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We directly or indirectly depend on the environment for everything that we need. We get food, water, air and clothing from the environment. Manu useful products such as paper, gum and medicines are made from materials we get from the environment. We also get materials such as stones mud and wood from the environment. However, we have caused a lot of damage to the environment in order to get more from it. Forest are destroyed on a large scale to increase the area available for growing crops and building cities and factories. Many animals are killed for their fur, skin, meat and horns. Soil is dug up to get metals, precious stones such as diamonds and fuels will such as coal and petroleum. Due to the increase in such activities, the purity of air, water and soil is decreasing and they are getting polluted. It's our duty to keep the environment clean to help us and other living things live a healthy life.
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Make mcq quiz with 4 option in which one is correct -'10 Basis of Material Science ⢠.....;;;";;;"~~;;,,;;,,,,;.;.,,;;,,,;,,;.;,.,------------ 6. Temporary materials: Some materials are meant to be placed in the oral cavity for a short period of time for different reasons. ⢠Temporary crowns: While a permanent crown is prepared in the dental laboratory, the patient must wait for few days before it can be fabricated and cemented into place. Does patient experience any problems during this time period? If the tooth is vital (the pulp is alive), the patient is likely to experience pain and sensitivity while eating and drinking, also it looks unesthetic. What can be done to solve this problem? A temporary crown is placed before the patient leaves the clinic. It is constructed and luted in the same appointment in which the crown preparation is done. Temporary crowns are not very strong or esthetic but they serve adequately till the permanent crown is ready to be cemented. ⢠Temporary restorations: Sometimes it is difficult to decide immediately the best line of treatment for a particular tooth. The exact condition of the pulp may not be obvious to the dentist from the patient's symptoms. A dentist removes all or part of the decay and then places a temporary restoration to have time to observe the behaviour of the pulp or to give the pilip time to heal before deciding the further treatment required. Classification based on Location of Fabrication 4,9 Materials can be classified based on the location of fabrication into: ⢠Direct restorative materials. ⢠Indirect restorative materials Direct restorative materials: They include those materials which are used to restore cavity preparations directly in the oral cavity (Box 1.5). Box 1.5: Examples of direct restorative materials Amalgam, composites, glass ionomer and other materials, which set by chemical reactions in the mouth. Indirect restorative materials: It includes those restorations which must be fabricated outside the mouth, indirectly on a cast/ model/ die, because their processing condition would harm oral tissues. Materials used in the construction of such prosthesis are called indirect restorative materials (Box 1.6). Box 1.6: Examples of indirect restorative materials Gold inlays, crowns of metal, ceramic and polymers, which are processed at elevated temperatures. Some indirect composite restorations can be processed under specific wavelength of light, e.g. Ceramage. Classification based on Longevity of Use 1. Permanent restorations: These restorations are not planned to be replaced for a particular time period. Though they are referred to as permanent, actually they are not, e.g. fillings, crowns, bridges and dentures do not last forever (Fig. 1.5). 2. Temporary restorations: These restorations are planned to be replaced in a short period of time, such as few days to weeks. For ~ Permanent C/) c c -.2 0 c- :;::; Cll co Interim ~ Q; 0 .8ll::1iJ C/) o~ Cll a:: c:=:J Temporary Time period Fig. 1.5: Diagram depicting the time period of use of a restoration. (Arrow in permanent restoration depicts that such restorations are not planned to be replaced for a long period of time.) Introducton to Dental Materials Dental materials Box 1.7: Characteristics of metals 1. High thermal and electrical conductivity 2. Ductility (pure metals are very soft and they can be bent without breaking) 3. Opacity (they do not transmit light) 4. Luster (they have a surface that strongly reflects light and appears bright and shiny) 5. They tend to dissolve to some extent in water or other aqueous solutions, producing cations. 6. All metals are white (actually gray) except for gold, which is yellow, and copper, which is reddish. 7. All metals are solid at room temperature except mercury, which is liquid at room temperature and is used with silver alloys as amalgam. 8. All metals have high melting temperatures because of high strength of the metallic bond that holds the atoms together. 3. Polymers 4. Composites Composites are mixtures of two or more of the first three classes in which the different components remain distinct from one another in the final structure. A common example is composite resin. Fig. 1.7a: Three-dimensional structure of iron (metal) Metals Metals are the oldest of the three classes of materials that have been used as dental materials. Metals are characterized by metallic bonds (Box 1.7) which will be discussed in the next chapter. Metals solidify with their atoms in a regular or crystalline arrangement (see Chapter 2), often in the form of a cube (Fig. 1.7a). example, temporary fillings done in a tooth during root canal treatment, which have to be replaced within 2-4 days during subsequent visits. They are used to protect the tooth and provide function till the final restoration is done. 3. Interim restoration: At times, dental treatment requires "long-term" definite temporary restorations or "interim" restorations. For examle, a 7-year-old child, met with trauma and fractured one of his central incisors. A large composite build- up may serve his immediate requirement until the root formation is completed and a permanent crown is placed. 5 Classification based on the Chemical Nature of the Material These are the atoms that make up a material and the way they are bonded together determine the properties of that materiaLS Weak bonds make for weak materials and vice versa (Table 1.4). Materials can be classified into different categories based on their primary atomic bonds (Fig. 1.6): 1. Metals 2. Ceramics Fig. 1.6: Classification of dental materials based on chemical nature 12 Basis of Material Science Box 1.9: Benefits of ceramics in dentistry 1. Many ceramic oxides are used as pigmenting agents. These oxides produce good range of colors. Due to this characteristic, we are able to match almost any tooth color with good esthetic results. 2. They are inert, i.e. not chemically reactive. This quality provides ceramics with good bio- compatibility. 3. Ceramic materials are translucent, like natural teeth. This translucency gives the ceramic crown a more natural appearance than any other dental material. Fig. 1.7b: Internal arrangement of tetrahedral structure of ceramic (silica) four large oxygen atoms surround smaller silicon atom Ceramics A ceramic is a compound formed by the union of a metallic and a non-metallic element (Box 1.8). Most of these materials are oxides, formed by the union of oxygen with metals such as silicon, aluminum, calcium and magnesium (Fig.1.7b). Ceramics may be simple or complex. Examples of simple ceramics are alumina and silica. Examples of complex ceramics are feldspar (potassium aluminum silicate) and kaolin (hydrated aluminum silicate). Ceramics may be crystalline or non- crystalline (i.e. amorphous). Porcelain is a specific type of ceramic used extensively in dentistry (Box 1.9). Box 1.8: Characteristics of ceramics 1. High melting points. 2. Brittleness, which means they cannot be bent or deformed (no sliding) to any extent without actually cracking and breaking. 3. They are poor conductor of heat and electricity. 4. They are chemically inert. 5. They have excellent esthetic result in terms of matching natural teeth. Fig. 1.8: Stucture of synthetic polymer Polymers They are the latest addition (early to mid- 1900s) to dental materials. Most of the polymers are nowadays synthesized by humans. Polymers are giant, long-chain organic molecules (Fig. 1.8). Polymers are characterized by covalent bonds within each molecule, giving them tremendous strength in a single direction. Try to break a nylon rope by pulling it! They are poor conductors of heat and electri- city. Most polymers have a structure containing thousands of carbon atoms linked together like beads on a string. Others, such as silicone polymers are formed with silicon-oxygen bonds. Introducton to Dental Materials Table 1.4: Characteristics of different materials 13 Characteristics Bond Properties Crystal structure Metals Metallic bonding High strength and hardness, high electrical and thermal conductivity BCC, FCC, or HCP unit cells Ceramics Ionic or covalent bonding, or both High hardness and stiffness, electrically insulating, refractory, and chemically inert Crystalline or amorphous Polymers Covalent bonding Low sensitivity, high electrical resistivity, and low thermal conductivity, strength and stiffness vary widely Amorphous and crystalline Composites Composites are combinations of any of the basic ceramic, metallic and polymeric materials (Box 1.10). Each material that makes up composites is called a phase. Their properties tend to be somewhere between those of their basic constituents and are used to enhance their performance, longevity and handling chracterstics. Box 1.10: Types of composites in dentistry 1. Ceramic - metallic composite: Tungsten carbide bur. 2. Metal - polymer composite: Die materials in dental laboratory. 3. Ceramic - polymer composite: Enamel, dentin, bone and restorative composites. A composite is a kind of "combination" of materials, which compliment each other. The properties lacking in one material are compensated by those of the other material. For example, restorative composite has two phases, namely resin and fillers. Teeth and bones are examples of natural composites. Enamel is a composite of hydroxyapatite (which is a ceramic material) and protein (which is a polymer). EVALUATION OF DENTAL MATERIALS Most manufacturers of dental materials maintain a quality assurance programme (As per international standard like ADA specifications) and materials are thoroughly tested before being released into the market for dental practitioner (Fig. 1.9). Laboratory Evaluations Most ADA/ ANSI specifications involve laboratory tests. The tests performed as per these specifications are useful but they all are performed in vitro, (carried out in the laboratory away from the clinical conditions) which have a lot of limitations in clinical practice.lO Clinical Notes 1. For example, most of the direct restorative materials are tested for their compressive strength but ultimately the material is subjected to a combination of compressive, tensile and shear stresses, which may decide the final success or failure of the material under masticatory load. 2. Similarly upper dentures mostly fracture along the midline because of bending. Hence a bending or transverse strength ~B-a-s-is-o-f-M-a-t-e-ria-I-S~c-ie-n-c-e-------------- ---------. test is far more meaningful for denture base materials than a compression test. Clinical Trials The majority of new materials are subjected to extensive clinical trials normally in co-operation with a dental college or hospital departments prior to their release. CONCLUSION As the number of available materials is going up, it is important that the dentist remains more aware about new products so that their judgement about the selection of material remains successful. Materials which have not been thoroughly evaluated should be avoided, specially with clinical dentistry falling under Consumer Protection Act (CPA). I Research and development I iI Manufacturer/analysis Ideal requirements for clinical use: Thermal, optical, mechanical, chemical, biological Available materials and their properties are evaluated Launch of new I product Choice and selection of material by the dentist Critical assessment based on clinical performance I I H feedback to ISPANISH STUDENTS 10/22/25 In the sentence 'The author chose to juxtapose the wealthy neighborhood with the impoverished area to highlight social inequality,' what does 'juxtapose' most likely mean based on context clues? * 1 point to separate completely to describe in detail to criticize harshly to place side by side for comparison When reading 'This paradox confused everyone: the more he tried to save time, the less time he seemed to have,' what can you infer about a paradox? * 1 point a mathematical equation a simple solution a type of poem a contradictory statement that reveals truth The passage states: 'The author's use of symbolism was evident when the broken mirror represented the character's shattered dreams.' Based on this context, symbolism involves: * 1 point using objects to represent deeper meanings creating rhyming patterns writing in chronological order using literal descriptions only In the text 'Please elaborate on your answer by providing specific examples and detailed explanations,' the word 'elaborate' suggests the need to: * 1 point use simpler words change the topic add more detail make it shorter The critic wrote: 'The actor's performance captured every nuance of emotion, from subtle sadness to barely contained rage.' What does 'nuance' refer to in this context? * 1 point subtle variations in meaning simple emotions loud expressions obvious differences When the text says 'The implication of her silence was clear to everyone in the room, though she never spoke a word,' what does 'implication' mean? * 1 point a command given a direct statement a question asked a conclusion drawn indirectly The scientist stated: 'Based on our limited observations, our hypothesis suggests that plants grow faster with classical music.' What is a hypothesis? * 1 point a type of experiment a proven fact a final conclusion a possible explanation needing more evidence In 'Three witnesses were able to corroborate the defendant's alibi, strengthening his case significantly,' the word 'corroborate' most likely means: * 1 point to question or doubt to confirm or support to change the story to ignore completely The passage reads: 'The student needed to justify her controversial thesis with solid evidence and logical reasoning.' What does 'justify' mean here? * 1 point to make it longer to make excuses for to avoid explaining to prove something is reasonable When the text states 'The researcher was able to synthesize information from five different studies to create a comprehensive theory,' what does 'synthesize' involve? * 1 point copying one source exactly combining multiple sources to create something new rejecting all previous research focusing on only one idea When a reader encounters 'The symbolism in the novel was complex, with the recurring image of doors representing new opportunities throughout the story,' they should: * 1 point memorize all symbols skip symbolic passages look for deeper representational meanings focus only on the literal meaning If a teacher says 'Your essay needs more elaboration - expand on your main points with examples and analysis,' what critical thinking skill is being requested? * 1 point developing ideas with supporting details summarizing briefly using fewer examples changing the topic entirely In the passage 'The dark clouds gathering on the horizon seemed to foreshadow the troubles that would soon befall the village,' what literary technique is being demonstrated? * 1 point The author is using environmental details to hint at future plot developments The author is focusing on realistic weather descriptions The author is using weather to predict actual meteorological events The author is describing a coincidental weather pattern When analyzing 'Sarah knew the antagonist in her favorite novel wasn't just evilâhe represented the fear of change that many people experience,' what deeper understanding about antagonists is revealed? * 1 point Antagonists are always completely evil characters Antagonists can represent abstract concepts or human struggles Antagonists must be human characters Antagonists only exist to create action scenes In the sentence 'The protagonist's journey wasn't just about reaching the destinationâit was about discovering who she truly was,' what does this suggest about effective protagonists? * 1 point Protagonists must always succeed in their missions Protagonists should remain unchanged throughout the story Protagonists undergo both external and internal development Protagonists should focus only on external goals When the text states 'The word 'home' carried different connotations for each characterâwarmth and safety for some, confinement and obligation for others,' what critical reading skill is being highlighted? * 1 point Memorizing dictionary definitions Understanding that words have only one correct meaning Identifying grammatical structures Recognizing that word meanings can vary based on personal experience In 'While the denotation of 'snake' is simply a reptile, the author's use of it to describe the character suggests something far more sinister,' what analytical skill is required? * 1 point Understanding reptile biology Memorizing animal classifications Distinguishing between literal and figurative meanings Identifying sentence structure When examining 'The author's tone shifted from hopeful in the opening chapters to increasingly cynical as the story progressed,' what does this reveal about sophisticated writing? * 1 point Tone is unimportant in storytelling Tone changes reflect the author's developing attitude toward the subject Only the ending tone matters Authors should maintain the same tone throughout In analyzing 'The theme of the novel wasn't stated directly but emerged through the characters' repeated struggles with moral choices,' what does this demonstrate about themes? * 1 point Themes develop through patterns in the narrative Themes are only found in the conclusion Themes should always be explicitly stated Themes must be simple moral lessons When the passage reads 'From the character's nervous glances and hesitant speech, readers can infer that she's hiding something important,' what critical thinking process is being described? * 1 point Following explicit plot statements Memorizing character descriptions Making random guesses about character motivations Using textual evidence to draw logical conclusions In 'The ending was deliberately ambiguous, allowing readers to decide whether the character's actions were heroic or selfish,' what does this suggest about sophisticated literature? * 1 point Good stories always have clear, definitive endings Unclear endings indicate poor writing Ambiguity can enhance reader engagement and interpretation Authors should avoid confusing readers When analyzing 'The controversial decision to ban the book sparked debates about censorship versus protecting young readers,' what critical thinking skill is most important? * 1 point Choosing one side immediately Examining multiple perspectives before forming an opinion Avoiding difficult topics entirely Following popular opinion In 'Each character's perspective on the same event revealed how personal experiences shape our understanding of truth,' what deeper concept is being explored? * 1 point All perspectives are equally valid Perspective is unimportant in understanding events There is only one correct way to view any situation Personal background influences how we interpret events When the text states 'The community proved resilient, rebuilding not just their homes but their hope after the disaster,' what does this reveal about the concept of resilience? * 1 point Resilience encompasses both practical and emotional recovery Resilience is an innate trait that cannot be developed Resilience means avoiding all difficulties Resilience only involves physical recovery In analyzing 'The author's portrayal of the character's empathyâher ability to understand her enemy's pain even while fighting himâadded complexity to the conflict,' what does this suggest about empathy? * 1 point Empathy means agreeing with everyone Empathy makes people weak in conflicts Empathy should be avoided in difficult situations Empathy can coexist with opposition and create moral complexity When examining 'The character's integrity was tested when telling the truth would hurt people she loved,' what does this reveal about integrity? * 1 point Integrity means always following rules regardless of consequences Integrity means never causing any harm to others Integrity is only important in public situations Integrity involves making difficult moral choices even when costly In 'The student learned to advocate for her ideas by presenting evidence rather than just stating opinions,' what critical skill is being developed? * 1 point Supporting positions with logical reasoning and evidence Avoiding controversial topics entirely Learning to argue loudly and persistently Always agreeing with authority figures If you rewrote a scene from 'The Birchbark House' from Omakayas's grandmother's first-person perspective instead of Omakayas's, how would this most likely change the reader's understanding? * 1 point Nothing would change since they're both female characters The language would become more formal and difficult The story would become less interesting because adults are boring Readers would gain wisdom from experience but lose the innocence of childhood discovery In a plot diagram, the rising action serves which critical purpose beyond simply building toward the climax? * 1 point To provide background information about the setting To confuse readers so the ending is surprising To develop character relationships and establish stakes that make the climax meaningful To make the story longer and more detailed When analyzing the falling action in 'The Birchbark House,' which element would be most important to consider when writing an alternate version? * 1 point Whether the consequences of the climax align with the new direction you want the story to take Making sure it's shorter than the rising action Including a moral lesson for readers How quickly the conflicts get resolved In the exposition of a story, conflict serves which essential function that many readers don't realize? * 1 point To immediately grab attention with action scenes To provide comic relief before serious events To show off the author's writing skills To establish what the characters characterization/personality, which determines what they' must learn to overcome as they face more problemsThe outdoor recreation industry represents a new economy. The leaders of this economy will need to have a deep understanding of our local natural resources and integrate the components of innovation, health, and wellness into a vision for what comes next. Everyone wins when you do the right things for the environment, the community, and the venture. We want to offer the young generation a chance to be part of the foundation we are building for adventure tourism in the emirates and the region. Adventure Tourism Is the Fastest-Growing Global Niche. What does this mean? It means that thereâs plenty of room for young experts to enter the field. Itâs not just the "guides" that the adventure tourism industry needs. Itâs everything that goes with it, from adventure tourism accommodations to trip planners, event managers, marketing and finance directors, advertising, public relations, and communications. We want to highlight that adventure tourism requires more than just guides, and various careers within adventure tourism play a big role in attracting high-value customers, supporting local economies, and encouraging sustainable practices. The continued growth of this sector creates net positive impacts not only for tourism, but also for destination economies, their people, and their environment. 1) Understanding Tourism Tourism is one of the worldâs fastest-growing industries and a major foreign exchange and employment generation for many countries. It is one of the most remarkable economic and social phenomena. 2) Understanding Adventure Tourism Adventure tourism is defined as the movement of the people from one to another place outside their comfort zone for exploration or travel to remote areas, exotic and possibly hostile areas. Adventure tourism is a type of tourism in which tourists engage in adventure activities such as trekking, climbing, rafting, scuba diving, or the likes. Adventure tourism gains much of its excitement by allowing the tourist to step outside their comfort zone. This may be from experiencing culture shock or through the performance of acts that required some degree of risk whether real or perceived. It is also about connecting with a new culture or a new landscape and being physically active at the same time. It is not only about being risky or pushing your boundaries. In fact, it is especially important to know and respect your limits while you are in an unfamiliar area. Adventure travel is a leisure activity that takes place in an unusual, exotic, remote, or wilderness destination. It tends to be associated with high levels of activity by the participant, most of it outdoors. Adventure tourists expect to experience various levels of risk, excitement, and tranquillity and be personally tested. In particular, they are explorers of unspoiled, exotic parts of the planet and also seek personal challenges. The main factor distinguishing adventure tourism from all other forms of tourism is the planning and preparation involved. 3) Definitions of Adventure Tourism Adventure tourism is a new concept in the tourism industry. The tourism industry adopted adventure tourism, but there is not any specific definition of adventure tourism. Most commentators concur that adventure tourism is a niche sector of the tourism industry, but there are many other niche sectors in tourism that have the same characteristics that overlap with adventure tourism such as ecotourism, activity tourism, or adventure travel. One of them can confuse. Adventure tourism is a complicated and ambiguous topic. Some important definitions of adventure tourism are as following: A) According to the Adventure Travel Trade Association (ATTA): âadventure tourism is a tourist activity that includes physical activity, cultural exchange, or activities in nature.â B) According to Muller and Cleaver: âAdventure tourism is characterized by its ability to provide the tourist with relatively high levels of sensory stimulation, usually achieved by including physically challenging experiential components with the tourist experience.â C) The Canadian Tourism Commission in 1995 defines adventure tourism as: âan outdoor leisure activity that takes place in an unusual, exotic, remote or wilderness destination, involves some form of unconventional means of transportation, and tends to be associated with low or high levels of activity.â D) According to Sung et al: âadventure tourism is the sum of the phenomena and relationships arising from the interactions of adventure touristic activities with the natural environment away from the participantâs usual place of residence area and containing elements of risk in which the outcome is influenced by the participation, setting, and the organizer of the touristâs experience.â E) According to UNWTO: â adventure tourism can be domestic or international, and like all travel, it must include an overnight stay, but not last longer than one year.â 4) Types of Adventure Tourism Adventure tourism has grown exponentially all over the world in recent years with tourists visiting destinations previously undiscovered. This allows for new destinations to market themselves as truly unique, appealing to those travellers looking for a rare, incomparable experience. Adventure tourism includes various activities like caving, hiking, sailing, trekking, etc. Adventure tourism is categorized into two categories: ⢠Hard Adventure ⢠Soft Adventure Hard Adventure Hard adventure refers to activities with high levels of risk, requiring intense commitment and advanced skills. Hard tourism includes the activities like climbing mountains/rock/ice, trekking, caving, etc. Hard adventure activities are highly risked in nature. Professional guides and advanced levels of skills are required to perform these activities. Many tourists died during climbing mountains, caving every day. Soft Adventure Soft adventure refers to activities with a perceived risk but low levels of risk, requiring minimal commitment and beginner skills; experienced guides lead most of these activities. Soft tourism includes the activities like backpacking, camping, hiking, kayaking, etc. Soft adventure activities are low-risk in nature. Professional guides lead these activities. Soft adventure is a popular category in adventure tourism as it caters to a wider audience. 5) Adventure Tourism Activities Adventure travellers are early adopters by nature, meaning they are generally more willing to try new destinations, activities, and travel products. Popular activities change rapidly, and it seems there is a new twist on an existing sport every year. Some activities have low risk and some have high. Adventure tourism activities are classified into two types: ⢠Hard Adventure Activities ⢠Soft Adventure Activities Hard Adventure Activities Hard adventure activities are highly risky and dangerous in nature. These activities are as the following: ⢠Caving ⢠Mountain Climbing ⢠Rock Climbing ⢠Ice Climbing ⢠Trekking ⢠Sky Diving Soft Adventure Activities These activities are less dangerous and risk as compared to hard adventure activities. These activities are mostly lead by professional guides. An example of these activities are: ⢠Backpacking ⢠Bird watching ⢠Camping ⢠Canoeing ⢠Eco-tourism ⢠Fishing ⢠Hiking ⢠Horseback riding ⢠Hunting ⢠Kayaking/sea/whitewater ⢠Orienteering ⢠Safaris ⢠Scuba Diving ⢠Snorkeling ⢠Skiing ⢠Snowboarding ⢠Surfing Adventure tourism activities sit well with the environment because the natural world provides us with the resources for many of the activities that provide risk, challenge, sensory stimulus, novelty, discovery, and so on. 6) Characteristics and Features of Adventure Tourism The threefold combination of activity, nature, and culture marks adventure travel as an all-around challenge. Some unique characteristics and features of adventure tourism are as the following: ⢠Physical activity, like involving physical exertion or psychomotor skills ⢠Contact with nature, activities bringing contact with the natural world in general, or with specific wildlife ⢠Contact with different cultures, i.e. people, faith, lifestyles ⢠Journeys for example vehicle, animal, or human power ⢠Uncertain outcomes ⢠Danger and risk ⢠Challenges ⢠Anticipated rewards ⢠Novelty ⢠Stimulation and excitement ⢠Exploration and discovery ⢠Contrasting emotions 7) Adventure Tourism Supplier A tourism supply chain is the system of people, products, activities, and materials that get a product or service from its raw state through production and distribution to the consumer. As with any sector, volume discounts drive the mass price point, so major retailers primarily market select trips that sell in high volume. The supply chain for these mass tourism products is often very simple, comprising only transportation and accommodation elements. The adventure tourism supply chain is more complex. Niche products often require specializes in knowledge and operations. Adventure tourismâs supply chain linkages go very deep, and this is one of the key reasons that adventure tourism delivers greater benefits at the local level. Supply chains vary from destination to destination. Without a proper supply chain, the tourism sector cannot survive. Tourism suppliers are the backbone of the tourism industry. Adventure tourism suppliers work at a different, different level like as domestic as well international level. 8) Adventure Tourism Importance and Benefits Adventure tourism is one of the fastest-growing sectors of the tourism sector, attracting high-value customers, supporting local economies, and encouraging sustainable practices. The continued growth of this sector creates net positive impacts not only for tourism, but also for destination economies, their people, and their environment. Some importance and benefits of adventure tourism are: A) Employment Generation Adventure tourism generates jobs. Adventure tourism generates directs jobs to accommodation, transportation sector, and travel agencies or tour operators. Adventure tourism also provides indirect jobs to tourism suppliers. Adventure tourism plays an important role in the generation of employment in the economy. B) Foreign Exchange Adventure tourism attracts foreign tourists on a large scale, as a result, it helps in foreign exchange generation. When tourists travel to another country, they spend a large amount of money on accommodation, transportation, and shopping. Adventure tourism generates foreign exchange and supports the economy of the host country. C) Economy Development Adventure tourism helps in the development of the host countryâs economy. Adventure tourism activities directly support the economy in various forms. The more tourists, the more economic growth. D) Support Local Communities Adventure tourism helps in the development of infrastructure and supports local communities. Adventure tourism activities directly contributed to the local economy of the communities and increase local people's living standards. E) Conservation of Natural Resources Adventure tourism activities are nature-based activities. Leaders in the adventure tourism industry are dedicated to making this tourism segment as sustainable as possible. They help in the conservation of natural resources as well as culture. F) Creating Business Opportunities Adventure tourism activities create new business opportunities. Several companies specialize in helping emerging adventure tourism operators market their products. Each new adventure tourism activity creates a new business opportunity. G) Local and Foreign Investment Adventure tourism creates business opportunities; as a result, it attracts local as well as international investors. Investors invest their money in accommodation, transportation, and travel trade organization. Adventure tourism plays an important role in the economy of the host country.Chapter 22 Antihypertensive Drugs Hypertension Defined (JNC-8) Pharmacology Overview 7 main categories of drugs to treat HTN Adrenergic drugs (old friend) Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers (ARBs) Calcium channel blockers (CCBs) Diuretics Vasodilators Direct renin inhibitors A. Adrenergic Drugs: 5 Subcategories and where they act A1. Adrenergic neuron blockers (central and peripheral)- we wonât talk about this A2. Alpha1 receptor blockers (peripheral) A3. Alpha2 receptor agonists (central) A4. Beta receptor blockers (peripheral) A5. Combined Îą and β receptor blockers (peripheral) A2. Peripherally Acting Adrenergic Drug Alpha1 Blockers (weâve met these) Doxazosin, prazosin, alfuzosin Block alpha1-receptors which causes BP to decrease Reduces peripheral vascular resistance and BP by dilating both arterial and venous blood vessels Main Use: benign prostatic hyperplasia (BPH) Alpha1 Blockers REMEMBER Tamsulosin (Flomax)* is an Îą1 blocker BUT *Tamsulosin is not used to control BP, just for BPH. A3. Centrally Acting Adrenergic Drugs Alpha 2 agonist Clonidine and methyldopa 1- Stimulate alpha2-adrenergic receptors. in the brain Decreases sympathetic outflow from the CNS which decreases NE production 2. Stimulate alpha2-adrenergic receptors in kidneys remember alpha 2 opposes alpha 1 Dilates peripheral blood vessels â lowers peripheral resistance â Results in decreased BP So âŚ.Clonidine (Catapres) Used primarily for its ability to decrease blood pressure in an urgent setting Also use in opioid withdrawal as previously discussed Oral (multiple times a day), and topical patch formulations Do not stop abruptly as it may lead to rebound hypertension In reality, Clonidine and methyldopa Not prescribed as first-line home antiHTN drugs High incidence of unwanted adverse effects: orthostatic hypotension, fatigue, and dizziness MIGHT be uses as adjunct drugs after other drugs have failed, in conjunction with other antiHTN such as diuretics A4. Adrenergic Drugs Selective Beta 1 Blockers Metoprolol, Atenolol Reduction of HR through β1 receptor blockade (remember adrenergic blocking of this receptor???) HR results in BP Cause reduced secretion of renin = BP A4. Adrenergic Drugs Selective Beta1 Blockers Nebivolol (Bystolic) Uses: hypertension and HF Action: blocks β1 receptors and produces vasodilatation, which results in a decrease in SVR High doses loses selectivity and blocks both β1 and β2 Less sexual dysfunction All BB- Do not stop abruptly; must be tapered over 1 to 2 weeks A4. Adrenergic Drugs NONSelective Beta Blockers Propranolol Acts equally on β1 and β2 Other uses include situational anxiety associated with public speaking, test taking As mentioned on previous slide, nebivolol at high doses becomes beta nonselective A5. Dual-Action Adrenergic Drugs Îą1 and β Receptor Blockers Dual antihypertensive effects of reduction in heart rate (beta1 receptor blockade) and vasodilation (alpha1 receptor blockade) Examples are carvedilol (common) and labetalol (not as common) A5. Dual-Action Adrenergic Drugs Îą1 and β Receptor Blockers Carvedilol (Coreg) Widely used drug that is well tolerated Uses: HTN, mild to moderate HF in conjunction with digoxin, diuretics, and ACE inhibitors Contraindications: severe bradycardia or unstable HF, bronchospastic conditions such as asthma, and various cardiac conduction problems Adrenergic Drugs Indications - HTN But also for Glaucoma (topical) BPH: doxazosin, prazosin, and terazosin (2 for 1) Management of severe HF when used with cardiac glycosides and diuretics Contraindications Acute HF- have to stabilize first MOAIs- yeah doesnât everything interact with MAOIs? Peptic ulcers Severe liver/kidney disease Asthma (with beta blockers) Adrenergic Drugs: Adverse Effects Orthostatic hypotension 1st-dose syncope Rebound hypertension with abrupt discontinuation Most common: Dry mouth, drowsiness, constipation, sedation Interactions- always check for specific drug interactions Can cause additive CNS depression with alcohol, benzodiazepines, opioids Question #1 When administering an alpha-adrenergic drug for hypertension, it is most important for the nurse to assess the patient for the development of what response? Hypotension Hyperkalemia Oliguria Respiratory distress Answer A Hypotension This is a key point in patient education These drugs have strong vasodilating properties and may cause severe hypotension, especially at the beginning of therapy. B. Angiotensin-Converting Enzyme Inhibitors aka ACE Inhibitors or ACEi Large group of safe and effective drugs Currently are 10 ACEi Often used as first-line drugs for HF and hypertension May be combined with a thiazide diuretic, loop diuretic, or Calcium Channel Blocker (CCB) You need to understand the basics ACE Inhibitors: Review RAAS ACE converts angiotensin I, formed through the action of renin, to angiotensin II Angiotensin 2 is a potent vasoconstrictor and also induces aldosterone secretion by the adrenal glands Aldosterone stimulates sodium resorption (H20 follows Na Both act to raise BP which causes kidneys to reduce renin production ACEi= Great drug to treat HTN BUT contraindicated in pregnancy (2nd,3rd trimester due to fetal renal damage) and breastfeeding first few weeks after birth B. ACE Inhibitors - PRIL Lisinopril (Prinivil) super common, often the 1st drug Enalapril (Vasotec) also common Captopril (Capoten) great if liver disease present Benazepril (Lotensin) Fosinopril (Monopril) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik) Primary Effects of the ACE Inhibitors Prevent Na (and H2O) resorption by inhibiting aldosterone secretion (volume reduction) (GO BACK TO RAAS DIAGRAM) blood volume decreases work of the heart preload, or the left ventricular end-diastolic volume which is important in HF ACE SUMMARY OF ACTIVITY 1) Prevent vasoconstriction caused by angiotensin 2 (2) Prevent aldosterone secretion ď¨ less sodium and water resorption Cardioprotective Effects of ACEi They slow progression of left ventricular hypertrophy (ventricular remodeling) after MI so considered cardioprotective ACE inhibitors have been shown to decrease morbidity and mortality in patients with HF Renal Protective Effects of ACEi ACE inhibitors: reduce glomerular filtration pressure by volume reduction Cardiovascular drug of choice for patients with diabetes since it helps protect kidneys by reducing pressure. Sometimes used low dose for kidney protection with DM without HTN B. ACEi Enalapril (Vasotec) Only ACEi available in both oral and IV Enalapril IV does not require cardiac monitoring Oral enalapril: prodrug (metabolized in liver) Improves patientâs chances of survival after an MI Reduces the incidence of HF B. ACEi Captopril (Capoten) Uses: prevention of ventricular remodeling after MI; reduce the risk of HF after MI Shortest half-lifeď¨ Must be administered multiple times throughout the day so this limits its use Not a prodrug so good for patient with liver disease Question #2 A patient with diabetes has a new prescription for the ACE inhibitor lisinopril. She questions this order because her provider has never told her that she has hypertension. What is the best explanation for this order? The doctor knows best The patient is confused This medication has cardioprotective properties This medication has a protective effect on the kidneys for patients with diabetes Answer D ACE inhibitors have been shown to have a protective effect on the kidneys because they reduce glomerular filtration pressure. This property makes them the cardiovascular drug of choice for patients with diabetes. Question #3 A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension. Which drug will most likely be ordered for this patient? Clonidine Prazosin Diltiazem Captopril Answer D Captopril Captopril is not a prodrug; therefore, it does not need to be metabolized by the liver to be effective. This is an advantage in patients with liver disease. ACE Inhibitors: Adverse Effects *Dry, nonproductive cough, which reverses when therapy is stopped. This is a class effect Dizziness- Note: First-dose hypotensive effect may occur Headache & Fatigue Possible hyperkalemia ** Angioedema: rare but potentially fatal Not safe in pregnancy-are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage C. Angiotensin II Receptor Blockers (ARB) Considered an alternative to ACEi Less likely to cause a dry cough and hyper K+ that is common with ACE inhibitors Angiotensin II Receptor Blockers: Mechanism of Action Go back to RAAS diagram! ARBs affect primarily 2 places 1. Vascular smooth muscle - blocks vasoconstriction 2. Adrenal gland -Selectively blocks the binding of Ang 2 to certain Ang 2 receptors inhibiting secretion of aldosterone Lowers volume retention and BP Angiotensin II Receptor Blockers -ARTAN Losartan (Cozaar)- very common Eprosartan (Teveten) Valsartan (Diovan) Irbesartan (Avapro) Candesartan (Atacand) Olmesartan (Benicar) Telmisartan (Micardis) Azilsartan (Edarbi) C. ARB Losartan (Cozaar) Beneficial in patients with HTN and HF Used with caution in patients with kidney or liver dysfunction and in patients with renal artery stenosis ***Not safe for breastfeeding women and should not be used in pregnancy (Cat C 1st trimester, Cat D 2nd-3rd trimester), potential fetal toxicity Appear to be equally effective for the treatment of hypertension and well tolerated ARBs less likely to cause cough and hyperK+ but can still happen Evidence that ARBs are associated with lower mortality after MI than ACE inhibitors Never take ACEi and ARBs at the same time* 5. Calcium Channel Blockers (CCB) Primary use: HTN, angina, some dysrhythmias Cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction Results in: Relaxed blood vessels to the heart Decreased peripheral smooth muscle tone Decreased SVResistance Decreased BP E. Diuretics First-line antiHTN in JNC 8 guidelines Decreases fluid volume The results from diuresis: preload, Peripheral resistance Overall effect ď Decreased workload of the heart and decreased BP Thiazide diuretics are the most commonly used diuretics for HTN Ie hydrochlorothiazide (HCTZ), chlorthalidone We will discuss diuretics further in the chapter on diuretics F. Vasodilators Directly relax arterial or venous smooth muscle (or both) Results in: Decreased SVR Decreased afterload Peripheral vasodilation Indicated for treatment of HTN May be used in combination with other drugs F. Vasodilators Hydralazine (Apresoline) Orally: routine cases of essential hypertension Injectable: hypertensive emergencies BiDil: specifically indicated as an adjunct for treatment of HF in African-American patients F. Vasodilators Sodium Nitroprusside (Nitropress) *Sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies. Contraindications: severe HF, known inadequate cerebral perfusion (especially during neurosurgical procedures) F. Vasodilators Adverse Effects Hydralazine: dizziness, headache, tachycardia, edema, dyspnea, N/V/D, vitamin B6 deficiency, rash Sodium nitroprusside: hypotension, bradycardia, decreased platelet aggregation, rash G. Direct Renin Inhibitors Aliskirin (Tekturna) Blocks the RAS pathway at the point of activation. Inhibiting renin production prevents the downstream production of Ang II (potent vasoconstrictor) Adverse effects: N/V, severe hypotension, hyponatremia, hyperkalemia⌠Contraindicated in patients with DM taking ACEi or ARB Miscellaneous Antihypertensives Eplerenone (Inspra) Newer class of drugs called selective aldosterone blockers (remember RAAS?) Reduces BP by blocking the actions of aldosterone at its corresponding receptors in the kidney, heart, blood vessels, and brain Indications: routine treatment of hypertension and for post-MI HF Contraindicated if serum potassium levels are high (above 5.6 mEq/L) A Special Form of HTN Treatment of Pulmonary Hypertension Sildenafil and Tadalafil Commonly used for erectile dysfunction Used for pulmonary hypertension but with different trade names Sildenafil: Revatio* (Viagra for ED) Tadalafil: Adcirca* (Cialis for ED)Energy is very useful to us. We have proved it in our previous lessons. But do you know that, energy can also be harmful? Yes, energy can harm or cause different health problems if we expose ourselves too much to it. Too much exposure to the bright light of the sun and other artificial lights can cause⌠a. damage to our eyes that may lead to blindness b. skin allergies that may lead to skin cancer c. sunburn We can prevent the above health problems by⌠a. avoiding looking directly to the source of bright light such as the sun. b. wearing hat or using umbrella when going out of the house during the hottest part of the day which is from 10 am to 2 pm. c. putting on sunblock to protect your skin Too much heat can cause⌠a. dehydration or loss of body fluids because of perspiration b. burns These can be prevented by⌠a. drinking plenty of water b. using pot holders when handling hot objects SCIENCE 2 â MODULE 6 SEIBO COLLEGE 29 Too much exposure to loud sounds can cause⌠a. hearing difficulty that may lead to deafness b. nervousness We can avoid these health problems if⌠a. we talk softly especially when the person we are talking to is near us b. we avoid places which have loud sounds. Electrical energy can give us a comfortable life, but it can cause great danger to us. So to avoid accidents that may harm us in handling electrical devices we need to practice safety precautions. Below is a list of the things that we should do. Study it carefully. Safety Precautions in Handling Electrical Devices 1. Never play with live wires and electrical plug. 2. Never touch any electrical device with wet hands. 3. Do not overload electrical sockets. 4. Do not play or insert things especially metals into electrical outlets. 5. Never play with the switch of any electrical devicePersonal Cleanliness is a way of taking good care of our body. THE FOLLOWING ARE WAYS WE CAN TAKE CARE OF DIFFERENT PARTS OF THE BODY. 1.CARE OF THE HAIR ON THE HEAD: (a)Wash the hair with shampoo or soap and water at least twice a month for girls and daily for the boys (b). Apply hair cream on the hair after drying. (c) Comb or brush the hair properly after washing. 2.CARE OF THE EYES: (a) Always use clean water to wash your face and eyes and wipe them with a clean towel. (b) Clean your eyes with a clean handkerchief. (c) Do not use dirty hands to clean your eyes. (d)Do not look directly at the bright light from the sun, because it could damage them. (e) Do not read in dim or poor light such as candles. (f)Do not read under the sun. 3.CARE OF THE NOSE: (a) Do not use your fingers to clean your nostrils. (b)You must not allow people to hit your nose so as to avoid nose bleeding. (c) Do not poke or pick your nose with sharp objects. (d) Do not put beads into your nose. 4.CARE OF THE TONGUE AND TEETH: (a) By brushing our tongue and teeth twice daily. (b) Do not break hard objects such as bones or hardnuts with your teeth. (c) Do not open bottles with your teeth. (d) Brush your mouth with toothbrush and toothpaste or chewing stick. (e)Do not remove food particles with needles or pins from between the teeth. 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) solutionsâsolutions in which water is the solventâare 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 Š 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 âto loosenâ 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 â 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 â 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 â 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 â Na OH Copyright Š 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 solutionâs 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 environmentâin terms of acidity and alkalinityâ varies greatly. Some of your body fluids, such as stomach acid and urine, are acidic. Others, such as intestinal fluid and blood, areOwls, such as the young snowy owls on the previous page, have for centuries been symbols of both wisdom and mystery. To many cultures their piercing eyes have conveyed a look of intelligence. Their silent flight through darkened landscapes in search of prey has projected an air of power or wonder. For this chapter and this book, owls are an engaging example of a living organism from the world of biologyâthe study of life. BIOLOGY AND YOU Living in a small town, in the country, or at the edge of the suburbs, one may be lucky enough to hear an owl's hooting. This experience can lead to questions about where the bird lives, what it hunts, and how it finds its prey on dark, moonless nights. Biology, or the study of life, offers an organized and scientific framework for posing and answering such questions about the natural world. Biologists study questions about how living things work, how they interact with the environment, and how they change over time. Biologists study many different kinds of living things ranging from tiny organisms, such as bacteria, to very large organisms, such as elephants. Each day, biologists investigate subjects that affect you and the way you live. For example, biologists determine which foods are healthy. As shown in Figure 1-1, everyone is affected by this impor- tant topic. Biologists also study how much a person should exer- cise and how one can avoid getting sick. Biologists also study what your air, land, and food supply will be like in the near future. SECTION 1 OBJECTIVES â Relate the relevance of biology to a personâs daily life. â Describe the importance of biology in human society. â List the characteristics of living things. â Summarize the hierarchy of organization within complex multicellular organisms. â Distinguish between homeostasis and metabolism and between growth, development, and reproduction. VOCABULARY biology organization cell unicellular multicellular organ tissue organelle biological molecule homeostasis metabolism cell division development reproduction gene Copyright Š by Holt, Rinehart and Winston. All rights reserved. Biology, the study of life, directly applies to your health, life, and future in ways as simple as daily food choices. FIGURE 1-1 6 CHAPTER 1 Biology and Society By studying biology you can make informed decisions on issues that impact you and our society. Every day newspapers, television, and the Internet contain issues that relate to biology. For example, you may read that your local water or air supply is polluted. How will that pollution affect your health and the health of other living things? You may hear about new technologies or tools that biolo- gists have invented. How will we control how those technologies and tools are used? Biologists actively work to solve these and other real-world issues and problems, including improving our food supply, curing diseases and preserving our environment.