PUBLIC HEALTH P2 M1

Hey Guys,

Describe the origins of public health in the UK. (P2) Compare historical and current features of public health. (M1)

Public health refers to all organized measures, whether it is public or private, to prevent disease, promote health, and prolong life among the population as a whole. Its activities aim to provide conditions in which people can be healthy and focus on entire populations, not on individual patients or diseases. Thus, public health is concerned with the total system and not only the eradication of a particular disease. It encompasses the science, the art and the politics of preventing illness and disease and promoting health and well-being. Public health also addresses inequalities present in health which frequently explain large variations in health locally, nationally and globally.

The industrial revolution is the name given to the period of the 18^th and 19^th century where Britain transitioned to the development of new manufacturing techniques making more food available. This meant that by 1901 the population had increased to about 30 million and people began to migrate to urban locations also known as urbanisation. Due to a large amount of the population moving at once, it created problems such as overcrowding as they couldn’t build enough houses for the large increase in population. Communities lacked facilities and were deemed unsanitary as there was no sewage system, drainage and no clean water. Due to the living conditions, communicable diseases where very common and could spread quickly.

The Board of Health was set up to give advice on preventing the spread of fever in February 1805. The early 1830’s had seen the following activity which was prompted by the threat of a cholera epidemic and in June 1831 the consultative Board of Heath was again set up. The regulations where to prevent the spread of cholera and by November 1831 the Central Board of Health was established and local boards began to set up. In 1834, the Poor Law Act was passed by parliament which ensured that poor people had housing, were clothed and also fed. However, if they wanted this they had to go into a workhouse to receive it. They were given these things in exchange for several hours of manual labour each day. The conditions were made harsh and so that only people who desperately need it would go there.  

In 1842, Edwin Chadwick had published a report on the ‘Sanitary Condition of the Labouring Population of Great Britain’. Chadwick argued that disease was directly related to living conditions and that there was a desperate need for public health reform. He noted that people lived in dirty, overcrowded conditions and this caused illness, leading to people becoming too sick to work and a higher tax expenditure on helping them. Due to this Chadwick introduced a set of solutions which would help improve public health. He suggested that sewers should be improved, rubbish should be removed, clean water should be provided and medical officers should be appointed to check each area. This helped because with an improved sewerage system, human waste would not contaminate the water supply and therefore a fall in cholera and other related communicable diseases would be noticed.  Removing rubbish would stem the increase in pest and the development of disease and the medical officers would check that all these reforms were being obeyed. At this time there was an attitude of lazzise-faire, which was the belief that the government should not interfere in the lives of ordinary people or business. However, another cholera epidemic in 1848 causing 21,000 deaths, led the government to try out some of Chadwick’s ideas.

The public Health Act was then finally passed in 1848 and it set up a General Board of Health, Chadwick being one of its three commissioners. This allowed local Health Boards to be set up in towns, however, this was only where the mortality rate is higher than 23 per 1,000. The Act also encouraged a local medical officer to be appointed and also allows them to organise rubbish removal and to build a sewage system. However, only one third of towns set up a Board of Health and even fewer appointed a medical officer. The terms of the act were only temporary and by 1854 the three commissioner had to resign and the General Board of Health was done away with in 1858.

In London, 1854, John Snow mapped the cholera epidemic and had discovered an infected water pump on Broad Street as the source. The result of this discovery was that cholera was now identified as a water borne disease and Snow then became recognised as a pioneer of epidemiology.

As a result of people disposing their human toxic waste into the river, it lead to The Great Stink in London when the river Thames was full of raw sewage. This smell was overpowering and it had permeated Parliament to be adjourned. Joseph Bazalgette (1819-91) however, eradicated this by designing and building a sewer system.

In 1861, the upper class realised that they too had just as much reason to be concerned when Prince Albert dead as a result of typhoid. This then proved that the wealthy people, could also be susceptible to infectious disease. The first stage in the development of social housing was when Octavia Hill began her campaign in 1864, to improve the housing of working people to a decent standard.

There was a fourth Cholera epidemic in 1866, which caused 6,000 deaths. The Sanitary Act made sanitary inspectors compulsory in cities and demanded that the local governments provides fresh water. Overcrowding, which was a major cause of disease, became classified as being a ‘nuisance’. Also in 1869, the Peabody trust had built cheap flats that provided good living conditions and are of a good quality in London. These buildings are still used to this day.

By the time of 1914, the basic legislative framework had been created to improve the health of the population and the government had accepted a share of the responsibility for this. During the Second World War, in 1942, William Beveridge had written a report on how Britain ought to be rebuilt. The report was designed to encounter the five great evils which included, want, disease, ignorance, squalor and idleness.

The welfare was formed when the government changed in 1945, which aimed to provide free medical treatment and social security so that people are protected from the cradle to the grave. The government had now accepted responsibility for promoting and protecting the health of the public.

When comparing historical and current features of public health we are able to see that there has been many changes. In the 19^th Century the diseases that were prevalent were known as communicable diseases. Communicable diseases are caused by micro-organisms, such as viruses and bacteria. These diseases can be transmitted from one individual to another (Walsh et al). An individual may use the words 'contagious' or 'infectious' when they are talking about communicable diseases. They usually include virus, fungus, bacteria and protozoa. Examples include small pox, TB, typhoid and also diseases which are associated with malnourishment. These diseases were so prevalent due to a number of reasons. Firstly, there was a lack of knowledge and education. This meant that people were unable to learn about the different types of communicable diseases and so couldn’t try and prevent it. They may not have even known what the disease was, how it was caused or what the symptoms of it were. Another reason why the diseases were so prevalent was because of the poor living conditions. People were living in cramped conditions with a large number of people and so disease was easily spread, this meant that if one person got it, everyone around them would also get it. There was also no health service to help prevent disease and so vaccinations or medicine was unavailable, there was a lot of poverty and also a lack of government intervention.

Studies of disease were carried out particularly by John Haygarth and John Snow. These studies mapped diseases and showed a link between the spread of the disease and the area. John Snow found the link between bacteria and living conditions. He found that bacteria caused disease within the body of people rather than their living conditions. The government eventually listened to Chadwick and decided to then try out his ideas. His report led to the Public Health Act being passed in 1848 and local Health Boards where set up, encouraging the appointing of a medical adviser and also allowing the organisation of rubbish remover and the building of a sewage system. In the mid 1900’s, the Beveridge report then furthered the involvement of the government and they began to take responsibility of the health of the public. He also suggested the establishment of the National Health Service and this was then development in 1948.

In 1822, Pasteur and Jenner came together in the development of the vaccination process and this combined with the invention of antibiotics e.g. penicillin. The focus was on infection, and immunisation programmes were set up improving the knowledge of the population.

In the early 20^th century there were environmental reforms meaning that there was the clearance of slums and the population was being provide with a clean water supply. This then prevent disease and the number of infections therefore decreased.

Non communicable diseases such as heart disease and cancers became the big killers in the mid-20^th century. This was link to the lifestyle of the individuals and they were then blamed for their own ill health, which was often the reason for the behaviour being ignored. This led to the New Public Health order, which approached and addressed the causes of the causes e.g. poverty, poor housing and unemployment in a bid to improve the health and well- being of the population.

In the UK the most prevalent non communicable disease is lung cancer and there are 42,026 people who have lung cancer, 23,175 in men which are 55% and 18,851 in women, 45%. This gives a ratio of male to female of more than 12:10. The crude incidence rate shows that there are 76 new lung cancer cases for every 100,000 males and 60 for every 100,000 females. Lung cancer is so prevalent mainly due to the lifestyle choice in which people choose. Smoking accounts for 80-90% of global lung cancer deaths in males. Non-smokers on the other hand account for only around 10-20% of lung cancer.  Altogether around 41,000 people are diagnosed each year in the UK with lung cancer. In addition a further 3% of lung cancer cases are caused by exposure to second hand smoke in non-smokers.

Public health is now managed by a number of different agencies such as the Department of Health, NHS, Public Health Agency, DHSSPSNI and also GP.

The PHA was established in 2009 under a major reform of health structures in Northern Ireland. They were set up to provide a renewed and more enhanced focus on public health and well-being by bringing together a wide range of public health functions under the one organisation.

The DHSSPSNI has a mission to improve the health and social well-being of the population in NI. They had three main responsibilities including HSC, including policy and legislation for hospitals, family practitioner services and community health and personal services. Public health is another responsibility which covers policy, legislation and administrative action to promote and protect the health and well-being of the population and also public safety, which cover policy and legislation for fire and rescue services.

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PUBLIC HEALTH P1 AND P5

Hey everyone, so this assignment was P1 and P5 for public health!!

Describe key aspects of public health strategies (P1) Explain health promotion and protection (P5).

There are many strategies in public health to ensure that the population stays healthy, and has a longer life expectancy. Public health is now managed by a number of different agencies such as the Department of Health, NHS, Public Health Agency, DHSSPSNI and also GP. The DHSSPSNI has a mission to improve the health and social well-being of the population in NI. They had three main responsibilities including HSC, including policy and legislation for hospitals, family practitioner services and community health and personal services. Public health is another responsibility which covers policy, legislation and administrative action to promote and protect the health and well-being of the population and also public safety, which cover policy and legislation for fire and rescue services.

To ensure the Department of Health achieve their aims, the government needs information about how health the population are. They need to find out the mortality and morbidity rates and often ask individuals to complete surveys rating their own health.  It is important for the government to monitor these as it keeps track of the statistics for both mortality and morbidity rates and also allows them to be able to identify the actions that need to be taken for example if they need to improve on their health campaigns or set up new facilities and undergo more recent research to improve on the statistics.  There are over 41,000 people diagnosed with lung cancer each year (NHS, 2013). A further 3% of lung cancer cases are caused by exposure to second hand smoke in non-smokers. Lung cancer is known to be the second highest cancer to affect the UK. The more you smoke will certainly increase the likelihood of developing lung cancer however it is the length of time that you have been a smoker that is the most important factor (cancer research, 2014). Approximately 2.3 million people in the UK are living with Coronary Heart Disease (CHD) (NHS, 2014). The main causes for CHD are hypertension, diabetes, high cholesterol and also smoking (NHS, 2014). Around 800,000 people in the UK are affected by dementia (NHS, 2015). This risk of developing dementia usually increases as individual age. The mortality rates in Northern Ireland alone, in 2013 were 14,968 (NISRA).

An aspect for strategies of public health is to identify the health needs of the population and to develop programmes to reduce the risk and screen for early onset of disease. When the government have recognised and are aware of the population’s health status, they will then concentrate on their resources on key health issues. One key health issue is cancer and bowel cancer is known to be one of the most common cancers which is diagnose in the UK, with approximately 40,000 new cases each year (NHS, 2014). The Northern Ireland Bowel Cancer Screening Programme is offered to all men and women who are aged 60 to 74 every two years. Individuals within this age group will be sent a screening test so that they are able to do the test at home (HSC, 2011).  This is done by taking a sample of the faeces, and when completed, sent to a laboratory to be tested for any signs of blood. If blood traces are recognised the individual may be then sent for a further colonoscopy. An abdominal aortic aneurysm or (AAA) is when the main artery in the body widens as it passes through the abdomen. The artery balloons out as the walls weaken. This is more common in those who smoke, who have high blood pressure, those with cardiovascular disease and also in older men (HSCNI, 2015). If this is not treated, it can be fatal and 80-100 individuals in Northern Ireland die from a ruptured AAA each year.  The Northern Ireland AAA screening programme was implemented in 2012 and is offered to men in their 65^th year in Northern Ireland. Its aim is to reduce AAA mortality by providing a systematic, population based screening programme which uses a simple ultrasound scan (HSCNI, 2015). For those who undergo the ultrasound screening a reduction in mortality to 45% has been highlighted in men between the ages of 65 and 79 years.

Another key aspect is controlling communicable diseases. Any outbreaks of infectious diseases must be investigated and should be controlled by the DOH to protect the public. The Health Protection Service has a role in protecting the population from environmental hazards and also infections and it is delivered by a multi-disciplinary team (HSCNI, 2015). The DOH make individuals aware of diseases like influenza by having posters and leaflets in for example doctor surgeries and clinics, in which individuals are able look at and take away with them. This can be telling them how disease is spread and what can be done to prevent it. To control seasonal flu the DOH are giving immunisations to those who are at most risk from this disease including, the elderly, young children, asthmatics and diabetics. This reduces the likelihood that these individuals will come in contact with this disease.

A further key aspect is promoting the health of the population. Health promotion is motivating individuals to increase control and responsibility over their own health and improve it by changing their lifestyle and behaviour. The DOH wants to reduce the mortality and morbidity rates of disease/illness in Northern Ireland. This is done by setting out health campaigns which often use the fear approach in order to shock or fear the individuals into changing their behaviour. An example of a health campaign is the, “is your waistline creeping up on you?” poster which was used to support the, “choose to live better” campaign (PHA, 2011). This is also a television advertisement. On the poster it shows a man with a waistline of 37” and ‘cancer’ wrote on the band on his underwear. This shows that if men of a certain age have a waistline of 37” or more then it can be seen as a health risk and could therefore lead to cancer.  During the year of 2011, over 4,000 individuals from across Northern Ireland had been surveyed about a variety of health and wellbeing issues. In relation to obesity, the CMO report stated that 59% of the adults that were measured were either overweight (36%) or obese (23%). Males were seen to be more likely overweight (44%) than females (30%). This therefore make men who have a waistline like this think twice about it, and so may persuade them to change their lifestyle to lose weight as they may have a fear of developing cancer due to being overweight. This can be linked to the victim model. It suggests that people have limited influence over their health and that it may be determined by genes and by social and economic environments.  There is a link between obesity and social class. This suggests that poverty limits choice. Individuals and families who have a lower income have less choice in the food that they are able to buy and therefore eat. This is because processed, junk food tends to be cheaper than it is to eat healthily. A diet that is processed is loaded with the wrong nutrition, for example high in fats and carbohydrates and so leads to obesity. In addition low income individuals often live in areas where there are few facilities for healthy, safe exercise. This model highlights that people who have low income are victims of economic circumstances.

Another campaign is, “every cigarette rots you from the inside out”, which features a father lighting a roll-up cigarette made of rotting flesh (BBC, 2015). The aim of this campaign is to try to shock smokers into giving up. It also highlights the belief that hand rolled cigarettes are just as harmful as normal, packed cigarettes. The statistics for those who smoked hand rolled cigarettes in 1990 was 18% for males and 2% for females. In 2011 this had a big increase to 40% males and 26% females (action on smoking and health, 2015). In 2013, the opinions and lifestyle survey highlighted that 40% male and 23% females smoked hand- rolled cigarettes. These figures are almost still the same as they were in 2011. This can be linked to the empowerment model which suggests that individuals are empowered and have a free choice, meaning that they are free to choose between a healthy and unhealthy lifestyle. They are the ones who decide what they are going to spend their money on whether it be cigarettes or not.

The fifth key aspect is planning and evaluating the national provision of health and social care. The DOH sets out plans each year for health and social care and they must measure how successful they have been by carrying out an evaluation. It is beneficial to set targets as it gives you a laser focus, so that all the attention is set on one area at a time. This means that the DOH can put attention on to one key area at a time to give it a better chance of being achieved. Targets will also help make good decisions as they will help to identify and establish priorities and make right choices based on long term views and in this case what’s important for the population. This is when the evaluation comes into play in that, if the targets have not been met the DOH are able to look back on them along with statistics and therefore see where they have gone wrong and what needs to be changed and improved. 

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P5 M2 D2 ANATOMY AND PHYSIOLOGY !

Hey everyone!!

Explain the concept of homeostasis (P5) Discuss the probable homeostatic responses to changes in the internal environment during exercise (M2)

Homeostasis can be defined as the maintenance of a constant internal environment within the body. Sensors within our body monitor a number of things including breathing, heart rate, body temperature and also blood sugar levels. These can also be known as detectors, which send signals to the control centre when there is a change, or the value has deviated from the norm. This value will then be corrected so that the norm can be maintained (study.com, 2015). 

Negative feedback is important in homeostasis and it responds when certain conditions change. This therefore means that receptors and effectors, i.e. muscles or organs, carry out a reaction so that these conditions can remain. This may also be explained by saying that a change in variable is detected by the receptor and the information from this is sent along an afferent pathway to the control centre. The control centre then sends the information along an efferent pathway to the effector whereby it either opposes or enhances the stimulus (Bioserv, 2001).

In the medulla oblongata there are chemoreceptors which are adjacent to the respiratory centre. These chemoreceptors are sensitive to the changes of arterial PCO2, PO2 and also pH, and send information to the medulla, determining the nervous response depending on the changes of the variables (Bioserv, 2001). Nerve impulses are therefore then sent to the repiratory muscles controlling both the force and how often it contracts. Furthermore, this changes the rate and depth of breathing and also ventilation (UWE, 2015). The change in ventilation brings CO2, O2 and pH back to their norm. Nerve impulses are sent along the phrenic nerve towards the external intercostal muscles which stimulates muscle contraction for inspiration. Expiration occurs due to the elastic recoil of the lungs and chest wall. This nerve firing is what gives us our resting breathing rate of 12-15 breaths per minute. During exercise, the muscles have to metabolise faster as they require both more oxygen and nutrients. Due to this, the heart then pumps the blood harder and faster to keep up this demand, as the heart is doing more work to supply this blood. This means that more oxygen is required, meaning, the response given is breathing being increased so that oxygen is pumped to all cells quicker. Due to homeostasis, levels of oxygen in the blood are always being measured, ensuring oxygen, carbon dioxide and also pH levels return to their norm. Messages that are sent to the effectors informing them that the breathing rate has to be increased, however, will decrease again when all activity has been stopped.

Homeostasis also controls heart rate. The medulla which is located within the brain also controls heart rate. It sends information or messages normally in form of chemicals/hormones. When we are carrying out exercise the heart has to supply oxygenated blood to the rest of the body. There is information sent to the medulla from the muscles via the nervous system. This allows the release of chemicals, to travel to the sinus node. The sinus node then therefore stimulates the contractions of the heart, also increasing the force which in turn, increases heart rate. When you are at rest, or stop exercising, another message is sent to the medulla, which in turn releases acetylcholine, slowing the heart rate. When engaging in more intense exercise, epinephrine and norepinephrine is released, increasing heart rate to supply more oxygen to the body.

There are two pathways known as the autonomic nervous system and the parasympathetic nervous system. During exercise the sympathetic nervous system is activated and this increases heart rate and also the force of the contractions due to the nerve impulses being transmitted to the heart via the sympathetic nervous system (Cvphysiology, 2013). In comparison the parasympathetic nervous system decreases heart and rate and therefore it returns back to the norm and this system is activated when we are resting. The vagal nerve is what reduces heart rate.

The sinoatrial node (SA node) acts as the body’s pacemaker. The impulses initiate at the SA node moving a wave of electrical excitation across the atria, which respond by contracting. The ventricles are relaxed meaning that more blood is being pushed into them. The impulses are then passed to the atrioventricular node (AV node), however, the AV node delays the passage of impulses to the bundle of His and is then conducted to the purkinje fibres (Campton, 2010). The ventricle walls will contract from the apex working up, meaning that blood is ejected from the ventricles efficiently sending blood to the lungs and the rest of the body (Campton, 2010).

The level of glucose within the blood is also controlled by homeostasis. The maintenance of the level of glucose within the blood involves both the pancreas and the liver. Islets of Langerhans are cells located in the pancreas and these secrete two hormones known as insulin and glucagon. Blood sugar rises after we have ate a meal resulting in the stimulation of the pancreas cells, meaning b-cells of Langerhans are stimulated, releasing more insulin, enabling the sugar uptake by cells and also the storage of sugar within the liver and muscles. As a result, blood sugar levels are decreased (Tortora and Anagnostakos, 2003 recited in Nursing times, 2015). If however, blood glucose levels are low, the body will not be able to produce the sufficient amount of ATP needed for bodily functions. Alpha cells in the pancreas are then stimulated releasing glucagon into the blood. The liver then breaks this down into glucose which is then released into the blood. Glucose levels in the blood have now risen and there is no need for the release of glucagon (Bioserv, 2001). During exercise there is a demand for glucose due to the contraction of the muscles and more energy being required and so this causes an increased uptake of glucose to working skeletal muscles which is caused by an increase in the insulin. Normal blood glucose levels however, can be maintained during exercise by increased glucose production and the release through the stimulation of the breakdown of glycogen and glucose synthesis from other substances. This increase allows the maintenance of blood sugars. When we stop exercising, receptors send information to the liver telling it to slow down glucose production.

There are four different ways in which heat can be gained or lost from the body including radiation, evaporation, convection and conduction. Radiation is when heat from the body is given off into the atmosphere. Evaporation is when you sweat and the evaporation from the liquid generates heat, resulting in a cooling effect. Convection is the process of heat leaving the body via moving air flowing by the skin. Conduction is the transfer of heat from direct contact with another object (Beyondcoldwater, 2011)

The main control centre in the brain that controls body temperature is known as the thermoregulatory centre. When we exercise, body temperature will increase as the body is working hard in attempt to be able to have more oxygen in the blood which then can be delivered to the muscles providing them with energy. Change within the temperature in the blood is detected by thermoreceptors. There are also receptors which are in the skin and they detect changes in temperature within the environment. Homeostasis will occur due to the negative feedback triggering homeostatic mechanisms. The hypothalamus in the brain detects signals and sends impulses to both blood vessels and sweat glands. Firstly the hairs on the skin lie flat as the erector muscles are relaxed. This therefore increases the process of heat loss by conduction and radiation. Increased sweating also known as hyperhidrosis is due to the sweat glands releasing a salty liquid onto the skins surface, taking heat with it. Blood vessels can also dilate allowing more blood to flow through. The blood flows close to the body’s surface meaning that there is increased radiation. This is a process known as vasodilation. Also due to an increased body temperature there will also be increased sweating, and the need to drink due to thirst. When we become too cold however, the opposite of this happens and begin to shiver as a mechanism to rise body temperature. Heat loss will be reduced as the hairs on the skin stand so that they are able to trap a layer of air, acting as an insulator.

In conclusion, homeostasis is important as it maintains the appropriate levels within our body that our cells need to function properly and it allows us to adapt to environmental changes. It keeps the body at a norm, however, if conditions are at the extreme, the negative feedback mechanism will no longer work, resulting in death, if there is no medical help.

D2

Evaluate the importance of homeostasis in maintaining the healthy functioning of the body (D2).

Homeostasis is maintaining a constant internal balance within the body, which can adjust to extreme external conditions/factors. Cold blooded organisms for example are unable to maintain and regulate their internal body temperature, and so when they become too cold they are slow. Therefore, this means that ectotherms, rely on external factors such as the sun to regulate their temperature. On the other hand, warm blooded organisms are able to regulate and maintain their body temperature by carrying out exercise. Due to homeostasis, both the nervous and endocrine system will maintain a core body temperature, resulting in shivering when it is too cold at low temperatures or sweating if the temperature rises. During exercise, we can maintain body temperature as we sweat to cool down. To account for this loss in water, there will be a decrease in the production of urine. ATP is produced from the stores of glucose, therefore breathing becomes faster which will provide the body with more oxygen and also heart rate will increase meaning that blood can be pumped around the body at a faster rate.

The body is able to maintain our temperature, even if we are surrounded by extreme conditions e.g. a snow storm, or extreme heat, this is due to homeostasis. If we were in extreme heat, homeostasis would occur to ensure that we survive. The body would start to sweat and the process of vasodilation would occur, cooling down the body. The opposite would then happen if we were in a snow storm. The body would start to shiver, producing heat and also vasoconstriction would occur, rising body temperature. If however, homeostasis did not occur this would then start to cause problems as the body would be unable to recognise the changes within the environment and respond to them appropriately.

If we are in extremely hot conditions for a long period of time, the enzymes in the body will start to denature and this in turn results in the body cells dying (ABPI, 2015). This is known as hyperthermia. Due to this homeostatic mechanisms will stop working and so the hypothalamus can no longer function. If there is an excessive amount of sweating, too much salt may be lost from the body, making ions in the blood fall out of balance, leading to cramps in the muscles (ABPI, 2015). This extreme heat can also effect the messages from the brain to both the nerves and spinal cord slowing them down. Dehydration may also occur, meaning that the kidneys will hold on to urea and ammonium, however, this can be dangerous, as these toxins need to be removed (Campton, 2010). The heart may also start to beat faster as it needs to maintain blood pressure, therefore blood vessels will dilate (Bradfield, 2001)

On the other hand, if the body was exposed to extremely cold conditions, homeostasis still may not work. Hypothermia is define as when the core body temperature drops to below the norm for bodily functions to be carried out efficiently and so chances of survival would decrease. Shivering may occur however, this may not work and so when hypothermia gets more severe it will stop. Heart rate and breathing rate will decrease and there may also be an incontinence of urine due to the kidneys having a larger workload which also relates to the blood being shunted to the major organs (better health channel, 2015). If there was no action taken to support homeostasis then the body would eventually shut down, resulting in death.

A continuous supply of glucose is required by the body to carry out normal metabolism. This glucose is then converted to ATP. B-cells of Langerhans are stimulated, releasing insulin into the blood if the blood glucose levels rise, leading to a decrease in these levels. The opposite then happens if blood glucose levels fall. The a- cells of Langerhans, releases glucagon into the blood, rising blood glucose levels. In relation to blood glucose, if there was a homeostatic imbalance it could result in the development of type 1 diabetes. Type 1 diabetes is when beta cells in the pancreas are destroyed, therefore, preventing the body from producing enough insulin to regulate blood glucose levels (Diabetes.co.uk, 2015). This is also known as hyposecretion of insulin. If blood glucose levels get too low, then hypoglycaemia may occur (Diabete.co.uk, 2015). Diabetes can also lead to long term complications such as heart disease, stroke or kidney disease just to name a few. Diabetes is an example of what may happen if the homeostatic mechanism fails.

Homeostasis helps to control breathing rate. The respiratory centre and chemoreceptors regulate the breathing rate by sending information to the medulla. This in turn increases carbon dioxide levels in the blood, and nerve impulses are then sent to respiratory muscles. These muscles are then informed that they have to work harder, ensuring that there is a sufficient supply of oxygen in the blood (Campton, 2010). If the mechanism happened to fail, oxygen supplies in the blood would be insufficient, as there the blood would contain an increased amount of carbon dioxide. This may cause problems as the body needs oxygen for all body cells to work efficiently carrying out their bodily functions and without which, the body would shut down.

The medulla also controls heart rate as well as the sinus node. The sinus node receives information, responding accordingly, depending on the body’s needs. An example of this would be if the body isn’t receiving enough oxygen for the muscles to work efficiently during exercise, meaning the sinus node would then give instructions for the heart to work faster, pumping the blood around the body quicker and at a stronger force. If the homeostatic mechanism was not initiated due to problems with either the medulla or the sinus node, the body would become oxygen deprived and so would result in a heart attack, resulting in possible death if the body was to be left in this way for a period of time (Bradfield 2001

In conclusion, homeostatic mechanisms in the body are vital for survival and without such mechanism, it may result in heart failure and possibly even death, highlighting just how important it is.

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P4 M1 D1 ANATOMY AND PHYSIOLOGY

Explain the physiology of two named body systems in relation to energy metabolism in the body. (p4, M1, D1)

In this piece I will analyse how the cardiovascular system and the digestive system interrelate to perform energy metabolism.

Campton (2013) defines energy as, ‘the capacity to do work’. This energy exists in a number of forms such as light, heat, sound, electrical, nuclear and also chemical which is known to be the most common. Chemical energy is released in the breakdown of food, or digestion. We can therefore say that chemical energy is within the bonds of chemical compounds i.e. atoms and molecules. As the bonds loosen or break, the chemical reaction will take place and oxidation will occur. The conservation of energy states that, energy can neither be created nor destroyed only changed.

Energy is essential for the body to survive. It is absolutely necessary to circulate blood, lymph as well as tissue fluid around the body. If energy wasn’t present we wouldn’t be able to take part in activities that we love to do, this would be because we need energy for the movement of our muscles. It is used to transmit nerve impulses throughout our body so that we are able to respond to changes within the environment. Furthermore, we need energy to carry out respiration and to also synthesise new cells for carrying out growth and repair. Energy is also important to build different complex molecules e.g. enzymes and hormones from the simple ones produced after the digestion of food.

Metabolism is when nutrients are converted to energy by the body; it is the sum of both biological and chemical processes within the body, relating to the amount of nutrients used in each cell. Metabolism can then be divided into two processes, anabolism and catabolism. Anabolism allows the formation of new tissues and the growth of new cells. It also enables us to synthesise new large, complex molecules instead of simple ones. However, in catabolism, these larger complex molecules are broken down into simpler ones, and there components used by the body’s cells. An important molecule used in metabolism is ATP, short for adenosine triphosphate. It was discovered in 1929 by a German scientist, Karl Lohnmann. An example of this is a process called glycolysis where by glucose is broken down to obtain energy. Within the first steps of glycolysis, a phosphate is added from the ATP to the glucose molecule. When this happens the ATP reduces its phosphate molecules from 3 to 2, therefore it becomes ADP and it normally written as ADP+Pi. ATP is clearly needed in the body and without which cannot function. Although within the body ATP is always being recycled, it also has to make new ATP. An enzyme, named ATP synthase, which is found within the mitochondrial membrane, generates the ATP in the mitochondria.

Digestion is the process whereby food is broken down from being complex molecules into more simple, soluble ones. This means that the digestive system converts this food into fuel that we need for the body’s energy demands. First of all ingestion has to take place whereby food is taken into the mouth via the buccal cavity i.e. the mouth. This is also the start of starch digestion initiated by the enzyme amylase which is in saliva from the salivary gland. In the mouth the teeth can also aid digestion as they cut and grind food particles down into smaller ones. This material is then passed down through the oesophagus, by a process called peristalsis which moves food into the stomach. The muscles behind the food contract involuntarily and so push it along. Digestion continues further in the stomach, where protease, digests protein, resulting in the product of amino acids. The strong stomach walls consist of three layers of smooth muscle. This muscle is spread within the stomach allowing there to be a large amount of motion created, churning and breaking down food into small particles. This food mixes with gastric juices to form chyme. The chyme then enters the top of the small intestine which is known as the duodenum. This is where fat digestion begins and lipase breaks down lipid into glycerol and fatty acids. Bile helps fat digestion and also the absorption of fat. The salts which are contained within the bile emulsifies this fat by breaking down large fat globules into smaller globules. The jejunum is the primary site of absorption and most of the absorption of food is done in this part of the digestive tract. Simple sugars for e.g. glucose, water soluble vitamins (apart from vitamin C and some B vitamins) and amino acids made from the food are passed into the bloodstream from the villi. Fat is then passed into lymph capillaries and the rest of the food enters the ileum. The ileum is where mainly B12 is absorbed into the blood capillaries. The unabsorbed and undigested food passes from the ileum and enters the cecum. This is the start of the large intestine. The undigestible food passes into the colon via the cecum, and this is where water and salts are absorbed. This is the last part of the digestive tract.

As said above, the molecules are absorbed into the capillaries of the bloodstream in the cardiovascular system. This systems main function is to transport these molecules to all body cells via the bloodstream driven by the pumping of the heart. The blood is the main transport medium and consists of a number of components such as red blood cells, white blood cells and also platelets. Red blood cells have no nucleus and are biconcave. They contain haemoglobin which allows them to carry oxygen around the body. White blood cells have a lobed nucleus and they are fewer in number than red blood cells. White blood cells are important in defence. Platelets are important in blood clotting as they help convert fibrinogen to fibrin which forms a mesh of fibres to allow clotting to occur.

The heart is myogenic and is described as being a double circulatory system. One circuit from the heart to the lungs and back is the pulmonary circulation and the other circuit, from the heart to the rest of the body is the systemic circulation. The right atrium receives the deoxygenated blood via the vena cava and this passes into the right ventricle. The tricuspid valve is present which prevents the back flow of deoxygenated blood from the right ventricle into the atrium. The right ventricle then pumps the deoxygenated blood to the lungs through the pulmonary arteries. The pulmonary vein takes the oxygenated blood back from the lungs and it enters through the left atrium. The oxygenated blood then passes from the left atrium into the left ventricle. The bicuspid valve here prevents the backflow of oxygenated blood from the left ventricle into the left atrium. Once the oxygenated blood enters the left ventricle, it is pumped into the aorta and then around the rest of the body.

These two systems inter relate particularly due to the small intestine as there is where absorption takes place into the blood through a process called diffusion.  The digestive system breaks down food into small particles so that it is able to be transport to other parts of the body where it is then converted into energy via catabolism and used by the body cells. The cardio vascular system transports oxygen to the digestive system so that it is able to carry out its work and break down the food to obtain the nutrients which are contained within this.

In conclusion, energy metabolism is very important regarding these two systems and no one body system is able to work in isolation. The digestive system and the cardiovascular system need and rely on each other from the minute of ingestion.  

I hope you all found this helpful, your study pal!
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Hey everyone,

I currently study Health Science at college and when I am completing my assignments/coursework and I need help, I often look online to see if anyone has done the same piece. So I thought that I would post each piece of my own written work on a blog so that if anyone else needs help, its there as I have found it useful.

This blog would be mainly for those who are studying health and social care, health science or something similar, although there are quite a few topics!

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