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Here, we can only describe the faulty functioning


of our bodys machinery, or the role of external
circumstances in overwhelming our bodys machinery.

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Bruce Wallace, Department of Biology, Virginia Polytechnic Institute
and State University

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Human Homeostasis:
Health and Disease
The processes of homeostasis allow most people to enjoy relatively long and

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healthy lives. For these people, the common cold and other minor illnesses are only
temporary disruptions. Their bodies are quite capable of recovering through normal

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regulatory processes. Occasionally, disruptions can affect our homeostasis. In turn,
these disruptions affect our health in more serious and sometimes permanent ways.
These cases often require medical care to help the body stay within the internal limits

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necessary for life.

In this chapter, you will examine what happens when homeostasis is disrupted in
various ways. You will explore the effects of severe dehydration, allergic reactions,

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trauma, and a variety of other emergency health care situations. You also will consider
how medical technology can help compensate for disruptions in the bodys
homeostasis. Then you will examine how certain personal behaviors can increase or

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reduce your risk of disrupting your bodys homeostasis. After you have completed
these activities, you will evaluate your understanding of disruption by developing a
mock proposal that requests funds for a worthy health care initiative of your choice.

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ACTIVITIES
ACTIVITIES

Engage Pushing the Limits

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Explore
Hospital Triage
Explain

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Explain Self-Defense!

Explain
Whats the Risk?
Elaborate

Evaluate Health Care Proposal

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Engage Pushing the Limits


Just how much stress can the human body endure and still function? As you work
through this activity, you will examine the limits of the human body. In the activities
that follow, you will use your knowledge of the mechanisms for maintaining an
internal balance to understand the limits of homeostasis further.

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PROCESS AND PROCEDURES

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1. Read the story A Sweltering Experience. As you read, use your journal to record
details about the physical condition of the 2 hikers at the time of their rescue.
2. With your partner, complete the following tasks. Write your responses in your

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journal.

A Sweltering Experience

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The two hikers thought they had It was then that Nelson
nothing to worry about. The day pointed out that they had finished
was beautiful: warm and clear, most of the water from the single

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with a pleasant breeze sweeping canteen they had brought.
off the high desert. The canyon Neither of them was tired. But
trail offered great views. Monique given the heat, and the distance
and her father, Nelson, tromped remaining to the bottom, they

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enthusiastically downward. They decided they had better turn
stopped to enjoy the brilliant around and start back up
wildflowers and watched their toward the rim where they
steps as they skirted around a had left their car in the Forest

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narrow switchback. Monique cried Service parking lot.
out in delight as she spotted an Almost immediately, the effects
eagle soaring nearby, riding the of gravity became apparent. A trail

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warm air currents rising from the that had been an easy stroll going
canyon depths. down now became a daunting
They never thought about the ramp rising steeply upward. Their
distance, trekking downhill over progress was slow, and the canyon
nine miles of trail before they rim seemed impossibly high
began to grow tired. They stopped overhead. Monique started to feel
to rest. Nelson removed his jacket, concerned as, after an hour of
tying it around his waist, while climbing, they finally reached the
Monique applied more sunscreen switchback that had been just a
to her face. They remarked, with few minutes away when they were
some surprise, that it was much going down.
warmer in the canyon than they
had expected.

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a. List at least 4 human body systems that would be involved in restoring


internal balance in the hikers.
Think about your work in Chapters 4 and 5. Use your understanding of
interacting body systems that work to maintain internal balance to complete
your list.
b. List 4 situations not discussed in the story that could also severely disrupt
homeostasis.

Analysis
Respond in your journal to the following:

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Use the information in the essay Beyond the Limits (page 242) as a resource. PAGE 242

1. List two mild stressors and two severe stressors. Describe the effects that each
stressor would have on the human body.

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2. From your personal experience, describe two examples of disruptions of
homeostasis in nonhuman organisms.

They were very thirsty but had to ration the last

T cool itself adequately through perspiration. He was dizzy

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few mouthfuls of water carefully. Frequently, they and nauseous, suffering from an excruciating headache,
stopped to mop the sweat from their faces, drawing so confused that he couldnt think of what to do next.
deep, ragged breaths of dry air that didnt seem to It was only good fortune that a ranger who was a
refresh them much at all. They had no strength for trained paramedic drove into the parking lot on a

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conversation, merely plodded along slowly, kicking up routine patrol. Immediately, he noticed that Nelson
clouds of dust with each footstep on the dry, gritty trail. needed help. The hiker was breathing loudly and
Suddenly, Monique cried out in pain and slapped at rapidly through his mouth, and the skin of his hand was
her leg, swatting away a beebut not before the insect hot and dry to the touch. Yet, his face was not very

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had driven its stinger through her skin. Grimly, she flushed. Even as he radioed for a backcountry rescue
continued on. But within minutes, her leg began to team to go after Monique, the ranger knew that Nelson
swell around the sting. Limping in pain, she moved even himself was dangerously ill.

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slower than before, and soon she had to stop and rest. The rescuers reached Monique 3 hours after she had
Nelson was growing frantic. They still had three or been stung. Her condition was alarming. They quickly
four miles to go to reach the parking lot. They had seen loaded her onto a stretcher and carried her to the
no other hikers during the whole day. He found a small nearest clearing wide enough for a helicopter to land.
patch of shade near the trail and told Monique to stay Meanwhile, the ranger reported the patients condition
there while he went for help. Leaving her the canteen, to the emergency room personnel.
with its remaining sip or two of water, he started Her vision is blurred, and her breathing labored.
climbing as fast as he could. He hoped to find a ranger Her leg is red and swollen near the bee sting, and she
or call for help from the pay phone near where they has a rash over her leg, spreading to her stomach. Her
had parked the car. lips are crackedshe had trouble drinking when we
Climbing with all his strength and endurance, gave her water.
gasping for breath and sweating profusely, Nelson still The helicopter flight will not take long, but Nelson
took 2 hours to reach the rim. When he arrived at the and Moniques fates both remain uncertain. Its up to
car, he was badly dehydrated. His body could no longer you, the emergency room personnel, to save them!

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Explore Hospital Triage


Explain You and your partners are a team of physicians in the emergency room of Desert
Metropolitan Hospital. Its about 8:30 P.M. on a Friday in July. You have been busy, as
you usually are on summer weekends. Unfortunately, you are about to become even
busier. You have just received a flurry of calls from local paramedics, and now you and
your colleagues are preparing for an influx of patients suffering from a variety of

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illnesses and trauma injuries. This influx includes a flight-for-life helicopter carrying
the two canyon hikers discussed in A Sweltering Experience.

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Because there are many patients and only a handful of doctors, you cannot treat
every patient at the same time. Your first task is to assess the severity of each patients
condition and establish a priority for treatment, which is called triage. Triage is a

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process used in battlefields, disaster areas, and emergency rooms to assign the order
for assisting patients and maximizing medical efficiency and success. You will need to
use everything you know about the bodys normal homeostatic mechanisms to

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complete this triage. Keep in mind that there are no right answers for your medical
team. The most important measure of your success will be your teams ability to
explain the treatment choices that you make.

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PROCESS AND PROCEDURES

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Part A Triage in the Emergency Room
When you visit your doctors office, a medical professional first measures and
records your vital signs. Have you ever considered what your vital signs tell the

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doctor? Vital signs are body characteristics that can be measured quickly. They
provide important information about major body systems. This information is
particularly important to obtain and quickly interpret when patients are experiencing

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severe trauma.
1. Meet with your team of doctors, and read the Glossary of Vital Signs in
preparation for interpreting your patients conditions.

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2. Review the normal, serious, and critical ranges for the vital signs in the need to
know box. You will refer to this information to determine the level of trauma
that your patients are experiencing.
3. Obtain the handout Patients Vital SignsPreliminary Information from your
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teacher. As a team, read about your patients.
Topic: vital signs Pay particular attention to the description of each patients injury or illness.
Go to: www.scilinks.org
Code: human3E196
4. With your medical team, briefly discuss the possible outcomes for each patient.
5. Obtain 2 triage data sheets from your teacher. Divide your triage team to work
in pairs to complete the following tasks. Work with your partner to evaluate
the data for half of the patients. The rest of your triage team will evaluate the
other half. When both teams have completed the initial patient evaluations,
compare your findings and develop your treatment strategy.

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Glossary of Vital Signs


Vital signs are body characteristics that can be measured quickly. They provide
important information about major body systems.

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Pulse is the rate (how fast or slow) at which the heart is beating. It provides
clues to how well the heart is
functioning. It also indicates how

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well the blood is carrying oxygen
and other important substances to
the tissues, including brain tissues.

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Blood pressure is another indicator
of the hearts ability to pump blood
throughout the body. It is measured
at an artery and is usually

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represented as two numbers such as
125/85. The first number (systolic)
is a measurement of the force of
blood against the walls of the

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arteries, veins, and chambers of the
heart as the heart contracts. The
second number (diastolic) is a
measurement of the lowest pressure reached as the heart relaxes.

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Body temperature indicates whether the bodys thermal regulation is
working. An elevated body temperature could indicate an infection.
A low central body temperature, or core temperature, indicates a type of

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shock.
Rate of breathing reflects how well oxygen is being delivered to the body.
It also is associated with heart rate and circulation.
Taken together, vital signs give the physician a quick view of a patients internal

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state, even if the patient is unconscious and cannot explain how he or she feels. These
measurements vary over a relatively narrow range in healthy people, indicating that
the body normally has precise control of internal conditions. When the vital signs are
far outside these normal ranges, homeostasis usually is disrupted in the patient. Under

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these circumstances, the vital signs are direct indicators of problems with internal
systems that are involved in maintaining homeostasis. Vital signs, however, usually do
not indicate the cause of the disruption of homeostasis.

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Range of vital signs Normal Serious Critical

Blood pressure 110/70 to 140/90 mm Hg 90100 mm Hg <90 mm Hg


Systolic pressure (the top number) (systolic/diastolic) systolic systolic
is the pressure created when the

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heart contracts and pumps blood.
Diastolic pressure (the bottom
number) is the pressure between

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contractions when the heart relaxes
and fills.

Resting pulse 60100 beats/min <60 or >100 beats/min <50 or >120 beats/min

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Temperature 37C (98.6F) 39C40C (102.2F104F) >40C (>104F)

Breathing rate 1020 resp./min <10 or >20 resp./min <10 or >30 resp./min

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Key to units: mm Hg = millimeters of mercury, a measure of pressure; < is less than, > is greater than
Note: The figures quoted above are simplified guidelines. They are based on those used by medical personnel. More precise ranges
for different age-groups and sexes also are used. Occasionally, healthy individuals have normal readings that are outside of these
average ranges. For example, many young people have systolic blood pressure lower than 100 mm Hg.

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In general, blood pressure must be evaluated in relation to the other vital signs and the patients age and condition. For
the purposes of this activity, assume that the normal state for each patient is within the normal ranges listed in the table.

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Task 1: Compare the vital signs of each patient with the normal ranges.
Procedure: Use the information in the need to know box to decide whether
each vital sign for every patient is within normal limits or not. Record the

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vital signs for each patient in the 2nd column on the data sheet. In the 3rd
column, record a checkmark () to indicate vital signs that are within
normal limits. Use an X to indicate those outside normal limits.

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Task 2: Identify the body systems most likely disrupted by each patients
injuries or illness.
Procedure: Work with your partner to develop a list of systems that are
disrupted for each patient. Record your lists in the 4th column on your data
sheet. Use your knowledge of interactions between internal body systems in
maintaining homeostasis from Chapters 4 and 5 to make logical inferences
from the vital signs.
Task 3: Join with your other team members to compare all of your patients
and to assign treatment priorities.
Procedure: Use your best listening skills. Encourage all team members to
contribute ideas about how your team should treat each patient.

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Task 4: Suggest initial triage treatments, and explain your priority choice
for each patient.
Procedure: a. Read General Triage Guidelines on page 200.
b. Reread the description of each patient.
c. In the 1st column of the data sheet next to each
patients name, write the number that corresponds to

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the order of treatment that your team agrees upon for
this triage. a

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d. In the 6th column, write a brief justification for the
treatment priority that your team assigned each
patient.

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e. For each of your patients, list 1 or 2 emergency
medical treatments that might help each restore
homeostasis. Record this list in the 6th column as

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well. Use the back of the data sheet if you need more
space to record your responses.

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b
Part B Lets Get More Information
While you were performing your triage evaluation, medical technicians and
laboratory staff conducted some additional tests. These include analyses of blood and

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urine samples. These new data may provide you with important information about
each patients condition that you were not able to discern from vital signs alone.
1. Obtain the Copymaster First Priority from your teacher. Discuss the

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importance of this new information with your teammates.
2. Working as a team, reevaluate the order you should treat each patient. Record
your order of priority in the 7th column of your teams triage data table. (This

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may be different from the order given in task 4c.)
Be prepared to share your ideas and your teams triage results in a class discussion.
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3. Obtain the Copymaster Additional Information from your teacher. Read the

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information to learn the consequences of your secondary triage decisions. Figure 6.1
Examples of
4. In the 8th column, indicate any additional internal body systems (systems that technology in
were not identified as being disrupted in Part A) that your team thinks are medicine. (a) MRI
disrupted. Base your decisions on the new information. and monitor (b) CT
scans (c) Intensive Care
The information in the Copymaster Additional Information may provide additional Monitoring Station
clues about your patients body systems.
5. With your team, discuss any additional factors that may have contributed to
each patients condition and to your priority choices. Write a brief explanation
for your patients final ranking in the 8th column of the triage data sheet.
These may include nonmedical factors, such as behavior and luck, which your team
took into consideration.

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GENERAL TRIAGE GUIDELINES


1. All emergency care begins with the ABCs. Make sure there is an open
Airway, that the patient is Breathing, and that the patient has adequate

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Circulation.
a. Airway. Remove obstructions from the mouth, if necessary. Move the
tongue if it is obstructing the airway. Close openings such as the nose or

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wounds that prevent the lungs from filling with air.
b. Breathing. Restore breathing by artificial resuscitation. (This is a
technique by which another person or device can temporarily provide
air to a patient.) Or administer oxygen, if necessary.

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c. Circulation. Stop blood loss from serious wounds. Restore heartbeat by
cardiopulmonary resuscitation (CPR), if necessary. CPR is a technique in
which another person temporarily provides air and heart contractions

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for a patient whose heart has stopped beating or is not pumping blood
effectively.
2. Look at the patient, and assess his or her injuries. Immobilize any injuries
to the neck. The patient may become paralyzed if you initiate any

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movement. Always suspect neck injuries when there is extensive injury to
the head or face.
3. Shock is extremely serious and life threatening. It occurs when blood

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pressure drops so low that it no longer delivers adequate supplies of
oxygen and nutrients to the tissues. Shock can result from failure of the
heart to pump vigorously enough. It can also result from serious blood loss
or from a reduction of effective blood volume due to pooling in the

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capillaries or to dehydration.
Shock due to reduced blood volume can be treated by elevating the
feet, by using pressure suits that force blood from the extremities back
into the body core, or by infusing blood or saline solution into the

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circulatory system. Shock due to weakness of the heart or damage to the
circulatory system may require medications or mechanical devices that
assist circulation.
4. The hypothalamus normally controls internal body temperature. If this

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control is lost, the core body temperature can rise to dangerously high
levels, a condition known as hyperthermia. Extreme hyperthermia can
kill cells, particularly brain cells. In these cases, external measures must be
taken, such as rubbing the patient with ice to bring the body temperature
back within normal limits.
Conversely, the body can cool to dangerous levels. This is a condition
known as hypothermia. Hypothermia can occur when people are cold
and wet for a long period of time. Rapid evaporation of water can cool
a person quite quickly, even if the air temperature is not extremely cold.
In such cases, the body must be warmed slowly to bring it back within
normal limits.

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6. As a team, discuss what the prognosis, or long-term outlook, is for each


patient. Prepare to present your reasoning in a class discussion.
For instance, you might think that some patients will recover completely, others will
recover slowly and may suffer long-lasting effects, and others may never recover and
even die because of their injury or illness.

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Analysis
Work individually to respond to the following. Write your answers in your journal.

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The essay Coping with Disruptions: The Role of Medicine in Homeostasis (page 244) and
the facts in the need to know boxes provide important background information for
PAGE 244
writing well-reasoned answers.

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1. Why are vital signs so valuable in assessing a patients condition quickly?
2. Explain how a head injury, such as the one Albert suffered when his

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motorcycle crashed, could affect so many internal body systems that are
necessary to maintain homeostasis.
3. How did a bacterial infection cause a higher-than-normal temperature in

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Maria?
4. Monique and Nelson both had very high temperatures when they were
brought into the emergency room. Why do you think Moniques heart rate

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was high and Nelsons heart rate was low?
5. Why was Monique likely to survive if she received treatment in time but
Nelson died in spite of the priority he was given?

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6. What, if any, nonmedical considerations did you use to rank the patients?
Explain your response.
7. In one or two paragraphs, compare and contrast an illness or injury that the

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body can recover from on its own with one that requires medical intervention.
Explain how the responses of internal body systems that are necessary to
maintain homeostasis differ in the two situations.

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Looking Ahead
In the evaluate activity for this chapter, you will work with your teammates to
develop a health care proposal. Because you will need extra time to collect
information for your proposal, you need to start now.
With your team, turn to Health Care Proposal (page 209). Read the introduction
to the activity, and complete steps 1 and 2. Then begin step 3. Developing your
proposal will be more rewarding if you are well prepared.

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Explain Self-Defense!
You have seen how the body corrects minor disruptions in homeostasis and
how medical technology can help when the disruptions are more serious. But would
you believe that a battle is going on inside your body even when you are healthy?
This battle is being fought by internal body systems that work together to protect
your body against external conditions before they threaten to disrupt your bodys

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normal balance.
As a living system, your body constantly

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fights against foreign chemicals and invading
microorganisms and viruses. Where do these
invaders come from? Recall the bee sting that

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Monique, the hiker, suffered. When a bee
stings you, it injects venom into your body.
This venom is made up of molecules that are

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foreign to your body, and your body reacts to
them. Another source of invading particles is
the air that you breathe. Air contains many

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unhealthy things. These include particles of
pollutants, spores of fungi and bacteria, and
virus particles. The number of potential

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Figure 6.2 A single kachoo can release 10,000 to invaders is even higher if you breathe the air
100,000 virus particles. near a person who has a cold and who sneezes.
It might seem impossible for living organisms to protect themselves against the

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disrupting influence of so many threats. Yet, all living systems have some means of
protecting their internal environment against infection. As a human, you have a
particularly elaborate system of natural defense, which is known as the immune
system. Although it is not perfect, the immune system generally wins its battles.

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This activity will help you explain how your body defends itself.

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Materials (per team of 4)

test subject card scenario card

PROCESS AND PROCEDURES


Part A Natural Defenses
1. Respond to the following statements about how the immune system helps
maintain homeostasis. Record your answers in your journal.
PAGE 246 PAGE 250 Use the background information in the essays Avoiding Disruptions: The Immune
System (page 246), Self and Nonself (page 250), and Immune System Memory (page 251)
to help you with this task. The information in the Glossary of Immune System
Components should also help.
PAGE 251

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a. Why is it important for the body to distinguish material that is part of itself
from nonself material? Explain what happens when the body fails to make
that distinction.
b. Provide 2 examples of the immune systems nonspecific defense mechanisms.
Explain how nonspecific immunity differs from specific immunity.
c. Explain why viruses are unaffected by antibiotics such as penicillin and

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tetracycline.
d. Describe how vaccination is a technological innovation that takes

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advantage of a basic property of the immune system.
2. Share your answers as part of a class discussion.

Glossary of Immune System Components


Antibodies are protein molecules that B-cells
produce when they have been activated in response

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to foreign antigens, such as those present on
pathogens. Antibodies have two identical binding
sites, so they can bind two of the same pathogens. This

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forms clumps that inactivate the pathogens. Antibodies
may be located on the cell surface of certain immune
system cells. Or they may circulate freely in the bloodstream.
Antigens (antibody generators) are specific molecules.

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They may be the proteins that are present on the surface of
pathogens or foreign (nonself) molecules that are harmless. Antigens that the Topic: immune system
Go to: www.scilinks.org
immune system recognizes as nonself, or foreign, can induce an immune response. Code: human3E203
B-cells are immune cells that are made and mature in the bone marrow. When B-
cells are activated, they divide and produce two groups of cellsplasma B-cells and

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memory B-cells.
Plasma B-cells produce free antibodies
(identical to their surface antibodies). These

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antibodies circulate throughout the body to
counter infections.
Memory B-cells are long-lived cells. These cells
ensure that future infections by the same pathogen
will trigger a much more rapid immune response.
Because of memory B-cells, it is less likely that a
person will become ill a second time from the same
pathogen. If a second illness does occur, it is usually less severe.
B-cells can be activated in two ways. One way is by directly encountering an
antigen that they bind to and process. The processed antigen presented on the
B-cell surface can signal other immune cells. The second way B-cells are activated is
through interaction with antigens presented on a macrophage or helper T-cell. B-cells
require the presence of helper T-cells to mount a full immune response.
(continued )

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Glossary of Immune System


Components (continued )
Complement is a group of proteins found in the
blood that acts in a sequential manner, destroying
pathogens. Antibody-antigen complexes can activate
the first complement factors. These in turn activate

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other complement factors. After a series of step-wise
activations, enough complement factors are activated
to eliminate antigens in two ways. First, some of the

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activated complement proteins can attract macrophages,
which engulf and destroy the antigen. Second, activated
complement molecules can aggregate within the cell membrane of a pathogen.

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These molecules eventually form holes that cause the pathogen to burst.
Lymphocytes are the white blood cells involved in the specific immune
response. They include the various types of B-cells and T-cells.
Lymphokines are molecules released by helper T-cells and other lymphocytes

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that help activate other cells of the immune
system.
Macrophages are nonspecific scavenger
cells of the immune system that are present

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throughout the body. They engulf the foreign
material, including pathogens, that they
encounter. Then they degrade it and present its
antigens on their surface.

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Macrophages move about in a manner
similar to that of one-celled amoebas and are
attracted to an infection site. If enough

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macrophages are present, the infection may be
stopped at this stage.
Macrophages can interact with and activate other immune cells, including B-
cells and helper T-cells.
Pathogens are organisms or particles such as a bacterium, fungus, or virus that

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have the potential to cause a disease.
T-cells are immune cells that are formed in the bone marrow but mature in the
thymus. There are at least two types: helper T-cells and killer T-cells.

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Helper T-cells are activated by interacting with macrophages or B-cells that
have encountered foreign antigens. Activated
helper T-cells secrete chemicals known as
lymphokines, which activate B-cells and killer T-cells.
Killer T-cells carry out cell-to-cell combat.
They destroy cells that are infected with a virus
as well as cells that have become cancerous. These
T-cells recognize virus-infected cells because the
infected cells have viral antigens on their surface.
These antigens are recognized as foreign. Killer
T-cells must be activated by helper T-cells before
they can multiply and attack virus-infected cells.

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Part B Diagnosis: A Puzzle


Now you will use your knowledge about pathogens and the immune system to
solve a puzzle. Use all available resources, including what you have learned in earlier
activities. First, you will see how each test subject reacts to the same, known pathogen.
Then you will use this information and similar strategies to try to determine the
identity of an unknown pathogen.

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1. Have 1 team member obtain a test subject card from the container that your
teacher provides. Share the information on the card with the rest of the team.

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2. Assume that your subject has just been exposed to the influenza virus.
Complete the following tasks with your team. Record in your journal the
evidence and inferences that support your conclusions.

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a. Generate a prognosis for your subject.
A prognosis is a prediction based on evidence and inference about whether a
person will become ill, and if so, how soon he or she will recover.

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b. Discuss what effect penicillin would have if it were administered the 1st
day that symptoms occur.
3. As your teacher directs, share your teams prognosis for your test subject with

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your classmates.
4. Try a different version of this exercise. Instead of knowing the identity of the
pathogen and determining the prognosis, now you will know the prognosis of

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your test subject. Your job will be to identify this unknown pathogen.
a. Assume that your test subject has been exposed to 1 of the pathogens from

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the list below:
Streptococcus bacterium

common cold virus

rubella virus

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b. Obtain a scenario card that describes what happened after your test subject
was exposed to the unidentified pathogen.

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c. Work with your teammates to analyze all available clues. Use this 1st level
of analysis to determine the identity of your test subjects pathogen.
You might wish to organize your reasoning by filling in a table like the one shown
in Figure 6.3. The available information may not help you determine with
certainty the identity of your test subjects pathogen. However, you may be able to
use this information to eliminate some pathogens from further consideration and
to narrow the possibilities. Support your decision with reasons based on evidence.
In your team, practice using the skill of consensus building.
5. Pick up the Copymaster Complete Scenario Information so that you can begin a
2nd level of analysis.

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Figure 6.3 Pathogen identification table. Use a table like this to organize
your thinking.

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6. Use this new information to try to determine your test subjects pathogen with

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greater certainty and to justify your refined answer. Include reasons and
evidence that support your refined conclusions.
The additional information should allow you to use a process of elimination to

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determine the unknown pathogen. For this 2nd level of analysis, you may wish to add
rows to your table to organize your reasoning.
N S TA
7. Use the table that you generated as a record of your thinking. Participate in a

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Topic: stress (management, class discussion of the results of this exercise.
bodys response)
Go to: www.scilinks.org
Code: human3E206
Analysis

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Complete the following in your journal:
1. In Part B of this activity, you used the prognoses of different patients to

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determine the identity of an unknown pathogen. Explain how a combination
of information from different scenarios was more helpful in identifying the
pathogen than the information from a single scenario card.
2. What effect do risk factors such as fatigue, anxiety, and smoking have on a
persons ability to defend himself or herself against infection and other
homeostatic disruptions?
3. Assume that one healthy person had rubella as a child. A second healthy
person was vaccinated against rubella as a child. And a third healthy person
never encountered the rubella pathogen or vaccine as a child. If all of these
people are exposed to rubella when they are 25 years old, how will their bodies
respond to this pathogen?

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Figure 6.4 Humans are exposed to many risks. Some risks are affected by
behavior. Others are unavoidable despite an individuals behavior. Think about the risks

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involved in each of the images depicted and how those risks compare with each other.

Whats the Risk?

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Explain

Have you ever cut your finger while you were slicing vegetables or fallen and Elaborate
broken a bone? Your homeostasis can be disrupted at any time by accident or illness

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because you are exposed to many risks in your daily life (see Figure 6.4). You
probably accept, consciously or subconsciously, some of these risks as unavoidable
while you try to minimize other risks. In this activity, you will explore controllable

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and uncontrollable risks and explain what some of these risks mean in your life.

Materials

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(per student) N S TA

Topic: AIDS
1 prepared test tube in a rack Go to: www.scilinks.org
Code: human3E207
additional materials that your teacher supplies

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PROCESS AND PROCEDURES
Part A Fluid Exchange

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1. Choose 1 test tube from those at the station your teacher has prepared.
2. Follow your teachers instructions.
3. When you have completed the tests, return the test tubes to the station and
wash your hands thoroughly.
4. Discuss the following questions with your classmates:
a. What observations about the fluid exchange surprised you?
b. Many illnesses, including the common cold, hepatitis, and AIDS, are
spread by fluid transfer. What types of behaviors spread those illnesses, Figure 6.5
and what body fluids are involved? Electron micrograph
of the human
c. How can people completely eliminate their chances of contracting a immunodeficiency
sexually transmitted disease? virus (HIV).

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Part B Risk Assessment


1. Develop a list of at least 20 risks faced by humans.
Use your personal experience and the essays Avoiding Disruptions: Behavior, Choices, and
Risk (page 253) and Individual Behavior Can Affect Larger Groups (page 255) to make
PAGE 253 PAGE 255
your list.
2. With your teammates, look through the headings on the Copymaster Risk
Assessment Data. Decide who will be responsible for analyzing each of the

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following risk categories:
Smokeless Tobacco and Smoking

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Alcohol
Cancer

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Sex and Sexually Transmitted Diseases

3. Divide the remaining categories evenly. In your journal, record the categories
you are responsible for.

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4. Study the information in your risk categories.
a. Highlight the statements in each category that provide information about
whether that risk is a serious threat for teenagers only (t) or for the general

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population (g).
Label each of these statements with a t or g to distinguish them.
b. Use an asterisk (*) to mark the most shocking or surprising statistic in each

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of your categories.
c. For each of your categories that are affected by behavior, record in your

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journal 1 or 2 behaviors that might reduce the risk.
5. Briefly discuss the results of your analysis by sharing some of the more
relevant or surprising statistics with your teammates.
6. As a team, complete the following tasks in your journals:

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a. Make a list of 3 risks in our society that could be reduced if people would
change their behavior.

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Select risks that would have a significant impact on the entire population if they
were reduced.
b. Make a list of 3 risks in our society that are unlikely to be reduced, either
because the risk is not controllable or because people would be unwilling
or unable to change their behavior.
c. Next to each of the items on your lists, write a brief explanation for your
choice.
7. Complete the Copymaster Taking Risks: A Self-Evaluation to determine your
own personal risk level.
Your teacher will collect these surveys and tally the responses for the entire class. Your
individual responses will remain anonymous. You will use the summary data in the Analysis.
8. In your journal, write 2 paragraphs that analyze behaviors that you could
change to reduce your own risk level.

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Part C Ethical Analysis


1. Draw a vertical line to divide a page of your journal in half. Use the left half to
make a simplified list of the steps in ethical analysis.
For example, you might list the 1st step as, Identify the question precisely. The essay
Ethical Analysis (page 256) will help you with this task.
PAGE 256
2. On the right half of the page, next to the steps you have written, list the

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related steps in scientific inquiry as you have been learning about them in
previous chapters.
3. With your team, discuss the following questions:

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a. How does the process of ethical analysis compare with the process of
scientific inquiry?

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b. How similar or different are their uses?

Analysis

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Respond to the following as part of a class discussion:
1. Identify several behaviors that are socially acceptable even though they have a

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negative impact on others. Explain why you think these behaviors are
tolerated.
Use the information in your journal and in the Risk Assessment Data.

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2. Explain whether the behaviors you just identified in question 1 pose any
ethical dilemmas. State how the behaviors pose an ethical dilemma and

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whether society has made any decisions that affect those behaviors.
3. Review the class data that your teacher has compiled from the survey Taking
Risks: A Self-Evaluation.
a. Compare the high-risk behaviors that are most common among students in

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your class to those of society.
Use the list your team made in Part B, step 6.

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b. Which, if any, of the class risks match the risks that your team felt could be
reduced if people changed their behavior?
c. If any of these risks are the same, why do you think students in the class
take these risks?

Health Care Proposal Evaluate

In this activity, your team will develop a health care proposal and apply for some
funds from the J. Nelson Jones Foundation. You will need to have a clear idea of what
you want to do with the money and how your idea addresses societys needs. In
addition, your job is to explain how your proposed program will affect the people
involved. Specifically, you will need to explain what internal body systems will be

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Entrepreneur to Fund Worthy Health Care Programs

Phoenix, ArizonaSamantha S. Jones, whose son, Nelson, died

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recently in a hiking mishap, announced Thursday that she will
contribute a portion of her software companys profits to establish
a health care endowment fund, the J. Nelson Jones Foundation. An

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annual award of $1 million, which may be split among as many as
three different groups, will be given to worthy health care
programs. The money will be distributed by a panel of health care

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experts who will evaluate proposals and choose the best. Groups
interested in obtaining funds must demonstrate that their
program is biologically sound, cost effective, beneficial to a

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significant number of people, and sensitive to ethical concerns in
society and within the health care industry. When asked why she
decided to fund this type of program, Jones replied, Id like to
create a world with better health care, better education, and a

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better understanding of the limits of the human body so that this
kind of tragedy can be prevented.

Samantha S. Jones creates health care

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endowment.

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helped by your program. Remember, this assignment is an evaluate. Your proposal
will be the evidence of what you have learned about homeostasis. To develop your

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proposal fully, gather information from different sources, such as this program, your
journal, the Internet, and the library.
Your teacher will evaluate your proposal based on the criteria established by the

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private foundation. These are listed on a scoring rubric that your teacher will provide.
An exceptional proposal may be funded in its entirety, or as many as three
proposals may be partially funded. However, if two or more proposals are submitted
that deal with the same topic, only the strongest will be chosen.

PROCESS AND PROCEDURES


1. As a team, review the Possible Health Care Options (beginning on page 212).
Choose an option that interests your team.
Your teacher will keep track of which teams select which options.
2. As a team, develop a short description of your program. Then decide which
team members will gather information for each of the following sections of
the proposal:

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Homeostasis
Risk Assessment
Ethical Issues
Refer to the proposal guidelines in the need to know box to review the questions and
issues that you must address in each of these sections. Regardless of which option your
team chooses, you may use information from other options to support your position.

J. Nelson Jones Foundation Guidelines


for Proposal Development
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You must include each of the following sections in your
proposal. Address each question or issue presented.

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Short Description of Proposed Program
J. Nelson Jones Foundation

Give a brief overview of the program that you


are proposing.

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Is the treatment or program that you propose the only one available? (In
other words, do the participants in your proposed program have any other
choices?)

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Homeostasis
Which organs or regulatory system does your proposal most directly affect or
influence? The biology of this system will be the focus of your proposal. What is

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the normal function of these organ systems in maintaining homeostasis? This
should include a description of the anatomy involved, physiology, and the role
of the immune system. (Many options involve several organ systems, but you
need to choose only one system.)
What is the nature of the homeostatic disruption that your proposal seeks to

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correct? How will this correction be accomplished?

Risk Assessment

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How common is the illness or injury that your proposal seeks to treat? For
example, how many people will take advantage of your services?
If your proposal targets a particular population, explain how this populations
needs will be met.
How does behavior affect a persons likelihood of experiencing the risks that
your proposal addresses?
Describe the controllability or uncontrollability of the risks involved. How can
a person change his or her behavior to minimize the risks?

Ethical Issues
Identify an ethical dilemma that is associated with your proposal. Describe
the concerns surrounding this dilemma.
Use the six steps of ethical analysis to analyze this dilemma. Explain your
decision about what should be done.

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3. Individually, gather all of the information that you will need to develop your
part of the proposal. Analyze this information to identify the evidence that
will support your arguments.
Your teacher will suggest where you can find additional material. You will have about
1 week to complete this step.
4. Present the information that you have analyzed to your team. Explain how
this information will strengthen the proposal.

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Practice the skill of advocating a position.

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5. Work with your team. Discuss this information, and decide what specific data
to include in your proposal.
Focus on the most important and persuasive data because proposal space is limited.

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6. As a team, use the steps presented in the essay Ethical Analysis (page 256) to
conduct an ethical analysis of an issue that is involved in your chosen health
care area.

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The team member who was responsible for gathering information on ethical issues
should provide the team with several ethical issues to consider. Your team must
choose 1 issue on which to focus the ethical analysis.

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7. Write your proposal according to the proposal guidelines (page 211).
Divide this task evenly among your teammates. Your work will be evaluated
according to the criteria listed in the scoring rubric that your teacher distributed.

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Review those criteria carefully before you start writing.
8. Submit your proposal to your teacher.

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Analysis
In your journal, write one paragraph in which you reflect on your experience of

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developing the proposal. Consider these questions as you write the paragraph:
What section was hardest to write? Why do you think that was so?

Why is ethical analysis a useful tool in science and in society?

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How can you positively or negatively influence the internal systems that are
involved in maintaining homeostasis in your body?

Possible Health Care Options

N S TA
Option 1 Alcohol and Drug Treatment Program
Topic: alcohol and drug
treatment In the United States, 9 months of treatment for a drug-addicted mother costs
Go to: www.scilinks.org approximately 1/6 what it costs to provide medical care for a drug-exposed
Code: human3E212
baby for 20 days.

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Most people suffering from alcohol or drug abuse who cannot afford private
treatment in hospitals receive their care as outpatients at clinics. Many receive
no treatment at all. Because the addiction is so strong, many of these people
eventually turn to crime to obtain the money that they need to pay for more
alcohol or drugs.
One federally funded treatment facility in a city of 300,000 serves 700 heroin
addicts of all age-groups per month. A staff of 18 full-time counselors and

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17 part-time employees implement a program designed to eliminate chemical
dependency. This program provides heroin addicts with daily doses of

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methadone, a chemical narcotic that minimizes the craving for heroin and
helps the addicts stay clean. There is no limit to how long an addict can
participate in this program. Approximately 2540 percent of those on

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methadone stay on it for a year or more. Many find it extremely difficult to
quit the drug habit completely. About 30 percent, however, are able to find
work and at least partially support themselves. Methadone treatment

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dramatically reduces crime by addicts. (Statistics show that crime dropped
from 237 crime days per person per year before treatment to 69 crime days per
person per year after 4 months of treatment.) Methadone treatment also

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reduces HIV infection rates (from 39 percent among addicts not in treatment
to 18 percent among addicts in treatment for 3 years).

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N S TA

Topic: heart disease


Option 2 Heart Disease Prevention and Treatment

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Go to: www.scilinks.org
Code: human3E213a
The dietary habits of Americans are substantially different from those of other
countries. This difference has contributed to the prevalence of heart disease
in the United States. For instance, the typical diet in Japan contains far less

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cholesterol and saturated fat than the typical American diet. Consequently,
a 50-year-old Japanese man has an average blood cholesterol level of
180 mg/dL. Compare that with an average of 245 mg/dL for a 50-year-old

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American man.
Fifty-five percent of Americans in the United States are overweight or obese.

After an individual has a heart attack, there is at least a 50 percent chance that
the individual will die in less than 5 years unless the individual takes preventive
measures.

N S TA

Topic: sexually transmit-


Option 3 Education Programs Focusing on the Prevention of AIDS ted diseases
and Other Sexually Transmitted Diseases (STDs) Go to: www.scilinks.org
Code: human3E213b
Twenty-three percent of all 14-year-olds and 30 percent of all 15-year-olds
have engaged in sexual intercourse.

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Fifty-eight percent of 912th-grade students reported using a condom the last


time they had sexual intercourse. Twenty-seven percent of 912th-grade students
report that they are currently abstinent.
Approximately 1 in 4 teenagers who are sexually active get an STD every year.
However, 68 percent of sexually active teens do not consider themselves to be
at risk.

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Antiretroviral drugs (sometimes called the AIDS cocktail) given to HIV-
positive individuals soon after infection helps to suppress the development of
full-blown AIDS and the disabling effects of the illness.

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People without health insurance who are HIV-positive cannot receive payment
for antiretroviral drugs through Medicaid (2001).

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Medicaid covers medical services for approximately 55 percent of all adults
living with AIDS and up to 90 percent of all children living with AIDS. In
2003, federal and state Medicaid programs to treat HIV and AIDS were

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estimated to cost $8.5 billion.
For individuals who qualify, Medicaid covers the costs for approved
prescription drugs. These include drugs that help prevent opportunistic

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infections and those that treat AIDS, such as protease inhibitors.
For every dollar spent notifying sex partners of HIV-positive patients, at least
$11 is saved in annual medical care costs for each case of HIV that is prevented.

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Option 4 Hospital Equipment and Procedures (National Statistics)
N S TA Dialysis, a procedure that substitutes for the normal functioning of the kidneys,

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Topic: hospital equipment costs $16,000$18,000 for a typical 4- to 7-day hospital stay for kidney failure.
and procedures
Go to: www.scilinks.org A kidney transplant, which eliminates the need for dialysis, costs
Code: human3E214 approximately $69,000.

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An electrocardiograph (ECG), an instrument used to monitor and diagnose
heart problems, costs approximately $12,000.
Pacemaker surgery, a procedure performed on patients who suffer from certain
forms of heart disease, costs approximately $28,500.
Angioplasty, a surgical procedure to open arteries in the heart that are blocked
by cholesterol and plaque buildup, costs approximately $13,000.
An appendectomy, the removal of a diseased appendix, typically requires a
3-day hospital stay and costs approximately $6,000.

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Alcohol and drug rehabilitation and detoxification costs approximately $5,000.


A mastectomy, the removal of a cancerous breast, costs approximately $9,000.
Arthroscopy, a surgical procedure to repair an injured joint, costs approximately
$11,000.
Magnetic Resonance Imaging, or MRI, is a technique in which strong
magnetic fields generate a picture of the inside of the body (similar to an

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X-ray). Physicians use it to help them locate tumors in cancer patients
(about $1,000 per use) or injuries and obstructions in people with

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difficult-to-diagnose illnesses ($950 per use).
A tonsillectomy, the removal of tonsils and adenoids, costs approximately
$6,000.

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Radiation therapy often is used to reduce the size and spread of malignant
tumors. This therapy can be used in place of or in addition to surgery. It is
frequently necessary if the patient is to have a chance of survival. Average cost

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for therapeutic radiology (to treat lung cancer, for example) is $13,000.

Option 5 Prenatal Care (National Averages)

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Prenatal care for a pregnant woman for 9 months (not including delivery) N S TA

averages $750. Topic: prenatal care


Go to: www.scilinks.org

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For a very low-birthweight baby, each day in the intensive care unit costs from Code: human3E215
$1,000 to $2,500. Low birthweight is often due to prematurity, which may be a
consequence of poor prenatal care. The lifetime medical costs for 1 premature
baby average $500,000.

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The cost of a normal delivery is approximately $6,400.
The cost for a complicated birth ranges from $20,000 to $400,000.

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Some public health care clinics have been established with good success for
improving prenatal care. A public health care clinic can provide prenatal care
for women, including education about nutrition, exercise, and avoidance of
harmful behaviors. Such a clinic also could provide regular visits by nurses and
handle uncomplicated deliveries. These programs are successful at producing
full-term, normal-birthweight babies (greater than 5 lbs 8 oz). In fact, with a
low birthrate incidence of only 7 percent, they produce a higher percentage of
normal-birthweight babies than privately funded health care facilities that do
not offer a prenatal care program.

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N S TA
Option 6 Quit Smoking Program
Topic: cigarettes
Go to: www.scilinks.org Cigarettes kill more Americans than do AIDS, alcohol, car accidents, murders,
Code: human3E216a
suicides, drugs, and fires combined (about 430,000 people per year). This
makes tobacco the number 1 cause of death and disease in the United States.

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Fourteen percent of all 10th-graders and 20 percent of all 12th-graders report
smoking cigarettes daily in the year 2000.

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The Centers for Disease Control and Prevention estimate that nationwide,
medical care costs attributable to smoking (or smoking-related disease) are
more that $50 billion annually. They also estimate that the value of lost
earnings and loss of productivity to be at least another $47 billion a year.

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Every dollar that is spent on smoking-cessation programs that are successful
saves $21 during a working lifetime (defined as ages 20 to 64).

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Option 7 Vaccine Programs
N S TA
Nearly everyone in the United States got measles before measles immunization

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Topic: vaccinations
Go to: www.scilinks.org was available. At that time, there were approximately 34 million cases of
Code: human3E216b measles each year. Between 1953 and 1962, an average of 450 people per year
died from measles.

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In industrialized countries, up to 20 percent of people with measles are
hospitalized. Seven to 9 percent suffer from complications such as pneumonia,
diarrhea, or ear infections. It is estimated that as many as 1 of every 1,000

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people with measles will die.
Measles is one of the most infectious diseases in the world and is frequently
imported into the United States. More than 90 percent of people who are not

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immune will get measles if they are exposed to the virus.
The measles-mumps-rubella vaccine led to a tremendous decline in the
occurrences of the diseases (see data below). According to the National
Immunization Survey, approximately 78 percent of all children age
1935 months had received 4 doses of the combined series vaccine. The
target vaccination rate set by Health People 2000 is 90 percent.
Disease Cases in U.S. (year) U.S. Cases (2001) % Change
Measles 319,124 (1950) 116 99.97
Mumps 104,953 (1970) 266 99.75
Poliomyelitis 33,300 (1950) 0 100.00

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Hepatitis B is an infection of the liver. It is caused by a virus found in the


blood, semen, menstrual blood, and other body fluids of a person with hepatitis
B. Five to 10 percent of adults who catch hepatitis B become carriers for the
rest of their lives and can pass the virus on to others. About half of all adults
who become infected with hepatitis B report never having felt sick at all.
Symptoms, if present, are flulike.
Hepatitis B infects more than 200,000 people each year and kills more than

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5,000. The virus can be spread during sex, by sharing needles, or by being stuck
with a dirty needle or tools used for tattooing or piercing. It can also be spread

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by getting blood or other infected fluids in the mouth, eyes, or onto broken
skin. The virus also can be passed from mother to baby during birth.
Carriers of hepatitis B are at risk of liver problems, like cancer or cirrhosis.

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Hepatitis B is 100 times easier to catch than the virus that causes AIDS. There
is no cure for hepatitis B, but a vaccination can prevent it.

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Option 8 Programs for Women, Infants, and Children
N S TA

Inadequate nutrition during childhood affects brain development and reduces Topic: women, infants,

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a childs ability to learn. and children
Go to: www.scilinks.org
Many U.S. counties have programs that try to prevent malnutrition in Code: human3E217
pregnant or nursing women and children under age 5. These programs provide

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food vouchers that families can redeem for wholesome foods such as formula,
baby food, milk, cheese, eggs, cereal, dry beans, peanut butter, and tuna fish.
In 2002, an average of 19 million people received food stamps in the

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United States.
Currently, the United States has medical costs of approximately $60 billion
per year associated with osteoporosis. Teenage girls and adult women only

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consume 2/3 of the calcium that is recommended.
Fifty percent of nutrition and health program participants adopt 1 or more
habits that improve the development of healthy eating behaviors by their
children.

EVALUATE: Health Care Proposal Unit 2: Chapter 6 217