7/22/2017 0 Comments Ams Weight Loss ProgramNumerous weight loss products and diets promise rapid weight loss. WebMD explores rapid weight loss claims, types of diets, and the risks and benefits of rapid weight.Part 5. 2—Solicitation Provisions and Contract Clauses. Scope of part. Subpart 5. Instructions for Using Provisions and Clauses. Scope of subpart. Using Part 5. 2. 5. Incorporating provisions and clauses. Identification of provisions and clauses. Procedures for modifying and completing provisions and clauses. Procedures for using alternates. Currency. 5. 2. 2. Instructions to Offerors—Competitive Acquisition. She has been a personal trainer and yoga instructor for almost a decade and is. Learn from and interact with hundreds of thousands of bodybuilding enthusiasts. Includes articles, supplement reviews, discussion forum and more. Fat Loss Dilemma – Why You’re Not Getting Results (at least as fast as you should) By Dr. K in Video If you’re ready to lose weight, AMS Rapid Weight Loss Center in Easley, SC will create a personal weight loss plan to help you achieve healthy weight loss. Audit and Records—Negotiation. Request for Information or Solicitation for Planning Purposes. Origin. 5. 2. 2. 47- 3. F. o. b. Origin, Contractor’s Facility. F. o. b. Origin, Freight Allowed. F. o. b. Origin, Freight Prepaid. F. o. b. Origin, with Differentials. F. o. b. Destination. F. o. b. Destination, Within Consignee’s Premises. F. a. s. Vessel, Port of Shipment. F. o. b. Vessel, Port of Shipment. F. o. b. Inland Carrier, Point of Exportation. F. o. b. Inland Point, Country of Importation. Ex Dock, Pier, or Warehouse, Port of Importation. C.& f. Destination. C. i. f. Destination. F. o. b. Designated Air Carrier’s Terminal, Point of Exportation. F. o. b. Designated Air Carrier’s Terminal, Point of Importation. F. o. b. Origin and/or F. Destination Evaluation. Shipping Point(s) Used in Evaluation of F. Origin Offers. 5. Evaluation—F. o. b. Origin. 5. 2. 2. 47- 4. F. o. b. Destination—Evidence of Shipment. Destination Unknown. No Evaluation of Transportation Costs. Evaluation of Export Offers. Clearance and Documentation Requirements—Shipments to Do. D Air or Water Terminal Transshipment Points. Freight Classification Description. Point for Delivery of Government- Furnished Property. Transit Arrangements. Transportation Transit Privilege Credits. Loading, Blocking, and Bracing of Freight Car Shipments. F. o. b. Origin—Carload and Truckload Shipments. Guaranteed Shipping Characteristics. F. o. b. Origin—Minimum Size of Shipments. Specific Quantities Unknown. Preference for U. S.- Flag Air Carriers. Preference for Privately Owned U. S.- Flag Commercial Vessels. F. o. b. Origin, Prepaid Freight—Small Package Shipments. Returnable Cylinders. Submission of Transportation Documents for Audit. Report of Shipment (REPSHIP). Value Engineering. Value Engineering—Architect- Engineer. Value Engineering—Construction. Termination for Convenience of the Government (Fixed- Price) (Short Form). Termination for Convenience of the Government (Fixed- Price). Termination for Convenience of the Government (Dismantling, Demolition, or Removal of Improvements). Termination for Convenience of the Government (Services) (Short Form). Termination for Convenience of the Government (Educational and Other Nonprofit Institutions). Termination (Cost- Reimbursement). Termination (Fixed- Price Architect- Engineer). Default (Fixed- Price Supply and Service). Default (Fixed- Price Research and Development). Default (Fixed- Price Construction). OA Guide to High Altitude: Acclimatization and Illnessesby Rick Curtis, Director, Outdoor Action Program. Last Page update 0. Navigation. Traveling at high altitude can be hazardous. The information provided here is. Princeton University and the author assume no liability for any individual's. This paper is. prepared to provide basic information about altitude illnesses for the lay person. Medical. research on high altitude illnesses is always expanding our knowledge of the causes and. When going to altitude it is your responsibility to learn the latest. The material contained in this article may not be the most current. Here is a classic. You fly from New York City to a Denver at. That afternoon you rent a car and drive up to the trailhead at. You hike up to your first camp at 9,0. You begin to have a severe. If your condition worsens, you may begin to have. Scenarios like this are not uncommon, so it's essential that you. What is High Altitude? Altitude is defined on the following scale High (8,0. Since few people have been to such altitudes, it is hard. There are no specific factors such as age, sex, or. Some people. get it and some people don't, and some people are more susceptible than others. Most. people can go up to 8,0. If you haven't been to. If you have been at that altitude. What Causes Altitude Illnesses. The concentration of oxygen at sea level is about 2. Hg. As altitude increases, the concentration remains the same but the. At 1. 2,0. 00 feet (3,6. Hg, so there are roughly 4. In order to properly oxygenate the body, your breathing rate (even while at rest). This extra ventilation increases the oxygen content in the blood, but not. Since the amount of oxygen required for activity is the same. In addition, for reasons not entirely. Continuing to higher. Acclimatization. The major cause of altitude illnesses is going too high too fast. Given time, your body. This process is. known as acclimatization and generally takes 1- 3 days at that altitude. For example, if. you hike to 1. If you climb to 1. A number of changes take place in the body to. Pressure in pulmonary arteries is increased, . The body produces more red blood cells to carry oxygen, The body produces more of a particular enzyme that facilitates the release of oxygen from hemoglobin to the body tissues. Prevention of Altitude Illnesses. Prevention of altitude illnesses falls into two categories, proper acclimatization and. Below are a few basic guidelines for proper acclimatization. Start below 1. 0,0. If you do fly or drive, do not over- exert yourself or move higher for the first 2. If you go above 1. You can climb. more than 1,0. If you begin to show symptoms of moderate altitude illness, don't go higher until. Don't go up until symptoms go down. If symptoms increase, go down, down, down! Keep in mind that different people will acclimatize at different rates. Make sure all of. Stay properly hydrated. Acclimatization is often accompanied by fluid loss, so you need. Urine. output should be copious and clear. Take it easy; don't over- exert yourself when you first get up to altitude. Light. activity during the day is better than sleeping because respiration decreases during. Avoid tobacco and alcohol and other depressant drugs including, barbiturates. These depressants further decrease the respiratory. Eat a high carbohydrate diet (more than 7. The acclimatization process is inhibited by dehydration, over- exertion, and alcohol and. Preventive Medications. Diamox (Acetazolamide) allows you to breathe faster so that you metabolize more. This is especially. Since it takes a while for Diamox to. The recommendation of the Himalayan. Rescue Association Medical Clinic is 1. These. side effects may be reduced with the 1. Side effects subside when the drug is. Contact your physician for a prescription. Since Diamox is a sulfonamide drug. Diamox. Diamox has also been known. Diamox or sulfa. allergies. Frank Hubbell of SOLO recommends a trial course of the drug before going to a. Dexamethasone (a steroid) is a prescription drug that decreases brain and other. AMS. Dosage is typically 4 mg twice a day for a few days. This prevents most symptoms of altitude illness. It should be. used with caution and only on the advice of a physician because of possible serious side. It may be combined with Diamox. No other medications have been proven valuable. AMS. Acute Mountain Sickness (AMS)AMS is common at high altitudes. At elevations over 1. The occurrence of AMS is dependent upon the elevation, the. Many people will experience mild AMS during. Symptoms usually start 1. The symptoms of Mild AMS are. Symptoms tend to be worse at night and when. Mild AMS does not interfere with normal activity. As long as. symptoms are mild, and only a nuisance, ascent can continue at a moderate rate. When. hiking, it is essential that you communicate any symptoms of illness immediately to others. AMS is considered to be a neurological problem caused by changes in the. It is basically a mild form of High Altitude Cerebral Edema (see. Basic Treatment of AMSThe only cure is either acclimatization or descent. Symptoms of Mild AMS can be. Diamox. Both help to reduce the severity of. Diamox allows. you to breathe faster so that you metabolize more oxygen, thereby minimizing the symptoms. This is especially helpful at night when respiratory drive is. Since it takes a while for Diamox to have an effect, it is advisable to start. The recommendation of the Himalayan Rescue Association Medical Clinic is 1. These side effects may be reduced with the 1. Side effects subside when the drug is stopped. Contact your physician for a. Since Diamox is a sulfonamide drug, people who are allergic to sulfa drugs. Diamox. Diamox has also been known to cause severe. Diamox or sulfa allergies. Moderate AMSModerate AMS includes severe headache that is not relieved by medication. Normal activity is difficult, although the person may still be able. At this stage, only advanced medications or descent can reverse the. Descending even a few hundred feet (7. Twenty- four. hours at the lower altitude will result in significant improvements. The person should. At this point, the. The best. test for moderate AMS is to have the person . It is. important to get the person to descend before the ataxia reaches the point. Severe AMSSevere AMS presents as an increase in the severity of the aforementioned symptoms. Severe AMS requires immediate. There are two other severe forms of altitude illness, High Altitude Cerebral Edema. HACE) and High Altitude Pulmonary Edema (HAPE). Both of these happen less frequently. When they do occur, it is usually with. The lack of oxygen. High Altitude Pulmonary Edema (HAPE)HAPE results from fluid buildup in the lungs. The fluid in the lungs prevents effective. As the condition becomes more severe, the level of oxygen in the. Symptoms include shortness of breath even at rest, . Confusion, and. irrational behavior are signs that insufficient oxygen is reaching the brain. One of the. methods for testing yourself for HAPE is to check your recovery time after exertion. If. your heart and breathing rates normally slow down in X seconds after exercise, but at. In cases of HAPE, immediate descent is a necessary life- saving. Anyone suffering from HAPE must. High Altitude Cerebral Edema (HACE)HACE is the result of swelling of brain tissue from fluid leakage. Symptoms can include. Severe instances can lead to. Immediate descent is a necessary life- saving. There are some medications that may be. Anyone suffering from HACE must be evacuated to a medical. Other Medications for Altitude Illnesses. Ibuprofen is effective at relieving altitude headache. Nifedipine rapidly decreases pulmonary artery pressure and relieves HAPE. Breathing oxygen reduces the effects of altitude illnesses. Gamow Bag (pronounced ga. The person is placed inside the bag and. Pumping the bag full of air effectively increases the concentration of. In as little as 1. After a 1- 2 hours in the bag, the person's body. This lasts for up to 1. The bag and pump weigh about 1. Bags can be rented for short term. Cheyne- Stokes Respirations. Above 1. 0,0. 00 feet (3,0. Cheyne- Stokes Respirations. The pattern begins with a few shallow breaths. Respirations may cease. During the period. This can disturb sleeping patterns, exhausting the climber. Acetazolamide. is helpful in relieving the periodic breathing. This type of breathing is not. However, if it occurs first during an illness. Sources: Mountain Sickness, Peter Hackett, The Mountaineers, Seattle, 1. High Altitude Illness, Frank Hubble, Wilderness Medicine Newsletter, March/April 1. The Use of Diamox in the Prevention of Acute Mountain Sickness, Frank Hubble, Wilderness. Medicine Newsletter, March/April 1. The Outward Bound Wilderness First Aid Handbook, J. Isaac and P. Goth, Lyons &. Burford, New York, 1. Medicine for Mountaineering, Fourth Edition, James Wilkerson, Editor, The Mountaineers. Seattle, 1. 99. 2. Gamow Bags - can be rented from Chinook Medical Gear, 3. Hwy 6, Edwards, Colorado. Going Higher, Charles Houston, Little Brown, 1. High Altitude Sickness and Wellness, Charles Houston, ICS Books, 1. High Altitude Medicine and Physiology, Ward Milledge, West, Chapman and Hall, New York. This article is written by Rick Curtis, Director, Outdoor Action Program. This material. may be freely distributed for nonprofit educational use. However, if included in. Commercial. use of this material is prohibited without express written permission from the author.
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