Level 5 (1-50) (Random)

Level Up B1+, unit 5, 5,1-5,50 READING

In this video we take a look at the 0:02 fetch to code 0:03 execute cycle including its effect on 0:06 the various registers we've previously 0:12 [Music] 0:14 discussed a computer is defined Definition 0:17 as an electronic device that takes an 0:20 input 0:22 processes data 0:25 and delivers output 0:29 in this simple example you can see we're 0:31 taking the input 5 0:35 we're multiplying it by 2 that's our 0:37 process 0:39 and we're outputting 10. 0:44 but this could be way more complex for 0:46 example of a game console 0:48 the input could be the buttons you press 0:50 on a controller 0:53 the processes would then be carried out 0:55 by the console itself 0:59 and the output would be some form of 1:01 update to a monitor 1:02 and sound out for a speaker possibly 1:04 vibration feedback through the 1:06 controller 1:10 to process data a computer follows a set 1:13 of instructions 1:14 known as a computer program 1:18 if we take the lid off a typical desktop 1:20 computer we can identify 1:22 two critical components the memory 1:26 that stores the program and the central 1:29 processing unit or processor 1:31 which is under this large fan and 1:33 carries out the instructions 1:37 a computer carries out its function by 1:40 fetching 1:41 instructions decoding them and then 1:43 executing them 1:44 in a continuous repetitive cycle 1:46 billions of times a second 1:48 let's look at each of these stages in a 1:50 little more detail Fetch 1:53 so let's start with the fetch stage the 1:55 very first thing that happens 1:57 is the program counter is checked as it 2:00 holds the address 2:01 of the next instruction to be executed 2:07 the address stored is then copied into 2:09 the memory address register 2:14 the address is then sent along the 2:16 address bus to main memory 2:18 where it waits to receive a signal from 2:21 the control 2:22 bus so it knows what to do 2:27 as we want to read the data that's 2:29 stored in memory address 2:30 0 0 0 0 the control unit sends 2:34 a read signal along the control bus to 2:36 main memory 2:41 now main memory knows the data needs to 2:44 be read 2:45 the content stored in memory address 000 2:49 can be sent along the data bus to the 2:51 memory data register 2:56 now as we're currently in the process of 2:58 fetching an instruction 3:00 the data received by the memory data 3:03 register gets copied 3:04 into the current instruction register 3:11 the instruction effectively has now been 3:14 fetched from memory 3:16 just before we proceed to the decode 3:18 phase we now 3:19 increment the program counter so that 3:22 the address it contains 3:24 points to the address of the next 3:26 instruction which will need to be 3:30 executed 3:32 the instruction now being held in the 3:33 current instruction register 3:35 is ready to be decoded 3:39 now as we mentioned in the previous 3:41 video the instruction is made up of two 3:43 parts 3:44 we have the op code that's what it is we 3:47 need to do 3:50 and we have the operand what are we 3:53 going to do it to 3:55 now the operand could contain the actual 3:57 data 3:58 or indeed it could contain an address of 4:01 where the data is to be found 4:06 by decoding this instruction we can see 4:08 the operation we need 4:10 is a load operation so we need to load 4:14 the contents of memory location0101 4:18 into the cpus accumulator 4:25 in the exam a simple model will be used 4:27 to describe the 4:29 structure of any given instruction 4:32 you're not going to be expected to 4:34 define how an opcode is made up 4:36 but simply to interpret opcodes in the 4:39 given context of an exam 4:40 question in the example here 4:44 you can see there's a total of 16 4:46 different opcodes available 4:48 and this is because we're using four 4:50 bits for our representation 4:56 so now we've fetched the instruction and 4:59 we've decoded it so we know what we need 5:00 to do 5:01 we're finally ready to execute it 5:05 so we now send address 0101 5:08 to the memory dress register 5:13 now we're in the memory address register 5:15 we can finally send the address 5:18 down the address bus to main memory 5:24 this time we want to read the data 5:26 that's stored in memory 5:28 and so the control unit again sends a 5:30 read signal along the control bus 5:36 so main memories now receive an address 5:38 and a read signal 5:40 so the content stored at memory location 5:43 0101 5:44 can now be sent along the data bus back 5:46 to the cpu 5:47 and into the memory data register 5:54 finally the contents of the memory data 5:56 register are copied to the accumulator 5:59 and this is one of a number of general 6:00 purpose registers found in the cpu 6:04 this first instruction is now complete Branching 6:11 so what does this program actually do 6:14 you should be able to work it through 6:16 carefully and figure it out 6:19 we're now pointing instructions zero 6:21 zero zero one in the program counter 6:23 and we're ready to fetch the second 6:25 instruction 6:27 at the end of this video we're gonna 6:29 provide you with the answer 6:34 so let's talk a second about programs 6:37 that branch 6:40 on the left here we have a very simple 6:42 piece of pseudo code 6:44 line zero says first execute this line 6:46 of code 6:47 line 1 now execute this line and then 6:50 line 2 says 6:52 if the age is greater than 18 then 6:56 we're going to execute lines 3 and 4 6:58 otherwise 6:59 we're going to execute lines six and 7:02 seven 7:03 so this program doesn't necessarily 7:05 follow strictly in sequence from line 7:07 zero through to seven there's a chance 7:10 here the program may branch and jump 7:14 around 7:16 so we're going to pretend that this 7:17 program has been loaded into memory 7:20 each line of code on the left here has 7:23 ended up 7:24 as a location in memory now this is not 7:27 strictly how this would happen in this 7:28 one-to-one way 7:29 but for the purpose of example it's 7:31 absolutely fine 7:35 so the program counter starts by 7:37 pointing to memory address zero 7:39 and we fetch the first instruction 7:41 decode it and execute it 7:44 it then updates and tells us the next 7:47 instruction 7:48 is zero zero zero one because remember 7:50 the program counter is being incremented 7:52 so we fetch it decode it and we execute 7:55 line one of our program 7:59 we then fetch line two which in binary 8:01 is one 8:02 zero 8:06 now at this point depending on what 8:10 happens during the execution 8:11 of line two the program may be required 8:15 to fetch line three from memory or 8:18 line five from memory 8:25 so let's look at how this actually works 8:27 because we've said the program counter 8:28 simply gets incremented 8:31 well in the current instruction register 8:33 we have an instruction with the op code 8:36 0 1 1 0. 8:41 now when we look this up in the decode 8:43 unit we discover that this 8:45 code means branch always 8:51 this replaces the value held in the 8:54 program counter 8:56 with the contents of the operand that's 8:58 the second part of the instruction 9:01 from the current instruction register so 9:03 this case 9:04 one zero zero one 9:09 now when the next fetch cycle begins the 9:12 program counter is obviously checked 9:14 and as its contents have been previously 9:16 updated to a new memory location 9:19 and not simply incremented the program 9:22 effectively is able to jump 9:24 around memory 9:28 so having watched this video you should 9:30 be able to answer the following key 9:32 question 9:33 how does a cpu work 9:39 okay so let's um answer the question we 9:41 posed 9:42 earlier what did that program actually 9:48 do 9:50 so this is the first fetch to code 9:53 execute cycle 9:55 and this is the one that we ran through 9:57 in detail earlier 9:58 it effectively loaded the contents of 10:01 the memory 10:02 stored at location location0101 10:05 into the accumulator in other words 10:08 the dna number 3 is moved 10:11 from memory into the cpu 10:18 we then proceed onto the second fetch 10:20 decode execute cycle 10:23 now this one adds the contents of memory 10:27 located at 0 1 1 0 10:30 to the current contents of the 10:32 accumulator 10:34 so in other words the dna number one 10:38 because that's what's stored at address 10:40 zero one one zero 10:43 is added to the number three that was in 10:45 the accumulator 10:46 the results are stored back over the 10:48 accumulator 10:49 so effectively we've done three plus one 10:53 equals four 10:58 the third fetch to code execute cycle 11:00 stores the contents which are in the 11:02 accumulator 11:03 into memory location zero one one one 11:07 and that's because the op code the first 11:09 part of this current instruction 11:10 zero zero one one is the command to 11:13 store when we look it up in the decoder 11:15 unit 11:16 so in other words the result of the 11:17 previous calculation three plus one 11:19 equals four 11:20 is now written back into main memory 11:28 the fourth fetch decode execute cycle 11:30 outputs the contents of the accumulator 11:33 remember they were copied into main 11:34 memory but they're still held in the 11:35 accumulator 11:37 so in this simple abstraction the number 11:40 four is now 11:41 output to the user so they can see the 11:43 result of the calculation 11:49 the fifth and final fetch code execute 11:51 cycle 11:52 brings a halt to the current program 11:58 so this very simple program which has 12:01 five 12:02 fetch decode execute cycles has 12:04 performed the calculation 12:06 three plus one is then stored the result 12:09 in main memory 12:10 and displayed the result four to the 12:12 user 12:13 and in a high-level language this may 12:15 look something very similar to the 12:17 following two lines of code 12:20 sum variable equals num1 plus num2 12:24 print sum to the user 12:27 so you can start to get an appreciation 12:29 here of how the high level code you 12:32 write actually ends up being fetched 12:34 decoded 12:35 and executed inside a processor 12:38 of course your processor is doing 12:40 billions and billions of these 12:42 operations a second 12:43 which when you think about it is really 12:45 very impressive 12:52 [Music] 13:03 you. make 10 questions for a standerd of a level

RPMS Quiz: Quality vs. Efficiency 1. A teacher spends five hours creating a highly interactive digital game for a single 40-minute lesson. This is an example of prioritizing: • A) Quality over Efficiency • B) Efficiency over Quality • C) Administrative Competence • D) Resource Management • Hint: The focus is on high-level engagement, but the time investment is very high. 2. Which of the following best describes "Efficiency" in the context of the RPMS? • A) Submitting all MOVs and reports on or before the deadline with minimal errors. • B) Ensuring 100% of students pass the quarterly examination. • C) Creating the most aesthetically pleasing portfolio in the department. • D) Conducting home visits for every single student in a class of 50. • Hint: Look for the option that emphasizes timeliness and resource use. 3. Using a "template" or a "reusable slide deck" for lesson planning is a strategy to improve: • A) Efficiency • B) Instructional Diversity • C) Subject Matter Mastery • D) Classroom Discipline • Hint: Templates reduce the time spent on repetitive formatting. 4. If a teacher provides detailed, personalized feedback to every student but submits the grades two weeks late, they have achieved: • A) High Quality, Low Efficiency • B) Low Quality, High Efficiency • C) High Quality, High Efficiency • D) Low Quality, Low Efficiency • Hint: The work itself is excellent, but the timing is poor. 5. Which tool improves Efficiency without sacrificing the Quality of assessment data? • A) Automated Google Forms for multiple-choice quizzes. • B) Giving everyone a passing grade to save time on checking. • C) Writing long paragraphs of feedback on 200 paper-based essays. • D) Skipping assessments entirely to finish the syllabus faster. • Hint: Look for a balance where technology handles the "busy work." 6. When discussing Quality in your RPMS portfolio, which "Means of Verification" (MOV) is most appropriate? • A) Sample of student work with constructive teacher comments. • B) A logbook showing you arrived at school at 7:00 AM daily. • C) A certificate for attending a 1-hour webinar. • D) A photo of your organized teacher's cabinet. • Hint: Quality is evidenced by the impact on student learning. 7. The concept of "Doing the right things" (Effectiveness) represents: • A) Quality • B) Efficiency • C) Speed • D) Compliance • Hint: "Doing the right things" is about results; "Doing things right" is about process. 8. How does "Efficiency" help a teacher maintain "Quality" in the long run? • A) It prevents burnout by optimizing workload, leaving energy for creative teaching. • B) It allows the teacher to take more side jobs. • C) It ensures the teacher never has to talk to parents. • D) It proves that the teacher is smarter than their peers. • Hint: Consider the relationship between teacher well-being and performance. 9. If a teacher's RPMS rating for Quality is 5 (Outstanding) but Efficiency is 2 (Fair), what is the most likely reason? • A) The teacher produces excellent work but often misses deadlines. • B) The teacher is very fast but makes many mistakes in their reports. • C) The teacher is both slow and produces poor results. • D) The students are failing despite the teacher being very organized. • Hint: Check the gap between the high-standard output and the slow delivery. 10. What is the ultimate goal of balancing Quality and Efficiency in the PPST-RPMS? • A) To achieve sustainable professional excellence that benefits the learners. • B) To get a higher salary increase only. • C) To impress the School Head during the observation. • D) To finish the school year with the least amount of work possible. • Hint: It's about long-term growth for both teacher and student. ________________________________________ Answer Key: 1. A | 2. A | 3. A | 4. A | 5. A | 6. A | 7. A | 8. A | 9. A | 10. A ________________________________________

A ______________ is the smallest military unit, typically consisting of 3-5 soldiers and working closely within a tactical operation. A ______________ consists of 8-12 soldiers and is led by a squad leader. A ______________, typically consisting of 30-50 soldiers, is commanded by a lieutenant and subdivided into smaller squads. The ______________ is a company-level unit of about 100-200 soldiers, typically commanded by a captain. A ______________ is made up of several companies, usually commanded by a lieutenant colonel, and consists of 300-1,000 soldiers. A ______________ typically consists of 3-5 battalions, is commanded by a colonel, and can operate independently in large-scale operations. A ______________ is made up of several brigades and is commanded by a major general, usually numbering 10,000-20,000 soldiers. A ______________ is a larger military formation made up of multiple divisions, commanded by a lieutenant general. The term ______________ refers to units designed for direct engagement with enemy forces, such as infantry, armor, and artillery. ______________ is a branch specializing in close-combat tactics and foot soldiers, serving as the backbone of ground forces. ______________ units provide long-range firepower to support ground forces, using cannons, howitzers, and rocket systems. ______________ are specialized units equipped with tanks and other armored vehicles for breakthrough and exploitation missions. The ______________ is responsible for building infrastructure like bridges, roads, and fortifications in combat and non-combat settings. The ______________ provides protection against nuclear, biological, and chemical weapons on the battlefield. ______________ are elite units trained for unconventional warfare, counter-terrorism, and specialized missions. ______________ are responsible for maintaining law and order within military ranks and ensuring security in both combat zones and bases. ______________ provide medical care to soldiers, ensuring health and emergency treatment in battlefield conditions.

Early society and accomplishments Origins Knowledge of the early prehistory of Southeast Asia has undergone exceptionally rapid change as a result of archaeological discoveries made since the 1960s, although the interpretation of these findings has remained the subject of extensive debate. Nevertheless, it seems clear that the region has been inhabited from the earliest times. Hominid fossil remains date from approximately 1,500,000 years ago and those of Homo sapiens from approximately 40,000 years ago. Furthermore, until about 7000 bce the seas were some 150 feet (50 metres) lower than they are now, and the area west of Makassar Strait consisted of a web of watered plains that sometimes is called Sundaland. These land connections perhaps account for the coherence of early human development observed in the Hoabinhian culture, which lasted from about 13,000 to 5000 or 4000 bce. The stone tools used by hunting and gathering societies across Southeast Asia during this period show a remarkable degree of similarity in design and development. When the sea level rose to approximately its present level about 6000 bce, conditions were created for a more variegated environment and, therefore, for more extensive differentiation in human development. While migration from outside the region may have taken place, it did not do so in a massive or clearly punctuated fashion; local evolutionary processes and the circulation of peoples were far more powerful forces in shaping the region’s cultural landscape. Technological developments and population expansion Perhaps because of a particular combination of geophysical and climatic factors, early Southeast Asia did not develop uniformly in the direction of increasingly complex societies. Not only have significant hunting and gathering populations continued to exist into the 21st century, but the familiar cultural sequences triggered by such events as the discovery of agriculture or metallurgy do not seem to apply. This is not to say that the technological capabilities of early Southeast Asian peoples were negligible, for sophisticated metalworking (bronze) and agriculture (rice) were being practiced by the end of the 3rd millennium bce in northeastern Thailand and northern Vietnam, and sailing vessels of advanced design and sophisticated navigational skills were spread over a wider area by the same time or earlier. Significantly, these technologies do not appear to have been borrowed from elsewhere but were indigenous and distinctive in character. Austronesian languages Austronesian languagesMajor divisions of the Austronesian languages. These technological changes may partially account for two crucial developments in Southeast Asia’s later prehistory. The first is the extraordinary seaborne expansion of speakers of Proto-Austronesian languages and their descendants, speakers of Austronesian (or Malayo-Polynesian) languages, which occurred over a period of 5,000 years or more and came to encompass a vast area and to stretch nearly half the circumference of Earth at the Equator. This outward movement of people and culture was evolutionary rather than revolutionary, the result of societal preference for small groups and a tendency of groups to hive off once a certain population size had been reached. It began as early as 4000 bce, when Taiwan was populated from the Asian mainland, and subsequently it continued southward through the northern Philippines (3rd millennium bce), central Indonesia (2nd millennium bce), and western and eastern Indonesia (2nd and 1st millennia bce). From approximately 1000 bce on the expansion continued both eastward into the Pacific, where that immense region was populated in a process continuing to about 1000 ce as voyagers reached the Hawaiian Islands and New Zealand, and westward, where Malay peoples reached and settled the island of Madagascar sometime between 500 and 700 ce, bringing with them (among other things) bananas, which are native to Southeast Asia. Thus, for a considerable period of time, the Southeast Asian region contributed to world cultural history, rather than merely accepting outside influences, as frequently has been suggested. The second development, which began possibly as early as 1000 bce, centred on the production of fine bronze and the fashioning of bronze-and-iron objects, particularly as they have been found at the site in northern Vietnam known as Dong Son. The earliest objects consisted of socketed plowshares and axes, shaft-hole sickles, spearheads, and such small items as fishhooks and personal ornaments. By about 500 bce the Dong Son culture had begun producing the bronze drums for which it is known. The drums are large objects (some weigh more than 150 pounds [70 kg]), and they were produced by the difficult lost-wax casting process and decorated with fine geometric shapes and depictions of animals and humans. This metal industry was not derived from similar industries in China or India. Rather, the Dong Son period offers one of the most powerful—though not necessarily the only or earliest—examples of Southeast Asian societies transforming themselves into more densely populated, hierarchical, and centralized communities. Since typical drums, either originals or local renditions, have been found throughout Southeast Asia and since they are associated with a rich trade in exotics and other goods, the Dong Son culture also suggests that the region as a whole consisted not of isolated, primitive niches of human settlement but of a variety of societies and cultures tied together by broad and long-extant trading patterns. Although none of these societies possessed writing, some displayed considerable sophistication and technological skill, and, although none appears to have constituted a territorial centralized state, new and more complex polities were forming.

Make a multiple choice quiz for my year 8 science students based on the science in this transcript from a video: 3°C 0:04 It can be the difference between snow and sleet 0:08 Wearing a jacket or not 0:11 In your day-to-day life, it may not seem significant 0:15 But 3°C of global warming would be catastrophic 0:20 Heatwaves, droughts, extreme precipitation, even fire 0:25 3°C of warming is really disastrous 0:28 The scary thing is, the world is well on its way there 0:32 Since the industrial revolution, the Earth has warmed between 1.1°C and 1.3°C 0:40 This is a problem that babies you pass in the street will have to live with 0:46 Children born today... 0:47 ...are up to seven times more likely to face extreme weather than their grandparents 0:52 If global temperatures do rise by 3°C... 0:55 ...what would their world look like? Climate change is already having devastating effects 1:03 Rising sea levels 1:05 Desertification 1:07 Hollywood has always enjoyed imagining the end of the world 1:11 While blockbusters like this are clearly fiction... 1:14 ...this film will show the scenario we all face... 1:17 ...unless more drastic measures are taken to stop burning fossil fuels 1:30 In some parts of the world the effects of inaction are already clear 1:35 The slums of Bangladesh’s capital are filling up with climate migrants 1:41 Minara comes from Bhola District, an area in southern Bangladesh 1:46 There, like many other parts of the country... 1:49 ...rivers swollen by heavier rain and melting Himalayan glaciers... 1:53 ...are washing away people’s homes 1:56 Many, like her, have lost everything 2:00 Our home in Bhola had endless amounts of land 2:03 There was lots of space for farming, we had a spacious house 2:08 There were different types of fruits, vegetation and trees growing at home 2:12 We used to eat the fruit from our own trees 2:18 I can’t eat them now because they don't exist anymore 2:21 Since the river flooded for the third time, I had to flee to Dhaka 2:26 Life was much better back home 2:29 It was unbearable to live through, truly intolerable 2:33 We didn’t have the time to save anything at all 2:38 1.1°C to 1.3°C of global warming has already transformed Minara’s life 2:45 It’s one of the reasons why so many migrants like her... 2:47 ...are moving to the city each year... 2:50 ...nearly 400,000 according to the last estimate 2:53 And climate models show there could be much worse to come How climate modelling works 3:02 Climate scientist Joeri Rogelj... 3:04 ...has spent the last ten years modelling future climate scenarios... 3:08 ...for the United Nations 3:10 The models we use to carry out this exercise... 3:13 ...really represent the state of the art... 3:15 ...of our current knowledge of climate change and where we are heading 3:19 Joeri’s projections use data collected by hundreds of scientists around the world 3:26 Here this is the 3°C level... 3:28 ...and so there is at least a one-in-four chance that under current policies... 3:32 ...we would hit 3°C by the end of the century 3:36 This is just one of the scenarios Joeri looks at 3:40 Another one imagines that all policy promises are kept 3:44 The most optimistic assumes that all promises have been kept... 3:47 ...and net-zero targets are met 3:50 Where our best estimate ends up around 2°C at the end of the century... 3:54 ...there is still a one-in-20 chance that we end up with 3°C instead 3:59 One would not be entering a plane if there is a one-in-20 chance... 4:03 ...that the plane will crash Nowhere is safe from global warming 4:07 A rise of 3°C would affect everyone 4:10 Even wealthy cities in rich countries wouldn’t be immune to the consequences 4:15 European capitals like Paris and Berlin... 4:18 ...would bake under more extreme heatwaves 4:22 Frequent storm-surges in New York could turn parts of the city desolate 4:27 In many ways, cities magnify, intensify climate events 4:33 Cities are hotter than the places around them... 4:36 ...they tend to be more vulnerable to flooding 4:39 And you can get a really bad event in a city in a way that you can’t in the countryside 4:46 And because of their denser populations... 4:49 ...disasters in a city affect far more people 4:52 Some cities might be badly prepared for the changes coming 4:56 But they have the means to adapt 4:59 Cities tend to be wealthier than surrounding places 5:03 They have a lot of amenities 5:05 A city that has taken seriously the risks of a 3°C world... 5:08 …wouldn’t necessarily be a worse place to be in a 3°C world 5:12 But a city that hasn’t prepared for these sort of eventualities... 5:16 ...that might be a really nasty place The impact of prolonged droughts 5:20 So far, many developed cities have got off lightly... 5:24 ...but some rural parts of the world are suffering disproportionately 5:29 Smallholders—small-scale farmers—are particularly vulnerable to climate change 5:35 And there are over 600 million around the world 5:38 Smallholders with farms under two hectares... 5:40 ...produce around a third of the global food supply 5:46 Central America’s “Dry Corridor”... 5:48 ...supports a mix of smallholdings and medium-sized farms 5:53 Sandwiched between the Pacific Ocean and the Caribbean Sea... 5:56 ...the area is prone to droughts 6:08 Israel Ramírez Rivera is a smallholder in Guatemala 6:12 Here, climate change is making the dry seasons longer, and more severe 6:18 This is the biggest ear of maize that this plot could deliver 6:23 He depends on his crops of corn and beans 6:26 But they’re getting harder to grow 6:30 The surrounding mountains... 6:32 ...used to provide us with native food... 6:38 ...and now that isn’t an option anymore... 6:41 ...due to climate change and its effects 6:46 Nearly two-thirds of the smallholders in the Dry Corridor now live in poverty 6:52 The impact of all of this for us... 6:59 ...malnutrition among children 7:03 We’ve lost a few 7:07 For my crops especially, the midsummer heat is harder than before 7:16 The plant dries up and can’t provide us... 7:19 ...with the necessary food provision 7:24 Severe droughts in Central America... 7:26 ...are now four times more likely than they were last century 7:30 Many families from here have gone to the States 7:37 The economic despair and debts... 7:44 ...have pushed many people from this community to do this journey 7:53 Migration from Guatemala to the United States has quadrupled since 1990 7:59 Not all of this has been due to climate change 8:02 But longer droughts would force even more to move 8:05 In a 3°C world, annual rainfall in this region... 8:09 ...could drop by up to 14% 8:12 At 3°C, over a quarter of the world’s population... 8:16 ...could endure extreme droughts for at least a month of the year 8:19 Northern Africa could see droughts that last for years at a time Rising sea levels, storm surges and flooding 8:24 But for some, too much water will be the problem 8:29 10% of the world’s population lives on a coastline... 8:32 ...that’s less than 10 metres above sea level 8:35 For these coastal inhabitants, a 3°C world would spell disaster 8:40 By 2100, global sea levels could have climbed by half a metre from 2005 levels 8:46 Low-lying cities like Lagos would be especially vulnerable... 8:49 ...with up to up to a third of the population displaced 8:54 And in Fiji, rising waters are already upending lives 9:04 You can see the graveyard there, it’s all under water now... 9:08 ...due to this rising sea level and climate change 9:15 The village of Togoru in Fiji is being swallowed by the sea 9:19 Barney Dunn, the village headman, has seen over half the village disappear 9:24 Relatives’ houses have been abandoned, and family graves are now under water 9:29 We have been asked by the government to relocate... 9:32 ...but no one wants to relocate... 9:34 ...because we have our great-great-grandparents down there in the sea 9:39 This is the place we’ve been brought up in 9:41 ...it’s not easy to leave 9:44 Past attempts to build a seawall haven’t worked 9:48 But Barney sees building a new one as the village’s only hope 9:52 If they do that, maybe we can save whatever is left 9:56 But if we don’t have the seawall, then it will be keep eroding and time will come... 10:01 ...maybe in ten,15 years, Togoru will be all eroded 10:05 Rising seas also mean storms cause more floods 10:11 And many more countries could suffer 10:14 The Philippines and Myanmar are just two countries... 10:17 ...that will also see an increase in storm surges in a 3°C world 10:21 To escape, many will move… 10:24 …often, to urban areas Extreme heat and wet-bulb temperatures 10:27 Half the world’s population already lives in cities... 10:31 ...almost a third in slums 10:36 For them, a 3°C world could be deadly 10:40 Minara has moved to Dhaka to escape the impact of climate change 10:44 But life could get even worse for her 10:47 I’m struggling a lot nowadays 10:49 The heat during the day is unbearable 10:52 Even late at night it doesn’t cool down 10:57 The heat is getting more intense every day 10:59 I mean, it’s going to get much worse 11:03 I can barely survive it now, how will I live through it in the future? 11:08 Dhaka is getting hotter 11:11 In the last 20 years the average daytime temperature... 11:13 ...has crept up by nearly half a degree 11:17 Days that approach 40°C are now being reported 11:20 And high so-called wet-bulb temperatures are on the rise 11:26 A wet-bulb temperature is a measure of heat and humidity 11:30 Humans cool themselves by sweating… 11:32 But in these conditions, when relative humidity is near 100%... 11:36 ...sweat doesn’t evaporate well 11:38 So people can’t cool down… 11:41 ...even if given unlimited shade and water 11:45 At a high wet-bulb temperature, the body can’t lose heat... 11:49 ...and so it gets hotter and hotter... 11:51 ...and the body is designed to work at a given temperature 11:53 And if it gets too hot inside, you will die 11:58 The human limit for wet-bulb temperatures is 35°C... 12:02 ...around skin temperature 12:04 Dhaka will have a much higher chance... 12:05 ...of reaching dangerous wet-bulb temperatures... 12:07 ...if global warming reaches 3°C 12:12 You can’t really adapt to that 12:14 You have to get out. If the temperature is so high that you can’t work... 12:20 ...can’t do hard manual labour outside for significant parts of the year... 12:25 ...then many places will become functionally no longer part of the economy 12:33 Jacobabad in Pakistan, and Ras al Khaimah, in the United Arab Emirates... 12:37 ...have already recorded deadly wet-bulb temperatures 12:40 More of the tropics and the Persian Gulf... 12:43 ...as well as parts of Mexico and the south-eastern United States... 12:47 ...could all get to this threshold by the end of the century 12:50 Climate modelling might show us the weather Increased migration and conflict 12:52 But it doesn’t show us its other effects on society 12:56 Established migration patterns could change 12:59 Climate disasters may exacerbate reasons people cross borders 13:03 Within countries, more people will move to cities 13:07 In a 3°C world, tens of millions of people a year... 13:10 ...could be displaced by disasters made worse by climate change 13:15 When people are displaced by climate... 13:18 …they may well go to cities... 13:19 ...because cities are the places that attract people from the countryside already 13:25 A lot of people who can get to the developed world... 13:28 ...not least because the developed world tends to be less hot, will give that a go 13:35 As migration around the world increases... 13:38 ...there could be more competition for fewer resources 13:42 Water—already a highly contested resource—will be a focal point 13:47 Turkey’s new Ilisu dam has reduced the flow of water into Iraq 13:53 China lays claim to rivers vital to India and Pakistan 13:57 The prospect of a water-conflict makes people very uneasy 14:03 How national tensions would exacerbate those sorts of reactions... 14:08 ...in a 3°C world... 14:09 ...is the sort of thing that no one should really want to find out 14:14 I think you’d have to be incredibly sanguine... 14:16 ...not to think that the sort of climate extremes that we talk about... 14:19 ...in a 3°C world wouldn’t lead some places... 14:22 ...to the brink of societal collapse 14:25 Those lucky enough to escape unrest... Adaptation and mitigation are crucial 14:28 ...would still have to adapt to a radically different world 14:32 People can adapt to climate change in all sorts of ways, one of the most obvious ones... 14:37 ...is air conditioning 14:39 But other ways to adapt at a local or regional level... 14:42 ...I mean, one of the most obvious is diversifying agriculture 14:47 There are physical things you can do, like seawalls 14:52 The fact that people can adapt and that adaptation will reduce suffering... 14:57 ...doesn’t mean that it will eliminate suffering 15:00 Suffering is built into this whole process of heating up the planet 15:06 Adaptation will only get the world so far 15:09 The best way to deal with a 3°C world... 15:12 ...is not to go to a 3°C world 15:14 And that’s why increasing efforts on mitigation are important 15:17 It’s why working towards negative emissions... 15:20 ...that could bring down the temperature after it peaks are important 15:25 Once you get to a 3°C world, you are in real bad global trouble 15:33 The scale of change needed... 15:35 ...and the slow progress of governments so far... 15:38 ...means 3°C of warming is uncomfortably likely unless more is done 15:44 Despite existing pledges, greenhouse-gas emissions... 15:48 ...are still set to rise by 16% from 2010 levels by 2030 15:54 The need to act has never been clearer 15:57 There’s still time to reduce emissions, so that a 3°C world remains fiction... 16:02 ...rather than becoming fact

[t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ • It is the commonest cause. no cause can be detected ( 65 % ) • It may be associated with positive family history in some cases. • It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: • Somatic: • Psychic: • Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: • Somatic: • Psychic: • Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: • High frequency ( 50 attacks / day). • Falling to the ground without warning. • Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. • The jerks are bilateral contractions, mainly of the shoulders and arms. • However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly • Simple: • As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: • Focal fits: • Motor jacksonian fits: 2. General Sensory fits: • Focal fits: • Sensory jacksonian fits: 3. Special Senso1y fits: • Visual hallucinations: • Auditory hallucinations: • Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY • Usually: • The cause: • Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. • It is associated with: • EEG: • It is not associated with: normal. • Missed ttt. • Menses. • Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. • Alcohol use & Drug abuse ( e.g. cocaine ). • S timulation by photons & Hyperventilation. • S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: • It is the most specific test for epilepsy because it records the electrical activity of the brain. • It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" • To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" • To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: • The patient stays free of symptoms for at least 2 years. • The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " • Place the patient on the ground, to guard against falling from bed. • Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). • Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.

Related quizzes

Related quizzes