SOCIOLOGY! Explain the differences between the two models and assess the strengths and weaknesses for each

There are a number of differences between the biomedical and the socio-medical model. The biomedical model focuses on health as being just the absence of disease. This means that it looks at the physical functioning of an individual and ill-health is described as being presence of an illness diagnosed through signs and symptoms from an injury, meaning environmental factors are ignored. The socio-medical model differs however as it focuses on social factors which contribute to the health and well-being of an individual within society. They highlight that environmental and social conditions are contributors of illness/disease and so instead of an individual approach; it focusses on communities and populations in order to promote health. The socio-medical model links easily with the conflict theorists as they believe that short life expectancy and higher morbidity rates among less fortunate individuals are due to the inequalities of the society (Billingham et al 2007). However, the biomedical model links easily with the functionalist perspective as illness is regarded as being dysfunctional for society (Billingham et al 2007). Regarding both models there are strengths and weaknesses. There are a number of advantages to the biomedical model. This model focuses on curing an individual’s illness/disease. Due to this some illness that used to be very fatal can now be cured e.g. some cancers. This is therefore a result of the development of successful treatments due to research being carried out. Health professionals have been well trained and have reliable information/knowledge regarding illness and how they can be treated. Due to this individual’s trust the doctors and other health professionals to cure their illness/disease. If the individual’s health improves it then proves that the doctor is professional and effective. This model relies on ojective and measurable observations and so it is said to be enticing. It also means that findings may be more reliable due to it being succinct (Zigmond, 2012). There are, however disadvantages to this model also. Individuals with a condition such as Downs’s syndrome are not focuses on as the biomedical model sees these individuals as not being normal. A doctor may not be interested in helping an individual with this kind of condition as the doctor’s expertise may not benefit the individual’s quality of life. It means that if an individual with downs syndrome and an individual seen as being normal needed heart surgery which was very expensive, the individual with the condition would not get it. This is because the biomedical model would see this as being wasteful as the individual who is seen as being normal may benefit more from the surgery. The biomedical model doesn’t consider social and environmental factors which can cause illness. The model focuses on biological factors and that medicines can cure illness/disease but completely ignores that it may be environmental factors such as damp within housing which could bring about illness/disease (Coward 1989). Doctors quite often don’t see people as an individual but see them as a case meaning that the treatment provided is due to illness/disease and not by the individual themselves. They tend to label individual with illness in groups even though the illness may be different. An example of this may be two individuals who have the same type of cancer however they illustrate different signs and symptoms and respond to treatments differently. The socio-medical model also has advantages. This model doesn’t just try to find a treatment for an illness/disease, it looks at what causes the illness e.g. environment, diet, mind-set. It then aims to treat the cause. It doesn’t focus on the individual itself but a society as a whole. It takes into consider environmental and social factors and how they can impact the population. There is research to back up information making it more reliable. In the late 19th century there was research carried out which confirms that when living conditions were improved in the UK there was an increase in life expectancy and mortality rates decreased (Billingham et al, 2007). This therefore improved health and reinforces that in this case it was environmental and social factors that caused illness/disease. This model believes that too much money is provided to the medical professionals and not enough given to communities in order to help individuals to improve their living standards. This could help to prevent illness/disease, having a healthier society. Like always, there are also disadvantages to this model. It will take more time to solve an individual’s problems as unlike the biomedical model, the socio-medical model treats the cause of the illness and it may take a longer period of time to find the root cause. Trying to motivate the population into choosing a healthier lifestyle may also be very difficult. Persuading smokers to quit smoking and encouraging individuals to eat healthier isn’t always easy. It will also be difficult to measure the effectiveness of this method. Individuals may not always be reliable in the information that the provided and so it would mean the findings therefore would not be reliable as it would not be a true finding. Dont forget to leave a wee comment!! xo

PUBLIC HEALTH P1 & P5

Unit 12 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 Christine Kelly Leah O’HaraUnit 12 Public Health 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 65th 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 Christine Kelly Leah O’HaraUnit 12 Public Health 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. Leave me a wee comment and let me know what you guys think!

Psychology. The effects of computer and video games.

Hey guys, heres another little essay. The question was about the effects of computer and video games. The effects of computer and video games The Negative Effects Video games and aggression Experimental studies- Lab experiments have found short-term increases in levels of physiological arousal, hostile feelings and aggressive behaviour following violent game play compared to non-violent game play (Gentile and Stone, 2005). Aggressive behaviour cannot be studied directly, as this is not permitted on ethical grounds, therefore other forms of behaviour must be used instead. For example, participants blasted their opponents with white noise (a random, multi-frequency sound) for longer and rated themselves higher on the State Hostility Scale after playing Wolfenstein 3D (a violent ‘first person shooter’ game) compared to those who played Myst (a slow-paced puzzle game) (Anderson and Dill, 2000). Longitudinal studies- Anderson et al. (2007) surveyed 430 children aged between seven and nine at two points during the school year. Children who had high exposure to violent video games became more verbally and physically aggressive and less prosocial (as rated by themselves, their peers and their teachers). Meta – analyses on the video games and aggression link- several meta-analyses have found a consistent link between violent game play and aggressive behaviour. This association appears to hold for children and adults (Gentile and Anderson,2003). It might be expected that there would be larger effects with newer studies as violent video games have become more violent over time. In the Gentile and Anderson study, this was the pattern found, with earlier studies showing smaller effect sizes than more recent studies. Children playing either violent or non–violent games and looked into the long term effects of game playing- Anderson et al (2007) had 161 9 to 12 year old children play either violent or non violent video games for 20 minutes. After this, the children were given another computer game to play which allowed them to select the degree of punishment to deliver to an opponent. They found that children who had played violent video games previously tended to deliver stronger punishments than those who had played a non-violent game. Anderson et al then looked into the long term effects of playing violent video games and found that the amount of violent game playing at the start of the study predicted the degree of increased aggressive behaviour and hostile feelings five months later. Violent video games might have a particular effect on people who already have aggressive personalities - Peng et al (2008). They had forty participants play two popular violent computer games for the first time 0 the godfather and true crime: streets of LA. Both games involved the characters in violent acts, such as punching, kicking, and using weapons. Some of this play was captured for content analysis. Several weeks before the study took place pps with higher physical aggressive personality scores from the questionnaire engaged in more frequent violence when playing the games. This study has important implications. It might be that people with aggressive predispositions are particularly attracted to such games, or that playing a game in a more violent way might have greater effects on later aggressive thoughts and actions. According to Padilla-walker et al (2009), the use of video games leads to poorer relationships with family and friends. In a survey of 813 university students they found that as the amount of time playing video game went up, the quality of relationships with parents and peers went down. In order to play video games, young people remove themselves from social setting, or it may be that they are already struggling with relationships and have turned to video game playing as an escape or an alternative way to spend time. A recently recognised problem associated with internet use is ‘internet addiction’. Typically, people show a psychological dependence on the internet and devote so much time to surfing that family, friends and employers suffer (Young 1998) research has found that high internet use can be related to reductions in psychological well being. In a two year study of internet users, Harman (1998) found that heavy users spent a reduced amount of time with family and friends, and this increased their feelings of loneliness. The fact that much online activity appeared to be social, in that it involved chat rooms and email, did not seem to have a positive influence. Computers: Facebook use Facebook friends and stress- Charles (2011) used focus groups and interview techniques to investigate the Facebook habits of 200 undergraduate students in Scotland. A significant number (12%) experienced anxiety linked to their use of the social networking site. The majority who reported anxiety had significantly more friends than other Facebook users. They reported stress from debating unwanted contacts, the constant pressure to be humorous and entertaining and worrying about the proper type of etiquette toward different friends. Of the students surveyed, 32% stated that rejecting friend requests made them feel guilty and uncomfortable and 10% reported that they dislike receiving friend requests. Daft et al. (1987) found that computer-mediated communications (CMCs) negatively affected feedback levels, communication cues, language variety and person focus. As these are important factors in communicating and negotiating, this suggests that computers hinder such processes. The Positive Effects Video games and prosocial behaviour Helping behaviour- research has also shown that playing a prosocial (relative to a violent or neutral) game can increase helping behaviour. Greitemeyer and Osswald (2010) demonstrated that participants who played the prosocial video game Lemmings, (where they had to ensure the safety of the lemmings) subsequently displayed significantly more prosocial behaviour than those who played an aggressive game (Lamers), or a neutral game (tetris). After playing the respective video games for eight minutes, participants saw the researcher accidentally knock a cup of pencils off a table and onto the floor. Of those who played the prosocial game 67% helped pickup the pencil, whereas only 33% of those who had played the neutral game and 28% of those who played the aggressive game helped. Multiplayer games and social commitment- games that involve other players offer the possibility of social outcomes, including learning about a problem in society, or exploring a social issue. Kahne et al. (2008) found that the majority of those who listed The Sims (a life simulation game) as a favourite game said they learned about problems in society and explored social issues while playing computer games. Lenhart et al. (2008) carried out a large-scale US survey to investigate the influence of multiplayer game play on social commitment. They found that 64% of those who played multiplayer games such as Halo) where players must battle to save humankind) or The Sims were committed to civic participation (compared to 59% of ‘solo’ players), and 26% had tried to persuade other how to vote in an election (compared to 19% of solo players). They also found that those who regularly took part in social interaction related to the game (e.g. on websites or discussion boards) were more committed civically and politically. De-Lin Sun et al (2008) point out that it is difficult to measure the effects of excessive game playing because payers suffer the negative consequences and the benefits from playing at the same time. They suggest that the positive effects of game play may last longer than those that are negative. Computer gaming has been found to improve a range of cognitive skills. Sims and Mayer (2002) found that players of the game Tetris had improved spatial skills of the kind required by the game. Evidence from Karni and Sagi et al (2003) shows that such cognitive experiences can lead to long term changes in the brain. Increased helping behaviour with video games and cultural relatedness also- Gentile et al (2009) conducted three studies in three countries with three age groups, to test whether video games in which character help each other increased both short term and long term pro-social behaviour. Findings from the US part of the study, involving 161 college students, showed that those who were randomly assigned to play pro-social games behaved more helpfully towards another student in a later task than those who played violent games. It appears that pro-social game playing can also have prolonged effects. In a sample of Japanese 10 to 17 years old, pro-social game playing was related to pro-social behaviour over a three to four month period. Gentile et al suggest that since games can have both positive and negative effects parents should monitor their child’s game playing to ensure that games with maximum benefits are played. Despite the issues regarding obesity, VG and computer can also aid physical activity – Lannigham-Foster et al (2006) found that, whilst watching TV and playing traditional computer games expended similar amounts of energy expenditure trebled with active video games. This is supported by Mellecker et al (2008) who compared heart rate and calorie expenditure in children while playing an active bowling game, an active running game, a seated bowling game and during rest. Compared to the resting condition, they found 39% more calories were burned during the seated game, 98% more in active bowling and 451% more on the running game, this clearly indicates a benefit in calorie expenditure for active game playing. They point out that the four-fold increase in energy expenditure during active game playing might compensate for weight gain caused by sedentary entertainment choices. As such, it could help prevent young people from becoming overweight. (Positive and negative) Whilst video games like Wii sports, Dance Dance revolution and guitar hero offer ways of getting people more active, it has been argued that they are not a replacement for more traditional forms of exercise. Graves et al (2009) compared the energy expenditure in adolescents whilst playing four computer games a sedentary Xbox 360 found that, whilst playing an active game used nowhere near as much energy as playing the sport for real. For example, it has been estimated that whilst playing virtual tennis will burn off calories, actually playing tennis will burin off four times as many. It is recommended that young people engage in an hour of moderate to vigorous activity each day, a clearly active gaming is not going to provide anything like that. One advantage of virtual gaming however is that they can develop confidence in people in something they might not ordinarily try by improving coordination skills and rue knowledge, which in turn might encourage them to try the real thing. Computers: Facebook use Facebook and Self-esteem Gonzales and Hancock (2011) argue that Facebook walls can have a positive influence on our self-esteem, because feedback posted in them by others tends to be overwhelmingly positive. In a study at Cornell University in the US, students were given three minutes to 1. Use their Facebook page, 2.look at themselves in the mirror and 3. Do nothing. Those who had interacted with their Facebook page subsequently gave much more positive feedback about themselves than the other two groups. Durkin and Barber (2002) found evidence of positive outcomes in 16 year olds playing computer games. Measures of family closeness, activity involvement, school engagement, mental health, lack of substance misuse and friendship networks were superior in game-players than non-playing peers, suggesting that computers can be a positive feature of a healthy adolescence. Keisler and Sproull (1992) found that CMCs led to disinhibition, with users becoming more selfish and self-concerned, and lacking in empathetic feeling for the welfare of others. But thy also found that anonymity could help those with social inhibitions to communicate across social and psychological boundaries, suggesting that CMCs can have positive and negative effects. Evaluation The negative effects of video games Problems with research- a major weakness of lab experiments in this area are that researchers cannot measure ‘real-life’ aggression. They therefore must use measures of aggressive behaviour that have no relationship to real-life aggression, and can only measure short-term effects. Longitudinal studies are able to observe real-life patterns of behaviour and document both short-term and long-term effects. However, a problem for most longitudinal studies in this area is that participants may be exposed to other forms of media violence (e.g. on television) during the course of the study, meaning that the effect from violent video game exposure alone is uncertain. Why might there be an effect? – research has yet to establish a reliable casual link between violent game play and aggressive behaviour. A ‘bi-directional model’ (Gentile et al., 2004) has been proposed whereby, although playing violent video games may cause an increase in aggressive behaviour, it is just as likely that people whop already posses personality traits that orientate them towards aggressive behaviour, preferentially select violent video games for recreational purposes. Computers The negative effect of Facebook use Facebook and college grades- Karpinski acknowledges that her study does not suggest that excessive Facebook use directly causes lower grades, merely that there is some relationship between the two. She suggests that other personality factors are likely to be involved, and perhaps Facebook users are simply prone to distraction. However, other psychologists have gone further. Greenfield (2009), in a presentation to the House of Lords, argued that social networks such as Facebook ‘infantilise’ the brain by shortening the attention span and providing constant instant gratification although, as yet, she had failed to provide the evidence to support this claim. Facebook use and stress- the stress associated with Facebook use has been supported in a case study of an 18 year old asthmatic man whose condition was stable until he split up with his girlfriend and she erased him from her Facebook page (D’Amato et al., 2010). He became depressed and change his Facebook name in order to become ‘friends’ with her again, but after logging on to the site and seeing her picture, his maximum breath force was reduced, a sign of his asthma worsening. This case indicates that social networking sites such as Facebook could be a significant source of psychological stress, and a triggering factor in depressed asthmatic individuals. The positive effect of video games Why don’t prosocial video games have more of an effect? – Greitemeyer and Osswald (2010) suggest that as 85% of video games involve some kind of violence. Therefore, although the content of prosocial games can cause behavioural shifts in an altruistic direction, people who play video games are much less likely to experience this type of game, partly because they are seen as less attractive. Consequently the video game industry is less likely to produce such games for purely commercial reasons (i.e. they are less likely to sell). Methodological limitations- a problem for surveys in game research concerns the lack of controls for young people’s prior civic commitments and prosocial activities. The lack of random exposure to civic gaming opportunities (i.e. young people choose these games rather than being randomly allocated to them) also limits our ability to make causal claims about how games or features of games influence the development of social and civic responsibilities. Therapeutic applications of video games- video games have been successfully used in the treatment of post traumatic stress. For example, the virtual Iraq computer ‘game’ is a ‘fully-immersive’ computer simulation, which allows soldiers suffering post traumatic stress disorder to relive and confront psychological trauma in a low threat context. Researchers have also discovered that playing the game Tetris minimises the mind’s tendency to flash back to memories of traumatic events. Computers The positive effects of Facebook use How does Facebook increase self-esteem? – One explanation for the relationship between Facebook use and positive self-esteem comes from the hyperpersonal Model (Walther, 1996). This claims that self-selection of the information we choose to represent ourselves (e.g. through photos, personal details and witty comments) can have a positive influence on self-esteem. Computer mediated communication (such as through the medium of Facebook) offers people such an opportunity for positive self-esteem as feedback left on their ‘wall’ is invariably positive. AO3 Real world application- research has shown that playing the computer game Tetris can help to reduce memory flashbacks after traumatic events. Holmes et al. (2010) showed volunteers traumatic images of personal injury (e.g. from traffic accidents). Thirty minutes later, some volunteers played Tetris for 10 minutes, some played Pub Quiz and some did nothing. In a second experiment , the wait between viewing the film and playing the computer games was extended to four hours. In both experiments, those who played Tetris had significantly fewer flashbacks from the film compared to the other groups. Tetris was effective as long as it was played within a four-hour 'window' after the traumatic event. This was achieved without altering the person's ability to make sense of the event. The researchers concluded that playing the game interfered with the way that traumatic memories are formed in the mind. It is thought that games like Tetris reduce flashbacks because they compete with the same sensory channels that are needed to form the memory. Have fun!! Leave me a wee comment and let me know if this was helpful. also give me any questions you may need assistance with and i will have a look to see if i have anything on that topic! Your Study Pal! xo

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.  

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