening: randomized controlled trial. Genetic Testing for Hereditary Colorectal Cancer: Challenges in Identifying, Counseling, and Managing High-Risk Patients. Meta-analysisL the diagnostic yield of chromoendoscopy for detecting dysplasia in patients with colonic inflammatory bowel disease. Prospective randomized controlled trial evaluating cap-assisted colonoscopy vs standard colonoscopy. Colon neoplasms develop early in the course of inflammatory bowel disease and primary sclerosing cholangitis. Faster recovery of gastrointestinal transit after laparoscopy and fast-track care in patients undergoing colonic surgery. One to 2-year surveillance intervals reduce risk of colorectal cancer in families with Lynch syndrome. Predictive and Protective factors associated with colorectal cancer in ulcerative colitis: A Case control study. The safety of intravenous fluorescein for confocal laser endomicroscopy in the gastrointestinal tract. A retrograde-viewing device improves detection of adenomas in the colon: a prospective efficacy evaluation. Eicosapentaenoic acid reduces rectal polyp number and size in familial adenomatous polyposis. Analysis of deaths occurring within the Nottingham trial of faecal occult blood screening for colorectal cancer. A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy. Eight year prognosis of postinfectious irritable bowel syndrome following waterborne bacterial dysentery. Prednisolone and Budesonide for Short and Long-Term Treatment of Microscopic Colitis: Systematic Review and Meta-analysis. The changing picture of high-grade anal intraepithelial neoplasia in men who have sex with men: the effects of 10 years of experience performing high-resolution anoscopy. Irritable bowel syndrome-type symptoms in patients with inflammatory bowel disease: a real association of reflection of occult inflammation? Mindfulness Training Reduces the Severity of Irritable Bowel Syndrome in Women: Results of a Randomized Controlled Trial.
If you could see it in stereo kapous treatment lopid 300 mg otc, you would note that it is growing of the surface of the retna and into the vitreous medicine 0025-7974 purchase lopid 300 mg line. You will miss the early proliferatve disease in these cases if you just quickly screen the fundus with a 20D lens and do not study the retna at the slit lamp treatment yeast cheap lopid 300 mg with amex. Although the color photo does not show the neo medications you can take during pregnancy lopid 300 mg visa, it is likely that a careful 90D exam of the periphery would have identfed the small new vessels. Also note that the color shows a very featureless retna? the retna is so damaged that the usual signs of worrisome retnopathy are absent; there are no telltale hemorrhages, etc. It is easy to focus only on the posterior pole when doing angiograms, but there is a lot of data in the periphery, especially with diabetes. In fact, it makes sense to have your photographer routnely do a survey of the periphery to look for leakage?they get to be a beter photographer and you get more info about how ischemic the eye is and where to place panretnal photocoagulaton. Newer wide-feld angiogram systems automatcally provide a view of the periphery that identfes lesions that standard photographs miss. Missing something obvious is much less likely at the early stages of your career, when everything is new and excitng. A big hemorrhage is usually about as subtle as a golf cart in a hotel bathtub?the diagnosis is easy. It is possible for patents to have limited hemorrhages, for which they will be very symptomatc, yet you will not see any blood because the amount is small or it has been rapidly washed out. Look at the vitreous with the slit lamp, as you would for a uveits patent?sometmes the only heme to be found is a few red blood cells in the anterior vitreous. Subtle hemorrhages will gravitate down there, and you may need to use a 90-diopter to fnd faint clouds of blood foatng around. You can actually see the red blood cells foatng in front of the retna (Figure 12). Figure 12: this patent presented complaining of new foaters, but there isn?t much to see clinically and there were no blood cells in the anterior vitreous. The patent had had a partal vitreous detachment, and the separaton had torn some superfcial retnal capillaries, so he could see the foaters but they were not obvious on exam. By the way, this technique is also useful for identfying white blood cells in patents with uveits. First of all, diabetcs tend to have a stckier vitreous that doesn?t separate as easily. If they do get even a partal age-related vitreous detachment, all of the fragile capillaries on the retnal surface are more likely to bleed as the vitreous peels away. By the way, never forget that diabetcs can get non-diabetc problems, such as retnal tears. If a vitreous hemorrhage makes you go into proliferatve-disease hunter-killer mode, you can totally miss a tear if you don?t also remember to study the far periphery for new breaks. Try to keep an open mind about all the wonderful ways an eye can go bad and do not limit your thinking to diabetc complicatons just because a patent is diabetc. Patents who present several months afer their symptoms began can also be confusing, because older hemorrhages can decolorize and look like whitsh or yellowish globs at the botom of the vitreous cavity (so-called chicken fat? hemorrhages). Do not mistake these old hemorrhages for infammatory vitreous changes such as snowballs or snow banking. Bombing a hemorrhagic diabetc eye with steroids is bad for the patent?and will remove stars from your god-of-ophthalmology score. Exactly why do you need to memorize the 4-2-1 rule and hunt around for all this stuf, anyway? Table 2 shows a good summary of how all the diferent factors were added up to assign the overall risk. Adapted from American Academy of Ophthalmology, Basic and Clinical Science Course, Secton 12. The reason is that patents tend to do rather horribly on their own once they have reached high-risk disease. This graph, and the heroic work behind its discovery, is truly awesome (in the traditonal, non-surfer sense of the word). Copyright Elsevier 1981) But deciding to treat defnite high-risk proliferatve disease is the easy part. As a result, the same conservatve approach was suggested: Given the hassle and risk of treatment and relatvely small beneft, some patents may be beter of with careful observaton rather than laser. Diabetc eyes tend to head down the same path, and the frst eye will let you know what the second eye may decide to do. This may be a very important factor in developing countries, where logistcs and economics may prevent careful sequental evaluatons, and where early treatment may give a patent much beter odds of remaining a functoning member of society. Poor control and/or lots of medical problems may warrant earlier interventon, since these patents may go downhill faster and/or may miss appointments. A patent who needs to be on Coumadin or other blood thinners may need earlier treatment, given the risk of more pronounced bleeding if more advanced proliferatve disease is allowed to develop. On the other hand, a patent who is rapidly going through these stages is at much greater risk for rapid progression to high-risk disease, and should have earlier treatment. This did not seem to be true for patents with Type 1 diabetes who had the same degree of retnopathy. It is not clear why this is the case; perhaps older patents are more likely to get a vitreous hemorrhage once they get neo because their vitreous is more jiggly compared to the more formed vitreous in younger patents. Whatever the reason, this data does support consideraton of earlier treatment in older patents. However, there is growing realizaton that injectons will stop the progression of proliferatve disease in its tracks, and actually reverse the overall level of retnopathy. The injectons may change how much laser you need to put in, or perhaps even obviate the need for laser in some cases (although you need to watch such patents closely for progression if the injectons stop). This issue starts to get complicated and will be covered in the next chapter?so hold this thought for now. Although knowing when to intervene earlier is important, it is also good to know when to hold of. Such a situaton may occur when you are faced with a patent who has a vitreous hemorrhage but no evidence of neovascularizaton. If there is a localized preretnal hemorrhage that blocks the view of a secton of the retna, or a dense vitreous hemorrhage that allows only a limited view, it is usually best to assume there are new blood vessels somewhere and treat the patent. Remember that if the hemorrhage is so dense that there is no view, you have to get an ultrasound to be sure the retna is not being pulled of. You are taking a big risk for both yourself and your patent if you can?t see the retna and you don?t get an ultrasound; if something is going wrong back there, it is usually bad to do nothing. If the fellow eye has already had proliferatve disease that required laser, it is worthwhile considering laser in the second eye even if you do not see any obvious neovascularizaton. On the other hand, if there is only minimal diabetc disease in the fellow eye, observaton may be the best course. If there are no vessels, then it is defnitely beter to watch such patents; recall that the diabetc vitreous is stcky and is more likely to break a few capillaries if it separates. You will end up needlessly burning retna if you automatcally treat every diabetc with a mild vitreous hemorrhage. Finally, for the second tme in the same chapter, never forget that diabetcs can get non-diabetc problems such as retnal tears, so remember to inspect the far periphery closely?don?t just look in the midperiphery and quit if you don?t see anything. Most of the tme, if the disease is allowed to run its course the retna ends up like a shriveled orchid in the center of a blind eye (hence the existence of books such as this). You may, however, occasionally see patents in whom this process has occurred with litle disrupton of the central retna?these patents essentally avoided the typical disastrous outcome and survived? the proliferatve phase of their retnopathy. Such patents ofen have very broad areas of fbrosis in the periphery, where the old neovascularizaton involuted and became quiescent. Deciding whether to treat such patents can be difcult?the standard rules do not apply. These patents have somehow achieved a metastable state, and there is always a concern that by going in and aggressively treatng with laser you will push them into hemorrhagic or tractonal problems that they might not otherwise have developed. This is because the wide swaths of untreated peripheral retna may become more ischemic with tme, and lead to late problems such as recurrent retnal proliferaton or anterior segment neovascularizaton. Note how everything seems to be quiescent prior to treatment, but afer laser there is an area where subtle neovascularizaton regressed and became fbrotc (arrow). The omnipresent neovascular stmulus of the ischemic retna makes treatment a safer bet than observaton in eyes like this; you are buying the patent insurance that nothing worse happens in the future.
All the inputs the Commit tee made during these deliberations have found a place in the current textbook medications every 8 hours purchase lopid once a day. I thus take plea sure in thanking the Committee Members for their wholehearted participatory role in evolving the curriculum medicines order lopid without prescription, which I have tried to translate into a textbook to uphold the spirit in which the curricu lum was framed medicine 100 years ago lopid 300mg low cost. Arun Nighvekar 2c19 medications buy lopid master card, who has whole heartedly supported the Committee and gave freely of his valuable time to deliberate the nature of the course. Shamita Kumar wrote the chap ter on pollution, which she has painstakingly developed to suit the needs of undergraduate stu dents from different faculties. Her expertise as a highly innovative teacher in environment has given her the background that is necessary to draft a suitable Unit for this book. I must thank our artists Sushma Durve and Anagha Deshpande who have painstakingly made a large number of drawings. One person who has done an excellent job of editing the English, rearranging bits of the book and removing redundant material is Chinmaya Dunster, a musician by profession, an editor by calling and an environmentalist at heart. He has spent many painful hours going over the text with a fine tooth English comb. I cannot thank him enough for his enormous contribution towards the completion of this book. Finally, for the one person who has put all her heart and soul into this book, working long hours, and cheerfully making the constant changes I demanded. It is expected to give you information about the environment that will lead to a concern for your own environment. When you develop this concern, you will begin to act at your own level to protect the environment we all live in. This is the objective of the course and the syllabus is a framework on which we must all realign our lives. These issues are related to the conflict between existing development? strategies and the need for environmental conservation. Unlike most other textbooks, it not only makes the reader better informed on these concerns, but is expected to lead him or her towards positive action to improve the environment. Firstly is the need for information that clarifies modern environmental concepts such as the need to conserve biodiversity, the need to lead more sustainable lifestyles and the need to use resources more equitably. Secondly, there is a need to change the way in which we view our own environment by a practical approach based on observation and self learning. Thirdly there is the need to create a concern for our environment that will trigger pro-environmental action, including activities we can do in our daily life to protect it. It is essentially a multidisciplinary approach that brings about an appreciation of our natural world and human impacts on its integrity. Thus most tra ditions refer to our environment as Mother Its components include biology, geology, chem Nature? and most traditional societies have istry, physics, engineering, sociology, health, learned that respecting nature is vital for their anthropology, economics, statistics, computers livelihoods. Most of us live in landscapes that have eties began to believe that easy answers to the been heavily modified by human beings, in vil question of producing more resources could be lages, towns or cities. Thus developing industry, led to rapid economic our daily lives are linked with our surroundings growth, the ill effects of this type of develop and inevitably affects them. We breathe air, we use resources from which food the industrial development and intensive agri is made and we depend on the community of culture that provides the goods for our increas living plants and animals which form a web of ingly consumer oriented society uses up large life, of which we are also a part. Everything amounts of natural resources such as water, around us forms our environment and our lives minerals, petroleum products, wood, etc. Non depend on keeping its vital systems as intact as renewable resources, such as minerals and oil possible. Renew cannot continue to live without protecting the the Multidisciplinary Nature of Environmental Studies 3 Chapter1. But these too will be depleted if we con tinue to use them faster than nature can re place them. For example, if the removal of timber and firewood from a forest is faster than the regrowth and regeneration of trees, it can not replenish the supply. And loss of forest cover not only depletes the forest of its resources, such as timber and other non-wood products, but ronment and change the way in which we use affect our water resources because an intact every resource. Unsustainable utilization can natural forest acts like a sponge which holds result from overuse of resources, because of water and releases it slowly. Deforestation leads population increase, and because many of us to floods in the monsoon and dry rivers once are using more resources than we really need. Most of us indulge in wasteful behaviour pat terns without ever thinking about their environ Such multiple effects on the environment re mental impacts. Thus, for all our actions to be sulting from routine human activities must be environmentally positive we need to look from appreciated by each one of us, if it is to provide a new perspective at how we use resources. How many of these compo nents are renewable resources and how Activity 2: many non-renewable? Try to answer the questions above for one Understanding and making ourselves more of the components in the article you chose aware of our environmental assets and prob in Activity 1. We, each one of us, must questions: become increasingly concerned about our envi 4 Environmental Studies for Undergraduate Courses Chapter1. The earth cannot be expected to sustain this expanding level of utilization of resources. These accumulate in our environ ment, leading to a variety of diseases and other. Air pollution leads to respi than many others who have less access ratory diseases, water pollution to to it? Once we begin to ask these questions of our selves, we will begin to live lifestyles that are more sustainable and will support our environ ment. It is an inte gration of several subjects that include both Improving this situation will only happen if each Science and Social Studies. To understand all of us begins to take actions in our daily lives the different aspects of our environment we that will help preserve our environmental re need to understand biology, chemistry, physics, sources. We cannot expect Governments alone geography, resource management, economics to manage the safeguarding of the environment, and population issues. Thus the scope of envi nor can we expect other people to prevent ronmental studies is extremely wide and covers environmental damage. Water, air, soil, minerals, oil, the products we get from forests, grasslands, oceans and from agriculture and livestock, are all a part of our life support systems. As we keep increas ing in numbers and the quantity of resources the Multidisciplinary Nature of Environmental Studies 5 Chapter1. List these activities and identify the main resources used during these ac Example Fossil fuels: tivities. What can you do to prevent waste, reuse articles that you normally How much do you use? Once all the fossil fuels are burnt off, it the environment will mean the end of oil as a source of energy. Only if each of us contributes our part in con Attempt to assess the level of damage to serving fossil based energy can we make it last the environment due to your actions that longer on earth. Then estimate the damage you are likely to do in your life Example Water: time if you continue in your present ways. How much do you really need to use, as against Use the following examples for the above exer how much you waste when you: cise: (a) Brush your teeth? Do you feel you should change the way you use How can you reduce the amount of plastic you water? Example Food: Where did the plastic come from/ how is it Where has it come from? Example Paper: Thus the urgent need to protect all living spe cies is a concept that we need to understand What is it made from? While individually, we perhaps cannot directly prevent the extinction of a spe Where does it come from and what happens cies, creating a strong public opinion to protect during manufacture? How can you prevent it from being tween agriculture and the forest, which illus wasted? For crops to be successful, the flowers of fruit trees and veg etables must be pollinated by insects, bats and Example Electrical Energy: birds.
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