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I40-420 - Certified Function Point Specialist - BrainDump Information

Vendor Name : IFPUG
Exam Code : I40-420
Exam Name : Certified Function Point Specialist
Questions and Answers : 249 Q & A
Updated On : April 18, 2019
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I40-420 Certified Function Point Specialist

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I40-420 exam Dumps Source : Certified Function Point Specialist

Test Code : I40-420
Test Name : Certified Function Point Specialist
Vendor Name : IFPUG
Q&A : 249 Real Questions

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IFPUG Certified Function Point Specialist

The foreign function factor clients neighborhood (IFPUG) | killexams.com Real Questions and Pass4sure dumps

From the author of 

important to the continuing success of function elements as a plausible utility metric is the work it's being accomplished by the overseas characteristic factor clients community (IFPUG). considering that 1986, IFPUG has persevered to grow in individuals and in its magnitude to the software dimension group. today IFPUG enjoys a membership of thousands of particular person, company, academic, and institutional members from more than 30 nations.

IFPUG is a no longer-for-earnings, member-run consumer community. IFPUG's mission is to be a diagnosed leader in promoting and inspiring the helpful administration of utility application building and preservation actions through the use of feature element analysis and other software-dimension ideas. For more advice, contact IFPUG at www.ifpug.org/, e-mail ifpug@ifpug.org, telephone (united states of america) 609-799-4900, or fax 609-799-7032. IFPUG serves to facilitate the exchange of expertise and ideas for superior utility-measurement recommendations and seeks to supply a composite environment that stimulates the very own and expert construction of its participants. IFPUG customarily meets twice a 12 months, once within the spring and then once more within the fall. The spring convention is dedicated to practising courses and committee meetings. the autumn application is committed to both committee work and practicing courses, but it surely also usually comprises a two-and-a-half-day consumer conference and seller showcase.

Committee work is the core of IFPUG. the two most visible committees are the Counting Practices Committee and the Certification Committee. The Counting Practices Committee is chargeable for preserving the current counting instructions, Counting Practices manual. The Certification Committee is accountable for organising and implementing the certification instructions. different crucial committees that generate guidelines for either counting or the usage of function features encompass New Environments, IT efficiency, and administration Reporting. IFPUG additionally has an educational Affairs Committee, a Communications and advertising Committee, a conference Committee, and an training Committee to support the members with academic experiences, assistance dissemination, conferences, and workshops.


Inspiring San Diego: Tech software gives career Breakthroughs for Adults with high Functioning Autism | killexams.com Real Questions and Pass4sure dumps

Monday through Friday, Stephen Kay arrives at his job as a top quality assurance tester at Qualitest and gets to work hunting for issues.

Kay, 30, and his group of coworkers check a large choice of software starting from clinical equipment to the latest Android and Apple apps for businesses all over the world.

They look for system defects, making bound the application does what it’s presupposed to.

This full-time job is a dream come real for Kay as a result of he’s an grownup residing with excessive-unctioning autism and the highway to employment hasn’t been easy.

“I actually have Asperger’s syndrome and ADHD and Turret's,” Kay talked about. “Some individuals affiliate autism or researching disabilities with some type of brain hurt or lack of intelligence. That’s now not the case at all.”

Kay graduated from point Loma Nazarene university with a level in desktop science in 2013. in the years that adopted, he applied for numerous jobs but came up empty.

"if you try this for months at a time it may simply be crushing,” he pointed out. “Three or 4 years of not getting anywhere, it’s fairly depressing.”

Kay spoke of the ratio of jobs he utilized for to interest he acquired from skills employers turned into astronomically low.

"It become likely it turned into less than a 1 percent factor," he talked about. "likely closer to perhaps a thousand to one."

Kay needed to wait until November of 2018 for his employment step forward, which got here with the support of a relatively new Technical practicing program developed by using the national foundation for Autism research known as NFAR Tech.

Chelsea Asaro, Outreach specialist with NFAR Tech, spoke of Kay’s story is widespread for a lot of individuals dwelling with autism. and he or she spoke of the boundaries individuals with high-functioning autism face leaves a startling variety of them unemployed.

"The unemployment fee for individuals with autism is eighty five percent,” she noted. “and that's even higher for americans with excessive-functioning autism. The individuals who're least impacted and have essentially the most capabilities even have the least entry to services so that you can aid them to transition to work.”

Asaro stated each year between 600 and 800 college students with some type of autism graduate from San Diego County high colleges.

“That’s just like the dimension of an entire excessive college class popping out of San Diego high schools able to take that next step,” Asaro talked about. “So what does the outlook look like for them right now? It’s really no longer very first rate.”

to date, NFAR Tech has knowledgeable more than one hundred americans through its seven-month software testing software. college students of the application are taught technical competencies obligatory to be an entry-level tester and are additionally organized to pass an industry-identified certification exam (ISTQ).

Asaro is certainly passionate concerning the program as a result of she is additionally the mom of an grownup living with excessive function Autism. Her son has graduated from the NFAR Tech program and is now working as a application tester in l. a..

Asaro pointed out in lots of instances, the inhabitants she works with is uniquely proper to do this class of work. That’s because many individuals with high functioning autism are extremely attentive to element, hyper-focused and dedicated to their work.

“They cherish to do things many times and to have expected effects,” she pointed out. “and they basically locate it soothing and comforting.”

Asaro stated a fresh graduate of her application informed her that he can spot errors in code like “Like or not it's written in neon, like it be a neon signal.”

apart from the technical practising, NFAR Tech trains students in interpersonal capabilities that assist them throughout the job screening system.

“These are things that do not come as naturally to them as the technical aptitude does,” Asaro defined. “they are things like interview advantage, workplace attire, e-mail etiquette and time administration.”

Asaro says the greatest hurdle along the route to employment for adults with high-functioning autism is the interview technique, which is why the unemployment quotes for this community of people is so high.

part of Asaro’s job with NFAR Tech is assisting employers like Qualitest understand the way to appear past applicants’ social shortfalls and instead see possibility in including americans with specialized ability-units to their staff.

Elle Gee, vice chairman of birth at Qualitest, referred to, “if you appear past the interview technique, you're going to add value to your group. The challenges dealing with Stephen have been the challenges dealing with any new tester. The concerns that got here up, the training we essential to do, we might provide for any of our new individuals. So we definitely didn't should do anything else diverse.”

Gee spoke of Kay became built-in into Qualitest’s crew as directly as every other new member.

“That has inspired us to the potential of alternative recruits coming from the [NFAR Tech] software,” Gee observed.

The software turned into considered one of NBC commonplace's 2018 project Innovation grant award winners.

Kay stated the possibility to be a full-time employee in the tech business has given his life new course.

"it be like i will be able to eventually delivery being a working member of society,” he spoke of.

Gee referred to she’s hopeful different agencies can be open-minded about hiring graduates of the NFAR Tech program.

“if you cease looking on the modifications and also you seem to be on the knowledge, you will get the benefit,” she said.

The software is increasing awareness in the community and helping leaders within the tech business be aware how beneficial americans like Kay may also be in the workplace.

“I really would like different companies to needless to say people with autism have true strengths to convey to the place of work,” Asaro spoke of. “I consider that americans should look to appoint people with Autism now not just since it's a superb element socially to do, however additionally because it's a superb return on funding.”

NFAR Tech develops partnerships with tech businesses like Qualitest for each internships and job placement. in case your enterprise is attracted to partnering with the software or hiring somebody with autism, click on here. 

NFAR is internet hosting its 15th annual Race for Autism on April 6. The race raises cash to assist help classes like NFAR Tech.


Opinions: Measuring Programmers' productiveness | killexams.com Real Questions and Pass4sure dumps

in the container of application building, simply as in any other area, managers need to recognize efficiency of their programmers and the growth of their initiatives. however, defining appropriate metrics to this conclusion looks to be a tough task.

Measuring supply lines of code (SLOC) is one in all favourite strategies that gifts youngsters a few important limitations highlighted recently by Shahar Yair and Steve McConnell. firstly, the quantity of strains of code does not allow with ease measuring the progress of a task since it specializes in activity in preference to results. LOC shouldn't have any price as such: the cost of the last product is dependent upon its efficiency and quality, not on the volume of code. therefore, specializing in the latter is truly a really confined approach to productivity.

SLOC doesn’t tell anything else in regards to the complexity of the challenge at hand or about the first-class of the closing product when it comes to maintainability, flexibility, extensibility, etc. with regard to excellent, it may well really be negatively correlated. Refactoring as well as some design patterns outcomes in reducing LOC whereas improving code’s first-rate. better code base may additionally suggest greater noise, extra useless complexity, much less readability and adaptability.

what is certainly risky about adopting one of these reductive view of programmers’ efficiency is that it creates wrong incentives. in place of optimizing their work in terms of last product, builders may be inspired to desire the quantity of code to the detriment of first-rate and even deliberately write greater verbose code. “What receives measured gets performed”, recollects Steve McConnell.

He points out that some of these issues can also be solved through the use of characteristic facets as measuring metric. The software size is then decided with the aid of the number of inputs, outputs, queries and data. having said that, this method also has its downsides. McConnell mentions some purposeful considerations just like the necessity of getting a licensed function aspect counter and the difficulties with mapping every feature aspect back to particular person programmers. an authorized characteristic element professional Daniel Yokomizo highlights in his comment other obstacles of such approach: lack of tools to measure characteristic aspects’ complexity and to take into account issues akin to code sharing, frameworks, libraries, and so on., that affect the time crucial to create a feature.

despite the fact that many commentators involved within the discussion about measuring tactics agree on their obstacles, they don't always push aside the need for measuring programmers’ efficiency. Many insist on the incontrovertible fact that SLOC, for example, will also be used as a baseline for a more complex evaluation combining various factors. This goes along the strains of 4 ideas outlined with the aid of McConnell that may still ebook any evaluation of programmers’ productivity:

1. Don’t predict any single dimensional measure of productiveness to offer you a good image of individual productiveness […]

2. Don’t predict any measures […] to support satisfactory-grain discrimination in productivity amongst individuals. [They] provide you with inquiries to ask however they don’t give you the solutions […]

three. remember that trends are constantly extra crucial than single-point measures […]

four. Ask why you need to measure individual productiveness in any respect […]

in which context measuring programmers’ productiveness is in reality meaningful? What criteria can be used for it? How can they be combined? Many questions are nevertheless open for dialogue and in case your event has introduced you some answers, don’t hesitate to share.


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Inspiring San Diego: Tech Program Provides Career Breakthroughs for Adults with High Functioning Autism | killexams.com real questions and Pass4sure dumps

Monday through Friday, Stephen Kay arrives at his job as a quality assurance tester at Qualitest and gets to work looking for problems.

Kay, 30, and his team of coworkers test a wide variety of software ranging from medical equipment to the latest Android and Apple apps for companies around the world.

They look for glitches, making sure the software does what it’s supposed to.

This full-time job is a dream come true for Kay because he’s an adult living with high-unctioning autism and the road to employment hasn’t been easy.

“I have Asperger’s syndrome and ADHD and Turret's,” Kay said. “Some people associate autism or learning disabilities with some kind of brain damage or lack of intelligence. That’s not the case at all.”

Kay graduated from Point Loma Nazarene University with a degree in computer science in 2013. In the years that followed, he applied for countless jobs but came up empty.

"If you do that for months at a time it can just be crushing,” he said. “Three or four years of not getting anywhere, it’s pretty depressing.”

Kay said the ratio of jobs he applied for to interest he received from potential employers was astronomically low.

"It was probably it was less than a 1 percent thing," he said. "Probably closer to maybe a thousand to one."

Kay had to wait until November of 2018 for his employment breakthrough, which came with the help of a relatively new Technical Training Program developed by the National Foundation for Autism Research called NFAR Tech.

Chelsea Asaro, Outreach Specialist with NFAR Tech, said Kay’s story is familiar for many people living with autism. And she said the obstacles individuals with high-functioning autism face leaves a startling number of them unemployed.

"The unemployment rate for people with autism is 85 percent,” she said. “And that's even higher for people with high-functioning autism. The people who are least impacted and have the most skills also have the least access to services that will help them to transition to work.”

Asaro said every year between 600 and 800 students with some form of autism graduate from San Diego County high schools.

“That’s like the size of an entire high school class coming out of San Diego high schools ready to take that next step,” Asaro said. “So what does the outlook look like for them right now? It’s really not very good.”

So far, NFAR Tech has trained more than 100 people through its seven-month software testing program. Students of the program are taught technical skills needed to be an entry-level tester and are also prepared to pass an industry-recognized certification exam (ISTQ).

Asaro is especially passionate about the program because she is also the mother of an adult living with High Function Autism. Her son has graduated from the NFAR Tech program and is now working as a software tester in Los Angeles.

Asaro said in many cases, the population she works with is uniquely suited to do this type of work. That’s because many people with high functioning autism are extremely attentive to detail, hyper-focused and dedicated to their work.

“They like to do things repeatedly and to have expected results,” she said. “And they really find it soothing and comforting.”

Asaro said a recent graduate of her program told her that he can spot errors in code like “Like it's written in neon, like it's a neon sign.”

In addition to the technical training, NFAR Tech trains students in interpersonal skills that help them during the job screening process.

“These are things that don't come as naturally to them as the technical aptitude does,” Asaro explained. “They are things like interview skills, workplace attire, email etiquette and time management.”

Asaro says the biggest hurdle along the path to employment for adults with high-functioning autism is the interview process, which is why the unemployment rates for this group of people is so high.

Part of Asaro’s job with NFAR Tech is helping employers like Qualitest understand how to look past applicants’ social shortfalls and instead see opportunity in adding people with specialized skill-sets to their workforce.

Elle Gee, Vice President of Delivery at Qualitest, said, “If you look past the interview process, you'll add value to your team. The challenges facing Stephen were the challenges facing any new tester. The issues that came up, the training we needed to do, we would provide for any of our new people. So we really didn't need to do anything different.”

Gee said Kay was integrated into Qualitest’s team as quickly as any other new member.

“That has inspired us to the potential of other recruits coming from the [NFAR Tech] program,” Gee said.

The program was one of NBC Universal's 2018 Project Innovation Grant award winners.

Kay said the opportunity to be a full-time employee in the tech industry has given his life new direction.

"It's like I can finally start being a working member of society,” he said.

Gee said she’s hopeful other companies will be open-minded about hiring graduates of the NFAR Tech program.

“If you stop looking at the differences and you look at the potential, you'll get the benefit,” she said.

The program is increasing awareness in the community and helping leaders in the tech industry understand how valuable people like Kay can be in the workplace.

“I really would like other companies to understand that people with autism have real strengths to bring to the workplace,” Asaro said. “I think that people should look to hire people with Autism not just because it's a good thing socially to do, but also because it's a good return on investment.”

NFAR Tech develops partnerships with tech companies like Qualitest for both internships and job placement. If your business is interested in partnering with the program or hiring someone with autism, click here. 

NFAR is hosting its 15th annual Race for Autism on April 6. The race raises money to help support programs like NFAR Tech.


Is a Gluten-Free Diet Still Enough for People with Celiac Disease? | killexams.com real questions and Pass4sure dumps

Celiac.com 03/28/2019 - You could say that I was pretty spoiled when it came to medical care while growing up. At 12 years old I was diagnosed with juvenile diabetes on my first visit to Children’s Hospital in Boston. Three years later, I was diagnosed with celiac disease at the same hospital in a single visit (blood tests and an endoscopy confirmed the diagnosis, but there was a presumptive celiac disease diagnosis made in less than an hour). My experience seems to contrast the norm: according to the University of Chicago’s Celiac Disease Center, the average child visits eight pediatricians before being accurately diagnosed with celiac disease.  

During my college years, I deftly managed both conditions with relative ease. I didn’t let my pair of autoimmune diseases stop me from traveling to Italy, Brazil, and Chile and living overseas in Israel and Jordan. I became very good at following a gluten-free diet across different cultures, cuisines, and languages. Overall, I became content with the state of my celiac disease. But that all changed after I graduated from college—the student health center was no longer an option and I was forced to find a doctor on my own for the first time. 

My first attempt was a somewhat frightening, but ultimately enlightening, experience. After meeting with a physician for what felt like five minutes, he informed me that he was interested in taking some general lab tests, and that he wanted me to schedule a follow-up appointment. “Standard stuff,” I thought to myself. Since I hadn’t seen a doctor relating to my celiac disease since my diagnosis, I asked the physician, “Are there any tests that I should get for my celiac condition? Aren’t I at risk for certain nutritional deficiencies? Are there any supplements I should be taking?” The physician responded with a puzzled look and blurted out, “I’m not sure what you’re talking about.”

I left that appointment feeling confused and upset. Was I wrong? I could have sworn a doctor told me at some point to take at least a multivitamin. My ignorance of celiac disease was profound; I thought I was doing a pretty good job of managing it. Until this point in time, it really only affected my lifestyle in two ways—it was always Jack and Diet Coke instead of beer, and meat and veggies instead of pasta and sandwiches.

After a basic Internet search, I discovered that it was the doctor who was wrong. There are follow-up tests that are appropriate for someone with celiac disease—especially for someone who hasn’t been seen by a specialist for several years (in my case, nearly a decade). He was also misinformed about supplement use for celiac disease patients, as there is a general consensus that people with celiac disease should take a gluten-free multivitamin.

While frustrating, that doctor’s visit turned out to be a life-changing experience. It was at that moment that I decided to take my health into my own hands. Until that point in time, all I knew about celiac disease was that I had to follow a gluten-free diet. I had an Earth-shattering paradigm shift about how celiac disease impacted my life. 

I immediately immersed myself in celiac disease information by scouring the articles on celiac.com (one of the most popular sources of educational material on celiac disease). I was surprised to find a wealth of information about the ways that celiac disease affects overall health. I went on to order and read the books Cereal Killers by Scott Adams and Dr. Ron Hoggan and Celiac Disease by Dr. Peter Green. Both books provide a great overview of celiac disease and its various manifestations. They also helped me understand the difference between gluten intolerance and celiac disease. Most importantly, they gave me more information on how to take extra steps to manage my celiac disease beyond the gluten-free diet. These books informed me about the most common celiac-induced nutrient deficiencies and touched on supplementation as well.

As I plunged deeper into the online world of celiac disease I stumbled upon Gluten-Free Faces, a social media site created just for people with celiac disease. This website is a phenomenal resource that helps people connect with others with celiac disease in your area. Members exchange information on restaurants and recipes, join common interest groups, and share tips on managing celiac disease. In my case, I was lucky to find Elizabeth Smith, a certified nutritionist and creator of www.manageceliac.com. Elizabeth was an immense help. She easily answered all of the questions I had about celiac disease, nutritional deficiencies, and supplementation.

During this time, I also had the pleasure of meeting Brian Dean, a registered dietitian with a Masters degree in nutrition. Brian was a tremendous resource in helping me understand the impact of celiac-induced malabsorption and the nutrients that I may be deficient in due to the absence of the major cereal grains from my diet.

After researching the issue extensively and consulting regularly with Elizabeth and Brian, it became obvious that there were steps beyond a gluten-free diet that people with celiac disease should take to improve their health. More specifically, those with celiac disease should add essential nutrients to their diet in order to optimize their health and augment their gluten-free diet. These supplements fall into five major categories, summarized below.

Full Spectrum Multivitamin

Above all else, it is imperative that people with celiac disease take a multivitamin. One of the primary manifestations of celiac disease is nutrient malabsorption. Intestinal villi become damaged during the immunological response to gluten ingestion, blunting nutrient absorption. Even after following a gluten-free diet normal absorption may never fully resume. In fact, a study done by Hallert et al showed that more than half of celiac patients who had been following a gluten-free diet for over 10 years still showed a higher total plasma homocysteine level than the general population, indicating B vitamin deficiencies(1). A celiac-specific multivitamin must contain the fat-soluble vitamins (A, D, E and K) and B-complex vitamins. Most importantly, it must include the anti-anemics of folic acid, vitamin B-12, and iron since anemia is one of the most common complications in people with celiac disease(2). 

Bone Density Support 

Another potential complication in both adults and children with celiac disease is an increased risk of low bone density. A recent study showed that 40% of newly diagnosed patients with celiac disease have osteopenia (reduced bone mass, but not severe enough to be classified as osteoporosis) and 26% have osteoporosis(3). This phenomenon occurs for a number of reasons. Firstly, calcium —the most critical bone-building nutrient— is not properly absorbed in people with celiac disease. Further, a significant portion of people with celiac disease are also lactose intolerant, limiting their ability to ingest calcium-rich dairy products.

However, calcium alone is not enough for optimal bone health. Vitamin D supplementation is critical due to its role in calcium absorption and utilization. It has been shown that Vitamin D increases calcium absorption by as much as 80%(4).  Another critical nutrient that should be included in any bone density-enhancing supplement is magnesium. Magnesium enhances calcium supplementation, as it’s used by the parathyroid gland to regulate calcium metabolism. Without magnesium, calcium is excreted from the body and not retained to perform its essential functions. Several studies have shown that magnesium deficiency alters calcium metabolism and the hormones that regulate calcium(5). 

Intestinal Healing / Strenghtening Nutrient

Intestinal damage is a hallmark sign of celiac disease. It’s well understood that villus atrophy caused by the autoimmune-mediated response to gluten is the underlying cause of poor nutrient status commonly seen in the celiac disease population. However, a gluten-free diet is insufficient for intestinal repair. Ciacci et al reports that more than half of diagnosed and treated celiac disease patients have clinically damaged intestines, as determined by biopsy. In addition, 23% of cases were determined to have severe intestinal damage(6). Furthermore, in a recent study conducted by the Mayo Clinic, it was found that only 37% of subjects showed mucosal recovery after two years on a gluten-free diet. After five years, this number increased to just 66%(7). Fortunately, there are a number of nutrients that can be supplemented to promote the healing of the intestinal lining. These nutrients include zinc, glutamine, and citrus bioflavonoids, among others.

Probiotics

Dr. Alessio Fasano of the University of Maryland’s Celiac Disease Center believes that probiotics may one day provide a cure for celiac disease(8). While this technology does not yet exist, probiotics have already been used to treat many illnesses and diseases pertaining to the human digestive system including irritable bowel diseases, intestinal infections, and celiac disease(9).

Celiac disease patients are vulnerable to dysbiosis, an imbalance of bacterial strains in the gut. In a study of gut microflora in patients both with and without celiac disease, researchers determined that patients with celiac disease have a much higher total and gram negative bacteria count. Bacteroides and E. coli were significantly more abundant in celiac disease patients with active disease, while those with inactive disease and those without celiac disease exhibited a much higher ratio of probiotic bacteria(10). In a literature review, Salminen et al determined that probiotics are clinically effective treatments for disorders of the gut stemming from dysbiosis(11).

In a recent study by Lindfors et al it was concluded that the live B. lactis bacteria may directly counteract the harmful effects of gluten(12). A 2010 study published by De Palma et al found that the use of probiotics significantly reduced intestinal inflammation of celiac disease affected cells in vitro(13).

Enzymes

Pancreatic exocrine insufficiency (reduced pancreatic enzyme secretion) is a consequence of many diseases of the pancreas, as well as extrapancreatic diseases like celiac disease(14). Pancreatic enzymes are essential in the digestive process(15). Supplementation of these enzymes aid in the breakdown of fats, proteins, and carbohydrates. The benefit of pancreatic enzyme supplementation is clinically significant for people who have compromised digestion, such as celiac disease patients(16).

Chronic diarrhea is a common symptom of celiac disease patients(17). A study done by Leeds et al examined the effect of pancreatic enzyme supplementation in celiac disease patients with chronic diarrhea. The authors concluded that supplementation of pancreatic enzymes significantly reduced the frequency of diarrhea(15).

Pancreatic enzymes are beneficial to patients with celiac disease because they are among the most potent digestive aids available. They help break down food, allowing for further absorption of nutrients. Also, they have anti-inflammatory properties that provide significant benefits to the digestive tract(18). 

Conclusion

Following a strict gluten-free diet is of utmost importance for people with celiac disease. However, there are additional steps that people with celiac disease should take to optimize their health. Since no medications are currently available, the best alternative is supplementation. It is my hope that others will be able to benefit from this ongoing research and that they will decide to take their health back into their own hands.

References1.    Hallert C et al Evidence of poor vitamin status in celiac patients on a gluten-free diet for 10 years. Alimentary Pharmacology Therapeutics. 2002;16:1333-1339.2.    Nelson DA. Gluten-sensitive enteropathy (celiac disease): more common than you think. American Family Physician. 2002;66:2259-2266.3.    See J and Murray JA. Gluten-free diet: the medical and nutrition management of celiac disease. Nutrition in Clinical Practice. 2006;21:1-15.4.    Adams S and Hoggan R. Cereal killers: celiac disease and the gluten-free a to z. Waterworks and Celiac.com. 2010.5.    NIH. Magnesium. Office of Dietary Supplements. 2009. http://ods.od.nih.gov/factsheets/magnesium.asp6.    Ciacci C, Cirillo M, Cavallaro R, Mazzacca G. Long-term follow-up of celiac adults on gluten-free diet: prevalence and correlates of intestinal damage. Digestion. 2002;66:178-85.7.    Rubio-Tapia A et al Mucosal recovery and mortality in adults with celiac disease after treatment with a gluten-free diet. American Journal of Gastroenterology. 2010;105:1412-1420.8.    Fasano A. Surprises from Celiac Disease. Scientific American. 2009;301(2):54-61. 9.    Mennigen R and Bruewer M. Effect of probiotics on intestinal barrier function. Annals of the New York Academy of Sciences. 2009;1165:183-189.10.    Nadal I et al Imbalance in the composition of the duodenal microbiota of children with celiac disease. Journal of Meicald Microbiology. 2007;56:1669-1674.11.    Saavedra JN. Clinical applications of probiotic agents. American Journal of Clinical Nutrition. 2001;73:S1147––S1151.12.    Lindfors K, Blomqvist T, et al Live probiotic bifidobacterium lactis bacteria inhibit the toxic effects induced by wheat gliadin in epithelial cell culture. Clinical and Experimental Immunology. 2008;152:552-558.13.    De Palma G, Cinova J, et al Pivotal advance: bifidobacteria and gram-negative bacteria differentially influence immune responses in proinflammatory milieu of celiac disease. Journal of Leukocyte Biology. 2010;87:765-778.14.    Dominguez-Munoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Current Gastroenterology Reports. 2007;9:116-122.15.    Malterre T. Digestive and nutritional considerations in celiac disease: could supplementation help? Alternative Medicine Review. 2009;14:247-257.16.    Roxas M. The role of enzyme supplementation in digestive disorders. Alternative Medicine Review. 2008;13:307-314.17.    U.S. Department of Health and Human Services. Celiac disease. National Digestive Diseases Information Clearinghouse. September 2008.18.    Britton RS, Leicester KL, Bacon BR. Iron toxicity and chelation therapy. International Journal of Hematology. 2002 Oct;76(3):219-228. 


Can exercise improve brain performance in kids? | killexams.com real questions and Pass4sure dumps

The positive impact of physical activity on brain performance is not a new concept.

The aphorism ‘I’m going for a walk to clear my head’ has been around for centuries. Ever since the scientific investigation of cognition and exercise began in the 1930s, a growing body of research is showing how being physically active improves a multitude of thinking and memory tasks.

A 2008 article from the journal Nature states “Human and non-human animal studies have shown that aerobic exercise can improve a number of aspects of cognition and performance”.

The same article addresses other effects of physical activity in children. It points out that a growing body of evidence is showing that kids are becoming increasingly sedentary and unfit, making them more likely to develop chronic disease later in life.

This is especially concerning because the article also states “...As a result, recent estimates have indicated that younger generations, for the first time in United States history, might live less healthy lives than their parents.”

Published in the journal Pediatrics, a group of scientists designed a study to establish a direct relationship between physical activity and performance. For the study, “Two hundred twenty-one children (7–9 years) were randomly assigned to a 9-month afterschool PA (physical activity) program or a wait-list control. In addition to changes in fitness (maximal oxygen consumption), electrical activity in the brain (P3-ERP) and behavioral measures (accuracy, reaction time) of executive control were collected by using tasks that modulated attentional inhibition and cognitive flexibility.”

The authors concluded, “The intervention enhanced cognitive performance and brain function during tasks requiring greater executive control. These findings demonstrate a causal effect of a PA program on executive control, and provide support for PA for improving childhood cognition and brain health.”

While further research is being conducted to find the ideal type and duration of exercise, there seems to be enough evidence for most major medical associations to strongly recommend regular physical activity during childhood.

For some local expertise, I spoke to Dr. Carrie Ricci. Dr. Ricci is a pediatrician at Petoskey Child Health Associates in Petoskey.

MYM: How much exercise do you recommend for your patients?

Ricci: “I recommend 60 minutes or more of moderate to vigorous physical activity daily for my patients. The activity should be vigorous at least three days per week. This recommendation can be met either through multiple short periods (at least 10 minutes) throughout the day or a continuous 60-minute period.”

MYM: Is there a specific type of exercise that you suggest to patients and their families?

Ricci: “It is important that the exercise is aerobic. I explain to my patients that this means that their heart should be beating fast, they should be breathing fast and sweating. I do not have a particular exercise or activity that I recommend. I try to brainstorm with the patient and parent(s) to come up with a list of aerobic activities that the child enjoys. My hope is that the patient feels the activities are fun and will stick with them, instead of viewing exercise as a chore.”

The American Academy of Pediatrics has some additional insight regarding exercise for kids.

Who can benefit?

Research has clearly shown that exercise improves cognitive performance in school-age children. The age groups 4-7 and 11-13 showed even more benefit compared to kids in other age ranges. Interestingly, older adults who exercise also showed significantly better performance compared to their sedentary counterparts on psychomotor tasks.

At what age should exercise begin?

As early as possible, it seems. Findings suggest that “... although physical activity might be beneficial at all stages of life, early intervention might be important for the improvement and/or maintenance of cognitive health and function throughout the adult lifespan”.

Jeff Samyn is a Physical Therapist, board certified Orthopedic Clinical Specialist, and Certified Strength and Conditioning Specialist at Northern Michigan Sports Medicine Center in Petoskey. He can be reached via e-mail at jsamyn@nmsportsmed.com. This information is not to be considered medical advice and is not intended to replace consultation with a qualified medical professional.



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