1.
Pattern
–
A pattern, apart from the terms use to mean Template, is a discernible regularity in the world or in a manmade design. As such, the elements of a repeat in a predictable manner. A geometric pattern is a kind of pattern formed of geometric shapes, any of the senses may directly observe patterns. Conversely, abstract patterns in science, mathematics, or language may be only by analysis. Direct observation in practice means seeing visual patterns, which are widespread in nature, visual patterns in nature are often chaotic, never exactly repeating, and often involve fractals. Natural patterns include spirals, meanders, waves, foams, tilings, cracks, Patterns have an underlying mathematical structure, indeed, mathematics can be seen as the search for regularities, and the output of any function is a mathematical pattern. Similarly in the sciences, theories explain and predict regularities in the world, in art and architecture, decorations or visual motifs may be combined and repeated to form patterns designed to have a chosen effect on the viewer. In computer science, a design pattern is a known solution to a class of problems in programming. In fashion, the pattern is a used to create any number of similar garments. Nature provides examples of many kinds of pattern, including symmetries, trees and other structures with a dimension, spirals, meanders, waves, foams, tilings, cracks. Symmetry is widespread in living things, animals that move usually have bilateral or mirror symmetry as this favours movement. Plants often have radial or rotational symmetry, as do many flowers, as well as animals which are largely static as adults, fivefold symmetry is found in the echinoderms, including starfish, sea urchins, and sea lilies. Among non-living things, snowflakes have striking sixfold symmetry, each flake is unique, crystals have a highly specific set of possible crystal symmetries, they can be cubic or octahedral, but cannot have fivefold symmetry. Many natural patterns are shaped by this apparent randomness, including vortex streets, waves are disturbances that carry energy as they move. Mechanical waves propagate through a medium – air or water, making it oscillate as they pass by, wind waves are surface waves that create the chaotic patterns of the sea. As they pass over sand, such waves create patterns of ripples, similarly, as the passes over sand. Foams obey Plateaus laws, which films to be smooth and continuous. Foam and bubble patterns occur widely in nature, for example in radiolarians, sponge spicules, cracks form in materials to relieve stress, with 120 degree joints in elastic materials, but at 90 degrees in inelastic materials
Pattern
–
Tilings, such as these from Igreja de Campanhã, Porto,
Portugal, are visual patterns used for decoration.
Pattern
–
Snowflake sixfold symmetry
Pattern
–
Aloe polyphylla phyllotaxis
Pattern
–
Vortex street turbulence
2.
Cause
–
In general, a process has many causes, which are said to be causal factors for it, and all lie in its past. An effect can in turn be a cause of other effects. The concept is like those of agency and efficacy, for this reason, a leap of intuition may be needed to grasp it. Accordingly, causality is built into the structure of ordinary language. In this case, failure to recognize that different kinds of cause are being considered can lead to futile debate, of Aristotles four explanatory modes, the one nearest to the concerns of the present article is the efficient one. The topic remains a staple in contemporary philosophy, while studying of meaning of causality semantics traditionally appeal to the chicken or the egg causality dilemma, i. e. which came first, the chicken or the egg. Then it allocates its constituent elements, a cause, an effect and link itself, the nature of cause and effect is a concern of the subject known as metaphysics. A general metaphysical question about cause and effect is what kind of entity can be a cause, one viewpoint on this question is that cause and effect are of one and the same kind of entity, with causality an asymmetric relation between them. That is to say, it would make good sense grammatically to say either A is the cause and B the effect or B is the cause and A the effect, though only one of those two can be actually true. In this view, one opinion, proposed as a principle in process philosophy, is that every cause and every effect is respectively some process, event, becoming. An example is his tripping over the step was the cause, another view is that causes and effects are states of affairs, with the exact natures of those entities being less restrictively defined than in process philosophy. Another viewpoint on the question is the classical one, that a cause. For example, in Aristotles efficient causal explanation, an action can be a cause while an object is its effect. Since causality is a metaphysical notion, considerable effort is needed to establish knowledge of it in particular empirical circumstances. Causality has the properties of antecedence and contiguity and these are topological, and are ingredients for space-time geometry. As developed by Alfred Robb, these allow the derivation of the notions of time. Max Jammer writes the Einstein postulate, opens the way to a straightforward construction of the causal topology. of Minkowski space. Causal efficacy propagates no faster than light, thus, the notion of causality is metaphysically prior to the notions of time and space
Cause
–
The Illustrated Sutra of Cause and Effect. 8th century, Japan
Cause
–
Key concepts
Cause
–
Time Portal
3.
Health
–
Health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt, other definitions have been proposed, among which a recent definition that correlates health and personal satisfaction. The definition of health has evolved over time, although this definition was welcomed by some as being innovative, it was also criticized as being vague, excessively broad, and was not construed as measurable. For a long time it was set aside as an impractical ideal, just as there was a shift from viewing disease as a state to thinking of it as a process, the same shift happened in definitions of health. Again, the WHO played a role when it fostered the development of the health promotion movement in the 1980s. This brought in a new conception of health, not as a state, the 1984 WHO revised definition of health defined it as the extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment. Health is a resource for everyday life, not the objective of living, it is a concept, emphasizing social and personal resources. Thus, health referred to the ability to maintain homeostasis and recover from insults, since the late 1970s, the federal Healthy People Initiative has been a visible component of the United States’ approach to improving population health. Progress has been limited for many objectives, leading to concerns about the effectiveness of Healthy People in shaping outcomes in the context of a decentralized and uncoordinated US health system. Healthy People 2020 gives more prominence to health promotion and preventive approaches, a new expanded digital interface facilitates use and dissemination rather than bulky printed books as produced in the past. The impact of changes to Healthy People will be determined in the coming years. Systematic activities to prevent or cure health problems and promote health in humans are undertaken by health care providers. Applications with regard to animal health are covered by the veterinary sciences, studies have shown that high levels of stress can affect human health. Generally, the context in which an individual lives is of importance for both his health status and quality of their life. The concept of the field, as distinct from medical care. The report identified three interdependent fields as key determinants of an individuals health, the maintenance and promotion of health is achieved through different combination of physical, mental, and social well-being, together sometimes referred to as the health triangle. The WHOs 1986 Ottawa Charter for Health Promotion further stated that health is not just a state, Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Health and illness can co-exist, as people with multiple chronic diseases or terminal illnesses can consider themselves healthy
Health
–
Donald Henderson as part of the CDC's
smallpox eradication team in 1966.
Health
–
Postage stamp,
New Zealand, 1933. Public health has been promoted – and depicted – in a wide variety of ways.
Health
–
A lady washing her hands c. 1655
4.
Disease
–
A disease is a particular abnormal condition, a disorder of a structure or function, that affects part or all of an organism. The study of disease is called pathology which includes the study of cause, Disease is often construed as a medical condition associated with specific symptoms and signs. When caused by pathogens, even in the literature, the term disease is often misleadingly used in the place of its causal agent. This language habitat can cause confusion in the communication of the principle in epidemiology. Diseases can affect not only physically, but also emotionally. Death due to disease is called death by natural causes, there are four main types of disease, infectious diseases, deficiency diseases, genetic diseases, and physiological diseases. Diseases can also be classified as communicable and non-communicable, the deadliest diseases in humans are coronary artery disease, followed by cerebrovascular disease and lower respiratory infections. In many cases, terms such as disease, disorder, morbidity, there are situations, however, when specific terms are considered preferable. Disease The term disease broadly refers to any condition that impairs the normal functioning of the body, for this reason, diseases are associated with dysfunctioning of the bodys normal homeostatic processes. The term disease has both a count sense and a noncount sense, by contrast, an infection that is asymptomatic during its incubation period, but expected to produce symptoms later, is usually considered a disease. Non-infectious diseases are all other diseases, including most forms of cancer, heart disease, acquired disease disease that began at some point during ones lifetime, as opposed to disease that was already present at birth, which is congenital disease. Acquired sounds like it could mean caught via contagion, but it simply means acquired sometime after birth and it also sounds like it could imply secondary disease, but acquired disease can be primary disease. It is often, genetic and can be inherited and it can also be the result of a vertically transmitted infection from the mother such as HIV/AIDS. Genetic disease disease that is caused by genetic mutation and it is often inherited, but some mutations are random and de novo. Hereditary or inherited disease a type of disease caused by mutation that is hereditary Iatrogenic disease A disease condition caused by medical intervention. Idiopathic disease disease whose cause is unknown, as medical science has advanced, many diseases whose causes were formerly complete mysteries have been somewhat explained or even extensively explained. Bacterial infections can be primary or secondary to a viral infection or burn. Terminal disease disease with death as an inevitable result Illness Illness is generally used as a synonym for disease, however, this term is occasionally used to refer specifically to the patients personal experience of his or her disease
Disease
–
Scanning electron micrograph of
Mycobacterium tuberculosis, a
bacterium that causes
tuberculosis.
Disease
–
Obesity was a status symbol in
Renaissance culture: "The Tuscan General
Alessandro del Borro ", attributed to
Andrea Sacchi, 1645. It is now generally regarded as a disease.
5.
Population
–
A population is the number of all the organisms of the same group or species, which live in a particular geographical area, and have the capability of interbreeding. In sociology, population refers to a collection of humans, Demography is a social science which entails the statistical study of human populations. This article refers mainly to human population, in population genetics a sexual population is a set of organisms in which any pair of members can breed together. This means that they can regularly exchange gametes to produce normally-fertile offspring and this also implies that all members belong to the same species. If the gamodeme is very large, and all gene alleles are uniformly distributed by the gametes within it, however, there may be low frequencies of exchange with these neighbours. This may be viewed as the breaking up of a sexual population into smaller overlapping sexual populations. The overall rise in homozygosity is quantified by the inbreeding coefficient, note that all homozygotes are increased in frequency – both the deleterious and the desirable. The mean phenotype of the collection is lower than that of the panmictic original – which is known as inbreeding depression. It is most important to note, however, that some lines will be superior to the panmictic original, while some will be about the same. The probabilities of each can be estimated from those binomial equations, in plant and animal breeding, procedures have been developed which deliberately utilise the effects of dispersion. It can be shown that dispersion-assisted selection leads to the greatest genetic advance and this is so for both allogamous and autogamous gamodemes. In ecology, the population of a species in a certain area can be estimated using the Lincoln Index. As of todays date, the population is estimated by the United States Census Bureau to be 7.496 billion. The US Census Bureau estimates the 7 billion number was surpassed on 12 March 2012, according to papers published by the United States Census Bureau, the world population hit 6.5 billion on 24 February 2006. The United Nations Population Fund designated 12 October 1999 as the day on which world population reached 6 billion. This was about 12 years after world population reached 5 billion in 1987, the population of countries such as Nigeria, is not even known to the nearest million, so there is a considerable margin of error in such estimates. Researcher Carl Haub calculated that a total of over 100 billion people have probably been born in the last 2000 years, Population growth increased significantly as the Industrial Revolution gathered pace from 1700 onwards. In 2007 the United Nations Population Division projected that the population will likely surpass 10 billion in 2055
Population
–
The years taken for every billion people to be added to the world's population, and the years that population was reached. (with future estimates). See also alt. chart
Population
–
The distribution of human
world population in 1994
6.
Public health
–
It is concerned with threats to health based on population health analysis. The population in question can be as small as a handful of people, Public health incorporates the interdisciplinary approaches of epidemiology, biostatistics and health services. Environmental health, community health, behavioral health, health economics, public policy, mental health and occupational safety, the focus of public health intervention is to improve health and quality of life through prevention and treatment of disease and other physical and mental health conditions. This is done through surveillance of cases and health indicators, there is a great disparity in access to health care and public health initiatives between developed nations and developing nations. In the developing world, public health infrastructures are still forming, many diseases are preventable through simple, nonmedical methods. For example, research has shown that the act of hand washing with soap can prevent many contagious diseases. Public health communications programs, vaccination programs and distribution of condoms are examples of public health measures. Measures such as these have contributed greatly to the health of populations, Public health plays an important role in disease prevention efforts in both the developing world and in developed countries, through local health systems and non-governmental organizations. The World Health Organization is the agency that coordinates and acts on global public health issues. Most countries have their own government public health agencies, sometimes known as ministries of health, for example, in the United States, the front line of public health initiatives are state and local health departments. In Canada, the Public Health Agency of Canada is the agency responsible for public health, emergency preparedness and response. The Public health system in India is managed by the Ministry of Health & Family Welfare of the government of India with state-owned health care facilities. Public health programs providing vaccinations have made strides in promoting health, including the eradication of smallpox, antibiotic resistance, also known as drug resistance, was the theme of World Health Day 2011. Although the prioritization of pressing public health issues is important, Laurie Garrett argues that there are following consequences, when foreign aid is funnelled into disease-specific programs, the importance of public health in general is disregarded. This public health problem of stovepiping is thought to create a lack of funds to other existing diseases in a given country. For example, the WHO reports that at least 220 million people suffer from diabetes. Its incidence is increasing rapidly, and it is projected that the number of diabetes deaths will double by the year 2030, the risk of type 2 diabetes is closely linked with the growing problem of obesity. The WHO’s latest estimates highlighted that globally approximately 1.5 billion adults were overweight in 2008, the United States is the leading country with 30. 6% of its population being obese
Public health
–
Newspaper headlines from around the world about
polio vaccine tests (13 April 1955)
Public health
–
Three former directors of the
Global Smallpox Eradication Programme read the news that smallpox had been globally eradicated, 1980
Public health
–
Emergency Response Team in
Burma after
Cyclone Nargis in 2008
Public health
–
The primitive nature of
medieval medicine rendered Europe helpless to the onslaught of the
Black Death in the 14th century. Fragment of a miniature from "The Chronicles of Gilles Li Muisis" (1272-1352). Bibliothèque royale de Belgique, MS 13076-77, f. 24v.
7.
Preventive healthcare
–
Preventive healthcare consists of measures taken for disease prevention, as opposed to disease treatment. Health, disease, and disability are dynamic processes which begin before individuals realize they are affected, Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention. Each year, millions of people die of preventable deaths, a 2004 study showed that about half of all deaths in the United States in 2000 were due to preventable behaviors and exposures. Leading causes included cardiovascular disease, chronic disease, unintentional injuries, diabetes. This same study estimates that 400,000 people die each year in the United States due to poor diet and this is an increase from the year 2000, during which 60% of deaths were attributed to these diseases. Preventive healthcare is especially important given the rise in prevalence of chronic diseases. There are many methods for prevention of disease, genetic testing can also be performed to screen for mutations that cause genetic disorders or predisposition to certain diseases such as breast or ovarian cancer. However, these measures are not affordable for every individual and the cost effectiveness of healthcare is still a topic of debate. Preventive healthcare strategies are described as taking place at the primal, primary, secondary, in the 1940s, Hugh R. Leavell and E. Gurney Clark coined the term primary prevention. They worked at the Harvard and Columbia University Schools of Public Health, respectively, goldston notes that these levels might be better described as prevention, treatment, and rehabilitation, though the terms primary, secondary, and tertiary prevention are still in use today. A separate category of health promotion has recently been propounded and this new way of promoting health is now commonly called primal prevention. It consists mainly in providing future parents with pertinent, unbiased information on primal health and this includes adequate parental leave - ideally for both parents - with kin caregiving and financial help where needed. Another related concept is primordial prevention which to refers to all measures designed to prevent the development of risk factors in the first place, primary prevention consists of traditional health promotion and specific protection. Health promotion activities are current, non-clinical life choices, for example, eating nutritious meals and exercising daily, that both prevent disease and create a sense of overall well-being. Preventing disease and creating overall well-being, prolongs our life expectancy, health-promotional activities do not target a specific disease or condition but rather promote health and well-being on a very general level. On the other hand, specific protection targets a type or group of diseases, whereas specific protective measures would be using prophylactics during sex and avoiding sexual promiscuity. Food is very much the most basic tool in preventive health care, the 2011 National Health Interview Survey performed by the Centers for Disease Control was the first national survey to include questions about ability to pay for food. Difficulty with paying for food, medicine, or both is a problem facing 1 out of 3 Americans and these are often low-income neighborhoods with the majority of residents lacking transportation
Preventive healthcare
–
An image of melanoma, one of the deadliest forms of skin cancer
Preventive healthcare
–
Distribution of lung cancer in the United States
Preventive healthcare
–
The presence of cancer (adenocarcinoma) detected on a pap test
8.
Statistical analysis
–
Statistics is a branch of mathematics dealing with the collection, analysis, interpretation, presentation, and organization of data. In applying statistics to, e. g. a scientific, industrial, or social problem, populations can be diverse topics such as all people living in a country or every atom composing a crystal. Statistics deals with all aspects of data including the planning of data collection in terms of the design of surveys, statistician Sir Arthur Lyon Bowley defines statistics as Numerical statements of facts in any department of inquiry placed in relation to each other. When census data cannot be collected, statisticians collect data by developing specific experiment designs, representative sampling assures that inferences and conclusions can safely extend from the sample to the population as a whole. In contrast, an observational study does not involve experimental manipulation, inferences on mathematical statistics are made under the framework of probability theory, which deals with the analysis of random phenomena. A standard statistical procedure involves the test of the relationship between two data sets, or a data set and a synthetic data drawn from idealized model. A hypothesis is proposed for the relationship between the two data sets, and this is compared as an alternative to an idealized null hypothesis of no relationship between two data sets. Rejecting or disproving the hypothesis is done using statistical tests that quantify the sense in which the null can be proven false. Working from a hypothesis, two basic forms of error are recognized, Type I errors and Type II errors. Multiple problems have come to be associated with this framework, ranging from obtaining a sufficient sample size to specifying an adequate null hypothesis, measurement processes that generate statistical data are also subject to error. Many of these errors are classified as random or systematic, the presence of missing data or censoring may result in biased estimates and specific techniques have been developed to address these problems. Statistics continues to be an area of research, for example on the problem of how to analyze Big data. Statistics is a body of science that pertains to the collection, analysis, interpretation or explanation. Some consider statistics to be a mathematical science rather than a branch of mathematics. While many scientific investigations make use of data, statistics is concerned with the use of data in the context of uncertainty, mathematical techniques used for this include mathematical analysis, linear algebra, stochastic analysis, differential equations, and measure-theoretic probability theory. In applying statistics to a problem, it is practice to start with a population or process to be studied. Populations can be diverse topics such as all living in a country or every atom composing a crystal. Ideally, statisticians compile data about the entire population and this may be organized by governmental statistical institutes
Statistical analysis
–
Scatter plots are used in descriptive statistics to show the observed relationships between different variables.
Statistical analysis
–
More
probability density is found as one gets closer to the expected (mean) value in a
normal distribution. Statistics used in
standardized testing assessment are shown. The scales include
standard deviations, cumulative percentages, percentile equivalents, Z-scores, T-scores, standard nines, and percentages in standard nines.
Statistical analysis
–
Gerolamo Cardano, the earliest pioneer on the mathematics of probability.
Statistical analysis
–
Karl Pearson, a founder of mathematical statistics.
9.
Peer review
–
Peer review is the evaluation of work by one or more people of similar competence to the producers of the work. It constitutes a form of self-regulation by qualified members of a profession within the relevant field, peer review methods are employed to maintain standards of quality, improve performance, and provide credibility. In academia, scholarly peer review is used to determine an academic papers suitability for publication. Peer review can be categorized by the type of activity and by the field or profession in which the activity occurs, professional peer review focuses on the performance of professionals, with a view to improving quality, upholding standards, or providing certification. In academia, peer review is common in decisions related to faculty advancement, a prototype professional peer-review process was recommended in the Ethics of the Physician written by Ishāq ibn ʻAlī al-Ruhāwī. He stated that a physician had to make duplicate notes of a patients condition on every visit. Professional peer review is common in the field of health care, further, since peer review activity is commonly segmented by clinical discipline, there is also physician peer review, nursing peer review, dentistry peer review, etc. Many other professional fields have some level of peer review process, accounting, law, engineering, aviation, and even forest fire management. Peer review is used in education to achieve certain learning objectives and this may take a variety of forms, including closely mimicking the scholarly peer review processes used in science and medicine. The peer review helps the publisher decide whether the work should be accepted, considered acceptable with revisions, peer review requires a community of experts in a given field, who are qualified and able to perform reasonably impartial review. Peer review is generally considered necessary to academic quality and is used in most major scientific journals, the European Union has been using peer review in the Open Method of Co-ordination of policies in the fields of active labour market policy since 1999. In 2004, a program of peer reviews started in social inclusion and these usually meet over two days and include visits to local sites where the policy can be seen in operation. The meeting is preceded by the compilation of a report on which participating peer countries submit comments. The results are published on the web, the State of California is the only U. S. state to mandate scientific peer review. This requirement is incorporated into the California Health and Safety Code Section 57004, thus, the terminology has poor standardization and specificity, particularly as a database search term
Peer review
–
A reviewer at the American
National Institutes of Health evaluates a
grant proposal.
10.
Systematic review
–
A systematic review is a type of literature review that collects and critically analyzes multiple research studies or papers. A review of existing studies is often quicker and cheaper than embarking on a new study, researchers use methods that are selected before one or more research questions are formulated, and then they aim to find and analyze studies that relate to and answer those questions. Systematic reviews of randomized controlled trials are key in the practice of evidence-based medicine, an understanding of systematic reviews, and how to implement them in practice, is highly recommended for professionals involved in the delivery of health care. Besides health interventions, systematic reviews may examine clinical tests, public health interventions, environmental interventions, social interventions, adverse effects, a systematic review aims to provide a complete, exhaustive summary of current literature relevant to a research question. The first step in conducting a review is to perform a thorough search of the literature for relevant papers. The titles and abstracts of identified articles are checked against pre-determined criteria for eligibility and this set will relate back to the research problem. Systematic reviews often, but not always, use techniques to combine results of eligible studies. An additional rater may be consulted to resolve any scoring differences between raters, Systematic review is often applied in the biomedical or healthcare context, but it can be applied in any field of research. Groups like the Campbell Collaboration are promoting the use of systematic reviews in policy-making beyond just healthcare, a systematic review uses an objective and transparent approach for research synthesis, with the aim of minimizing bias. The EPPI-Centre has been influential in developing methods for combining both qualitative and quantitative research in systematic reviews, recent developments in systematic reviews include realist reviews, and the meta-narrative approach. These approaches try to overcome the problems of methodological and epistemological heterogeneity in the diverse literatures existing on some subjects, the main stages of a systematic review are, Defining a question and agreeing an objective method. A search for relevant data from research that matches certain criteria, for example, only selecting research that is good quality and answers the defined question. This can include how the research was done, who participated in the research, how it was paid for, assess the quality of the data by judging it against criteria identified at the first stage. Analyse and combine the data which give a result from all of the data. This combination of data can be visualised using a blobbogram, the diamond in the blobbogram represents the combined results of all the data included. Once these stages are complete, the review may be published, disseminated and translated into practice after being adopted as evidence, when appropriate, they also include the results of other types of research. Cochrane Reviews are published in The Cochrane Database of Systematic Reviews section of the Cochrane Library, the 2015 impact factor for The Cochrane Database of Systematic Reviews was 6.103, and it was ranked 12th in the “Medicine, General & Internal” category. There are six types of Cochrane Review, Intervention reviews assess the benefits and harms of interventions used in healthcare, diagnostic test accuracy reviews assess how well a diagnostic test performs in diagnosing and detecting a particular disease
Systematic review
–
This diagram illustrates in a visual way and in plain language what review authors actually do in the process of undertaking a systematic review.
11.
Screening (medicine)
–
Screening, in medicine, is a strategy used in a population to identify the possible presence of an as-yet-undiagnosed disease in individuals without signs or symptoms. This can include individuals with pre-symptomatic or unrecognized symptomatic disease, as such, screening tests are somewhat unusual in that they are performed on persons apparently in good health. Screening interventions are designed to identify disease in a community early, thus enabling earlier intervention and management in the hope to reduce mortality and suffering from a disease. For these reasons, a test used in a program, especially for a disease with low incidence. Several types of screening exist, universal screening involves screening of all individuals in a certain category, case finding involves screening a smaller group of people based on the presence of risk factors. Screening interventions are not designed to be diagnostic, and often have significant rates of false positive and false negative results. In 1968 the World Health Organization published guidelines on the Principles and practice of screening for disease, the principles are still broadly applicable today, The condition should be an important health problem. There should be a treatment for the condition, facilities for diagnosis and treatment should be available. There should be a latent stage of the disease, There should be a test or examination for the condition. The test should be acceptable to the population, the natural history of the disease should be adequately understood. There should be a policy on whom to treat. The total cost of finding a case should be balanced in relation to medical expenditure as a whole. Case-finding should be a process, not just a once. • The objectives of screening should be defined at the outset, • There should be a defined target population. • There should be evidence of screening programme effectiveness. • The programme should integrate education, testing, clinical services, • There should be quality assurance, with mechanisms to minimize potential risks of screening. • The programme should ensure informed choice, confidentiality and respect for autonomy, • The programme should promote equity and access to screening for the entire target population. • Programme evaluation should be planned from the outset, • The overall benefits of screening should outweigh the harm
Screening (medicine)
–
A coal miner completes a screening survey for
coalworker's pneumoconiosis.
Screening (medicine)
–
A mobile clinic used to screen coal miners at risk of
black lung disease
12.
Clinical trials
–
Clinical trials are experiments or observations done in clinical research. Clinical trials generate data on safety and efficacy and they are conducted only after they have received health authority/ethics committee approval in the country where approval of the therapy is sought. These authorities are responsible for vetting the risk/benefit ratio of the trial – their approval does not mean that the therapy is safe or effective, only that the trial may be conducted. Clinical trials can vary in size and cost, and they can involve a research center or multiple centers. Clinical study design aims to ensure the validity and reproducibility of the results. Trials can be costly, depending on a number of factors. The sponsor may be an organization or a pharmaceutical, biotechnology or medical device company. Certain functions necessary to the trial, such as monitoring and lab work, may be managed by an outsourced partner, only 10 percent of all drugs started in human clinical trials become an approved drug. Some clinical trials involve healthy subjects with no pre-existing medical conditions, other clinical trials pertain to patients with specific health conditions who are willing to try an experimental treatment. When participants are healthy volunteers who receive financial incentives, the goals are different than when the participants are sick, during dosing periods, study subjects typically remain under supervision for one to 40 nights. Usually pilot experiments are conducted to gain insights for design of the trial to follow. There are two goals to testing medical treatments, to whether they work well enough, called efficacy or effectiveness. The benefits must outweigh the risks, in the US, the elderly constitute only 14 percent of the population, while they consume over one-third of drugs. Women, children and people with unrelated medical conditions are frequently excluded. For women, a reason for exclusion is the possibility of pregnancy. If the sponsor cannot obtain enough test subjects at one location investigators at other locations are recruited to join the study, during the trial, investigators recruit subjects with the predetermined characteristics, administer the treatment and collect data on the subjects health for a defined time period. The researchers send the data to the sponsor, who then analyzes the pooled data using statistical tests. Except for small, single-location trials, the design and objectives are specified in a document called a clinical trial protocol
Clinical trials
–
Edward Jenner vaccinating
James Phipps, a boy of eight, on 14 May 1796. Jenner failed to use a
control group.
Clinical trials
–
Austin Bradford Hill was a pivotal figure in the modern development of clinical trials.
Clinical trials
–
Example of informed consent document from the
PARAMOUNT trial
Clinical trials
–
Timeline of various approval tracks and research phases in the US
13.
Biology
–
Biology is a natural science concerned with the study of life and living organisms, including their structure, function, growth, evolution, distribution, identification and taxonomy. Modern biology is a vast and eclectic field, composed of branches and subdisciplines. However, despite the broad scope of biology, there are certain unifying concepts within it that consolidate it into single, coherent field. In general, biology recognizes the cell as the unit of life, genes as the basic unit of heredity. It is also understood today that all organisms survive by consuming and transforming energy and by regulating their internal environment to maintain a stable, the term biology is derived from the Greek word βίος, bios, life and the suffix -λογία, -logia, study of. The Latin-language form of the term first appeared in 1736 when Swedish scientist Carl Linnaeus used biologi in his Bibliotheca botanica, the first German use, Biologie, was in a 1771 translation of Linnaeus work. In 1797, Theodor Georg August Roose used the term in the preface of a book, karl Friedrich Burdach used the term in 1800 in a more restricted sense of the study of human beings from a morphological, physiological and psychological perspective. The science that concerns itself with these objects we will indicate by the biology or the doctrine of life. Although modern biology is a recent development, sciences related to. Natural philosophy was studied as early as the ancient civilizations of Mesopotamia, Egypt, the Indian subcontinent, however, the origins of modern biology and its approach to the study of nature are most often traced back to ancient Greece. While the formal study of medicine back to Hippocrates, it was Aristotle who contributed most extensively to the development of biology. Especially important are his History of Animals and other works where he showed naturalist leanings, and later more empirical works that focused on biological causation and the diversity of life. Aristotles successor at the Lyceum, Theophrastus, wrote a series of books on botany that survived as the most important contribution of antiquity to the plant sciences, even into the Middle Ages. Scholars of the medieval Islamic world who wrote on biology included al-Jahiz, Al-Dīnawarī, who wrote on botany, biology began to quickly develop and grow with Anton van Leeuwenhoeks dramatic improvement of the microscope. It was then that scholars discovered spermatozoa, bacteria, infusoria, investigations by Jan Swammerdam led to new interest in entomology and helped to develop the basic techniques of microscopic dissection and staining. Advances in microscopy also had a impact on biological thinking. In the early 19th century, a number of biologists pointed to the importance of the cell. Thanks to the work of Robert Remak and Rudolf Virchow, however, meanwhile, taxonomy and classification became the focus of natural historians
Biology
Biology
Biology
Biology
14.
Statistics
–
Statistics is a branch of mathematics dealing with the collection, analysis, interpretation, presentation, and organization of data. In applying statistics to, e. g. a scientific, industrial, or social problem, populations can be diverse topics such as all people living in a country or every atom composing a crystal. Statistics deals with all aspects of data including the planning of data collection in terms of the design of surveys, statistician Sir Arthur Lyon Bowley defines statistics as Numerical statements of facts in any department of inquiry placed in relation to each other. When census data cannot be collected, statisticians collect data by developing specific experiment designs, representative sampling assures that inferences and conclusions can safely extend from the sample to the population as a whole. In contrast, an observational study does not involve experimental manipulation, inferences on mathematical statistics are made under the framework of probability theory, which deals with the analysis of random phenomena. A standard statistical procedure involves the test of the relationship between two data sets, or a data set and a synthetic data drawn from idealized model. A hypothesis is proposed for the relationship between the two data sets, and this is compared as an alternative to an idealized null hypothesis of no relationship between two data sets. Rejecting or disproving the hypothesis is done using statistical tests that quantify the sense in which the null can be proven false. Working from a hypothesis, two basic forms of error are recognized, Type I errors and Type II errors. Multiple problems have come to be associated with this framework, ranging from obtaining a sufficient sample size to specifying an adequate null hypothesis, measurement processes that generate statistical data are also subject to error. Many of these errors are classified as random or systematic, the presence of missing data or censoring may result in biased estimates and specific techniques have been developed to address these problems. Statistics continues to be an area of research, for example on the problem of how to analyze Big data. Statistics is a body of science that pertains to the collection, analysis, interpretation or explanation. Some consider statistics to be a mathematical science rather than a branch of mathematics. While many scientific investigations make use of data, statistics is concerned with the use of data in the context of uncertainty, mathematical techniques used for this include mathematical analysis, linear algebra, stochastic analysis, differential equations, and measure-theoretic probability theory. In applying statistics to a problem, it is practice to start with a population or process to be studied. Populations can be diverse topics such as all living in a country or every atom composing a crystal. Ideally, statisticians compile data about the entire population and this may be organized by governmental statistical institutes
Statistics
–
Scatter plots are used in descriptive statistics to show the observed relationships between different variables.
Statistics
–
More
probability density is found as one gets closer to the expected (mean) value in a
normal distribution. Statistics used in
standardized testing assessment are shown. The scales include
standard deviations, cumulative percentages, percentile equivalents, Z-scores, T-scores, standard nines, and percentages in standard nines.
Statistics
–
Gerolamo Cardano, the earliest pioneer on the mathematics of probability.
Statistics
–
Karl Pearson, a founder of mathematical statistics.
15.
Social science
–
Social science is a major category of academic disciplines, concerned with society and the relationships among individuals within a society. It in turn has many branches, each of which is considered a social science, the social sciences include economics, political science, human geography, demography, psychology, sociology, anthropology, archaeology, jurisprudence, history, and linguistics. The term is sometimes used to refer specifically to the field of sociology. A more detailed list of sub-disciplines within the sciences can be found at Outline of social science. Positivist social scientists use methods resembling those of the sciences as tools for understanding society. In modern academic practice, researchers are often eclectic, using multiple methodologies, the term social research has also acquired a degree of autonomy as practitioners from various disciplines share in its aims and methods. Social sciences came forth from the philosophy of the time and were influenced by the Age of Revolutions, such as the Industrial Revolution. The social sciences developed from the sciences, or the systematic knowledge-bases or prescriptive practices, the beginnings of the social sciences in the 18th century are reflected in the grand encyclopedia of Diderot, with articles from Jean-Jacques Rousseau and other pioneers. The growth of the sciences is also reflected in other specialized encyclopedias. The modern period saw social science first used as a distinct conceptual field, Social science was influenced by positivism, focusing on knowledge based on actual positive sense experience and avoiding the negative, metaphysical speculation was avoided. Auguste Comte used the term science sociale to describe the field, taken from the ideas of Charles Fourier, following this period, there were five paths of development that sprang forth in the social sciences, influenced by Comte on other fields. One route that was taken was the rise of social research, large statistical surveys were undertaken in various parts of the United States and Europe. Another route undertaken was initiated by Émile Durkheim, studying social facts, a third means developed, arising from the methodological dichotomy present, in which social phenomena were identified with and understood, this was championed by figures such as Max Weber. The fourth route taken, based in economics, was developed and furthered economic knowledge as a hard science, the last path was the correlation of knowledge and social values, the antipositivism and verstehen sociology of Max Weber firmly demanded this distinction. In this route, theory and prescription were non-overlapping formal discussions of a subject, around the start of the 20th century, Enlightenment philosophy was challenged in various quarters. The development of social science subfields became very quantitative in methodology, examples of boundary blurring include emerging disciplines like social research of medicine, sociobiology, neuropsychology, bioeconomics and the history and sociology of science. Increasingly, quantitative research and qualitative methods are being integrated in the study of action and its implications. In the first half of the 20th century, statistics became a discipline of applied mathematics
Social science
–
Buyers bargain for good prices while sellers put forth their best front in
Chichicastenango Market,
Guatemala.
Social science
–
A depiction of world's oldest university, the
University of Bologna, in Italy
Social science
–
This article is about the science studying social groups. For the integrated field of study intended to promote civic competence, see
Social studies.
Social science
–
A trial at a criminal court, the
Old Bailey in
London
16.
Engineering
–
The term Engineering is derived from the Latin ingenium, meaning cleverness and ingeniare, meaning to contrive, devise. Engineering has existed since ancient times as humans devised fundamental inventions such as the wedge, lever, wheel, each of these inventions is essentially consistent with the modern definition of engineering. The term engineering is derived from the engineer, which itself dates back to 1390 when an engineer originally referred to a constructor of military engines. In this context, now obsolete, a referred to a military machine. Notable examples of the obsolete usage which have survived to the present day are military engineering corps, the word engine itself is of even older origin, ultimately deriving from the Latin ingenium, meaning innate quality, especially mental power, hence a clever invention. The earliest civil engineer known by name is Imhotep, as one of the officials of the Pharaoh, Djosèr, he probably designed and supervised the construction of the Pyramid of Djoser at Saqqara in Egypt around 2630–2611 BC. Ancient Greece developed machines in both civilian and military domains, the Antikythera mechanism, the first known mechanical computer, and the mechanical inventions of Archimedes are examples of early mechanical engineering. In the Middle Ages, the trebuchet was developed, the first steam engine was built in 1698 by Thomas Savery. The development of this gave rise to the Industrial Revolution in the coming decades. With the rise of engineering as a profession in the 18th century, similarly, in addition to military and civil engineering, the fields then known as the mechanic arts became incorporated into engineering. The inventions of Thomas Newcomen and the Scottish engineer James Watt gave rise to mechanical engineering. The development of specialized machines and machine tools during the revolution led to the rapid growth of mechanical engineering both in its birthplace Britain and abroad. John Smeaton was the first self-proclaimed civil engineer and is regarded as the father of civil engineering. He was an English civil engineer responsible for the design of bridges, canals, harbours and he was also a capable mechanical engineer and an eminent physicist. Smeaton designed the third Eddystone Lighthouse where he pioneered the use of hydraulic lime and his lighthouse remained in use until 1877 and was dismantled and partially rebuilt at Plymouth Hoe where it is known as Smeatons Tower. The United States census of 1850 listed the occupation of engineer for the first time with a count of 2,000, there were fewer than 50 engineering graduates in the U. S. before 1865. In 1870 there were a dozen U. S. mechanical engineering graduates, in 1890 there were 6,000 engineers in civil, mining, mechanical and electrical. There was no chair of applied mechanism and applied mechanics established at Cambridge until 1875, the theoretical work of James Maxwell and Heinrich Hertz in the late 19th century gave rise to the field of electronics
Engineering
–
The
steam engine, a major driver in the
Industrial Revolution, underscores the importance of engineering in modern history. This
beam engine is on display in the
Technical University of Madrid.
Engineering
–
Relief map of the
Citadel of Lille, designed in 1668 by
Vauban, the foremost military engineer of his age.
Engineering
–
The Ancient Romans built
aqueducts to bring a steady supply of clean fresh water to cities and towns in the empire.
Engineering
–
The
International Space Station represents a modern engineering challenge from many disciplines.
17.
Exposure assessment
–
These are the final steps in the path to release an environmental contaminant, through transport to its effect in a biological system. Exposure assessment is the process of estimating or measuring the magnitude, frequency and duration of exposure to an agent, along with the number, ideally, it describes the sources, pathways, routes, and the uncertainties in the assessment. Exposure analysis is the science that describes how an individual or population comes in contact with a contaminant, including quantification of the amount of contact across space, Exposure assessment and exposure analysis are often used as synonyms in many practical contexts. Risk is a function of exposure and hazard, for example, even for an extremely toxic substance, the risk of an adverse outcome is unlikely if exposures are near zero. Conversely, a toxic substance may present substantial risk if an individual or a population is highly exposed. The receptor-based approach is used in exposure science and it starts by looking at different contaminants and concentration that reach people. After the identification of the source, it is important to find out the most efficient way to adverse health effects. If the contaminant reaches a person, it is hard to reduce the associated adverse effects. Therefore, it is important to reduce exposure in order to diminish the risk of adverse health effects. It is highly important to use both regulatory and non-regulatory approaches in order to decrease exposure to contaminants. In many cases, it is better to change people’s activities in order to reduce their exposures rather than regulating a source of contaminants, the receptor-based approach can be opposed to the source-based approach. This approach begins by looking at different sources of such as industries. Then, it is important to find out if the contaminant of interest has reached a receptor, with this approach, it is very hard to prove that a pollutant from a source has reached a target. In this context exposure is defined as the contact between an agent and a target, contact takes place at an exposure surface over an exposure period. Mathematically, exposure is defined as E = ∫ t 1 t 2 C d t where E is exposure and it has dimensions of mass times time divided by volume. This quantity is related to the dose of contaminant by multiplying it by the relevant contact rate, such as breathing rate. The contact rate itself may be a function of time, contact between a contaminant and an organism can occur through any route. Exposure to a contaminant can and does occur through multiple routes, in many cases the main route of exposure is not obvious and needs to be investigated carefully
Exposure assessment
–
Simple representation of exposure risk assessment and management hierarchy based on available information
18.
Greek language
–
Greek is an independent branch of the Indo-European family of languages, native to Greece and other parts of the Eastern Mediterranean. It has the longest documented history of any living language, spanning 34 centuries of written records and its writing system has been the Greek alphabet for the major part of its history, other systems, such as Linear B and the Cypriot syllabary, were used previously. The alphabet arose from the Phoenician script and was in turn the basis of the Latin, Cyrillic, Armenian, Coptic, Gothic and many other writing systems. Together with the Latin texts and traditions of the Roman world, during antiquity, Greek was a widely spoken lingua franca in the Mediterranean world and many places beyond. It would eventually become the official parlance of the Byzantine Empire, the language is spoken by at least 13.2 million people today in Greece, Cyprus, Italy, Albania, Turkey, and the Greek diaspora. Greek roots are used to coin new words for other languages, Greek. Greek has been spoken in the Balkan peninsula since around the 3rd millennium BC, the earliest written evidence is a Linear B clay tablet found in Messenia that dates to between 1450 and 1350 BC, making Greek the worlds oldest recorded living language. Among the Indo-European languages, its date of earliest written attestation is matched only by the now extinct Anatolian languages, the Greek language is conventionally divided into the following periods, Proto-Greek, the unrecorded but assumed last ancestor of all known varieties of Greek. The unity of Proto-Greek would have ended as Hellenic migrants entered the Greek peninsula sometime in the Neolithic era or the Bronze Age, Mycenaean Greek, the language of the Mycenaean civilisation. It is recorded in the Linear B script on tablets dating from the 15th century BC onwards, Ancient Greek, in its various dialects, the language of the Archaic and Classical periods of the ancient Greek civilisation. It was widely known throughout the Roman Empire, after the Roman conquest of Greece, an unofficial bilingualism of Greek and Latin was established in the city of Rome and Koine Greek became a first or second language in the Roman Empire. The origin of Christianity can also be traced through Koine Greek, Medieval Greek, also known as Byzantine Greek, the continuation of Koine Greek in Byzantine Greece, up to the demise of the Byzantine Empire in the 15th century. Much of the written Greek that was used as the language of the Byzantine Empire was an eclectic middle-ground variety based on the tradition of written Koine. Modern Greek, Stemming from Medieval Greek, Modern Greek usages can be traced in the Byzantine period and it is the language used by the modern Greeks, and, apart from Standard Modern Greek, there are several dialects of it. In the modern era, the Greek language entered a state of diglossia, the historical unity and continuing identity between the various stages of the Greek language is often emphasised. Greek speakers today still tend to regard literary works of ancient Greek as part of their own rather than a foreign language and it is also often stated that the historical changes have been relatively slight compared with some other languages. According to one estimation, Homeric Greek is probably closer to demotic than 12-century Middle English is to modern spoken English, Greek is spoken by about 13 million people, mainly in Greece, Albania and Cyprus, but also worldwide by the large Greek diaspora. Greek is the language of Greece, where it is spoken by almost the entire population
Greek language
–
Idealized portrayal of
Homer
Greek language
–
regions where Greek is the official language
Greek language
–
Greek language road sign, A27 Motorway, Greece
19.
Logos
–
LOGOS cards is a collectible card game developed for Second Life. The game was first conceptualized by Florian Kraner in 2008, development began in earnest early 2009 with the addition of Darien Caldwell to the creative team. The full game was released on July 1,2010, LOGOS is played by two players. Both of them start with 100.000 Hit Points. They do so by battling with cards that follow a Rock-paper-scissors principle, LOGOS cards is played in Second Life using a HUD. It consists of two SL items that have to be worn and will add a display of the hand dealt to you as well as other elements to the screen. The game can be played anywhere in Second Life on the go and this allows players to play the game in a fully emersive 3D environment, where they have full control over how their avatars and surroundings are represented. The community that has formed is constantly adding and maintaining new play areas where players organize tournaments and events, cardmotives are mostly generated from Second Life sceneries and sorted into 5 categories of cards, Energy, Matter, Information, Life and Neutral. When building decks the player needs to keep combo requirements and effects for their cards in mind, LOGOS makes use of Googles App Engine, which allows the Second Life game to be enhanced by a website interface that allows players to edit card decks and more for no cost
Logos
20.
Plant disease epidemiology
–
Plant disease epidemiology is the study of disease in plant populations. Much like diseases of humans and other animals, plant diseases occur due to such as bacteria, viruses, fungi, oomycetes, nematodes, phytoplasmas, protozoa. Plant disease epidemiologists strive for an understanding of the cause and effects of disease, typically successful intervention will lead to a low enough level of disease to be acceptable, depending upon the value of the crop. Plant disease epidemiology is often looked at from an approach, requiring biological, statistical, agronomic. Biology is necessary for understanding the pathogen and its life cycle and it is also necessary for understanding the physiology of the crop and how the pathogen is adversely affecting it. Agronomic practices often influence disease incidence for better or for worse, native species of plants may serve as reservoirs for pathogens that cause disease in crops. Statistical models are applied in order to summarize and describe the complexity of plant disease epidemiology. Policy can be influential in the occurrence of diseases, through such as restrictions on imports from sources where a disease occurs. In 1963 J. E. van der Plank published Plant Diseases, Epidemics and Control, using this framework we can now model and determine thresholds for epidemics that take place in a homogeneous environment such as a mono-cultural crop field. An epidemic of potato blight, caused by Phytophthora infestans, led to the Great Irish Famine. Commonly the elements of an epidemic are referred to as the “disease triangle”, a susceptible host, pathogen, for disease to occur all three of these must be present. Below is an illustration of this point, where all three items meet there is disease. The fourth element missing from this illustration for an epidemic to occur, is time, as long as all three of these elements are present disease can initiate, an epidemic will only ensue if all three continue to be present. Any one of the three might be removed from the equation though, the age of the plant species can also play a role, as certain species change in their levels of disease resistance as they mature, a process known as ontogenic resistance. If all of the criteria are not met, such as a susceptible host and pathogen are present, likewise, it stands to reason if the host is susceptible and the environment favours the development of disease but the pathogen is not present there is no disease. When a pathogen requires a vector to be spread then for an epidemic to occur the vector must be plentiful, monocyclic epidemics are caused by pathogens with a low birth rate and death rate, meaning they only have one infection cycle per season. They are typical of soil-borne diseases such as Fusarium wilt of flax, polycyclic epidemics are caused by pathogens capable of several infection cycles a season. They are most often caused by diseases such as powdery mildew
Plant disease epidemiology
–
Plant disease triangle illustration
21.
Hippocrates
–
Hippocrates of Kos, also known as Hippocrates II, was a Greek physician of the Age of Pericles, and is considered one of the most outstanding figures in the history of medicine. He is referred to as the Father of Modern Medicine in recognition of his contributions to the field as the founder of the Hippocratic School of Medicine. Hippocrates is commonly portrayed as the paragon of the ancient physician, historians agree that Hippocrates was born around the year 460 BC on the Greek island of Kos, other biographical information, however, is likely to be untrue. Soranus of Ephesus, a 2nd-century Greek gynecologist, was Hippocrates first biographer and is the source of most personal information about him, later biographies are in the Suda of the 10th century AD, and in the works of John Tzetzes, which date from the 12th century AD. Hippocrates is mentioned in passing in the writings of two contemporaries, Plato, in Protagoras and Phaedrus, and, Aristotles Politics, which date from the 4th century BC. Soranus wrote that Hippocrates father was Heraclides, a physician, and his mother was Praxitela, the two sons of Hippocrates, Thessalus and Draco, and his son-in-law, Polybus, were his students. According to Galen, a physician, Polybus was Hippocrates true successor, while Thessalus. Soranus said that Hippocrates learned medicine from his father and grandfather, Hippocrates was probably trained at the asklepieion of Kos, and took lessons from the Thracian physician Herodicus of Selymbria. Hippocrates taught and practiced medicine throughout his life, traveling at least as far as Thessaly, Thrace, several different accounts of his death exist. He died, probably in Larissa, at the age of 83,85 or 90, Hippocrates is credited with being the first person to believe that diseases were caused naturally, not because of superstition and gods. Hippocrates was credited by the disciples of Pythagoras of allying philosophy, indeed there is not a single mention of a mystical illness in the entirety of the Hippocratic Corpus. However, Hippocrates did work with many convictions that were based on what is now known to be incorrect anatomy and physiology, ancient Greek schools of medicine were split on how to deal with disease. The Knidian school of medicine focused on diagnosis, Medicine at the time of Hippocrates knew almost nothing of human anatomy and physiology because of the Greek taboo forbidding the dissection of humans. The Knidian school consequently failed to distinguish when one disease caused many possible series of symptoms, the Hippocratic school or Koan school achieved greater success by applying general diagnoses and passive treatments. Its focus was on patient care and prognosis, not diagnosis and it could effectively treat diseases and allowed for a great development in clinical practice. Hippocratic medicine and its philosophy are far removed from that of modern medicine, now, the physician focuses on specific diagnosis and specialized treatment, both of which were espoused by the Knidian school. S. Houdart called the Hippocratic treatment a meditation upon death, after a crisis, a relapse might follow, and then another deciding crisis. According to this doctrine, crises tend to occur on critical days, if a crisis occurred on a day far from a critical day, a relapse might be expected
Hippocrates
–
Engraving by
Peter Paul Rubens, 1638
Hippocrates
–
Asklepieion on
Kos
Hippocrates
–
A number of ancient Greek surgical tools. On the left is a
trephine; on the right, a set of
scalpels. Hippocratic medicine made good use of these tools.
Hippocrates
–
Clubbing of fingers in a patient with
Eisenmenger's syndrome; first described by Hippocrates, clubbing is also known as "Hippocratic fingers".
22.
Medicine
–
Medicine is the science and practice of the diagnosis, treatment, and prevention of disease. The word medicine is derived from Latin medicus, meaning a physician, Medicine encompasses a variety of health care practices evolved to maintain and restore health by the prevention and treatment of illness. Medicine has existed for thousands of years, during most of which it was an art frequently having connections to the religious and philosophical beliefs of local culture. For example, a man would apply herbs and say prayers for healing, or an ancient philosopher. In recent centuries, since the advent of modern science, most medicine has become a combination of art, while stitching technique for sutures is an art learned through practice, the knowledge of what happens at the cellular and molecular level in the tissues being stitched arises through science. Prescientific forms of medicine are now known as medicine and folk medicine. They remain commonly used with or instead of medicine and are thus called alternative medicine. For example, evidence on the effectiveness of acupuncture is variable and inconsistent for any condition, in contrast, treatments outside the bounds of safety and efficacy are termed quackery. Medical availability and clinical practice varies across the world due to differences in culture. In modern clinical practice, physicians personally assess patients in order to diagnose, treat, the doctor-patient relationship typically begins an interaction with an examination of the patients medical history and medical record, followed by a medical interview and a physical examination. Basic diagnostic medical devices are typically used, after examination for signs and interviewing for symptoms, the doctor may order medical tests, take a biopsy, or prescribe pharmaceutical drugs or other therapies. Differential diagnosis methods help to rule out conditions based on the information provided, during the encounter, properly informing the patient of all relevant facts is an important part of the relationship and the development of trust. The medical encounter is then documented in the record, which is a legal document in many jurisdictions. Follow-ups may be shorter but follow the general procedure. The diagnosis and treatment may take only a few minutes or a few weeks depending upon the complexity of the issue, the components of the medical interview and encounter are, Chief complaint, the reason for the current medical visit. They are in the patients own words and are recorded along with the duration of each one, also called chief concern or presenting complaint. History of present illness, the order of events of symptoms. Distinguishable from history of illness, often called past medical history
Medicine
–
Early Medicine Bottles
Medicine
Medicine
–
The Doctor, by
Sir Luke Fildes (1891)
Medicine
–
The Hospital of
Santa Maria della Scala, fresco by
Domenico di Bartolo, 1441–1442
23.
Humorism
–
It is also present in the Indian Ayurveda system of medicine. The four humors of Hippocratic medicine are black bile, yellow bile, phlegm, and blood, a humor is also referred to as a cambium. The humoralist system of medicine was highly individualistic, for individual patient was said to have their own unique humoral composition. Moreover, it resembled a holistic approach to medicine as the link between mental and physical processes were emphasized by this framework, Ayurveda, which is known to have been practiced in the 6th century C. E, names three elemental substances, the doshas. Ayurveda is still practiced in India. The concept has not been used in medicine since then, the theory holds that the human body is filled with four basic substances, called humors, which are in balance when a person is healthy. Diseases and disabilities supposedly resulted from an excess or deficit of one of four humors. Disease could also be the result of the corruption of one or more of the humors and these deficits were thought to be caused by vapors inhaled or absorbed by the body. The four humors are black bile, yellow bile, phlegm and these terms only partly correspond to the modern medical terminology, in which there is no distinction between black and yellow bile, and in which phlegm has a very different meaning. It was believed that these were the basic substances from which all liquids in the body were made, when a patient was suffering from a surplus or imbalance of one of these four fluids, then said patients personality and or physical health could be negatively affected. Paired qualities were associated with humor and its season. The word humor is a translation of Greek χυμός, chymos, at around the same time, ancient Indian Ayurveda medicine had developed a theory of three humors, which they linked with the five Hindu elements. The following table shows the four humors with their elements, seasons, sites of formation. Excess of yellow bile was thought to produce aggression, and excess anger reciprocally gave rise to liver derangement, the word melancholy derives from Greek μέλαινα χολή meaning black bile, from the belief that an excess of black bile caused depression. Phlegm was thought to be associated with behavior, as preserved in the word phlegmatic /flɛgˈmatɪk/. The phlegm of humorism is far from the thing as phlegm as it is defined today. What can we say of this classification of humours into four groups. Although advances in cellular pathology and chemistry discredited humoralism by the nineteenth century, only in some instances did the theory of humoralism wane into obscurity
Humorism
–
The four temperaments as depicted in an 18th century woodcut: phlegmatic, choleric, sanguine and melancholic.
24.
History of emerging infectious diseases
–
The association of pathogens with disease can be a complex and controversial process, in some cases requiring decades or even centuries to achieve. Factors which have identified as impeding the identification of pathogens include the following,1. Lack of animal models, Experimental infection in animals has been used as a criterion to demonstrate a disease-causing ability, in cases where animal models were not available, scientists have sometimes infected themselves or others to determine an organisms disease causing ability. Pre-existing theories of disease, Before a pathogen is well-recognized, scientists may attribute the symptoms of infection to other causes, such as toxicological, psychological, once a pathogen has been associated with an illness, researchers have reported difficulty displacing these pre-existing theories. Variable pathogenicity, Infection with pathogens can produce varying responses in hosts, in some infectious diseases, the severity of symptoms has been shown to be dependent on specific genetic traits of the host. Lack of research effort, Slow progress has been attributed to the numbers of researchers working on a pathogen. Vibrio cholera bacteria are transmitted through contaminated water, once ingested, the bacteria colonizes the intestinal tract of the host and produces a toxin which causes body fluids to flow across the lining of the intestine. Death can result in 2–3 hours from dehydration if no treatment is provided and this theory was consistent with humorism, and led to such medical practices as bloodletting. The bacterium was first reported in 1849 by Gabriel Pouchet, who discovered it in stools from patients with cholera and he published further papers in 1866,1871,1876 and 1880, which were ignored by the scientific community. He correctly described how the bacteria caused diarrhea, and developed treatments that were found to be effective, whilst John Snows edpidemiology maps were well recognised, and led to the removal of the Broad Street pump handle, e. g.1854 Broad Street cholera outbreak. In 1884, Robert Koch re-discovered Vibrio cholerae as an element in cholera. Some scientists opposed the new theory, and even drank cholera cultures to disprove it and his conclusions were based upon the constant finding of the peculiar comma bacillus in the stools of cholera patients, and the failure to demonstrate this organism in the feces of other persons. It was not possible to reproduce typical cholera in laboratory animals and we now know that these were saprotrophic species of Vibrio, which may be differentiated from the cholera vibrio by cultural and immunological methods. But the correctness of Kochs opinion was dramatically demonstrated by von Pettenkofer and Emmerich who, doubting the relationship of Kochs organisms. Von Pettenkofer developed merely a transient diarrhea, but Emmerich suffered from a typical, von Pettenkofer considered his experience proof that Vibrio cholerae was harmless, as he did not develop cholera from consuming the culture. Between 1849 when Pouchet discovered Vibrio cholerae and 1891, over a million died in cholera epidemics in Europe. In 1995, researchers published a study in Science explaining why some persons are able to be infected with cholera without symptoms, the study showed that a series of genetic mutations in some people provide resistance to cholera toxin, but these mutations come at a price. If too many of them occur in a person, they will develop cystic fibrosis, Giardiasis is a disease caused by infection with the protozoan Giardia lamblia
History of emerging infectious diseases
–
Percentage of stool samples from US states found to contain various protozoa in 2000
History of emerging infectious diseases
–
Number of stool samples from Canadian Lab found to contain various protozoa in 2005
25.
Verona
–
Verona is a city on the Adige river in Veneto, Italy, with approximately 265,000 inhabitants and one of the seven provincial capitals of the region. It is the second largest city municipality in the region and the third largest in northeast Italy, the metropolitan area of Verona covers an area of 1,426 km2 and has a population of 714,274 inhabitants. Three of Shakespeares plays are set in Verona, Romeo and Juliet, The Two Gentlemen of Verona and it is unknown if Shakespeare ever visited Verona or Italy at all, but his plays have lured many visitors to Verona and surrounding cities many times over. The city has been awarded World Heritage Site status by UNESCO because of its structure and architecture. According to a theory that considers the geographical position of the city, Verona is short for Versus Romae which means In the direction of Rome because as italian people say All roads lead to Rome. The exclamation Vae Romae if understood in Latin means Alas Rome, in fact, to express distress or denounce a disgrace ancient Romans used the Latin interjection vae. So, you explain the famous poem by William Shakespeare There is no world without Verona walls, But purgatory, torture. Hence-banished is banishd from the world, And worlds exile is death, the writer would express a Roman concept through its character named Romeo, a name that invokes Rome, according to which the city of Verona was a boundary between the Roman world and barbaric one. Verona was a place of passage and to horses, for those who wanted to go and had walked the Via Claudia Augusta. So the expression Vae Romae Alas Rome would indicate spirit of the place, another theory is that it is connected to the river. Vera was a name of the river Adige before the adoption of the current name, as in many similar instances in Europe the name of the town is formed with the addition of suffix -ona which means settlement over. The city was sometimes known as Welsch-Bern in German. The precise details of Veronas early history remain a mystery, one theory is it was a city of the Euganei, who were obliged to give it up to the Cenomani. With the conquest of the Valley of the Po the Veronese territory became Roman, Verona became a Roman colonia in 89 BC, and then a municipium in 49 BC when its citizens were ascribed to the Roman tribe Poblilia or Publicia. The city became important because it was at the intersection of several roads, stilicho defeated Alaric and his Visigoths here in 403. But, after Verona was conquered by the Ostrogoths in 489, theoderic the Great was said to have built a palace there. It remained under the power of the Goths throughout the Gothic War, except for a day in 541. The defections that took place among the Byzantine generals with regard to the booty made it possible for the Goths to regain possession of the city, in 552 Valerian vainly endeavored to enter the city, but it was only when they were fully overthrown that the Goths surrendered it
Verona
–
A collage of the city of Verona, Clockwise from top left to right: View of Piazza Bra from Verona Arena, House of Juliet, Verona Arena, Ponte Pietra at sunset, Statue of Madonna Verona's fountain in Piazza Erbe, View of Piazza Erbe from Lamberti Tower
Verona
–
UNESCO World Heritage Site
Verona
–
Statue of
Dante Alighieri in Verona
Verona
–
Panoramic view of the city from Castel San Pietro
26.
Girolamo Fracastoro
–
Girolamo Fracastoro was an Italian physician, poet, and scholar in mathematics, geography and astronomy. Fracastoro subscribed to the philosophy of atomism, and rejected appeals to hidden causes in scientific investigation, Fracastoro was born in Verona, Republic of Venice and educated at Padua where at 19 he was appointed professor at the University. On account of his eminence in the practice of medicine, he was elected physician of the Council of Trent, a bronze statue was erected in his honor by the citizens of Padua, while his native city commemorated their great compatriot by a marble statue. He lived and practised in his hometown, in 1546 he proposed that epidemic diseases are caused by transferable tiny particles or spores that could transmit infection by direct or indirect contact or even without contact over long distances. In his writing, the spores of diseases may refer to rather than to any living entities. Which although not themselves corrupt, can nevertheless foster the essential seeds of the contagion and his theory remained influential for nearly three centuries, before being superseded by a fully developed germ theory. The poem suggests using mercury and guaiaco as a cure and his 1546 book also gave the first description for typhus. The collected works of Fracastoro appeared for the first time in 1555, a portrait of Fracastoro that has been in the collection of the National Gallery since 1924 has recently been attributed to the renowned Italian painter Titian. The re-attribution has led scholars to speculate that Titian may have painted the portrait in exchange for syphilis treatment. A marble portrait statue of Girolamo Fracastoro by the Carrarese sculptor Danese Cattaneo stands on an arch in the central Piazza dei Signori of Verona. On its base is the inscription, HIER FRACASTORIO \ PAULLI PHILIPPI F \ EX PUBLICA AUCTORITATE \ DICATA \ AN SAL MDLIX. According to a legend the stone ball Fracastoro holds in his right hand, symbolizing the world. Over the centuries people have passed every day under the arch. The lunar crater Fracastorius is named after him, as quoted from Charles Lyells Principles of Geology, It was not till the earlier part of the sixteenth century that geological phenomena began to attract the attention of the Christian nations. At that period a very animated controversy sprung up in Italy, concerning the nature and origin of marine shells. Thurston, H. T. Colby, F. M. eds. article name needed, the Latin text available in Google Books is from Poemata selecta Italorum, qui seculo decimo sexto latine scripserunt. Oxford and London, Slatter et Munday Longman, Hurst, Rees, & Orme 1808, Works by or about Girolamo Fracastoro in libraries Works by Girolamo Fracastoro at Open Library Poems (Siphilis, Lib. 1-3 and others in, Poemata Selecta Italorum, qui Seculo Decimo Sexto Latine scripserunt, London 1808, hieronymi Fracastorii Syphilis sive morbus Gallicus
Girolamo Fracastoro
–
Portrait of Girolamo Fracastoro by
Titian, c.1528
Girolamo Fracastoro
–
the statue in its context
27.
Galen
–
Aelius Galenus or Claudius Galenus, often Anglicized as Galen and better known as Galen of Pergamon, was a prominent Greek physician, surgeon and philosopher in the Roman Empire. The son of Aelius Nicon, an architect with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician. Galens understanding of anatomy and medicine was influenced by the then-current theory of humorism. His theories dominated and influenced Western medical science for more than 1,300 years, Medical students continued to study Galens writings until well into the 19th century. Galen saw himself as both a physician and a philosopher, as he wrote in his treatise entitled That the Best Physician is Also a Philosopher. Many of his works have been preserved and/or translated from the original Greek, although many were destroyed, although there is some debate over the date of his death, he was no younger than seventy when he died. In medieval Europe, Galens writings on anatomy became the mainstay of the medieval university curriculum. Some of Galens ideas were incorrect, he did not dissect a human body, Galens original Greek texts gained renewed prominence during the early modern period. In the 1530s, Belgian anatomist and physician Andreas Vesalius took on a project to many of Galens Greek texts into Latin. Vesaliuss most famous work, De humani corporis fabrica, was influenced by Galenic writing. Galens name Γαληνός, Galēnos comes from the adjective γαληνός, calm, Galen describes his early life in On the affections of the mind. Galen describes his father as an amiable, just, good. His studies also took in each of the philosophical systems of the time. His father had planned a career for Galen in philosophy or politics and took care to expose him to literary. However, Galen states that in around AD145 his father had a dream in which the god Asclepius appeared and commanded Nicon to send his son to study medicine, there he came under the influence of men like Aeschrion of Pergamon, Stratonicus and Satyrus. Asclepiea functioned as spas or sanitoria to which the sick would come to seek the ministrations of the priesthood, romans frequented the temple at Pergamon in search of medical relief from illness and disease. It was also the haunt of notable people such as Claudius Charax the historian, Aelius Aristides the orator, Polemo the sophist, in 148, when he was 19, his father died, leaving him independently wealthy. In 157, aged 28, he returned to Pergamon as physician to the gladiators of the High Priest of Asia, one of the most influential and wealthy men in Asia
Galen
–
Eighteenth-century portrait of Galenus by Georg Paul Busch
Galen
–
Statue of Galen in
Bergama, Turkey
Galen
–
De curandi ratione
Galen
–
Mondino dei Liuzzi, Anathomia, 1541
28.
Miasma theory of disease
–
The miasma theory held that diseases such as cholera, chlamydia, or the Black Death were caused by a miasma, a noxious form of bad air, also known as night air. The theory held that the origin of epidemics was due to a miasma, the miasma theory was accepted from ancient times in Europe, India, and China. The theory was given up by scientists and physicians after 1880, replaced by the germ theory of disease, specific germs, not miasma. However, cultural beliefs about getting rid of odor made the clean-up of waste a high priority for cities, the word miasma comes from ancient Greek and means pollution. The idea also gave rise to the name malaria through medieval Italian, Miasma was considered to be a poisonous vapor or mist filled with particles from decomposed matter that caused illnesses. The miasmatic position was that diseases were the product of environmental factors such as contaminated water, foul air, such infection was not passed between individuals but would affect individuals within the locale that gave rise to such vapors. It was identifiable by its foul smell and it was also initially believed that miasmas were propagated through worms from ulcers within those affected by a plague. In India, there was also a theory and the Indians take credit for being the first to put this miasma theory into clinical practice. The Indians invented paan, a paste, that was believed to help prevent miasma. This gambir tree is found in Southern India and Sri Lanka, the miasmatic theory of disease remained popular in the Middle Ages and a sense of effluvia contributed to Robert Boyles Suspicions about the Hidden Realities of the Air. In the 1850s, miasma was used to explain the spread of cholera in London and in Paris, the disease was said to be preventable by cleansing and scouring of the body and items. Dr. William Farr, the assistant commissioner for the 1851 London census, was an important supporter of the miasma theory and he believed that cholera was transmitted by air, and that there was a deadly concentration of miasmata near the River Thames banks. Such a belief was in part accepted because of the lack of air quality in urbanized areas. The wide acceptance of miasma theory during the cholera outbreaks overshadowed the partially correct theory brought forth by John Snow that cholera was spread through water and this slowed the response to the major outbreaks in the Soho district of London and other areas. The Crimean War nurse Florence Nightingale was a proponent of the theory and worked to make hospitals sanitary and it was stated in Notes on Nursing for the Labouring Classes that Nightingale would keep the air breathes as pure as the external air. Fear of miasma registered in early nineteenth century warnings concerning what was termed “unhealthy fog”. The presence of fog strongly indicated the presence of miasma, the miasmas behaved like smoke or mist, blown with air currents, wafted by winds. It did not simply travel on air, it changed the air through which it propagated, the atmosphere was infected by miasma, as diseased people were
Miasma theory of disease
–
A representation by
Robert Seymour of the cholera epidemic of the 19th century depicts the spread of the disease in the form of poisonous air.
Miasma theory of disease
–
Book of
Sebastian Petrycy published in
Kraków in 1613 about prevention against "bad air".
29.
Hygiene
–
Hygiene is a set of practices performed for the preservation of health. According to the World Health Organization, Hygiene refers to conditions and practices help to maintain health. Some regular hygienic practices may be considered good habits by a society while the neglect of hygiene can be considered disgusting, in ancient Greek religion, Hygeia was the personification of health, cleanliness and hygiene. Hygiene is a related to cleanliness, health and medicine. In medicine and in home and everyday life settings, hygiene practices are employed as preventative measures to reduce the incidence, the terms cleanliness and hygiene are often used interchangeably, which can cause confusion. In general, hygiene mostly means practices that prevent spread of disease-causing organisms, since cleaning processes remove infectious microbes as well as dirt and soil, they are often the means to achieve hygiene. Other uses of the term appear in phrases including, body hygiene, personal hygiene, sleep hygiene, mental hygiene, dental hygiene, Hygiene is also the name of a branch of science that deals with the promotion and preservation of health, also called hygienic. Hygiene practices vary widely, and what is considered acceptable in one culture might not be acceptable in another, medical hygiene pertains to the hygiene practices related to the administration of medicine, and medical care, that prevents or minimizes disease and the spreading of disease. Medical hygiene practices include, Isolation or quarantine of persons or materials to prevent spread of infection. Sterilization of instruments used in surgical procedures, use of protective clothing and barriers, such as masks, gowns, caps, eyewear and gloves. Proper bandaging and dressing of injuries, Some procedures were refined in response to late-20th century disease outbreaks, notably AIDS and Ebola. Hygiene in home and everyday life settings plays an important part in preventing spread of infectious diseases. It includes procedures used in a variety of situations such as hand hygiene, respiratory hygiene, food and water hygiene, general home hygiene, care of domestic animals. At present, these components of hygiene tend to be regarded as separate issues, preventing the spread of infectious diseases means breaking the chain of infection transmission. The simple principle is that, if the chain of infection is broken, targeted hygiene is based on identifying the routes of spread of pathogens in the home, and applying hygiene procedures at critical points at appropriate times to break the chain of infection. The main sources of infection in the home are people, foods and water, germs are constantly shed from these sources via mucous membranes, faeces, vomit, skin scales, etc. Thus, when circumstances combine, people become exposed, either directly or via food or water, the main highways for spread of germs in the home are the hands, hand and food contact surfaces, and cleaning cloths and utensils. Germs can also spread via clothing and household linens, such as towels, safe disposal of human waste is a fundamental need, poor sanitation is a primary cause of diarrhea disease in low income communities
Hygiene
–
Poster to raise awareness about the importance of clean water for good hygiene (poster designed for use in Asian countries)
Hygiene
–
Washing one's hands, a form of hygiene, is the most effective way to prevent the spread of
infectious diseases
Hygiene
–
Astronaut taking a hot bath in the crew quarters of the Orbital Workshop (OWS) of the
Skylab space station cluster in
Earth orbit. In deploying the
shower facility the shower curtain is pulled up from the floor and attached to the ceiling. The water comes through a push-button shower head attached to a flexible hose. Water is drawn off by a
vacuum system.
Hygiene
–
Some hygiene accessories.
30.
Antonie van Leeuwenhoek
–
Antonie Philips van Leeuwenhoek was a Dutch businessman, scientist, and one of the notable representatives in the golden age of Dutch science and technology. A largely self-taught man in science, he is known as the Father of Microbiology. Van Leeuwenhoek is best known for his work in the field of microscopy. Raised in Delft, in the Dutch Republic, Van Leeuwenhoek worked as a draper in his youth and he made a name for himself in municipal politics, and eventually developed an interest in lensmaking. Using his handcrafted microscopes, he was the first to observe and describe microorganisms, most of the animalcules are now referred to as unicellular organisms, though he observed multicellular organisms in pond water. He was also the first to document microscopic observations of muscle fibers, bacteria, spermatozoa, Van Leeuwenhoek did not write any books, his discoveries came to light through correspondence with the Royal Society, which published his letters. Antonie van Leeuwenhoek was born in Delft, Dutch Republic, on 24 October 1632, on 4 November, he was baptized as Thonis. His father, Philips Antonisz van Leeuwenhoek, was a maker who died when Antonie was only five years old. His mother, Margaretha, came from a well-to-do brewers family, and remarried Jacob Jansz Molijn, Antonie had four older sisters, Margriet, Geertruyt, Neeltje, and Catharina. When he was ten years old his step-father died. He attended school in Warmond for a time before being sent to live in Benthuizen with his uncle. At the age of 16 he became an apprentice at a linen-drapers shop in Amsterdam owned by the Scot William Davidson. Van Leeuwenhoek left after six years, Van Leeuwenhoek married Barbara de Mey in July 1654, with whom he would have one surviving daughter, Maria. That same year he returned to Delft, where he would live and he opened a drapers shop, which he ran throughout the 1650s. His wife died in 1666, and in 1671, Van Leeuwenhoek remarried to Cornelia Swalmius with whom he had no children and his status in Delft had grown throughout the years. In 1660 he received a job as chamberlain for the Delft sheriffs assembly chamber in the City Hall. Van Leeuwenhoek was a contemporary of another famous Delft citizen, the painter Johannes Vermeer and it has been suggested that he is the man portrayed in two of Vermeers paintings of the late 1660s, The Astronomer and The Geographer. However, others argue that there appears to be little physical similarity, while running his drapers shop, Van Leeuwenhoek wanted to see the quality of the thread better than the then-current magnifying lenses available allowed
Antonie van Leeuwenhoek
–
Portrait of Antonie van Leeuwenhoek (1632–1723) by
Jan Verkolje
Antonie van Leeuwenhoek
–
William Davidson had appointed Van Leeuwenhoek in 1648 as his assistant. Van Leeuwenhoek left after six years. (Portrait by
Abraham van den Tempel, 1664)
Antonie van Leeuwenhoek
–
The Geographer by
Johannes Vermeer.
Antonie van Leeuwenhoek
–
Microscopic section through one-year-old
ash tree (Fraxinus) wood, drawing made by Van Leeuwenhoek.
31.
Germ theory of disease
–
The germ theory of disease states that many diseases are caused by microorganisms. These small organisms, too small to see without magnification, invade humans, animals and their growth and reproduction within their hosts can cause a disease. Germ may refer to not just a bacterium but to any type of microorganisms, especially one which causes disease, such as protist, fungus, virus, prion, microorganisms that cause disease are called pathogens, and the diseases they cause are called infectious diseases. The germ theory was proposed by Girolamo Fracastoro in 1546, such views were held in disdain, however, and Galens miasma theory remained dominant among scientists and doctors. The nature of this doctrine prevented them from understanding how diseases actually progressed, by the early nineteenth century, smallpox vaccination was commonplace in Europe, though doctors were unaware of how it worked or how to extend the principle to other diseases. Viruses were discovered in the 1890s, the miasma theory of disease transmission held that diseases such as cholera, chlamydia or the Black Death were caused by a miasma, a noxious form of bad air. The theory held that the origin of these diseases was a miasma. Miasma was considered to be a vapor or mist filled with particles from decomposed matter that caused illnesses. The miasmatic position was that diseases were the product of environmental factors such as contaminated water, foul air, such infection was not passed between individuals but would affect individuals within the locale that gave rise to such vapors. It was identifiable by its foul smell and this was the predominant theory of disease transmission before the germ theory of disease took hold in the last decade of the 19th century. In Antiquity, the Greek historian Thucydides was the first person to state, in his account of the plague of Athens, one theory of the spread of contagious diseases that were not spread by direct contact was that they were spread by seeds that were present in the air. In his poem, De rerum natura, the Roman poet Lucretius stated that the world contained various seeds, the Greek physician Galen speculated in his On Initial Causes that some patients might have seeds of fever. In his On the Different Types of Fever, Galen speculated that plagues were spread by seeds of plague. During the Middle Ages, Isidore of Seville mentioned plague-bearing seeds in his On the Nature of Things, and in 1345, Tommaso del Garbo of Bologna, Italy mentioned Galens seeds of plague in his work Commentaria non parum utilia in libros Galeni. The diseases were categorised based on how they were transmitted, italian physician Francesco Redi provided early evidence against spontaneous generation. He devised an experiment in 1668 in which he used three jars and he placed a meatloaf and egg in each of the three jars. He had one of the open, another one tightly sealed. After a few days, he observed that the meatloaf in the jar was covered by maggots
Germ theory of disease
–
Scanning electron microscope image of
Vibrio cholerae. This is the bacterium that causes
cholera.
Germ theory of disease
–
A representation of the cholera epidemic of the 19th century depicts the spread of the disease in the form of poisonous air.
Germ theory of disease
–
Original map by John Snow showing the
clusters of cholera cases in the London epidemic of 1854
Germ theory of disease
–
Louis Pasteur in his laboratory, painting by
A. Edelfeldt in 1885
32.
Thomas Sydenham
–
Thomas Sydenham was an English physician. He was the author of Observationes Medicae which became a textbook of medicine for two centuries so that he became known as The English Hippocrates. Among his many achievements was the discovery of a disease, Sydenhams Chorea, Thomas Sydenham was born at Wynford Eagle in Dorset, where his father was a gentleman of property. His brother was Colonel William Sydenham and he completed his Oxford course in 1648, graduating as bachelor of medicine, and about the same time he was elected a fellow of All Souls College. It was not until thirty years later that he graduated as MD, not at Oxford, but at Pembroke Hall, Cambridge. In 1655 he resigned his fellowship at All Souls and married Mary Gee in his town of Wynford Eagle. They had two sons, William and Henry, another son, James, apparently died young and this minimum qualification to practice was the single bond between Sydenham and the College of Physicians throughout the whole of his career. He seems to have been distrusted by some members of the faculty because he was an innovator, Sydenham attracted to his support some of the most discriminating men of his time, such as Boyle and John Locke. His religious views have been described as a form of natural theology. In 1682 he published another Dissertatio epistolaris, on the treatment of confluent smallpox and on hysteria, the Tractatus de podagra et hydrope came out in 1683, and the Schedula monitoria de novae febris ingressu in 1686. A fragment on pulmonary consumption was found among his papers and his collected writings occupy about 600 pages 8vo, in the Latin, translated into that language by various scholars. In the series of Harveian Orations at the College of Physicians, Sydenham is first mentioned in the oration of Dr John Arbuthnot, herman Boerhaave, the Leyden professor, was wont to speak of him in his class as Angliae lumen, artis Phoebum, veram Hippocratici viri speciem. Albrecht von Haller also marked one of the epochs in his scheme of medical progress with the name of Sydenham. He is indeed famous because he inaugurated a new method and an ethics of practice. It remains to consider briefly what his innovations were, first and foremost he did the best he could for his patients, and made as little as possible of the mysteries and traditional dogmas of the craft. I therefore ordered him a roast chicken and a pint of canary, of a piece with this is his famous advice to Sir Richard Blackmore. There were cases, he tells us, in his practice where I have consulted my patients safety, in 1679, Sydenham gave Whooping cough the name pertussis, meaning a violent cough of any type. Sydenham was a zealous Puritan and He rejected on religious grounds attempts such as pathological anatomy and he argued God only gave man the ability to perceive the outer nature of things with his senses
Thomas Sydenham
–
Thomas Sydenham in a 1689 portrait by
Mary Beale.
Thomas Sydenham
–
Engraving by
Abraham Blooteling after the Mary Beale portrait; published as the frontispiece in a later edition of his Observationes medicinae
Thomas Sydenham
–
Opera medica
33.
John Snow (physician)
–
John Snow was an English physician and a leader in the adoption of anaesthesia and medical hygiene. He is considered one of the fathers of modern epidemiology, in part because of his work in tracing the source of an outbreak in Soho, London. Snow was born on 15 March 1813 in York, England, the first of nine born to William and Frances Snow in their North Street home. The neighbourhood was one of the poorest in the city frequently in danger of flooding because of its proximity to the River Ouse, growing up, Snow experienced unsanitary conditions and contamination in his hometown. Most of the streets were unsanitary and the river was contaminated by water from market squares, cemeteries. He demonstrated an aptitude for mathematics at a young age, in 1827, when he was 14 he obtained a medical apprenticeship with William Hardcastle in Newcastle-upon-Tyne. In 1832, during his time as an apprentice, he encountered a cholera epidemic for the first time in Killingworth. Snow treated many victims of the disease and gained a lot of experience, additionally, while he was an apprentice, Snow could not drink, gamble or marry. Eventually he adjusted to teetotalism and led a life characterized by abstinence, Snow was also vegetarian and tried to only drink distilled water that was “pure”. Between 1833 and 1836 Snow worked as an assistant to a surgeon, first in Burnopfield, County Durham. In October 1836 he enrolled at the Hunterian school of medicine on Great Windmill Street, in 1837, Snow began working at the Westminster Hospital. In 1850 he was one of the founding members of the Epidemiological Society of London. In 1857, Snow made an early and often overlooked contribution to epidemiology in a pamphlet and he designed the apparatus to safely administer ether to the patients and also designed a mask to administer chloroform. Snow published an article on ether in 1847 entitled On the Inhalation of the Vapor of Ether, a longer version entitled On Chloroform and Other Anaesthetics and Their Action and Administration was published posthumously in 1858. After finishing his studies in the University of London, he earned his MD in 1844. Snow set up his practice at 54 Frith Street in Soho as a surgeon, John Snow contributed to a wide range of medical concerns including anaesthesiology. He was a member of the Westminster Medical Society, a dedicated to clinical. Snow gained prestige and recognition all the while being able to experiment and he was a speaker multiple times at the society’s meetings and he also wrote and published articles
John Snow (physician)
–
John Snow
John Snow (physician)
–
All Saints, North Street
John Snow (physician)
–
Original map by John Snow showing the
clusters of cholera cases in the London epidemic of 1854, drawn and lithographed by
Charles Cheffins.
John Snow (physician)
–
John Snow memorial and public house on
Broadwick Street,
Soho
34.
1854 Broad Street cholera outbreak
–
The Broad Street cholera outbreak was a severe outbreak of cholera that occurred near Broad Street in the Soho district of London, England in 1854. This outbreak, which killed 616 people, is best known for the physician John Snows study of its causes and his hypothesis that contaminated water, not air and this discovery came to influence public health and the construction of improved sanitation facilities beginning in the 19th century. Later, the focus of infection would be used to describe places like the Broad Street pump in which conditions are good for transmission of an infection. Cowsheds, slaughter houses and grease boiling dens lined the streets and contributed animal droppings, rotting fluids, many cellars had cesspools underneath their floorboards which formed from the sewers and filth seeping in from the outside. Since the cesspools were overrunning, the London government decided to dump the waste into the River Thames, London had already suffered from a series of debilitating cholera outbreaks which included an outbreak in 1832 and 1849 which killed 14,137 people. Preceding the 1854 Broad Street cholera outbreak there were two competing theories on the causes of cholera in the human body, the London medical community debated between miasma theory and germ theory as two possible causes for the persistent cholera outbreaks in the city. Miasma Theory, Miasma theorists concluded that cholera was caused by disease causing particles in the air, Miasma particles were considered to travel through the air and infect individuals and cause cholera. Dr. William Farr, the commissioner for the 1851 London census, the soil surrounding the river contained decaying organic matter which contained miasmatic particles and were released into the London air. Miasma theorists believed in cleansing and scouring, rather than through the scientific approach of microbiology. Dr. William Farr later agreed with John Snows Germ Theory following Snows publications, Germ Theory, In contrast to the Miasma theory, the Germ Theory behind the cause of cholera labeled the principle cause of cholera as a germ cell that had not yet been identified. John Snow theorized that this unknown germ would be transmitted from person to person by ingesting water, John Simon, a pathologist and the lead medical officer for London labeled John Snows Germ Theory as Peculiar. Even though Simon understood John Snows theory he called into question Germ theories relation to the cause of cholera, on 31 August 1854, after several other outbreaks had occurred elsewhere in the city, a major outbreak of cholera reached Soho. John Snow, the physician who eventually linked the outbreak to contaminated water, later called it the most terrible outbreak of cholera which occurred in this kingdom. Over the next three days,127 people on or near Broad Street died, in the next week, three quarters of the residents had fled the area. By 10 September,500 people had died and the mortality rate was 12.8 percent in some parts of the city, by the end of the outbreak,616 people had died. Dr. Edwin Lankester, a physician who was part of a local research conglomerate that studied the 1854 Broad Street Cholera Epidemic, in 1866 Dr. Lankester came to his conclusion that the pump itself was the cause of the Cholera outbreak. He agreed with John Snow, however his opinion, like Snows, was not publicly supported, Lankester eventually was named the first medical officer of health for the St. James District in London. This was the area where the pump was located
1854 Broad Street cholera outbreak
–
Broadwick Street showing the John Snow memorial and public house.
1854 Broad Street cholera outbreak
–
Original map by John Snow showing the
clusters of cholera cases in the London epidemic of 1854. The pump is located at the intersection of Broad Street and Cambridge Street (now Lexington Street).
1854 Broad Street cholera outbreak
–
Rev. Henry Whitehead
1854 Broad Street cholera outbreak
–
Cholera
35.
John Graunt
–
John Graunt was one of the first demographers, though by profession he was a haberdasher. Born in London, the eldest of seven or eight children of Henry and Mary Graunt and his father was a draper who had moved to London from Hampshire. In February 1641, Graunt married Mary Scott, with whom he had one son and he worked in his fathers shop until his father died in 1662, and became influential in the City. He was able to secure the post of professor of music for his friend William Petty in 1650 and he served in various ward offices in Cornhill ward, becoming a common councilman about 1669–71, warden of the Drapers Company in 1671 and a major in the trained band. Graunt, along with William Petty, developed early human statistical and he is credited with producing the first life table, giving probabilities of survival to each age. Graunt is also considered as one of the first experts in epidemiology, though the system was never truly created, Graunts work in studying the rolls resulted in the first statistically based estimation of the population of London. His work ran to five editions by 1676, the erudition of the Observations led Graunt to the Royal Society, where he presented his work and was subsequently elected a fellow in 1662 with the endorsement of the King. He was chosen as a member of the council in November 1664 and his house was destroyed in the Great Fire of London and he encountered other financial problems leading eventually to bankruptcy. He died of jaundice and liver disease at the age of 53, John Aubrey reported that he was a pleasant facetious companion and very hospitable and noted that his death was lamented by all good men that had the happinesse to knowe him. Tribute to Graunts pioneering work was paid by Sir Liam Donaldson on the anniversary of the Public Health Observatories. Graunt, John, Petty, William, Morris, Corbyn, J. P. Collection of Yearly Bills of Mortality, from 1657 to 1758 Inclusive
John Graunt
–
Title page of Graunt's Observations on the Bills of Mortality (1662).
36.
Haberdasher
–
A haberdasher is a person who sells small articles for sewing, such as buttons, ribbons, zips, or a mens outfitter. The sewing articles are called haberdashery, or notions, the word appears in Chaucers Canterbury Tales. Haberdashers were initially peddlers, thus sellers of small items such as needles, the word is thought to have no connection with an Old Norse word akin to the Icelandic haprtask, which means peddlers wares or the sack in which the peddler carried them. If that had been the case, a haberdasher would be close to a mercier. Since the word has no recorded use in Scandinavia, it is most likely derived from the Anglo-Norman hapertas, a haberdasher would retail small wares, the goods of the peddler, while a mercer would specialize in linens, silks, fustian, worsted piece-goods and bedding. Saint Louis IX, King of France 1226–70, is the saint of French haberdashers. In Belgium and elsewhere in Continental Europe, Saint Nicholas remains their patron saint, while Saint Catherine was adopted by the Worshipful Company of Haberdashers in the City of London
Haberdasher
–
Paavo Nurmi, in 1939, at his Helsinki haberdashery
Haberdasher
–
A haberdashery in
Brussels
Haberdasher
–
A haberdasher's shop in central Madrid
37.
London
–
London /ˈlʌndən/ is the capital and most populous city of England and the United Kingdom. Standing on the River Thames in the south east of the island of Great Britain and it was founded by the Romans, who named it Londinium. Londons ancient core, the City of London, largely retains its 1. 12-square-mile medieval boundaries. London is a global city in the arts, commerce, education, entertainment, fashion, finance, healthcare, media, professional services, research and development, tourism. It is crowned as the worlds largest financial centre and has the fifth- or sixth-largest metropolitan area GDP in the world, London is a world cultural capital. It is the worlds most-visited city as measured by international arrivals and has the worlds largest city airport system measured by passenger traffic, London is the worlds leading investment destination, hosting more international retailers and ultra high-net-worth individuals than any other city. Londons universities form the largest concentration of education institutes in Europe. In 2012, London became the first city to have hosted the modern Summer Olympic Games three times, London has a diverse range of people and cultures, and more than 300 languages are spoken in the region. Its estimated mid-2015 municipal population was 8,673,713, the largest of any city in the European Union, Londons urban area is the second most populous in the EU, after Paris, with 9,787,426 inhabitants at the 2011 census. The citys metropolitan area is the most populous in the EU with 13,879,757 inhabitants, the city-region therefore has a similar land area and population to that of the New York metropolitan area. London was the worlds most populous city from around 1831 to 1925, Other famous landmarks include Buckingham Palace, the London Eye, Piccadilly Circus, St Pauls Cathedral, Tower Bridge, Trafalgar Square, and The Shard. The London Underground is the oldest underground railway network in the world, the etymology of London is uncertain. It is an ancient name, found in sources from the 2nd century and it is recorded c.121 as Londinium, which points to Romano-British origin, and hand-written Roman tablets recovered in the city originating from AD 65/70-80 include the word Londinio. The earliest attempted explanation, now disregarded, is attributed to Geoffrey of Monmouth in Historia Regum Britanniae and this had it that the name originated from a supposed King Lud, who had allegedly taken over the city and named it Kaerlud. From 1898, it was accepted that the name was of Celtic origin and meant place belonging to a man called *Londinos. The ultimate difficulty lies in reconciling the Latin form Londinium with the modern Welsh Llundain, which should demand a form *lōndinion, from earlier *loundiniom. The possibility cannot be ruled out that the Welsh name was borrowed back in from English at a later date, and thus cannot be used as a basis from which to reconstruct the original name. Until 1889, the name London officially applied only to the City of London, two recent discoveries indicate probable very early settlements near the Thames in the London area
London
–
Palace of Westminster,
Buckingham Palace and
Central London skyline
London
London
London
–
The name London may derive from the
River Thames
38.
Great Plague of London
–
The Great Plague, lasting from 1665 to 1666, was the last major epidemic of the bubonic plague to occur in England. The Great Plague killed an estimated 100,000 people - almost a quarter of Londons population - in 18 months, the plague was caused by the Yersinia pestis bacterium, which is usually transmitted through the bite of an infected rat flea. As in other European cities of the period, the plague was endemic in 17th century London, the disease periodically erupted into massive epidemics. There were 30,000 deaths due to the plague in 1603,35,000 in 1625, during the winter of 1664, a bright comet was to be seen in the sky and the people of London were fearful, wondering what evil event it portended. London at that time consisted of a city of about 448 acres surrounded by a city wall, there were gates at Ludgate, Newgate, Aldersgate, Cripplegate, Moorgate and Bishopsgate and to the south lay the River Thames and London Bridge. In the poorer parts of the city, hygiene was impossible to maintain in the tenements and garrets. There was no sanitation, and open drains flowed along the centre of winding streets, the cobbles were slippery with animal dung, rubbish and the slops thrown out of the houses, muddy and buzzing with flies in summer and awash with sewage in winter. The City Corporation employed rakers to remove the worst of the filth, the stench was overwhelming and people walked around with handkerchiefs or nosegays pressed against their nostrils. Some of the necessities such as coal arrived by barge. Carts, carriages, horses and pedestrians were crowded together and the gateways in the wall formed bottlenecks through which it was difficult to progress, the nineteen-arch London Bridge was even more congested. The better-off used hackney carriages and sedan chairs to get to their destinations without getting filthy, the poor walked, and might be splashed by the wheeled vehicles and drenched by slops being thrown out and water falling from the overhanging roofs. Another hazard was the black smoke belching forth from factories which made soap, from breweries and iron smelters. Outside the city walls, suburbs had sprung up providing homes for the craftsmen and these were shanty towns with wooden shacks and no sanitation. The government had tried to control this development but had failed, other immigrants had taken over fine town houses, vacated by Royalists who had fled the country during the Commonwealth, converting them into tenements with different families in every room. These properties were soon vandalised and became rat-infested slums, administration of the City of London was organised by the Lord Mayor, Aldermen and common councillors, but not all of the inhabited area generally comprising London was legally part of the City. Both inside the City and outside its boundaries there were also Liberties, Westminster was an independent town with its own liberties, although it was joined to London by urban development. The Tower of London was an independent liberty, as were others, areas north of the river not part of one of these administrations came under the authority of the county of Middlesex, and south of the river under Surrey. At that time, bubonic plague was a much feared disease and it was not until 1894 that the identification by Alexandre Yersin of its causal agent Yersinia pestis was made and the transmission of the bacterium by rat fleas became known
Great Plague of London
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Collecting the dead for burial during the Great Plague
Great Plague of London
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Map of London by Wenceslas Hollar, c.1665
Great Plague of London
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The
"Woodcut" map of London, dating from the 1560s
Great Plague of London
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Infected
Oriental rat flea.
Yersinia pestis bacteria appear as a dark mass in the gut. The bacteria block the flea's digestive system, leaving it hungry but unable to eat. Instead when it tries to feed it regurgitates yersinia into the wound.
39.
Life tables
–
In actuarial science and demography, a life table is a table which shows, for each age, what the probability is that a person of that age will die before his or her next birthday. In other words, it represents the survivorship of people from a certain population, there are two types of life tables used in actuarial science. The period life table represents mortality rates during a time period of a certain population. A cohort life table, often referred to as a life table, is used to represent the overall mortality rates of a certain populations entire lifetime. They must have had to be born during the specific time interval. A cohort life table is more frequently used because it is able to make a prediction of any expected changes in mortality rates of a population in the future and this type of table also analyzes patterns in mortality rates that can be observed over time. Both of these types of tables are created based on an actual population from the present. From this starting point, a number of inferences can be derived, the probability of surviving any particular year of age The remaining life expectancy for people at different ages Life tables are also used extensively in biology and epidemiology. An area that uses this tool is Social Security and it examines the mortality rates of all the people who have Social Security to decide which actions to take. The concept is also of importance in life cycle management. Static life tables sample individuals assuming a stationary population with overlapping generations, static Life tables and cohort life tables will be identical if population is in equilibrium and environment does not change. If a population were to have a constant number of each year it would mean that the probabilities of death from the life table were completely accurate. Also, a number of 100,000 people were born each year with no immigration or emigration involved. Life table primarily refers to period life tables, as cohort life tables can only be constructed using data up to the current point, a life table is created by mortality rates and census figures from a certain population, ideally under a closed demographic system. This means that immigration and emigration do not exist when analyzing a cohort, another benefit from mortality tables is that they can be used to make predictions on demographics or different populations. The life table observes the mortality experience of a generation, consisting of 100,000 births. Life tables are usually constructed separately for men and for women because of their substantially different mortality rates, other characteristics can also be used to distinguish different risks, such as smoking status, occupation, and socioeconomic class. Life tables can be extended to other information in addition to mortality
Life tables
–
2003 US mortality table, Table 1, Page 1
40.
Broadwick Street
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Broadwick Street is a street in Soho, City of Westminster, London. It runs for 0.18 miles approximately west-east between Marshall Street and Wardour Street, crossing Berwick Street, Broad Street was notorious as the centre of an 1854 outbreak of cholera. Dr John Snow traced the outbreak to a water pump on the street. The end of the outbreak swiftly followed, before this time, the disease was widely thought to be caused by air-borne miasma, Snows findings showed it to be water-borne. A replica pump, together with a plaque, was erected in 1992 close to the original location. The original pump was sited at the junction of Broad Street and Cambridge Street, the site is subtly marked with a pink granite kerbstone in front of small wall plaque. A house on the corner of Broadwick and Marshall Street was the birthplace, the street crosses, or meets with, Wardour Street, Duck Lane, Berwick Street, Hopkins Street, Ingestre Place, Poland Street, Lexington Street, Dufours Place, Marshall Street and Carnaby Street. Current institutions on Broadwick Street include Yauatcha, a noted Chinese restaurant, also at the same premises were T & A Wise Ltd. engravers, and The Flutemakers Guild, makers of flutes in precious metals
Broadwick Street
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Broadwick Street showing the John Snow memorial and pub
41.
Neonatal tetanus
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Neonatal tetanus is a form of generalised tetanus that occurs in newborns. Infants who have not acquired immunity from the mother having been immunised are at risk. It usually occurs through infection of the umbilical stump, particularly when the stump is cut with a non-sterile instrument. Neonatal tetanus mostly occurs in developing countries, particularly those with the least developed health infrastructure and it is rare in developed countries. In neonatal tetanus, symptoms usually appear from 4 to 14 days after birth, the fatality rate for infants has been estimated as 70% to 100%, death usually occurs by the age of 2 weeks. On the basis of findings, four different forms of tetanus have been described. The time from exposure to symptoms may be up to several months, the spores which cause tetanus are present everywhere, so the only prevention is immunization. In 2000 neonatal tetanus was responsible for about 14% of all neonatal deaths, in 200859,000 newborns worldwide died as a result of neonatal tetanus. In 2005,57 countries were identified as still at risk, as of December 2013 the number of countries at risk was reduced to 25. In 1989 the World Health Congress called for the elimination of neonatal tetanus, UNICEF took the lead, assisted by other United Nations agencies, individual governments, and non-profit organisations. By 2000 the disease was declared as eliminated from 104 of 161 developing countries, elimination is defined as less than 1 case per 1,000 live births in every district of the country. Since tetanus can also strike postpartum mothers, the campaign has expanded to target both maternal and neonatal tetanus. In many affected countries, there was a lack of awareness of maternal and neonatal tetanus, education and immunisation campaigns have been launched in the remaining countries at risk and are targeted particularly at pregnant women. Education focuses on hygienic birth practices and infant cord care as well as the need for immunisation, in Egypt, the number of cases of neonatal tetanus dropped from 4,000 to fewer than 500 annually as the result of an immunisation campaign. In Morocco, neonatal tetanus accounted for 20% of neonatal deaths in 1987, in 1998 in Uganda,3,433 tetanus cases were recorded in newborn babies, of these,2,403 died. After a major public health effort, Uganda in 2011 was certified as having eliminated tetanus, in 2011, Pampers joined with UNICEF to target maternal and neonatal tetanus in Yemen. In 2010, Kiwanis International pledged to raise $110 million to eliminate maternal and neonatal tetanus throughout the world in partnership with UNICEF, on 15 May 2015, The World Health Organization declared India free from maternal and neonatal tetanus. This announcement was made by Prime Minister Narendra Modi in his speech at the Call to Action Summit in New Delhi on 27 August 2015
Neonatal tetanus
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Neonatal tetanus
Neonatal tetanus
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A tetanus shot is administered to a child and her mother
42.
Vestmanna Islands
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Vestmannaeyjar is a town and archipelago off the south coast of Iceland. The largest island, Heimaey, has a population of 4,135, the other islands are uninhabited, although six have single hunting cabins. Approximately one fifth of the town was destroyed before the flow was halted by application of 6.8 billion litres of cold sea water. The Vestmannaeyjar archipelago is young in geological terms, the islands lie in the Southern Icelandic Volcanic Zone and have been formed by eruptions over the past 10, 000–12,000 years. The volcanic system consists of 70–80 volcanoes both above and below the sea, total,16.3 square kilometres There are 15 islands, and about 30 rock stacks and skerries. All the islands have built up in submarine eruptions and consist of alternating layers of palagonite tuff. The oldest geological formations are in the part of Heimaey, the largest island. There was a submarine eruption southeast of Hellisey in 1896, the next eruption began on 14 November 1963. It lasted about four years – one of the longest in Icelandic history – and gave birth to Surtsey, in the eruption of 1973 that lasted for 155 days, Heimaey grew by about 2.1 square kilometres. The Vestmannaeyjar group is about 38 kilometres long and 29 kilometres broad, There is generally very little snow, but a lot of rain. Owing to this microclimate, returning migrant birds are often first seen in the spring, all of Icelands seabirds can be found in Vestmannaeyjar, the guillemot, gannet, kittiwake, Iceland gull, and puffin. The puffin is the most plentiful species and is the Vestmannaeyjar emblem, more than 30 species of birds nest in their millions in the cliffs and grassy ledges, and other species make irregular appearances. There are about 150 plant species in the flora of the islands, the waters around the Vestmannaeyjar contain some of the North Atlantics richest fishing grounds. The two main commercially exploited species in Iceland, cod and haddock, are found in abundance in Vestmannaeyjar, other species, such as flat-fish, herring and capelin, are also commonly harvested as they migrate through the area in the autumn and winter. Lobsters and ocean perch are found in numbers in the deep water to the southeast of the islands. Seals, small types of whale and other species are also present in large numbers around the islands. It is often very windy in the islands, and the highest wind speed measured in Iceland was recorded in Stórhöfði, the main wind directions are easterly and south-easterly. The islands enjoy the countrys highest average temperature, the Gulf Stream having a strong warming effect
Vestmanna Islands
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Heimaklettur seen from Stakkagerðistún which is a public park in the middle of
Heimaey
Vestmanna Islands
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Elliðaey island.
Vestmanna Islands
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Suðurey, Hellisey, Súlnasker and Geldungur islands.
Vestmanna Islands
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Smáeyjar islands
43.
Iceland
–
Iceland is a Nordic island country in the North Atlantic Ocean. It has a population of 332,529 and an area of 103,000 km2, the capital and largest city is Reykjavík. Reykjavík and the areas in the southwest of the country are home to over two-thirds of the population. Iceland is volcanically and geologically active, the interior consists of a plateau characterised by sand and lava fields, mountains and glaciers, while many glacial rivers flow to the sea through the lowlands. Iceland is warmed by the Gulf Stream and has a climate, despite a high latitude just outside the Arctic Circle. Its high latitude and marine influence still keeps summers chilly, with most of the archipelago having a tundra climate. According to the ancient manuscript Landnámabók, the settlement of Iceland began in the year 874 AD when the Norwegian chieftain Ingólfr Arnarson became the first permanent settler on the island. In the following centuries, Norwegians, and to a lesser extent other Scandinavians, emigrated to Iceland, the island was governed as an independent commonwealth under the Althing, one of the worlds oldest functioning legislative assemblies. Following a period of strife, Iceland acceded to Norwegian rule in the 13th century. The establishment of the Kalmar Union in 1397 united the kingdoms of Norway, Denmark, Iceland thus followed Norways integration to that Union and came under Danish rule after Swedens secession from that union in 1523. In the wake of the French revolution and the Napoleonic wars, Icelands struggle for independence took form and culminated in independence in 1918, until the 20th century, Iceland relied largely on subsistence fishing and agriculture, and was among the poorest in Europe. Industrialisation of the fisheries and Marshall Plan aid following World War II brought prosperity, in 1994, it became a part of the European Economic Area, which further diversified the economy into sectors such as finance, biotechnology, and manufacturing. Iceland has an economy with relatively low taxes compared to other OECD countries. It maintains a Nordic social welfare system that provides health care. Iceland ranks high in economic, political and social stability and equality, in 2013, it was ranked as the 13th most-developed country in the world by the United Nations Human Development Index. Iceland runs almost completely on renewable energy, some bankers were jailed, and the economy has made a significant recovery, in large part due to a surge in tourism. Icelandic culture is founded upon the nations Scandinavian heritage, most Icelanders are descendants of Germanic and Gaelic settlers. Icelandic, a North Germanic language, is descended from Old Norse and is related to Faroese
Iceland
–
Norsemen Landing in Iceland – a 19th Century depiction by
Oscar Wergeland.
Iceland
–
Flag
Iceland
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Ingólfr Arnarson (modern Icelandic: Ingólfur Arnarson), the first permanent Scandinavian settler in Iceland
Iceland
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Ósvör, a replica of an old fishing outpost outside
Bolungarvík
44.
Hungary
–
Hungary is a unitary parliamentary republic in Central Europe. With about 10 million inhabitants, Hungary is a member state of the European Union. The official language is Hungarian, which is the most widely spoken language in Europe. Hungarys capital and largest metropolis is Budapest, a significant economic hub, major urban areas include Debrecen, Szeged, Miskolc, Pécs and Győr. His great-grandson Stephen I ascended to the throne in 1000, converting the country to a Christian kingdom, by the 12th century, Hungary became a middle power within the Western world, reaching a golden age by the 15th century. Hungarys current borders were established in 1920 by the Treaty of Trianon after World War I, when the country lost 71% of its territory, 58% of its population, following the interwar period, Hungary joined the Axis Powers in World War II, suffering significant damage and casualties. Hungary became a state of the Soviet Union, which contributed to the establishment of a four-decade-long communist dictatorship. On 23 October 1989, Hungary became again a democratic parliamentary republic, in the 21st century, Hungary is a middle power and has the worlds 57th largest economy by nominal GDP, as well as the 58th largest by PPP, out of 188 countries measured by the IMF. As a substantial actor in several industrial and technological sectors, it is both the worlds 36th largest exporter and importer of goods, Hungary is a high-income economy with a very high standard of living. It keeps up a security and universal health care system. Hungary joined the European Union in 2004 and part of the Schengen Area since 2007, Hungary is a member of the United Nations, NATO, WTO, World Bank, the AIIB, the Council of Europe and Visegrád Group. Well known for its cultural history, Hungary has been contributed significantly to arts, music, literature, sports and science. Hungary is the 11th most popular country as a tourist destination in Europe and it is home to the largest thermal water cave system, the second largest thermal lake in the world, the largest lake in Central Europe, and the largest natural grasslands in Europe. The H in the name of Hungary is most likely due to historical associations with the Huns. The rest of the word comes from the Latinized form of Medieval Greek Oungroi, according to an explanation the Greek name was borrowed from Proto-Slavic Ǫgǔri, in turn borrowed from Oghur-Turkic Onogur. Onogur was the name for the tribes who later joined the Bulgar tribal confederacy that ruled the eastern parts of Hungary after the Avars. The Hungarians likely belonged to the Onogur tribal alliance and it is possible they became its ethnic majority. The Hungarian endonym is Magyarország, composed of magyar and ország, the word magyar is taken from the name of one of the seven major semi-nomadic Hungarian tribes, magyeri
Hungary
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Italian fresco depicting a Hungarian warrior shooting backwards
Hungary
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Flag
Hungary
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Hungarian raids in the 10th century
Hungary
–
King
Saint Stephen, the first
King of Hungary, converted the nation to Christianity
45.
Ignaz Semmelweis
–
Ignaz Philipp Semmelweis was a Hungarian physician of ethnic-German ancestry, now known as an early pioneer of antiseptic procedures. Described as the saviour of mothers, Semmelweis discovered that the incidence of puerperal fever could be cut by the use of hand disinfection in obstetrical clinics. Puerperal fever was common in hospitals and often fatal. He published a book of his findings in Etiology, Concept, Semmelweis could offer no acceptable scientific explanation for his findings, and some doctors were offended at the suggestion that they should wash their hands. In 1865, Semmelweis was committed to an asylum, where he died at age 47 of pyaemia, after being beaten by the guards, Ignaz Semmelweis was born on 1 July 1818 in Tabán, neighbourhood of Buda, Hungary, today part of Budapest. He was the child out of ten of the prosperous grocer family of József Semmelweis. His father was an ethnic German born in Kismarton, then part of Hungary, now Eisenstadt and he achieved permission to set up a shop in Buda in 1806 and, in the same year, opened a wholesale business for spices and general consumer goods. The company was named zum Weißen Elefanten in Meindl-Haus in Tabán, by 1810, he was a wealthy man and married Teréz Müller, daughter of the coach builder Fülöp Müller. Ignaz Semmelweis began studying law at the University of Vienna in the autumn of 1837 and he was awarded his doctorate degree in medicine in 1844. Maternity institutions were set up all over Europe to address problems of infanticide of illegitimate children and they were set up as gratis institutions and offered to care for the infants, which made them attractive to underprivileged women, including prostitutes. In return for the services, the women would be subjects for the training of doctors. Two maternity clinics were at the Viennese hospital, the First Clinic had an average maternal mortality rate of about 10% due to puerperal fever. The Second Clinics rate was lower, averaging less than 4%. This fact was known outside the hospital, Semmelweis was puzzled that puerperal fever was rare among women giving street births. To me, it appeared logical that patients who experienced street births would become ill at least as frequently as those who delivered in the clinic, the only major difference was the individuals who worked there. The First Clinic was the service for medical students, while the Second Clinic had been selected in 1841 for the instruction of midwives only. He excluded overcrowding as a cause, since the Second Clinic was always more crowded and he eliminated climate as a cause because the climate was the same. The breakthrough occurred in 1847, following the death of his good friend Jakob Kolletschka, kolletschkas own autopsy showed a pathology similar to that of the women who were dying from puerperal fever
Ignaz Semmelweis
–
Dr. Ignaz Semmelweis, aged 42 in 1860 copperplate engraving by Jenő Doby
Ignaz Semmelweis
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Teresia Müller and Josef Semmelweis, the parents of Ignaz Semmelweis
Ignaz Semmelweis
–
Streptococcus pyogenes (red-stained spheres) is responsible for most cases of severe
puerperal fever. It is commonly found in the throat and
nasopharynx of otherwise healthy carriers.
Ignaz Semmelweis
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Wedding portraits of Ignaz Semmelweis and Maria Weidenhoffer (1857)
46.
Joseph Lister, 1st Baron Lister
–
Joseph Lister, 1st Baron Lister, OM PC PRS, known between 1883 and 1897 as Sir Joseph Lister, Bt. was a British surgeon and a pioneer of antiseptic surgery. He promoted the idea of sterile portable ports while working at the Glasgow Royal Infirmary, Lister successfully introduced carbolic acid to sterilise surgical instruments and to clean wounds. Applying Louis Pasteurs advances in microbiology, Lister championed the use of acid as an antiseptic. He first suspected it would prove an adequate disinfectant because it was used to ease the stench from fields irrigated with sewage waste and he presumed it was safe because fields treated with carbolic acid produced no apparent ill-effects on the livestock that later grazed upon them. Listers work led to a reduction in post-operative infections and made safer for patients. Lister came from a prosperous Quaker home in West Ham, Essex, England, a son of Joseph Jackson Lister, at school, he became a fluent reader of French and German. A young Joseph Lister attended Benjamin Abbotts Isaac Brown Academy, a Quaker school in Hitchin, as a teenager, Lister attended Grove House School Tottenham, studying mathematics, natural science, and languages. He attended University College, London, one of only a few institutions which accepted Quakers at that time and he initially studied botany and obtained a bachelor of Arts degree in 1847. He registered as a student and graduated with honours as Bachelor of Medicine. In 1854, Lister became both first assistant to and friend of surgeon James Syme at the University of Edinburgh, Edinburgh Royal Infirmary in Scotland. There he joined the Royal Medical Society and presented two dissertations, in 1855 and 1871, which are still in the possession of the Society today and he subsequently left the Quakers, joined the Scottish Episcopal Church, and eventually married Symes daughter, Agnes. On their honeymoon, they spent 3 months visiting leading medical institutes in France, by this time, Agnes was enamoured of medical research and was Listers partner in the laboratory for the rest of her life. Before Listers studies of surgery, most people believed that damage from exposures to bad air was responsible for infections in wounds. Hospital wards were occasionally aired out at midday as a precaution against the spread of infection via miasma, a surgeon was not required to wash his hands before seeing a patient because such practices were not considered necessary to avoid infection. Despite the work of Ignaz Semmelweis and Oliver Wendell Holmes, Sr. hospitals practiced surgery under unsanitary conditions, Surgeons of the time referred to the good old surgical stink and took pride in the stains on their unwashed operating gowns as a display of their experience. Pasteur suggested three methods to eliminate the micro-organisms responsible, filtration, exposure to heat, or exposure to solution/chemical solutions, Lister confirmed Pasteurs conclusions with his own experiments and decided to use his findings to develop antiseptic techniques for wounds. As the first two suggested by Pasteur were dangerous and unsafe for the treatment of human tissue, Lister experimented with the third idea. In 1834, Friedlieb Ferdinand Runge discovered phenol, also known as carbolic acid, upon hearing that creosote had been used for treating sewage, Lister began to test the efficacy of carbolic acid when applied directly to wounds
Joseph Lister, 1st Baron Lister
–
Photograph 1902
Joseph Lister, 1st Baron Lister
–
Lister with fellow Residents at the Old Royal Infirmary, Edinburgh, c.1855 (Lister is in the front row with his hands clasped)
Joseph Lister, 1st Baron Lister
–
Grave of Joseph Lister, West Hampstead Cemetery
Joseph Lister, 1st Baron Lister
–
Lister Building at
Glasgow Royal Infirmary
47.
Antiseptics
–
Antiseptic are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. Disinfectants do not kill bacterial spores e. g. on surgical instruments, even sterilization may not destroy prions. Some antibiotics are true germicides, capable of destroying microbes, while others are bacteriostatic, antibacterials are antiseptics that have the proven ability to act against bacteria. Microbicides which destroy virus particles are called viricides or antivirals, antisepsis was recommended by Hungarian physician Ignaz Semmelweis in 1847 but, tragically, he was ignored. In this paper, Lister advocated the use of acid as a method of ensuring that any germs present were killed. Some of this work was anticipated by, Ancient Greek physicians Galen and Hippocrates and their theories were bitterly opposed by Galenist Guy de Chauliac and others trained in the classical tradition. Joseph Smith alluded to the use of alcohol as an antiseptic in February 1833, specifically, verse 7 states, And, again, strong drinks are not for the belly, but for the washing of your bodies. More commonly, 3% solutions of hydrogen peroxide have been used in household first aid for scrapes, however, the strong oxidization causes scar formation and increases healing time during fetal development. Iodine is usually used in a solution or as Lugols iodine solution as a pre-. Some people do not recommend disinfecting minor wounds with iodine because of concern that it may induce scar tissue formation, however, concentrations of 1% iodine or less have not been shown to increase healing time and are not otherwise distinguishable from treatment with saline. Polyhexanide is a compound suitable for clinical use in critically colonized or infected acute. The physicochemical action on the bacterial envelope prevents or impedes the development of resistant bacterial strains, balsam of Peru is a mild antiseptic. By continued exposure to antibiotics, bacteria may evolve to the point where they are no longer harmed by these compounds, bacteria can also develop a resistance to antiseptics, but the effect is generally less pronounced. The mechanism by which bacteria evolve may vary in response to different antiseptics, low concentrations of an antiseptic may encourage growth of a bacterial strain that is resistant to the antiseptic, where a higher concentration of the antiseptic would simply kill the bacteria. In addition, use of a high concentration of an antiseptic may cause tissue damage or slow the process of wound healing
Antiseptics
–
Joseph Lister
Antiseptics
–
A bottle of ethanol (95%) – an antiseptic
48.
Louis Pasteur
–
Louis Pasteur was a French biologist, microbiologist and chemist renowned for his discoveries of the principles of vaccination, microbial fermentation and pasteurization. He is remembered for his breakthroughs in the causes and prevention of diseases. He reduced mortality from puerperal fever, and created the first vaccines for rabies and his medical discoveries provided direct support for the germ theory of disease and its application in clinical medicine. He is best known to the public for his invention of the technique of treating milk and wine to stop bacterial contamination. He is regarded as one of the three founders of bacteriology, together with Ferdinand Cohn and Robert Koch, and is popularly known as the father of microbiology. Pasteur was responsible for disproving the doctrine of spontaneous generation and he performed experiments that showed that without contamination, microorganisms could not develop. Under the auspices of the French Academy of Sciences, he demonstrated that in sterilized and sealed flasks nothing ever developed, although Pasteur was not the first to propose the germ theory, his experiments indicated its correctness and convinced most of Europe that it was true. Today, he is regarded as one of the fathers of germ theory. Pasteur also made significant discoveries in chemistry, most notably on the basis for the asymmetry of certain crystals. Early in his career, his investigation of tartaric acid resulted in the first resolution of what is now called optical isomers and his work led the way to the current understanding of a fundamental principle in the structure of organic compounds. He was the director of the Pasteur Institute, established in 1887, till his death, although Pasteur made groundbreaking experiments, his reputation became associated with various controversies. Historical reassessment of his notebook revealed that he practiced deception to overcome his rivals, Louis Pasteur was born on December 27,1822, in Dole, Jura, France, to a Catholic family of a poor tanner. He was the child of Jean-Joseph Pasteur and Jeanne-Etiennette Roqui. The family moved to Marnoz in 1826 and then to Arbois in 1827, Pasteur entered primary school in 1831. He was a student in his early years, and not particularly academic. He drew many pastels and portraits of his parents, friends, Pasteur attended secondary school at the Collège dArbois. In October 1838, he left for Paris to join the Pension Barbet, in 1839, he entered the Collège Royal de Besançon to study philosophy and earned his Bachelor of Letters degree in 1840. He was appointed a tutor at the Besançon college while continuing a degree course with special mathematics
Louis Pasteur
–
Photograph by
Nadar
Louis Pasteur
–
The house in which Pasteur was born,
Dole
Louis Pasteur
–
Pasteur in 1857
Louis Pasteur
–
Pasteur experimenting in his laboratory.
49.
Ronald Ross
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His discovery of the malarial parasite in the gastrointestinal tract of a mosquito proved that malaria was transmitted by mosquitoes, and laid the foundation for the method of combating the disease. He was a polymath, writing a number of poems, published several novels and he was also an amateur artist and natural mathematician. He worked in the Indian Medical Service for 25 years and it was during his service that he made the groundbreaking medical discovery. After resigning from his service in India, he joined the faculty of Liverpool School of Tropical Medicine, in 1926 he became Director-in-Chief of the Ross Institute and Hospital for Tropical Diseases, which was established in honour of his works. He remained there until his death, Ronald Ross was born in Almora, India, the eldest of ten children of Sir Campbell Claye Grant Ross, General in the British Indian Army, and Matilda Charlotte Elderton. At age eight he was sent to England to live with his aunt and he attended Primary schools at Ryde, and for secondary education he was sent to a boarding school at Springhill, near Southampton, in 1869. From his early childhood he developed passion for poetry, music, literature, at fourteen years of age he won a prize for mathematics, a book titled Orbs of Heaven which sparked his interest in mathematics. In 1873, at sixteen, he secured first position in the Oxford, although he wanted to become a writer, his father arranged enrollment at St Bartholomews Hospital Medical College in London, in 1874. Not fully committed, he spent most of his composing music. He qualified on second attempt in 1881, and after a training at Army Medical School. Ronald Ross embarked for India on 22 September 1881 on the troopship Jumma, between 1881 and 1894 he was variously posted in Madras, Burma, Baluchistan, Andaman Islands, Bangalore and Secunderabad. In 1883, he was posted as the Acting Garrison Surgeon at Bangalore during which he noticed the possibility of controlling mosquitoes by limiting their access to water, in March 1894 he had his home leave and went to London with his family. On 10 April 1894 he met Sir Patrick Manson for the first time, Manson who became Rosss mentor, introduced him to the real problems in malaria research. Manson always had a belief that India was the best place for the study. Ross returned to India on P&O Ferries Ballaarat on 20 March 1895, even before his luggage was cleared in the custom office, he went straight for Bombay Civil Hospital, looking for malarial patients and started making blood films. Ross made his first important step in May 1895 when he observed the early stages of malarial parasite inside a mosquito stomach, however, his enthusiasm was interrupted as he was deployed to Bangalore to investigate an outbreak of cholera. Bangalore had no cases of malaria. He confided to Manson stating, I am thrown out of employment and have no work to do, in May 1896, he was given a short leave that enabled him to visit a malaria-endemic region around Ooty
Ronald Ross
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Sir Ronald Ross
Ronald Ross
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The page in Ross' notebook where he recorded the "pigmented bodies" in mosquitoes that he later identified as malaria parasites
Ronald Ross
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Ross, Mrs Ross, Mahomed Bux, and two other assistants at Cunningham’s laboratory of Presidency Hospital in Calcutta
Ronald Ross
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Ronald Ross Memorial,
SSKM Hospital,
Kolkata
50.
Richard Doll
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Sir William Richard Shaboe Doll CH OBE FRS was a British physiologist who became a epidemiologist in the 20th century, turning the subject into a rigorous science. He was a pioneer in research linking smoking to health problems, with Ernst Wynder, Bradford Hill and Evarts Graham, he was credited with being the first to prove that smoking caused lung cancer and increased the risk of heart disease. He also carried out pioneering work on the relationship between radiation and leukemia as well as that between asbestos and lung cancer, and alcohol and breast cancer. Doll was born at Hampton into an affluent family, though his fathers work as a doctor was cut short by multiple sclerosis, educated first at Westminster School, Doll originally then intended to study mathematics at Trinity College, Cambridge. Doll claimed to have failed the scholarship from the effects of drinking 3 pints of the Colleges 8% alcohol own-brewed beer the night before. He subsequently chose to study medicine at St Thomass Hospital Medical School, Doll was a socialist, and one of the significant figures in the Socialist Medical Association whose campaign helped lead to the creation of Britains postwar National Health Service. He joined the Royal College of Physicians after the outbreak of World War II, after the war, Doll returned to St Thomas to research asthma. In 1948 he joined a team under Dr Francis Avery-Jones at the Central Middlesex Hospital. Over a 21-year career in the unit, Doll rose to become its director and his research there initially focused on the role of occupational factors in causing peptic ulcers. It may be 50 times as great among those who smoke 25 or more cigarettes a day as among non-smokers, in 1955 Doll reported a case controlled study that has firmly established the relationship between asbestos and lung cancer. In 1966 Doll was elected to the Royal Society, in clinical medicine he has made carefully controlled trials of treatments for gastric ulcer. In 1969, Doll moved to Oxford University, to sit as the Regius Professor of Medicine, initially, epidemiology was held in low regard, but in his time at Oxford he helped reverse this. He was the primary agent behind the creation of Green College, Doll was appointed the first Warden of Green College, from where he retired in 1983. Green College merged with Templeton College in 2008 to become Green Templeton College, Doll also helped found the National Blood Service, and was key in avoiding a system of paying donors for their blood, as had been adopted in the United States. Doll was made a Fellow of the Royal Society in 1966, knighted in 1971, also in 1981, Doll became a founding member of the World Cultural Council. In 1996 he was made a Companion of Honour for services of national importance, International honours included the Presidential Award of the New York Academy of Sciences as well as a UN Award for his research into cancer. In April 2005, he was awarded the Saudi Arabian King Faisal International Prize for medicine jointly with Peto for their work on diseases related to smoking, in 2004, he was awarded the inaugural Shaw Prize for Life Sciences and Medicine for his contribution to modern cancer epidemiology. He was also awarded honorary degrees by thirteen different universities and he was a supporter of the Liberal Democrats at the 2005 general election
Richard Doll
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Richard Doll in 2002
Richard Doll
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Richard Doll Building, Oxford.
51.
Exposure Assessment
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These are the final steps in the path to release an environmental contaminant, through transport to its effect in a biological system. Exposure assessment is the process of estimating or measuring the magnitude, frequency and duration of exposure to an agent, along with the number, ideally, it describes the sources, pathways, routes, and the uncertainties in the assessment. Exposure analysis is the science that describes how an individual or population comes in contact with a contaminant, including quantification of the amount of contact across space, Exposure assessment and exposure analysis are often used as synonyms in many practical contexts. Risk is a function of exposure and hazard, for example, even for an extremely toxic substance, the risk of an adverse outcome is unlikely if exposures are near zero. Conversely, a toxic substance may present substantial risk if an individual or a population is highly exposed. The receptor-based approach is used in exposure science and it starts by looking at different contaminants and concentration that reach people. After the identification of the source, it is important to find out the most efficient way to adverse health effects. If the contaminant reaches a person, it is hard to reduce the associated adverse effects. Therefore, it is important to reduce exposure in order to diminish the risk of adverse health effects. It is highly important to use both regulatory and non-regulatory approaches in order to decrease exposure to contaminants. In many cases, it is better to change people’s activities in order to reduce their exposures rather than regulating a source of contaminants, the receptor-based approach can be opposed to the source-based approach. This approach begins by looking at different sources of such as industries. Then, it is important to find out if the contaminant of interest has reached a receptor, with this approach, it is very hard to prove that a pollutant from a source has reached a target. In this context exposure is defined as the contact between an agent and a target, contact takes place at an exposure surface over an exposure period. Mathematically, exposure is defined as E = ∫ t 1 t 2 C d t where E is exposure and it has dimensions of mass times time divided by volume. This quantity is related to the dose of contaminant by multiplying it by the relevant contact rate, such as breathing rate. The contact rate itself may be a function of time, contact between a contaminant and an organism can occur through any route. Exposure to a contaminant can and does occur through multiple routes, in many cases the main route of exposure is not obvious and needs to be investigated carefully
Exposure Assessment
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Simple representation of exposure risk assessment and management hierarchy based on available information
. PMID 22845482. doi:10.1586/erm.12.46.
