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Osteoporosis Medical Background

Transcript: Medical Background Bone Structure Bone Introduction In the human body at birth, there are approximately 270 bones present; many of these fuse together during development, leaving a total of 206 separate bones in the adult, not counting numerous small Sesamoid bone. The largest bone in the body is the femur or thigh-bone, and the smallest is the stapes in the middle ear. Bone Cells Bone Cells Remodeling Remodeling Approximately 10% of the skeletal mass of an adult is remodeled each year. Bone is constantly being created and replaced in a process known as remodeling. This ongoing turnover of bone is a process of resorption followed by replacement of bone with little change in shape. Remodeling This is accomplished through osteoblasts and osteoclasts. Cells are stimulated by a variety of signals, and together referred to as a remodeling unit. The purpose of remodeling is to: 1- Regulate calcium homeostasis 2- Repair micro-damaged bones from everyday stress 3- Shape the skeleton during growth. Remodeling The action of osteoblasts and osteoclasts are controlled by a number of chemical enzymes that either promote or inhibit the activity of the bone remodeling cells, controlling the rate at which bone is made, destroyed or changed in shape. The cells also use Paracrine Signaling to control the activity of each other. For example, the rate at which osteoclasts resorb bone is inhibited by Calcitonin and Osteoprotegerin (OPG). Calcitonin is produced by parafollicular cells in the thyroid gland, and can bind to receptors on osteoclasts to directly inhibit osteoclast activity. Remodeling Osteoprotegerin is secreted by osteoblasts and is able to bind RANK-L, inhibiting osteoclast stimulation. Osteoblasts can also be stimulated to increase bone mass through increased secretion of osteoid and by inhibiting the ability of osteoclasts to break down osseous tissue. Increased secretion of osteoid is stimulated by the secretion of growth hormone by the pituitary, thyroid hormone and the sex hormones (estrogens and androgens). Remodeling These hormones also promote increased secretion of osteoprotegerin. Osteoblasts can also be induced to secrete a number of cytokines that promote reabsorption of bone by stimulating osteoclast activity and differentiation from progenitor cells. Vitamin D, Parathyroid hormone & Stimulation from osteocytes induce osteoblasts to increase secretion of RANK-ligand and interleukin 6, which cytokines then stimulate increased reabsorption of bone by osteoclasts. Remodeling These same compounds also increase secretion of macrophage colony-stimulating factor by osteoblasts, which promotes the differentiation of progenitor cells into osteoclasts, and decrease secretion of osteoprotegerin. Calcium Ca++ Calcium Ca++ Measurement in blood Calcium Foods rich in calcium include dairy products, such as yogurt and cheese, sardines, salmon, soy products, kale, and fortified breakfast cereals. Because of concerns for long-term adverse side effects, including calcification of arteries and kidney stones, both the U.S. Institute of Medicine (IOM) and the European Food Safety Authority (EFSA) set Tolerable Upper Intake Levels (ULs) for combined dietary and supplemental calcium. Calcium Bone Calcium is the most abundant mineral in the human body The average adult body contains in total approximately 1 kg, 99% in the skeleton in the form of calcium phosphate salts. Calcium From the IOM: 1- People of ages 9–18 years are not to exceed 3 g/day combined intake. 2- For ages 19–50, not to exceed 2.5 g/day. 3- For ages 51 and older, not to exceed 2 g/day. EFSA set the UL for all adults at 2.5 g/day, but decided the information for children and adolescents was not sufficient to determine ULs The body regulates calcium homeostasis with two pathways; one is signaled to turn on when blood calcium levels drop below normal and one is the pathway that is signaled to turn on when blood calcium levels are elevated The amount of calcium in blood (more specifically, in blood plasma) can be measured as total calcium, which includes both protein-bound & free calcium. In contrast, ionized calcium is a measure of free calcium. An abnormally high level of calcium in plasma is termed hypercalcemia and an abnormally low level is termed hypocalcemia, with "abnormal" generally referring to levels outside the reference range. Homeostasis Osteoporosis Osteoporosis World War II, also known as the Second World War, was a global war that lasted Osteoporosis is a disease in which bone weakening increases the risk of a broken bone. It is the most common reason for a broken bone among the elderly. Osteoporosis is defined as a bone density of 2.5 standard deviations below that of a young adult which measured by dual-energy X-ray absorptiometry (DEXA) Osteoporosis Osteoporosis Osteoporosis may be due to lower-than-normal maximum bone mass & greater-than-normal bone loss. Bone loss increases after menopause due to lower levels of estrogen. Osteoporosis may

Background Presentation

Transcript: 14th Week Consulting interns can be expensive Time and Money Personal Experience Preliminary Design Stage NFPA 101 and NFPA 13 New and Existing Education, Business, and Mercantile Definition of Project This app would be used to provide interns and recent graduates with an outline of guidelines for how to design and review designs of specific occupancies. With the given time frame, I will be writing the information that will go into the app Begin parametric study: Speak with my mentor and Jason to understand more about what critical variables I could concentrate on for this app. Choose those parameters and begin my study Gather information from NFPA 101 and NFPA 13 for new and existing education, business, and mercantile occupancies. By: Breanne Thompson Next Steps (Continued) Finish preparing for Draft of Analysis Pull together and discuss results of project Draw my conclusions and state future work needed Turn in Final Paper! 10th and 11th Week Turn in my parametric study Begin draft of analysis Map out the process of the app for the key elements 15th Week References Next Steps 7th Week Prepare for Final Presentation Summarize my draft of analysis into presentation Work on how to incorporate a live demonstration for my presentation App Development Background Information 8th-9th Week Continuous Process Objective-C for Apple products Java for Android products 6 months of studying Places to Learn: Codecademy, iOS Dev Center, Android Developers Training Hire App Developer will cost thousands Prepare Final Paper Dive into Shark Tank! 1. 2. 6th Week Background Presentation 12th-13th Week

Background Presentation

Transcript: Real action and accountability Amnesty International Non-state actors/ Rebel Groups?? ...and what about men?? ignoring male rape victims? would rape exist without a man? Weapons of War: Rape UN as an Arena - NGO's - Discussion and dialogue Arena Instrument Actor Critical Thinking Weapons of War: Rape UN as an instrument UNSC Resolution 1820 (2008) UN as an Actor - UN Action Against Sexual Violence in Conflict Weapons of War: Rape Problems with 1820 "Roles and Functions of International Organizations" "Sexual violence, when used as a tactic of war in order to deliberately target civilians or as a part of a widespread or systematic attack against civilian populations, can significantly exacerbate situations of armed conflict and may impede the restoration of international peace and security… effective steps to prevent and respond to such acts of sexual violence can significantly contribute to the maintenance of international peace and security" (UNSC Resolution 1820, p. 2)" Background Presentation- Kristin Mann Weapons of War: Rape Brief Insight - used to manipulate social control - destabilize communities - weaken ethnic groups and identities Examples: - Sudanese Militia - Rwanda Genocide - DRC Critical Thinking Critical Thinking Increased Data Collection by international organizations - determine humanitarian responses - ensures justice and reparation - provides recognition and dignity

Medical Background: Concussions

Transcript: Number of children visiting emergency departments over last 10 years: football, basketball, baseball, soccer and ice hockey-related concussions doubled 1997-2007 children aged 8-13, 200% children aged 14-19 Prevent swelling by icing or cold towel how does a concussion happen Troy Aikman -Dallas Cowboys quarterback Jeff Beukeboom -Rangers Defenseman Mike Cameron -Mets Outfielder Wayne Chrebet -Jets Wide Reciever Sidney Crosby -Pittsburgh Penguins Frank Gifford -Giants Running Back Brett Farve -Green Bay Packers Quarterback James Harden -Thunder Shooting Guard Pat LaFontaine -Rangers/ Islanders Center Brett Lindros -Islanders Right Wing Eric Lindros Philadelphia Flyers/ NY Rangers Center Treatment. What methods were done in the past? What methods are done now? Mike Piazza -Mets Catcher Mike Richter -Rangers Goaltender Al Toon -Jets Wide Receiver Steve Young -San Francisco 49ers Quarterback Marc Stall -Rangers Defenseman Rest is the most appropriate way to allow your brain to recover from a concussion. Your doctor will recommend that you physically and mentally rest to recover from a concussion. are there different types or degrees of a concussion? Past Evaluations: Finger Method Walk a straight line Reading Number line reaction time Current Evaluations: Balance testing Physical examination concentration months of the year in reverse, digits backwards memory (recall of 3 words at 5 minutes) examination of the cranial nerves neurological examination-deficits may persist for up to 10 days after concussion cervical spine assessed for tenderness, spasm and range of motion SCAT2 Well known athletes that have suffered from concussions Short Term concussive effects (lasting a few hours to a few weeks): Physical: concussion signs headaches vertigo change in sleep patterns lightheadedness tinnitus (Ringing in ears) coma blurred vision/seeing stars being dazed nausea/vomiting difficulty with mobility or coordination loss of consciousness Short and long term effects a concussion is when the brain shifts or shakes suddenly inside the skull and can knock against the skulls bony surface. A hard hit to the body can cause whiplash in the neck making the brain brush against bony protuberances inside the skull. Hard hits can also result in a rotational injury in which the brain twists, potentially causing shearing of the brain nerve fibers. Emotional: depression mood swings and change in personality fear of future harm feeling helpless to protect self and family frustration overarching anxiety guilty feeling easily overwhelmed Sports Football Volleyball Lacrosse Hockey Soccer confusion or feeling dazed clumsiness slurred speech nausea or vomiting headache balance problems or dizziness blurred vision sensitivity to light sensitivity to noise sluggishness ringing in ears behavior or personality changes concentration difficulties memory loss Contact a doctor diagnosis of the injury Recovery. And if you were able to cooperate you were able to play again Then vs. now Treatment now Simple Concussion: Results in persistent symptoms and can effect the brain function. Grade 1: Is a mild concussion it doesn't effect much on the brain and will wear off in a matter of days. Grade 2 (post traumatic amnesia: Does not result in loss of consciousnesses but symptoms last longer than 20 min. Grade 3: Is the most severe concussion of them all. You can loose consciousness and can often cant remember what happen before the injury. Past Recovery as of 2012 physical and cognitive rest until symptoms resolve graded program of exertion medical clearance and return to play concentration and attention scholastic work, videogames, text messaging, etc. SCAT2 They used to not think too much of it, you just got rattled up Medical Background: Concussions They were viewed less seriously Long-Term Concussive Effects (Lasting many months to years): long-term memory loss emotional distress slowing of some types of movements depression increased possibility of suicide attempts Citations Cognitive: partial or total memory loss loss of concentration slow reaction time difficulty talking and communication

Background Presentation

Transcript: Death rate 2012: 12.84 deaths/1,000 population (World ranking: 22) Infant (Child Mortality) Total: 79.02 deaths/1,000 live births (world ranking: 10) HIV/AIDS (2) Appropriate Technology Landlocked country Great African Rift Valley system: East – Lake Malawi South – mountains, tropical palm-lined beaches Mainly a large plateau, with some hills Lake Malawi (Lake Nyasa) Almost 1 million people have AIDS 60% of these are female Declining in urban areas, Rising in rural areas Leading cause of death amongst adults Contributes to the low life expectancy: 54.2 years 209th ranking (One of the lowest) 500,000 children have been orphaned due to AIDs Micro-finance Policy Framework and Strategies (Health SWAp) increasing the availability and accessibility of antenatal services; utilization of skilled health personnel during pregnancy, childbirth and postnatal period at all levels of the health system; strengthening the capacity of individuals and institutions to improve maternal and neonatal health; increasing the number of skilled health personnel; constructing and upgrading health facilities to offer essential health services particularly focusing on rural and underserved areas; and provision of ARVs and micronutrients during pregnancy. Geography of Malawi CCST 9004 Appropriate Technology for the Developing World Indicator 3: Literacy Rate of 15 – 24 year-olds According to the World Bank, microfinance is defined as: Microfinance is the provision of financial services to the entrepreneurial poor.This definition has two important features:it emphasizes a range of financial services—not just credit— and it emphasizes the entrepreneurial poor. Goal 2: Achieve Universal Primary Education Appropriate Technology: SIRDAMAIZE 113 Population: 16,777,547 (estimated in July 2013) Population growth rate: 2.758% (2012 est.) (World ranking: 18) Age structure Children: 50% of total population HIV/AIDS Human Resources Education Poverty Food Insecurity Erratic Rainfall Patterns/Droughts Corruption Lack of Foreign Investment Languages Indicator 5: Proportion of seats held by women in National Parliaments Central Region: 1-9 (Yellow) *Capital: Lilongwe Northern Region: 10-15 (Red) Southern Region: 16-27 (Green) Lake Malawi (Blue) Land surface area 45,747 square miles Challenges: · shortage of qualified primary school teachers; · inadequate physical infrastructure; · poor retention of girls mainly from standard five to eight; · high disease burden due to HIV and AIDS consequently leadinto absenteeism, especially among girls who take care of the sick · Poverty levels are high in rural areas. Malawi – Climate/Agriculture Trading partners: South Africa, Zambia, China, US Challenges: · shortage of qualified primary school teachers; · inadequate physical infrastructure; · poor retention of girls mainly from standard five to eight; · high disease burden due to HIV and AIDS consequently leading to absenteeism especially among girls who take care of the sick; and · poor participation of school committees and their communities in school management. · Poverty levels are high in rural areas. 1 Doctor per 50,000 people Hinders the ability to deliver medical services to people in need Reason: Emigration Lack of access to education Aggravated by AIDS > 4 nurses are lost each month This also affects other sectors: Government Business Farmers Human Resources HIV/AIDS - Contemporary GDP: US $14.58 billion (2012 est.) (World ranking: 142) Labor force: agriculture: 90%; industry and services: 10% (2003 est.) Countries main income Agriculture Main crops: maize, tobacco, tea, sugar cane, groundnuts, cotton, wheat, coffee, and rice Industry: tobacco, tea, sugar, sawmill products, cement, consumer goods Challenges: limited capacity in terms of human and material resources to facilitate adult literacy and continuing education; early marriages perpetuated by socioeconomic factors; socio–cultural factors that make people believe that men should be leaders while women are followers; and, poor learning environment which affects girls in primary and secondary schools e.g. sanitary facilities, long distances to education facilities, extra burden from domestic chores especially for adolescent girls resulting into high dropout rate. 1964: Independent from Britain Indicator 1: Maternal Mortality Ratio Malawi Demographics Problems - Outline Indicator 4: Share of Women in Wage Employment in the Non- Agriculture Sector measure of employment opportunities ( i.e equal proportions of men and women in formal employment) Yet, more women participate in the agriculture sector than in the formal wage employment especially in jobs that require professional qualifications. Due to: literacy levels, gender disparity and cultural values. Facts About the Product: Drought tolerant maize variant Able to mature under limited rainfall Suitable for marginal rainfall areas 136 days to mature Normally: 150 – 180 days Able to mature under limited rainfall Suitable for marginal rainfall areas

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