Part of the Body Test

[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.

A solution is a mixture in which one or more substances are uniformly distributed in another substance. Solutions can be mixtures of liquids, solids, or gases. For example, plasma, the liquid part of blood, is a very complex solution. It is composed of many types of ions and large molecules, as well as gases, that are dissolved in water. A solute (SAHL-YOOT) is a substance dissolved in the solvent. The particles that compose a solute may be ions, atoms, or molecules. The solvent is the substance in which the solute is dissolved. For example, when sugar, a solute, and water, a solvent, are mixed, a solution of sugar water results. Though the sugar dissolves in the water, neither the sugar molecules nor the water molecules are altered chemically. If the water is boiled away, the sugar molecules remain and are unchanged. Solutions can be composed of various proportions of a given solute in a given solvent. Thus, solutions can vary in concentra- tion. The concentration of a solution is the amount of solute dis- solved in a fixed amount of the solution. For example, a 2 percent saltwater solution contains 2 g of salt dissolved in enough water to make 100 mL of solution. The more solute dissolved, the greater is the concentration of the solution. A saturated solution is one in which no more solute can dissolve. Aqueous (AY-kwee-uhs) solutions—solutions in which water is the solvent—are universally important to living things. Marine microorganisms spend their lives immersed in the sea, an aqueous solution. Most nutrients that plants need are in aqueous solutions in moist soil. Body cells exist in an aqueous solution of intercellu- lar fluid and are themselves filled with fluid; in fact, most chemical reactions that occur in the body occur in aqueous solutions. Copyright © by Holt, Rinehart and Winston. All rights reserved. Liquid water Solid water Ice (solid water) is less dense than liquid water because of the structure of ice crystals. The water molecules in ice are bonded to each other in a way that creates large amounts of open space between the molecules, relative to liquid water. FIGURE 2-12 solvent from the Latin solvere, meaning “to loosen” Word Roots and Origins CHEMISTRY OF LIFE 43 ACIDS AND BASES One of the most important aspects of a living system is the degree of its acidity or alkalinity. What do we mean when we use the terms acid and base? Ionization of Water As water molecules move about, they bump into one another. Some of these collisions are strong enough to result in a chemical change: one water molecule loses a proton (a hydrogen nucleus), and the other gains this proton. This reaction really occurs in two steps. First, one molecule of water pulls apart another water molecule, or dissociates, into two ions of opposite charge: H2O ∏ H OH The OH ion is known as the hydroxide ion. The free H ion can react with another water molecule, as shown in the equation below. H H2O ∏ H3O The H3O ion is known as the hydronium ion. Acidity or alkalin- ity is a measure of the relative amounts of hydronium ions and hydroxide ions dissolved in a solution. If the number of hydronium ions in a solution equals the number of hydroxide ions, the solution is said to be neutral. Pure water contains equal numbers of hydro- nium ions and hydroxide ions and is therefore a neutral solution. Acids If the number of hydronium ions in a solution is greater than the number of hydroxide ions, the solution is an acid. For example, when hydrogen chloride gas, HCl, is dissolved in water, its mol- ecules dissociate to form hydrogen ions, H, and chloride ions, Cl, as is shown in the equation below. HCl ∏ H Cl These free hydrogen ions combine with water molecules to form hydronium ions, H3O. This aqueous solution contains many more hydronium ions than it does hydroxide ions, making it an acidic solution. Acids tend to have a sour taste; how- ever, never taste a substance to test it for acidity. In concentrated forms, they are highly corrosive to some materials, as you can see in Figure 2-13. Bases If sodium hydroxide, NaOH, a solid, is dissolved in water, it dissociates to form sodium ions, Na, and hydroxide ions, OH, as shown in the equation below. NaOH ∏ Na OH Copyright © by Holt, Rinehart and Winston. All rights reserved. Eco Connection onnection Acid Precipitation Acid precipitation, more commonly called acid rain, describes rain, snow, sleet, or fog that contains high levels of sulfuric and nitric acids. These acids form when sulfur dioxide gas, SO2, and nitrogen oxide gas, NO, react with water in the atmosphere to produce sulfuric acid, H2SO4, and nitric acid, HNO3. Acid precipitation makes soil and bodies of water, such as lakes, more acidic than normal. These high acid levels can harm plant and animal life directly. A high level of acid in a lake may kill mollusks, fish, and amphibians. Even in a lake that does not have a very elevated level of acid, acid precipitation may leach aluminum and magnesium from soils, poisoning water- dwelling species. Reducing fossil-fuel consump- tion, such as occurs in gasoline engines and coal-burning power plants, should reduce high acid levels in precipitation. Sulfur dioxide, SO2, which is produced when fossil fuels are burned, reacts with water in the atmosphere to produce acid precipitation. Acid precipitation, or acid rain, can make lakes and rivers too acidic to support life and can even corrode stone, such as the face of this statue. FIGURE 2-13 44 CHAPTER 2 This solution then contains more hydroxide ions than hydronium ions and is therefore defined as a base. The adjective alkaline refers to bases. Bases have a bitter taste; however, never taste a substance to test for alkalinity. They tend to feel slippery because the OH ions react with the oil on our skin to form a soap. In fact, commercial soap is the product of a reaction between a base and a fat. pH Scientists have developed a scale for comparing the relative con- centrations of hydronium ions and hydroxide ions in a solution. This scale is called the pH scale, and it ranges from 0 to 14, as shown in Figure 2-14. A solution with a pH of 0 is very acidic, a solution with a pH of 7 is neutral, and a solution with a pH of 14 is very basic. A solution’s pH is measured on a logarithmic scale. That is, the change of one pH unit reflects a 10-fold change in the acidity or alkalinity. For example, urine has 10 times the H3O ions at a pH of 6 than water does at a pH of 7. Vinegar, has 1,000 times more H3O ions at a pH of 3 than urine at a pH of 6, and 10,000 times more H3O ions than water at a pH of 7. The pH of a solution can be measured with litmus paper or with some other chemical indicator that changes color at various pH levels. Buffers The control of pH is important for living systems. Enzymes can function only within a very narrow pH range. The control of pH in organisms is often accomplished with buffers. Buffers are chemi- cal substances that neutralize small amounts of either an acid or a base added to a solution. As Figure 2-14 shows, the composition of your internal environment—in terms of acidity and alkalinity— varies greatly. Some of your body fluids, such as stomach acid and urine, are acidic. Others, such as intestinal fluid and blood, are

“There’s No Such Thing as Sound Science” by By Christie Aschwanden was a lead science writer for FiveThirtyEight. FiveThirtyEight, Science, Dec. 6, 2017 Science is being turned against itself. For decades, its twin ideals of transparency and rigor have been weaponized by those who disagree with results produced by the scientific method. Under the Trump administration, that fight has ramped up again. In a move ostensibly meant to reduce conflicts of interest, Environmental Protection Agency Administrator Scott Pruitt has removed a number of scientists from advisory panels and replaced some of them with representatives from industries that the agency regulates. Like many in the Trump administration, Pruitt has also cast doubt on the reliability of climate science. For instance, in an interview with CNBC, Pruitt said that “measuring with precision human activity on the climate is something very challenging to do.” Similarly, Trump’s pick to head NASA, an agency that oversees a large portion the nation’s climate research, has insisted that research into human influence on climate lacks certainty, and he falsely claimed that “global temperatures stopped rising 10 years ago.” Kathleen Hartnett White, Trump’s nominee to head the White House Council on Environmental Quality, said in a Senate hearing last month that she thinks we “need to have more precise explanations of the human role and the natural role” in climate change. The same entreaties crop up again and again: We need to root out conflicts. We need more precise evidence. What makes these arguments so powerful is that they sound quite similar to the points raised by proponents of a very different call for change that’s coming from within science. This other movement strives to produce more robust, reproducible findings. Despite having dissimilar goals, the two forces espouse principles that look surprisingly alike: Science needs to be transparent. Results and methods should be openly shared so that outside researchers can independently reproduce and validate them. The methods used to collect and analyze data should be rigorous and clear, and conclusions must be supported by evidence. These are the arguments underlying an “open science” reform movement that was created, in part, as a response to a “reproducibility crisis” that has struck some fields of science.1 But they’re also used as talking points by politicians who are working to make it more difficult for the EPA and other federal agencies to use science in their regulatory decision-making, under the guise of basing policy on “sound science.” Science’s virtues are being wielded against it. What distinguishes the two calls for transparency is intent: Whereas the “open science” movement aims to make science more reliable, reproducible and robust, proponents of “sound science” have historically worked to amplify uncertainty, create doubt and undermine scientific discoveries that threaten their interests. “Our criticisms are founded in a confidence in science,” said Steven Goodman, co-director of the Meta-Research Innovation Center at Stanford and a proponent of open science. “That’s a fundamental difference — we’re critiquing science to make it better. Others are critiquing it to devalue the approach itself.” Calls to base public policy on “sound science” seem unassailable if you don’t know the term’s history. The phrase was adopted by the tobacco industry in the 1990s to counteract mounting evidence linking secondhand smoke to cancer. A 1992 Environmental Protection Agency report identified secondhand smoke as a human carcinogen, and Philip Morris responded by launching an initiative to promote what it called “sound science.” In an internal memo, Philip Morris vice president of corporate affairs Ellen Merlo wrote that the program was designed to “discredit the EPA report,” “prevent states and cities, as well as businesses from passing smoking bans” and “proactively” pass legislation to help their cause. The sound science tactic exploits a fundamental feature of the scientific process: Science does not produce absolute certainty. Contrary to how it’s sometimes represented to the public, science is not a magic wand that turns everything it touches to truth. Instead, it’s a process of uncertainty reduction, much like a game of 20 Questions. Any given study can rarely answer more than one question at a time, and each study usually raises a bunch of new questions in the process of answering old ones. “Science is a process rather than an answer,” said psychologist Alison Ledgerwood of the University of California, Davis. Every answer is provisional and subject to change in the face of new evidence. It’s not entirely correct to say that “this study proves this fact,” Ledgerwood said. “We should be talking instead about how science increases or decreases our confidence in something.” The tobacco industry’s brilliant tactic was to turn this baked-in uncertainty against the scientific enterprise itself. While insisting that they merely wanted to ensure that public policy was based on sound science, tobacco companies defined the term in a way that ensured that no science could ever be sound enough. The only sound science was certain science, which is an impossible standard to achieve. “Doubt is our product,” wrote one employee of the Brown & Williamson tobacco company in a 1969 internal memo. The note went on to say that doubt “is the best means of competing with the ‘body of fact’” and “establishing a controversy.” These strategies for undermining inconvenient science were so effective that they’ve served as a sort of playbook for industry interests ever since, said Stanford University science historian Robert Proctor. The sound science push is no longer just Philip Morris sowing doubt about the links between cigarettes and cancer. It’s also a 1998 action plan by the American Petroleum Institute, Chevron and Exxon Mobil to “install uncertainty” about the link between greenhouse gas emissions and climate change. It’s industry-funded groups’ late-1990s effort to question the science the EPA was using to set fine-particle-pollution air-quality standards that the industry didn’t want. And then there was the more recent effort by Dow Chemical to insist on more scientific certainty before banning a pesticide that the EPA’s scientists had deemed risky to children. Now comes a move by the Trump administration’s EPA to repeal a 2015 rule on wetlands protection by disregarding particular studies. (To name just a few examples.) Doubt merchants aren’t pushing for knowledge, they’re practicing what Proctor has dubbed “agnogenesis” — the intentional manufacture of ignorance. This ignorance isn’t simply the absence of knowing something; it’s a lack of comprehension deliberately created by agents who don’t want you to know, Proctor said.2 In the hands of doubt-makers, transparency becomes a rhetorical move. “It’s really difficult as a scientist or policy maker to make a stand against transparency and openness, because well, who would be against it?” said Karen Levy, researcher on information science at Cornell University. But at the same time, “you can couch everything in the language of transparency and it becomes a powerful weapon.” For instance, when the EPA was preparing to set new limits on particulate pollution in the 1990s, industry groups pushed back against the research and demanded access to primary data (including records that researchers had promised participants would remain confidential) and a reanalysis of the evidence. Their calls succeeded and a new analysis was performed. The reanalysis essentially confirmed the original conclusions, but the process of conducting it delayed the implementation of regulations and cost researchers time and money. Delay is a time-tested strategy. “Gridlock is the greatest friend a global warming skeptic has,” said Marc Morano, a prominent critic of global warming research and the executive director of ClimateDepot.com, in the documentary “Merchants of Doubt” (based on the book by the same name). Morano’s site is a project of the Committee for a Constructive Tomorrow, which has received funding from the oil and gas industry. “We’re the negative force. We’re just trying to stop stuff.” Some of these ploys are getting a fresh boost from Congress. The Data Quality Act (also known as the Information Quality Act) was reportedly written by an industry lobbyist and quietly passed as part of an appropriations bill in 2000. The rule mandates that federal agencies ensure the “quality, objectivity, utility, and integrity of information” that they disseminate, though it does little to define what these terms mean. The law also provides a mechanism for citizens and groups to challenge information that they deem inaccurate, including science that they disagree with. “It was passed in this very quiet way with no explicit debate about it — that should tell you a lot about the real goals,” Levy said. But what’s most telling about the Data Quality Act is how it’s been used, Levy said. A 2004 Washington Post analysis found that in the 20 months following its implementation, the act was repeatedly used by industry groups to push back against proposed regulations and bog down the decision-making process. Instead of deploying transparency as a fundamental principle that applies to all science, these interests have used transparency as a weapon to attack very particular findings that they would like to eradicate. Now Congress is considering another way to legislate how science is used. The Honest Act, a bill sponsored by Rep. Lamar Smith of Texas,3 is another example of what Levy calls a “Trojan horse” law that uses the language of transparency as a cover to achieve other political goals. Smith’s legislation would severely limit the kind of evidence the EPA could use for decision-making. Only studies whose raw data and computer codes were publicly available would be allowed for consideration. That might sound perfectly reasonable, and in many cases it is, Goodman said. But sometimes there are good reasons why researchers can’t conform to these rules, like when the data contains confidential or sensitive medical information.4 Critics, which include more than a dozen scientific organizations, argue that, in practice, the rules would prevent many studies from being considered in EPA reviews.5 It might seem like an easy task to sort good science from bad, but in reality it’s not so simple. “There’s a misplaced idea that we can definitively distinguish the good from the not-good science, but it’s all a matter of degree,” said Brian Nosek, executive director of the Center for Open Science. “There is no perfect study.” Requiring regulators to wait until they have (nonexistent) perfect evidence is essentially “a way of saying, ‘We don’t want to use evidence for our decision-making,’” Nosek said. Most scientific controversies aren’t about science at all, and once the sides are drawn, more data is unlikely to bring opponents into agreement. Michael Carolan, who researches the sociology of technology and scientific knowledge at Colorado State University, wrote in a 2008 paper about why objective knowledge is not enough to resolve environmental controversies. “While these controversies may appear on the surface to rest on disputed questions of fact, beneath often reside differing positions of value; values that can give shape to differing understandings of what ‘the facts’ are.” What’s needed in these cases isn’t more or better science, but mechanisms to bring those hidden values to the forefront of the discussion so that they can be debated transparently. “As long as we continue down this unabashedly naive road about what science is, and what it is capable of doing, we will continue to fail to reach any sort of meaningful consensus on these matters,” Carolan writes. The dispute over tobacco was never about the science of cigarettes’ link to cancer. It was about whether companies have the right to sell dangerous products and, if so, what obligations they have to the consumers who purchased them. Similarly, the debate over climate change isn’t about whether our planet is heating, but about how much responsibility each country and person bears for stopping it. While researching her book “Merchants of Doubt,” science historian Naomi Oreskes found that some of the same people who were defending the tobacco industry as scientific experts were also receiving industry money to deny the role of human activity in global warming. What these issues had in common, she realized, was that they all involved the need for government action. “None of this is about the science. All of this is a political debate about the role of government,” she said in the documentary. These controversies are really about values, not scientific facts, and acknowledging that would allow us to have more truthful and productive debates. What would that look like in practice? Instead of cherry-picking evidence to support a particular view (and insisting that the science points to a desired action), the various sides could lay out the values they are using to assess the evidence. For instance, in Europe, many decisions are guided by the precautionary principle — a system that values caution in the face of uncertainty and says that when the risks are unclear, it should be up to industries to show that their products and processes are not harmful, rather than requiring the government to prove that they are harmful before they can be regulated. By contrast, U.S. agencies tend to wait for strong evidence of harm before issuing regulations. Both approaches have critics, but the difference between them comes down to priorities: Is it better to exercise caution at the risk of burdening companies and perhaps the economy, or is it more important to avoid potential economic downsides even if it means that sometimes a harmful product or industrial process goes unregulated? In other words, under what circumstances do we agree to act on a risk? How certain do we need to be that the risk is real, and how many people would need to be at risk, and how costly is it to reduce that risk? Those are moral questions, not scientific ones, and openly discussing and identifying these kinds of judgment calls would lead to a more honest debate. Science matters, and we need to do it as rigorously as possible. But science can’t tell us how risky is too risky to allow products like cigarettes or potentially harmful pesticides to be sold — those are value judgements that only humans can make.

Health 11/12 Review for Final Exam Core Concepts - Mental and Emotional Health, Substance Abuse Prevention, Safety and Violence Prevention, Family Life and Human Sexuality, Disease Prevention and Control, Healthy Eating Health Education Skills - goal setting, decision making, accessing information/resources, analyzing influences, communication, self-management, advocacy DIMENSIONS of Wellness - social, spiritual, emotional/mental, environmental, financial, intellectual, multicultural, occupational, physical, sexual RISK factors - anything that increases the risk of disease, injury, or illness. PROTECTIVE factors - anything that decreases the risk of disease, injury, or illness. INTERNAL health factors - health factors that can be either hereditary and genetic or acquired elements -- include smoking and personal diet or eating habits. Example – a genetic predisposition to an illness. EXTERNAL health factors - health factors that are part of the direct outer environment, the geographical location, micro-organisms, socio-economic elements that could affect an individual's health. Example – being unable to afford mental health services. Unit 1- Managing Personal and Community Wellness Explain Maslow’s Hierarchy of Needs in your own words using the image provided. Explain how each Social Determinant of Health may impact a person’s health. Levels of Disease Prevention • PRIMARY The goal is to avoid conditions altogether. • SECONDARY The goal is early detection. • TERTIARY The goal is to minimize the damage (manage). Define the following terms. Fads/Trends Sleep hygiene Driver safety Unit 2- Investigating Social Ecological Factors on Well-Being Socio-Ecological Model – The SEM examines how health behaviors form based on characteristics of individuals, communities, nations and levels in between. Each level overlaps with other levels signifying how the best public health strategies are those that encompass and target a wide range of perspectives. Interpersonal (personal) health vs. intrapersonal (relationship) health Health INEQUITY - systemic, ingrained and unjust barriers that prevent segments of the population from having the opportunity of health leading to health disparity. IMPLICIT BIAS - a form of bias that occurs automatically and unintentionally, that nevertheless affects judgments, decisions, and behaviors. Research has shown implicit bias can contribute to unequal access to quality healthcare, negative patient-provider relationships and interactions; and create mistrust in the healthcare system and practitioners among patients. This can contribute to health disparities. Health DISPARITY - represents a difference in health between populations. It is often used to describe disease burden and other negative health outcomes socially disadvantaged groups may face. Health EQUITY - The opposite of health inequity. It describes a system that supports a high standard of health and healthcare for all people. Racism - Beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals or groups because of phenotypic characteristics or ethnic group affiliation. DISCRIMINATION - An unjust differential treatment of a person or a group. PRIVILEGE- The unearned access to resources and social power that are only available to some because of their membership within certain social groups. OPPRESSION is the act of taking away choices from others and can be defined as a system that maintains advantage and disadvantage based on social identities and that acts on multiple levels from interpersonal to institutional and societal. (internalized, interpersonal, institutional, structural) Systematic Oppression - Intentional disadvantage of groups of people based on their identity while advantaging members of dominant group (race, gender, sexual orientation, language, size, ability, etc.). Intersectionality - The complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, and classism) combine, overlap, or intersect especially in the experiences of marginalized individuals or groups Unit 3- Accessing Resources and Communicating to Support Mental and Emotional Health What is anger? What is anxiety? What is stress? STRESSORS are the things that cause stress. Stressors can be internal and external. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. INTERNAL Stressors - are made by your belief system and the way you evaluate yourself. Examples include pessimistic attitude, negative self-talk, deep need to be perfect, low self-esteem or body image, unhealthy standards for self. EXTERNAL Stressors - are stressful things that happen in your surroundings and/or in your environment. Examples include busy schedules, work problems, family issues, financial trouble, social problems, injury, unforeseen circumstances. Socio-economic issues are also a part of external stressors such as poverty, violence, and racism. Define the following mental health conditions. Depression Eating disorders NSSI Non-suicidal self-injury Grief/Loss Suicide prevention A.C.T. • ACKNOWLEDGE- Tell them in a caring way that you recognize that they are having a problem • CARE- You can show you care by actively listening - put away anything else you are doing, make eye contact, sit down, ask questions. • TELL-(call 988 for additional help and support) - Tell them it is important that they speak with a trusted adult. Help them figure out who this may be and offer to go with your friend. A social norm is an unwritten, informal rule meant to guide behavior among the of society. It distinguishes between acceptable and unacceptable, good and bad, and so on. Social norms can influence a person with emotional or mental health disorders, access to care and stigmatize their situation. STIGMA- a mark of disgrace associated with a particular circumstance, quality, or person. • Self-stigma - This describes the internalized stigma that people with mental health conditions feel about themselves. • Public stigma - This refers to the negative attitudes around mental health from people in society. • Institutional stigma - This is a type of systemic stigma that arises from corporations, governments, and other institutions. Unit 4- Evaluating Risks of Substance Use and Abuse Harm Reduction - a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Explain how each level of the Social Ecological Model is impacted by addiction. Individual Relationship Community Society SEM Level Contributing/Risk Factors to substance use Preventative/Protective Factors for substance use Individual Interpersonal/Relationship Community Society Unit 5- Analyzing Influences to Examine Ways to Increase Safety and Reduce Violence HATE CRIME - a crime, usually violent, motivated by prejudice or intolerance toward an individual’s national origin, ethnicity, color, religion, gender, gender identity, sexual orientation, or disability. Explain how the media influences violence in society. The Pyramid of Hate Explain the escalation of hate using the Pyramid of Hate visual. List several hate crime motivators. Example: age HEALTHY Relationship Signs - comfortable pace, trust, honesty, independence, respect, equality, kindness, taking responsibility, healthy conflict, fun UNHEALTHY Relationship Signs - intensity, possessiveness, manipulation, isolation, sabotage, belittling, guilting, volatility, deflecting responsibility, betrayal Sexual Assault is a sexual behavior WITHOUT consent. Human trafficking - the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, using force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. Sex trafficking - commercial sex act induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age. Trafficking happens using… • Force - using violence to control someone. • Fraud - using lies to control someone. • Coercion - using threats to control someone. Unit 6- Family Life and Human Sexuality Agency - A belief about yourself and the extent to which you can act on that belief. • The ability to choose freely one’s own narrative. • To embrace the idea that I am the cause (or agent) of my own thoughts and actions. • Personal agency is a personal responsibility for who we are, what we experience, what we do about that experience, and how we shape our world to give us more of the experiences we want. SEXUAL Agency • The ability to choose your own interests and desires vs. what we see in the media or others’ perceptions • The ability to identify, communicate, and negotiate one’s sexual needs • The ability to initiate behaviors that allow for the satisfaction of those needs Sexually Explicit Material - photographs, videos, films, magazines, and books whose primary themes, topics, or depictions involve sexuality that may cause sexual arousal. Sexual scripts - thoughts, patterns, or behavior that a person has about themselves in a romantic or sexual context. It is how people picture themselves or want to project themselves in front of others. Reproductive Rights of Teens - In Maryland, teens have the right to an abortion, keep their child, obtain and use birth control, paternity tests, adoption, give up custody of their child within 10 days of birth (Safe Haven Law). • REPRODUCTIVE RIGHTS- legal rights and the freedom of the individual to control decisions regarding contraception, abortion, sterilization and childbirth. • SAFE HAVEN LAW- a distressed parent who is unable or unwilling to care for their infant can safely give up custody of their baby, no questions asked. CONSENT is an agreement between participants to engage in sexual activity. • It is clearly and freely communicated, verbal, and affirmative. Consent CANNOT be given if… • A person is underage, one or both partners is intoxicated or incapacitated by drugs or alcohol, one partner is asleep or unconscious, one partner feels pressured, threatened or intimidated, or one partner holds a position of power or authority over the other. Unit 7- Advocating for Enhanced Nutrition, Food Systems, and Health Outcomes Dietary Guidelines for Americans Guideline 1: Follow a Healthy Dietary Pattern at Every Life Stage Guideline 2: Customize and Enjoy Food and Beverage Choices to Reflect Personal Preferences, Cultural Traditions, and Budgetary Considerations Guideline 3: Focus on Meeting Food Group Needs with Nutrient-Dense Foods and Beverages, and Stay Within Calorie Limits Guideline 4: Limit Foods and Beverages Higher in Added Sugars, Saturated Fat, and Sodium, and Limit Alcoholic Beverages FOOD DESERT- a neighborhood where there is little or limited access to healthy and affordable food such as fruits, vegetables, whole grains, low-fat milk and other foods that make up the full range of a healthy diet. FOOD INSEQURITY lack of access to a sufficient amount of food because of limited funds. More than 49 million American households are considered food insecure and are vulnerable to poor health as a result. PROCCESED FOODS- any raw agricultural commodities that have been washed, cleaned, milled, cut, chopped, heated, pasteurized, blanched, cooked, canned, frozen, dried, dehydrated, mixed or packaged — anything done to them that alters their natural state.

PART OF THE BODY

Part of the body ( kelas 7 smp)

Cells of different organisms and even cells within the same organism are very diverse in terms of shape, size, and internal organization. One theme that occurs again and again throughout biology is that form follows function. In other words, a cell’s function influences its physical features. Cell Shape The diversity in cell shapes reflects the different functions of cells. Compare the cell shapes shown in Figure 4-4. The long extensions that reach out in various directions from the nerve cell shown in Figure 4-4a allow the cell to send and receive nerve impulses. The flat, platelike shape of skin cells in Figure 4-4b suits their function of covering and protecting the surface of the body. As shown below, a cell’s shape can be simple or complex depending on the function of the cell. Each cell has a shape that has evolved to allow the cell to perform its function effectively. SECTION 2 OBJECTIVES ● Explain the relationship between cell shape and cell function. ● Identify the factor that limits cell size. ● Describe the three basic parts of a cell. ● Compare prokaryotic cells and eukaryotic cells. ● Analyze the relationship among cells, tissues, organs, organ systems, and organisms. VOCABULARY plasma membrane cytoplasm cytosol nucleus prokaryote eukaryote organelle tissue organ organ system Cells have various shapes. (a) Nerve cells have long extensions. (b) Skin cells are flat and platelike. (c) Egg cells are spherical. (d) Some bacteria are rod shaped. (e) Some plant cells are rectangular. FIGURE 4-4 (a) Nerve cell (b) Skin cells (c) Egg cell (d) Bacterial cells (e) Plant cells Copyright © by Holt, Rinehart and Winston. All rights reserved. 1. All cubes have volume and surface area. The total surface area is equal to the sum of the areas of each of the six sides (area = length X width). 2. If you split the first cube into eight smaller cubes, you get 48 sides. The volume remains constant, but the total surface area doubles. 3. If you split each of the eight cubes into eight smaller cubes, you have 64 cubes that together contain the same volume as the first cube. The total surface area, however, has doubled again. CELL STRUCTURE AND FUNCTION 73 Cell Size Cells differ not only in their shape but also in their size. A few types of cells are large enough to be seen by the unaided human eye. For example, the nerve cells that extend from a giraffe’s spinal cord to its foot can be 2 m (about 6 1/2 ft) long. A human egg cell is about the size of the period at the end of this sentence. Most cells, how- ever, are only 10 to 50 μm in diameter, or about 1/500 the size of the period at the end of this sentence. The size of a cell is limited by the relationship of the cell’s outer surface area to its volume, or its surface area–to-volume ratio. As a cell grows, its volume increases much faster than its surface area does, as shown in Figure 4-5. This trend is important because the materials needed by a cell (such as nutrients and oxygen) and the wastes produced by a cell (such as carbon dioxide) must pass into and out of the cell through its surface. If a cell were to become very large, the volume would increase much more than the surface area. Therefore, the surface area would not allow materials to enter or leave the cell quickly enough to meet the cell’s needs. As a result, most cells are microscopic in size. Comparing Surface Cells Materials microscope, prepared slides of plant (dicot) stem and ani- mal (human) skin, pencil, paper Procedure Examine slides by using medium magnification (100). Observe and draw the sur- face cells of the plant stem and the animal skin. Analysis How do the surface cells of each organism differ from the cells beneath the surface cells? What is the function of the surface cells? Explain how surface cells are suited to their function based on their shape. Quick Lab Small cells can exchange substances more readily than large cells because small objects have a higher surface area–to-volume ratio. FIGURE 4-5 mb06se_csfs02.qxd 5/18/07 10:54 AM Page 73 74 CHAPTER 4 BASIC PARTS OF A CELL Despite the diversity among cells, three basic features are common to all cell types. All cells have an outer boundary, an interior sub- stance, and a control region. Plasma Membrane The cell’s outer boundary, called the plasma membrane (or the cell membrane), covers a cell’s surface and acts as a barrier between the inside and the outside of a cell. All materials enter or exit through the plasma membrane. The surface of a plasma mem- brane is shown in Figure 4-6a. Cytoplasm The region of the cell that is within the plasma membrane and that includes the fluid, the cytoskeleton, and all of the organelles except the nucleus is called the cytoplasm. The part of the cytoplasm that includes molecules and small particles, such as ribosomes, but not membrane-bound organelles is the cytosol. About 20 percent of the cytosol is made up of protein. Control Center Cells carry coded information in the form of DNA for regulating their functions and reproducing themselves. The DNA in some types of cells floats freely inside the cell. Other cells have a mem- brane-bound organelle that contains a cell’s DNA. This membrane- bound structure is called the nucleus. Most of the functions of a eukaryotic cell are controlled by the cell’s nucleus. The nucleus is often the most prominent structure within a eukaryotic cell. It maintains its shape with the help of a protein skeleton called the nuclear matrix. The nucleus of a typical animal cell is shown in

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