THARAKA UNIVERSITY

P.O BOX 193-60215, Telephone :|+(254)-0202008549,

MARIMANTI, +(254)-02020076920
KENYA Mobile: (+254)0728229548
Website: tharaka.ac.ke

COLLEGE
(A Constituent College of Chuka University)
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DEPARTMENT : EDUCATION
COURSE TITLE : HEALTH AND PHYSICAL EDUCATION
COURSE CODE : EDCI 201
LECTURE HOURS : 45.0 (3.0 C.F)
PRE-REQUISITE : NONE

Course Purpose
The course provides an opportunity for the students to discuss the influence of Human factors,
financial resources, physical resources, physical environment, school environment, home
environment and sanitation on human health.
Expected Learning Outcomes
(i) Discuss the influence of the following factors on human health: Human factors, financial
resources, physical resources physical environment, school environment, home
environment, sanitation.
(ii) Explain problems facing health Education and health services.
(iii) Discuss communicable diseases under: Causal agents, Mode of transmission, Symptoms
Treatment and control.
(iv) Explain the components of physical fitness
(v) Describe various methods of family planning.
(vi) Discuss drugs and drug abuse in schools.

Course Content

Week Content Remarks

1 Concept of health & Health education
2 Concept of physical education & physical fitness
3 Historical foundations of physical education in Kenya
4 Safety education at school and home
5 CAT 1
6 Non-communicable diseases: Heart diseases, Cancer, diabetes etc
7 Drug abuse, alcoholism and smoking
8 Environmental pollution
9 Communicable (infectious diseases): air borne, water borne, insect borne
10 A study of immune system and the body defense mechanism
11 Family planning
12 CAT 2
13 Revision for examinations
 14 - 16 Examination

Course Assessment
Continuous assessment tests 30%, Final Examination 70%, Total 100%

Teaching Methods
Lectures, Discussions, Class assignments and presentations

References
Blorkman M., Klingen L., & Birch (2011). Effects of biotic component to human health.
Christ, W. (2008). Community health (3rd Ed.). Nairobi: The African Medical and Research
Foundation.
Muraa, W.M. & Kiarie, W.N. (2001). HIV and AIDS. Facts that can change your life. Nairobi:
English press limited.
United Nations Department of Economics and Social Affairs (2008). World population policies
2007. New York: United Nation.

TOPIC ONE
HEALTH EDUCATION
Health is a state of complete physical, mental, and social well-being and not merely the absence
of disease. Thus health is a resource that is used to support an individual’s function in a society
enabling a human being to lead a full life that has meaning and purpose.
Education is the process of facilitating learning, or the acquisition of knowledge, skills, values,
morals, beliefs, and habits. It can also be understood as the process of receiving or giving
systematic instruction, especially at an institution
Health education can be defined as the principle by which individuals and groups of people
learn to behave in a manner conducive to the promotion, maintenance, or restoration of health.
It is a form of education that promotes an understanding of how to maintain personal health.
Accordingly, it is a profession of educating people about health in matters relating to
environmental health, physical health, social health, emotional health, intellectual health, and
spiritual health, as well as sexual and reproductive health education.

Any system of Physical education without the support of health education cannot possibly
accomplish the best rules. The mutual coordination of physical and health education is a matter
of fundamental importance in any system. As such, Health Education is concerned with
promoting health as well as reducing behavior induced diseases. In other words, health education
is concerned with establishing or inducing changes in personal and groups attitudes and behavior
that promote healthier living. It can be defined as the sum of experiences, which favorably
influence habits attitudes and knowledge relating to the individual community and social health-
Thomas wood
Health education like general education is concerned with changes in knowledge, feelings and
behaviour of people. In its most usual form, it concentrates on developing such health practices
as are believed to bring about the best possible state of wellbeing. –W.H. O technical Report
(1954)

Aims of Health Education

The following are the some of the main aims of health education
a) To provide information about health and its value as community asset – Health education
aims at acquainting people with the rules of health and hygiene while taking
precautionary measures to ward off diseases and to provide a disease-free working
environment.
b) To maintain norms of good health: The authorities should provide hygienic environment
in the form of adequate ventilation proper temperature, good sanitation and all round
cleanliness. It helps the authorities to keep certain norms of health.
c) To take precautionary and preventive measures against communicable diseases. Its aim is
to take adequate precautions against contamination and spread of diseases. Thus, good
sanitary arrangements are made. Precautionary and preventive measures. If they are
properly adopted can help in improving the health standards of society.
d) To render assistance to the school going children an understanding of the nature and
purpose of health services and facilities – It aims at discovering physical defects and
other abnormalities in the child and promoting their reduction if they are easily curable.
e) To develop and promote mental and emotional health – mental and emotional health are
also equally important along with physical health. While physical health makes a pupil
physically fit, mental and emotional health enables him to maintain an even temper and a
happy disposition
f) To develop a sense of civic responsibility. School is a miniature society Responsibility of
one’s health does not lie on any one’s shoulders but a combined effort and work for the
community.
Objectives of health Education
The following are the functional objectives of health education as adopted in schools
1. To enable the students to develop a scientific point of view of health with reference to
traditional and modern concept of health.
2. To enable the students to identify health problems and understand their own role on
health and to medical agencies in meeting those problems
3. To enable the student to take interest in current events related to health
4. To enable the students to arrive at suitable conclusions based on scientific knowledge and
take action as an individual member of the family and community for protecting,
maintaining and promoting individual and community health.
5. To enable the students to set an example of desirable health behaviour
6. To enable the student to understand the causes of the pollution of air, water, soil and food
as well as their ways and means of prevention
7. To enable the students to gain sufficient knowledge of first aid
8. To provide desirable knowledge about marriage, sex and family planning to the students
9. To help students to understand the importance of Physical training sports, games, yogic
exercises as well as their relationship with health education programme.
10. To emphasize to the students on the bad effects of smoking and taking alcohol etc.
11. To acquaint students with the functioning of various organizations working for the
maintenance of health.
12. To help students understand how the present-day rapid development of science and
technology has increased the hazards of life and health problems and also how to face
and prevent them.

Importance of Health Education

Health education helps us in following ways
1) Health education provides information to the students and the teachers about the function
of the body the rule of health and hygiene and precautionary measures for keeping off
diseases.
 2) Health education helps in discovering physical defects of children and discovering
various types of abnormalities of children
3) Health education develops health habits like need of fresh air, hygienic feeding and
various class room habits
4) Health education provide knowledge regarding good health habits
5) Health education develops better human relations between school, home and community
6) Health education provides knowledge regarding prevention and control of various
diseases
7) Health education provide first aid training which is essential for everyone as emergency
may arise to any one and at any time.
Health Education in Schools
The programme of health education should not confine itself to personal hygiene of pupils only.
It should include all aspects which may help in promoting health of the community as a whole. A
school programme is twofold.
i. Prevention of the development of poor health
ii. Preservation of good health
The school health program is divided in to three parts
1) Health instruction
2) Health service
3) Health supervision

Teaching Health Education in Schools

The school has major responsibility in the area of health instruction. It should instruct youth in
such things as the structures and functioning of their bodies the causes and methods of
preventing certain diseases, the factors that contribute to and maintain good health, and the role
of the community in the health program. Such an instructional program if planned wisely and
taught intelligently will contribute to good health habits and attitudes on the part of the student.
Health instruction should avoid too much stress on the field of diseases and medicine. This is
pointed out by Dr. Baue health authority in an article entitled Teach health Not Disease. He says
that teachers should primarily teach health how to live correctly and how to protect one’s body
against infection rather that teaching diseases and medicine. Proper health instruction should
impress upon each individual his responsibility of his own health and as a member of a
community for the health of others. Thus health teaching is that organization of learning
experience directed towards development of favourable health knowledge attitude and
practice. Its aim to acquaint pupils about the functioning of the various organs of the body the
rules of health and hygiene and methods for curing diseases.

Methods of imparting health instructions

There is nothing very special about the methods of imparting health Education. Health Education
forms an essential part of total education. As such all aspects of health education should be
carried on at all stages of educational process according to age and maturity. The following are
some of the important ways and means through which health education and its instruction can be
imparted effectively in institutions.

Healthful Environment of the institution

Environment is the most important of all educational media. Any scheme of health education
must receive top priority to the improvement of physical and human environment. Neat clean
attractive and well-maintained institutional building, classrooms, equipments and plays fields,
sympathetic and affectionate teachers contribute greatly to inculcate healthful living, health
habits and conditions of work and health notions about work and life. As is the environment. So
is the individual therefore healthful environment of the institution plays key role in achieving
success.

Systematic Health Instructions

Direct health instruction should be provided through subjects like hygiene, physiology, general
science physical education home science social studies etc. This will enable students to
understand the structures and function of human body realize the need for keeping physically fit
and take precautionary and remedial measures in case of illness and diseases. Such instruction
will also lay emphasis on physical exercises, sports, games and nutritional value of different
kinds of food and diet.
Incidental Teaching
At the school stage the teacher can give health instruction in the class room situation when there
is any incident of communicable disease in the school. In this way such incidental teaching may
benefit the individual or the entire class. Similarly teachers have opportunities to give instruction
off and on, on personal hygiene in a simple language which is benefit at for the school and
community as a whole.

Lectures on health by experts

The school authorities should make arrangement on certain occasions to request medical officer
or physical instructor and other experts on health to visits the school and to deliver a lecture on
various items o health and hygiene. However, emphasis should be laid on the fact that talks
should be supplemented by illustrative aids and material. At the end of the talk the pupils must
be given opportunities to ask any questions concerning the topic to get their doubts cleared.

Printed Material
The school can accumulate printed material on health and hygiene such as short leaflets,
pamphlets posters and standard books. Even the school authority can have the material from the
local health department to highlight certain diseases, their causes and cures.

Films and Film Strips

The school can arrange documentary film from various sources which generally displayed the
various diseases and how to prevent ourselves from these. They also stress the importance of
personal habits like cleanliness. Similarly, film strips accompanied by talks or commentary by
experts can be displayed and may be retained on the screen as long as wishes.

School broadcast and radio talks

Radio talks are a powerful medium for giving health instruction to the young pupil and reaching
a wide public at the same time. Radio talks can be delivered on problem of health and hygiene by
way of songs or play. In this way the children not only get entertainment but useful instruction
also similarly the school broadcast programme does include items of health and hygiene.
Educational field trips
Actual field trips provide learning situation for the children and they can get firsthand
experience. Such trips include visit to red cross hospitals. Clinics, fairs exhibitions, yogic centre
public health centre and water supply centres etc. however each visit needs proper planning and
advance class room discussion to motivate young children. At the end of visit if the teacher
clarifies the doubts of the students it will be more beneficial for the children.

Health Weeks
It is a good method of imparting health instruction to the young pupils. Health week may be
celebrated in the school every year in which emphasis is laid on personal hygiene and upkeep of
the school campus. Special talks by the expert may be arranged on personal hygiene and
sanitation.

Health Club
Each institution should organize a health club as self governing unit. Through this club the
students can be associated with institution health laws and their administration. They can also be
encouraged to practice health rules in their daily lives. These clubs in co-operation with the
institutions Red Cross society should arrange debates declamations plays and dreams on makers
concerning health.

Health Scrap Books

Students should be encouraged to maintain scrap books on health on the top of every page one
important health rule should be written or pasted. Pictures illustrating important health rules,
causes and prevention of various disease neat and healthy living functions of various organs in
human body should be collected this book should contain the records concerned with the
students.
Health service

Health supervision
TOPIC TWO
PHYSICAL EDUCATION
Introduction
‘A sound mind is in a sound body in a sound environment.’ Every person must possess a healthy
mind: to have a healthy mind one must have a healthy physique. Healthy persons could alone
make a healthy society. Physical Education may provide the right direction and needed actions to
improve the health of members of any community, society, nation and the world too. Therefore,
an educational system encompassing the mental, emotional, social and physical dimensions of
health becomes imperative to bring about all around development in children which, in turn,
would pave way for the development of healthy society.

Meaning of Physical Education

The word physical education comprises of two words Physical and Education. The plain
dictionary meaning of word physical as relating to body characteristics of a person such as
physical strength, physical endurance, physical fitness physical appearance or physical health.
The word education may mean the systematic instructions or training or preparation for some
particular task. The two words combined together stands for the systematic instructions or
training related to physical activities or programme of activities necessary for development and
maintenance of human body or the development of physical powers or activities for cultivating
physical skills.

Aims of Physical Education

The aim of Physical Education is the same as that of general education, because physical
education is a part of general education. The primary aim of physical education is not to develop
star athletes winning teams or expert performance but a national vitality with character values
and physical fitness. Ministry of Education National plan of physical education and recreation
expressed that the aim of physical education must be to make every child physically, mentally
and emotionally fit and also to develop in him such personal and social qualities as will help him
to live happily with others and build him up as a good citizen.
Butcher listed the aims of physical education as follows:
(i) Physical development
(ii) Mental balance
(iii)Emotional adjustment
(iv) Manual training
(v) Social adaptability

Objectives of Physical Education

The objectives of physical education are stated differently by many of Physical Educationists.
The following are main objectives of physical education.
Development of Fitness:
This objective deals with the program of activities which builds physical power in an individual
through the development of the various organic systems of the body. The systems such a
circulatory system, respiratory system, nervous system, muscular system and digestive systems.
Physical education is related to physical activities, which create various effects on our systems.
These systems are developed in size, shape, efficiency etc. This promotes a sound health, which
enables the individual to be the valuable asset for the nation. If our systems remain in sound
health, they can perform their functions in an efficiency way.

Development of Mental health:

The mental development objective deals with the accumulation of a body of knowledge and the
ability to think and to interpret their knowledge. Physical education programmers need alertness
of mind, deep concentration and calculated movements. Physical activities sharpen the mind, to
perform various activities. It includes rules and regulations techniques of games, anatomatical
and physiological studies balanced diet, sanitation, health and diseases personal hygiene etc.
Through participation in various activities an individual learns to draw certain conclusions. He is
able to understand the new situations faced in the games. He is able to take decisions
independently.
Social Development:
In the democratic society in which we live it is necessary to have all individual develop sense of
group consciousness and cooperative living. Social traits are essential for better adjustment in
life. The programme of physical education develops these traits. They provide leadership
qualities. Through physical activities, the players come closer with each other and adjust
themselves according to situations. It helps in attaining the traits like cooperation courtesy fair
play, sportsmanship self control unselfishness tolerance and sympathy.

Development of Neuro muscular co-ordination:

The nervous system is strengthened only proper physical exercise. Neuro muscular coordination
develops well only of various of exercises are done repeated for a long period of time. Good
neuro muscular coordination helps to keep off fatigue coordination. We get accuracy and smooth
function of our body. Our reaction time becomes less. Neuro muscular development helps ones
be perform the daily work with proficiency develops a well poised quick and efficient movement
and body graceful carriage.

Development of Desirable habits

 To be inculcated regular activities rest regulated diet
 Maintaining cleanliness
 To be disciplined in one’s work
 Chalking out a schedule of desirable activities that may contribute towards a healthy
body and a happy mind

Development of Personality
 Attainment of sportsmanship
 Development of leadership qualities
 Development of social cooperation
 Development of fearlessness
 Attainment of positive qualities of self confidence
 Attainment of self-control

Providing for Mental Hygiene

 Mental Hygiene comprises those activities and techniques which promote and maintain
mental health.
 Development of ability to face stresses and string of like
 Elimination of worry and tension through games and sports
Development of Functional Knowledge
 To know the rules and techniques of different games
 To know and acquire knowledge, proper health procedure
 To know the methods and principles of games and exercises
 To know the body parts and the effects of exercise on various organs and systems.

Development of qualities of a good citizenship

 One has to abide rules and regulation
 One’s discipline improves the qualities of a good citizenship

Importance of Physical Education

a) Physical education develops the alertness of mind
b) Physical education provides knowledge about health and its hazards and communicable
and non-communicable diseases
c) Through physical activities leisure time can be utilized properly
d) Through physical education human body can be developed in good proportion. The
physical beauty also improves
e) A good sports man is a good citizen He knows how to adjust with others
f) Physical education helps in developing and maintaining of good relations among humans
beings. It develops social traits, like cooperation, sympathy, loyalty, fraternity, courtesy
and other traits of leadership.
g) Aggressiveness can be eliminated through physical activities. By participating physical
activities, we can overcome stress tension and sensitiveness
h) Physical education helps in creating discipline through games and sports
i) Physical education provides a number of opportunities to enhance the power of tolerance
j) Physical education enhances all the essential traits required for development of the
personality
k) Physical education leads to happiness efficiency and character building
 l) Physical education helps the people to become fit to develop their spiritual and more
forces. It increases the scope of human abilities and enriches the life of the individual and
that of the society as a whole.

TOPIC THREE
HISTORICAL DEVELOPMENT OF SCHOOL PHYSICAL EDUCATION AND SPORTS
IN KENYA

Physical Education and Sports practiced in schools in Kenya are not indigenous to East Africa.
Modern Physical Education and Sports were brought to East Africa through the work of
missionaries, colonial administrators, settlers and soldiers from Great Britain who settled in East
Africa during the 19th and 20th centuries. The influence of the British intruders no doubt led to
the introduction and development of English high school Physical Education and Sports
activities in the school systems of east African countries. The British Physical Training Syllabus
was introduced in East Africa in 1933 and used until the 1950s.

Physical Education Syllabus of 1959 and the corresponding one for Kenya of 1955 were both
derived from the British Physical Training Syllabus. Subsequent reforms made in the educational
systems, curricula and physical training syllabus in the post independence periods in the 1960s
and 1970s can be regarded as desperate attempts by the newly independent African countries to
break away and yet remain historically linked to the British system of Physical Education and
Sport.

Development of School Physical Education and Curriculum Reform in Kenya

The development of Physical Education in post-independence Kenya, like aspects of education is

not independent of the general educational reforms characteristic of Kenya at that time namely:
The development of the first Physical Education curriculum in post-independence Kenya was a
result of the Ominde Commission Report of 1964-65; the drafting of the first primary schools
Physical Education syllabus was in 1967; the secondary schools Physical Education curriculum
guide was completed in 1974; the first Physical Education expert at the Kenya Institute of
Education was recruited in 1979; the first draft Physical Education syllabus for secondary
schools was in 1980 and came as a result of the 1980 Presidential Directive making Physical
Education mandatory in Kenya (Nteere, 1982; Wamukoya, 1993). Thus, the changing political
and educational needs of Kenya have tended to shape the structure, content and stated objectives
of the Kenya Physical Education curriculum and its practices. The prescribed content for the
subject in schools has changed at different times namely 1973, 1980 and 1985 in order to
accommodate social, political and economic pressures on education.

The introduction of the 8-4-4 system of education in the late 1980s and early 1990s thus
precipitated changes in the content, form and status of Physical Education in the school
curriculum in Kenya (Wamukoya, 1993). Studies by Muniu (1987) and Kiganjo (1987) also
indicate that changes were introduced in the structure, practice and training of Physical
Education teachers in Kenya with subsequent impact on the practice of Physical Education in the
Kenyan schools (Njororai, 1996; Njororai and Gathua, 1997). Although Kenya had an education
system similar to Uganda before independence as well as during the immediate post-
independence period, it can be argued that a series of specific and deliberate educational reforms
have impacted changes on the general practice of education in Kenya (Eshiwani, 1996). The
Ominde Commission (1964); the Kericho conference on Education and rural development
(1966); the Ndegwa Commission (1971); the Gachathi Commision (1976); the Mackay
Commission (1981); the Kiruthi Report (1983); and the, Wanjigi Report (1983). These
commissions made the education system of Kenya to eventually assume the 8-4-4 structure. The
8-4-4 structure seems to have implanted specific features, structures and cultures on Physical
Education practices in Kenyan schools that make Physical Education uniquely different from the
practices in neighbor countries. The separation of East African education systems since the
collapse of the first East African Community treaty in 1977 may have caused differences in the
development of Physical Education and sports in the schools in Kenya and the rest of East
Africa.

In October 2000, the government of Kenya announced a new school curriculum structure and
introduced reforms in the educational practices at primary and secondary school levels in Kenya.
The new curriculum included a number of features namely: Shorter school week, lesser
examination papers at the end of the primary level, examinable and non-examinable subjects,
increased number of ‘O’ level examination subjects, introduction of science and humanities to
suit future career choices, increase in the amount of time allocated to key subjects of English,
Mathematics, Kiswahili and Science. Secondary schools were limited in the number of applied
technical subjects taught because of cost sharing. (Kihumba-Kamotho, 2000; Reprinted Syllabus,
Kenya Primary Education, MoEST, Volume 1 & 2, 2002; Kenya Secondary Education Syllabus,
MEoST, Volumes 1 & 2 April 2002).

Current Issues in Physical Education and Sports in Schools in Kenya

Since 2002, Kenya introduced curriculum reforms in Physical Education and Sports at primary
and secondary levels to address some of the shortcomings and disparities in Physical Education
reported at the Berlin World Summit on Physical Education 1999. New syllabuses have been
introduced at the primary and secondary schools levels to replace old syllabuses. These reforms
were expected to improve the status, structure, organization, quality and quantity in the delivery
of Physical Education and Sports in schools. But the diminishing amount of time allocated to
Physical Education on the teaching timetable, the crowding of the school curriculum, the over
packed school day and school week, and the numerous competing activities on the school
calendars suggested a reduction in the time for Physical Education and co-curricular sports
programmes in the schools. The introduction of new learning areas into both the primary and
secondary school curricula seemed to provide new rivals to out-compete and marginalize
Physical Education and co-curricular sports and thus edge them out of the school system.

There were fears that the introduction of new topics such as HIV/AIDS, STD/STI’s gender and
human rights, environment conservation into Physical Education would put an extra-burden for
an already overloaded syllabus. This fear would mean to suggest a reduction on the practical
time available for Physical Education. There were fears among Physical Educators that the
introduction of these new theoretical areas would render and relegate Physical Education in
Kenya schools to become more of an ‘indoor’, ‘Chalk and talk’, ‘Black board affair’ rather than
being a practical outdoor physical activity (K.I.E 2002). However, since 2002 not only new
syllabuses but new teachers' Guides for Physical Education have also been developed by the
Jomo Kenyatta Foundation to support the teaching of Physical Education and Sports in primary
and secondary schools in Kenya.

Factors Influencing Physical Education and Sports in Schools

According to Bucher and Koenig (1974), community and school factors influence physical
education and sport. Such factors include: economic, religious, political, climate, sociological
and cultural backgrounds, and attitudes towards education, and pressure groups or community
structures.

Economic factors base on the financial status of the community; their willingness to support
education, study conditions at home and sources of revenue for education.

In East Africa especially, most primary and secondary schools have a church or religious
foundation. Through direct or indirect involvement of churches or mosques such groups often
show their attitude towards physical education and sport.

Local politics also influences Physical Education and Sports in the schools through the work of
schools boards, school management committees or boards of governors most of which are
manned by politicians.

In a similar way most communities have a political interest or representation on the school
boards and their support of Physical Education and Sports programmes counts.

The geographical location of the school, the weather, time spent out, duration of Physical
Education and sport activities engaged in, the sociology, composition of the community, social
economic status, cultural background, educational level of parents, rural, urban or peri-urban
location, safety of the community, parental involvement in education, and beliefs of parents
about physical activities influence physical education and sports in the school.

Other factors include the general attitudes of the community towards education and its
willingness to support schools, providing support for school expansion and expenditure in
facilities, degree of acceptance of educational trends and changes, parental ideas and concern for
the education of their children, and the existence of clear lines of communication between the
school and community. The influence of pressure groups on the school provides both
constructive and supportive involvement. Pressure groups, too, provide formal and non-formal
contact for the Physical Education teacher that may support Physical Education and sports in the
school. The community structure, its size, type, governing body, is another source of influence
on sports.
Finally, the government and national institutions also shape the structure of Physical Education
and Sports in schools. The involvement of the national government, the Ministry of Education,
local governments, the District Education Department, municipal or urban authorities, or local
planning board; the establishment and enforcement of minimum standards for education and
inspectorate standard has a lot to contribute to the quality of Physical Education and Sports in the
Schools. Within the school itself the school structure, the administrative system, personnel,
curriculum, traditions, philosophy and policies, teacher/parent relationships also play a great role
(Bucher and Koenig, 1974).

TOPIC FOUR
SAFETY EDUCATION
Meaning of Safety Education
Safety education is an important device to control and prevent accidents. It has been shown
repeatedly that there is a need for cooperative action in safety education whether it be in school
playfield road and home.

Importance of Safety Education

Safety education forms an integral part of health education. In the modern civilized world though
man is able to conquer space and time, he has not yet conquered risks and dangers to life. Man’s
utmost desire is to live comfortably. For instance, electricity has become an unavoidable
necessity in providing convenience and comforts. But the slightest carelessness in dabbling with
it costs life. Man has a desire to save time and thus he has adopted a speedily life. Luxury has
enslaved him. The fashion of using speedy vehicles forces him to entangle in dangers. Speed has
become a religion. Every day the loss of life is untold due to carelessness in every walk of life.
Artificial life is closely associated with risks and dangers and at every moment one has to be
alert to maintain safety. Thus safety education forms an integral part of health education. Safety
education has to be taught to children. They should be trained to avert and avoid risks and
dangers instead of inviting them through carelessness.
Many of the risks hazards and dangers can be averted at home, school and play fields if the
teachers and parents take due care of the child. Children by nature are always naughty and
mischievous. They go about tampering with things not knowing the risks involved in them both
at school and at home. As such, all electrical appliances should be kept away from their easy
reach and they should never be allowed to operate electric switches and devices.

The gardens and lawns at home and the play fields should always be well maintained and should
serve as secure places ensuring safety. Until children learn to be safe, they should be watched
very carefully at home, school and playfields as they are the places to be taught and trained to be
safe. Hence safety education should find its place as a classroom subject to be taught along with
health education.

a. Safety at school
Students spend most of their time in schools. During leisure hours they get opportunities to get
them involved in such activities which may lead to accidents. To make the school life safe safety
education should be included in the curriculum.
Classroom
 Congestion of benches and tables in the class room should be avoided. There must be
sufficient elbow space for the student to move about in the classroom. Broken furniture
must be removed.
 Classroom should prove to be a safe place for every pupil to sit at ease and listen to
teachers. Any inconvenience in enjoying the comfort of sitting at ease is likely to disturb
his concentration
 All the walls should be white washed and there should be proper ventilation in the
classrooms
 Glass fitted to the windows should be highly fixed and there should be no broken places
hanging over anywhere.
 Sharp edges of the walls pillars and door are always dangerous to children especially
when they take sharp turns or dash against them.
Laboratories
  The laboratory rooms must be comparatively big as it is where experiments are
performed. It must have adjacent rooms to act as store room and a preparation room.
 There should be proper arrangement for ventilation and light in the laboratories
 Wall cabinets/cupboards for keeping apparatus and chemicals safely.
 Proper arrangement of gas burners, spirit and lamps.
 Proper arrangements of water sink and tap.
 Care in the use of equipment of chemicals.
 Aquarium for keeping fish and water plants and a germination bed.
 In home science lab, separate rooms for kitchen, laundry sewing and first aid are
provided.
 Computer switch boxes should be placed under computer tables.
 The laboratories where breakages of glass vessels are common: the floor and the works
table should be kept with perfect cleanliness.
 All bottles with poisonous chemicals should be labeled in bold letters.
Play Ground
 Play areas should be fenced properly avoiding barbed wires.
 During Physical activity classes students should wear suitable dress.
 Warming up exercise is essential before indulging in any vigorous activity.
 Playing equipment should be checked.
 Students should be divided in the groups before engaging in any play activity.
Play Area
 The field must be clean and articles like broken glass nails small pieces of stones and
other harmful articles must be removed from the field and rectified through periodic
inspection.
 Play grounds are not made in a day or two continuous attention and mending render the
fields playable.
 Space between courts is essential.
 In marking the play areas avoid using the ropes as there is a likely hood of the players
moving out of the court and getting trapped or stumbled. This may result in causing
damage to the players.
  Safety measures should be made available to prevent the fall, fear or injury to ensure
optimum performance.
 Pupils should be well guided to keep off the grass until the ground is well prepared
 Play areas should be fenced properly avoiding barbed wires.
 Care should be taken to keep the grounds smooth with a good grading for free flow of
water to the drains at rains.
 Students should not be allowed to remain under the sun for a long period of time. There
must be provision for rest shade to help the student to take rest for some time.
 First aid facilities should be made available as close as possible to the play field.
 Drinking water must be available.
 Posts should be painted with white paint.
Equipment
 Always check the equipment before using class/field
 Place the equipment in a suitable storage container such as trolleys bags or boxes
 Anklets must be used by the students while playing some games like foot ball
 Teacher should train the students in the use of different equipment so that the participants
will be able to play efficiently with those equipments for example while playing with
equipments like cricket balls. Short put, javelin etc they must know how to save
themselves from accidents and injury.
Rules and Regulations
 In the game of football; kicking, tripping, (even attempts) pushing an opponent or
jumping at him as well as pulling an opponent bodily or by his shirt constitutes foul play.
To charge dangerously or to injure a player is bad. As a safety measure players should be
advised to avoid bad fouls.
 Players must know what they are going to do and they should do different activities while
participating in games. They must be sure of the rules of the game and how to obey them.
 Teacher should make the students know rules of the game before attempting to teach it.
 Students who follow strictly the rules of game should be rewarded. However when a
student hits another, the teacher should be able to step in to guide.
 Teacher should carefully evaluate the situations in the field and discuss with the students
about their activities.
  We must be sure that teachers assisting any programme of games are aware of the safety
factors involved in the game. They should play the role of supervisors
 In order the avoid accidents in the field the teacher should use some tone of voice each
time he speaks to the students as a major cue to his feelings towards the players thus he
can avoid danger in the field.
Swimming Pool
 Children should be allowed in such swimming pools where the water level is not so deep.
 At the time of swimming certain principles must be followed by the swimmers.
 They should wear minimum clothes so as to save themselves from accidents.
 Children suffering from skin diseases should not be allowed to use the swimming pool.
 Provision must be made to recruit supervisors to look into the safety of the individuals
who use the swimming pool.
 There should be provision for first aid box to provide immediate help to those who are
met/involved in accidents.
Gymnasium
 The participants should strictly obey the rules and regulations for different gymnastic
activities.
 All gymnastic activities should be conducted under the strict supervision of a trained
physical education instructor.
 Learning of exercises should progress from simple exercises to difficult exercises.
 The students should be advised to wear gymnastic shoes. It will help the students to
escape from serious accidents in the gymnastic programmes.
 Exercises must be conducted according to fixed time.
 A large mat should also be placed under the flying rings.

Facilities
 They include; drinking water and points, sports, bathrooms, lavatories and all the
surroundings areas within the school compound and they should prove to be safe.
 Staircase should not be too high or too steep. They must be broad and should have side
support to a reasonable height.
  No child sits in the class permanently. They move from place to place during recess and
leisure time. To ensure safely all places should be free from obstructions. The parapet
(fortifications) walls should be as high as possible. / The cement flooring should not be
too much polished. When children move fast there is very likely hood of their falling
down. Such falls may result in heavy damage to the child.
 Drinking water areas should not be marshy slushy, muddy and slippery.
 The lavatories should always be kept clean.
 Fire extinguishers are to be fixed to the walls at place where fire can breakout or where
there are inflammable substances.

Learner’s role
 Areas outside the class room building and inside the classroom should be kept clean.
 Avoid pushing shoving and running in the school building.
 Go through doors carefully.
 Know the location of exits and fire escape.
 Don’t play inside the class room.

NOTE
The attitude of the children is not totally free from mischievousness. As such live wire laying
anywhere, uncovered switches and broken parts of electrical installation exposed anywhere are
tempting ones for the children to meddle with. Therefore instead of instructing them to keep off
from them immediate attention may be taken in rectifying and restoring them to order.

Teacher’s role
 Always give clear guidelines
 Explain them to follow rules and regulations in the classroom, laboratory and play
ground.
 Provide knowledge related to medical inspection rules and regulation of sports and
games.
 Maintain proper discipline in the class.
B. Safety at Home
This is a place where children ought to be observed. Home should be safe for the children. Thus;
 Children should be given proper training in the handling of electrical appliances except
electric switches.
 Children are under the care of their parents at home parents have to educate the children
to gain sufficient knowledge to keep themselves safe at all times.
 Children at home cannot confine themselves to studies at all hours.
 No child should be prevented from playing.
 Playing in the street should never be encouraged parents should be vigilant in keeping the
gate closed and see that the children are always indoor.
 Children should not be allowed to go alone to the upstairs of the buildings.
 The flooring of the bathroom and the lavatory should not be slippery.
 Electric switches and plug points should be fixed on the walls at a height above their
reach.
 Children should never be allowed to handle electric items such as iron box, electric stove,
mixer, grinder etc.
 Sharp instruments such as knives scissors, vegetables cutter etc should never be made
available to them.
 Children should never be allowed to go near the electric stove, mixer or grinder.

Kitchen
 It is essential to know the techniques of operating cooking appliances safely whichever
fuel is used be it wood, kerosene, gas or electricity.
 When gas is used the valve on the cylinder should be closed when not in use.
 The kitchen floor should be dry for from grease, skins of fruits and vegetables otherwise
there is a chance of slipping the cause a fall.
 When cooking it is dangerous to wear synthetic clothes.
 All sharp instruments such as can openers and knives should be stored in a drawer and
immediately after cleaning they must be put away safely.
 Pressure cookers should be used as per the manufacture’s direction.
  Electric switches and plug points should be fixed on the walls at a height above the reach
of children.
 Minimum mats should be used.
 Mosquito coils should not be kept in near beds and or clothings.
 Bath room should be kept clean.

Parent’s responsibility
Parents at home have total responsibility in looking after the safety of the children
1. Advise them to wear cotton clothes.
2. Keep away the drugs and chemical substances safely from the reach of the children.
3. Do not allow children to play near the parked cycle and motors.
4. Give proper guidance to close and open the door.
5. Windows should be opened for ventilation.
6. If not in use turn off the gas cylinder.

C. Safety on the road

Accidents on the roads have become very common in the modern society. Due to speed and
increase in the number of automobiles, road accident occurs almost every day. School children
who are not aware of the traffic rules meet with accidents. Their safety measures can be
successful if well taken into consideration on the road. The following safety measures are taken
into consideration to avoid accidents.

Road cleanliness
 Keep the road clean, do not throw garbage on the road
 Do not cause any damage on the road surface
 Do not use crackers (anything that may damage rubber) on the road

Rules & Regulations

 The instruction boards should be placed whenever they are needed
 To avoid accidents pupils should follow the rules and regulations of road
 Children should not play on the road
  The students should learn how to obey the traffic light signals and the instruction of the
traffic police
 While crossing the busy road they should be very careful when they feel that the road is
free from danger only then they should cross it.

Safe Driving of vehicles

 While driving automobiles the driver should be very careful and should follow traffic
rules.
 Driver should avoid alcohol.
 The driver should be aware of the safety driving rules.
 The driver should see that the vehicle is well equipped with indicators break light, horn
and other important materials.
 The number plate of vehicle the mirror etc should be visible to the people.
 The automobile driver should be aware of the all road signs and drive carefully according
to the sign.
 Riders should be respected while on the road.

Pedestrian
 Look at the signals at every crossing.
 Pedestrian should be aware that they must take on path way while walking keeping an
eye on the road.
 While crossing the road they should move straight looking to the both sides of the road
and avoid reading and thinking.
 They should be aware of drainage system

Role of government
 Rules and regulation awareness camp should be organized by the government.
 Sensitize people on good use and maintainance of roads
 Govt. should conduct drug addiction awareness camp among the driver
NOTE
  Bleeding, bruises, dislocation, tearing up of muscle, breaking of bones, heavy
hemorrhage and several other complications take places in their children for not being
careful

TOPIC FIVE
NON-COMMUNICABLE DISESASES
A non-communicable disease is a noninfectious health condition that cannot be spread from
person to person. It also lasts for a long period of time. This is also known as a chronic disease.
A combination of genetic, physiological, lifestyle, and environmental factors can cause these
diseases. Some risk factors include:
 unhealthy diets
 lack of physical activity
 smoking and secondhand smoke
 excessive use of alcohol
Non-communicable diseases cause 70 percent of all deaths worldwide and affect people
belonging to all age groups, religions, and countries. Non-communicable diseases are often
associated with older people. However, 15 million annual deaths from non-communicable
diseases occur among people aged 30 to 69. More than 85 percent of these deaths occur in low-
and middle-income countries and in vulnerable communities where access to preventative
healthcare is lacking.

1. Heart diseases

Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels.
Cardiovascular disease includes coronary artery diseases (CAD), stroke, hypertensive heart
disease, rheumatic heart disease, congenital heart disease, peripheral artery disease and venous
thrombosis.
Causes:
There are several risk factors for heart diseases. They are age, gender, tobacco use, physical
inactivity, excessive alcohol consumption, unhealthy diet, obesity, family history of
cardiovascular disease, raised blood pressure (hypertension), raised blood sugar (diabetes
mellitus) and raised blood cholesterol. While the individual contribution of each risk factor
varies between different communities or ethnic groups the overall contribution of these risk
factors is very consistent.

Age as a risk factor is very much related to serum cholesterol level. The serum total cholesterol
level increases as age increases. In men, this increase levels off around age 45 to 50 years. In
women, the increase continues sharply until age 60 to 65 years. The risk of stroke doubles every
decade after age 55. Men are at greater risk of heart disease than pre-menopausal women. Once
past menopause, it has been argued that a woman's risk is similar to men. If a female has
diabetes, she is more likely to develop heart disease than a male with diabetes. It is also found
that gender differences explain nearly half the risk associated with cardiovascular diseases. One
of the proposed explanations for gender differences in cardiovascular diseases is hormonal
difference. Among women, estrogen is the predominant sex hormone. Estrogen may have
protective effects through glucose metabolism and hemostatic system, and may have direct effect
in improving endothelial cell function. The production of estrogen decreases after menopause
and this may change the female lipid metabolism.

Another main cause is physical inactivity. Insufficient physical activity is currently the leading
risk factor for mortality worldwide. In addition, physical activity assists weight loss and
improves blood glucose control, blood pressure, lipid profile and insulin sensitivity. These
effects may, at least in part, explain its cardiovascular benefits. High dietary intakes of saturated
fat, trans-fats and salt and low intake of fruits, vegetables and fish are linked to cardiovascular
risk. The amount of dietary salt consumed is also an important determinant of blood pressure
levels and overall cardiovascular risk. Frequent consumption of high-energy foods, such as
processed foods that are high in fats and sugars, promotes obesity and may increase
cardiovascular risk.

Prevention:
 Low-fat, high-fiber diet including whole grains and fruit and vegetables. Five portions a
day reduce risk by about 25%.
 Tobacco cessation and avoidance of second-hand smoke
 Avoid alcohol consumption.
  Lower blood pressures, if elevated
 Decrease body fat if overweight or obese
 Increase daily activity to 30 minutes of vigorous exercise per day at least five times per
week
 Reduce sugar consumptions
 Decrease psychosocial stress.

EXAMPLES OF HEART DISEASES

1. Coronary heart diseases (C.H.D)/ coronary artery diseases (C.A.D)

Coronary artery disease develops when the major blood vessels that supply your heart become
damaged or diseased. Cholesterol-containing deposits (plaques) in your coronary arteries and
inflammation are usually to blame for coronary artery disease.
The coronary arteries supply blood, oxygen and nutrients to your heart. A buildup of plaque can
narrow these arteries, decreasing blood flow to your heart. Eventually, the reduced blood flow
may cause chest pain (angina), shortness of breath, or other coronary artery disease signs and
symptoms. A complete blockage can cause a heart attack.
Because coronary artery disease often develops over decades, you might not notice a problem
until you have a significant blockage or a heart attack. But you can take steps to prevent and treat
coronary artery disease. A healthy lifestyle can make a big impact.
Symptoms
 Chest pain (angina). You may feel pressure or tightness in your chest, as if someone
were standing on your chest. This pain, called angina, usually occurs on the middle or left
side of the chest. Angina is generally triggered by physical or emotional stress. The pain
usually goes away within minutes after stopping the stressful activity. In some people,
especially women, the pain may be brief or sharp and felt in the neck, arm or back.
 Shortness of breath. If your heart can't pump enough blood to meet your body's needs,
you may develop shortness of breath or extreme fatigue with activity.
 Heart attack. A completely blocked coronary artery will cause a heart attack. The classic
signs and symptoms of a heart attack include crushing pressure in your chest and pain in
your shoulder or arm, sometimes with shortness of breath and sweating.
Causes
Coronary artery disease is thought to begin with damage or injury to the inner layer of a coronary
artery, sometimes as early as childhood. The damage may be caused by various factors,
including:
 Smoking
 High blood pressure
 High cholesterol
 Diabetes or insulin resistance
 Not being active (sedentary lifestyle)
Risk factors:
  Age. Getting older increases your risk of damaged and narrowed arteries.
 Sex. Men are generally at greater risk of coronary artery disease. However, the risk for
women increases after menopause.
 Family history. A family history of heart disease is associated with a higher risk of
coronary artery disease, especially if a close relative developed heart disease at an early
age. Your risk is highest if your father or a brother was diagnosed with heart disease
before age 55 or if your mother or a sister developed it before age 65.
 Smoking. People who smoke have a significantly increased risk of heart disease.
Breathing in secondhand smoke also increases a person's risk of coronary artery disease.
 High blood pressure. Uncontrolled high blood pressure can result in hardening and
thickening of your arteries, narrowing the channel through which blood can flow.
 High blood cholesterol levels. High levels of cholesterol in your blood can increase the
risk of formation of plaque and atherosclerosis. High cholesterol can be caused by a high
level of low-density lipoprotein (LDL) cholesterol, known as the "bad" cholesterol. A
low level of high-density lipoprotein (HDL) cholesterol, known as the "good"
cholesterol, can also contribute to the development of atherosclerosis.
 Diabetes. Diabetes is associated with an increased risk of coronary artery disease. Type 2
diabetes and coronary artery disease share similar risk factors, such as obesity and high
blood pressure.
 Overweight or obesity. Excess weight typically worsens other risk factors.
 Physical inactivity. Lack of exercise also is associated with coronary artery disease and
some of its risk factors, as well.
 High stress. Unrelieved stress in your life may damage your arteries as well as worsen
other risk factors for coronary artery disease.
 Unhealthy diet. Eating too much food that has high amounts of saturated fat, trans fat,
salt and sugar can increase your risk of coronary artery disease.
Complications
Coronary artery disease can lead to:
 Chest pain (angina). When your coronary arteries narrow, your heart may not receive
enough blood when demand is greatest — particularly during physical activity. This can
cause chest pain (angina) or shortness of breath.
 Heart attack. If a cholesterol plaque ruptures and a blood clot forms, complete blockage
of your heart artery may trigger a heart attack. The lack of blood flow to your heart may
damage your heart muscle. The amount of damage depends in part on how quickly you
receive treatment.
 Heart failure. If some areas of your heart are chronically deprived of oxygen and
nutrients because of reduced blood flow, or if your heart has been damaged by a heart
attack, your heart may become too weak to pump enough blood to meet your body's
needs. This condition is known as heart failure.
 Abnormal heart rhythm (arrhythmia). Inadequate blood supply to the heart or damage
to heart tissue can interfere with your heart's electrical impulses, causing abnormal heart
rhythms.
Prevention
The same lifestyle habits used to help treat coronary artery disease can also help prevent it. A
healthy lifestyle can help keep your arteries strong and clear of plaque. To improve your heart
health, follow these tips:
  Quit smoking.
 Control conditions such as high blood pressure, high cholesterol and diabetes.
 Stay physically active.
 Eat a low-fat, low-salt diet that's rich in fruits, vegetables and whole grains.
 Maintain a healthy weight.
 Reduce and manage stress
2. High blood pressure/hypertension
High blood pressure is a common condition in which the long-term force of the blood against
your artery walls is high enough that it may eventually cause health problems, such as heart
disease.
Blood pressure is determined both by the amount of blood your heart pumps and the amount of
resistance to blood flow in your arteries. The more blood your heart pumps and the narrower
your arteries, the higher your blood pressure. A person can have high blood pressure
(hypertension) for years without any symptoms. Even without symptoms, damage to blood
vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases
your risk of serious health problems, including heart attack and stroke.
Causes
There are two types of high blood pressure.
a. Primary(essential) hypertension
For most adults, there's no identifiable cause of high blood pressure. This type of high blood
pressure, called primary (essential) hypertension, tends to develop gradually over many years.
Secondary hypertension
Some people have high blood pressure caused by an underlying condition. This type of high
blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood
pressure than does primary hypertension. Various conditions and medications can lead to
secondary hypertension, including:
 Kidney problems
 Thyroid problems
 Certain defects you're born with (congenital) in blood vessels
 Certain medications, such as birth control pills, cold remedies, decongestants, over-the-
counter pain relievers and some prescription drugs
 Illegal drugs, such as cocaine and amphetamines
Risk factors
High blood pressure has many risk factors, including:
 Age. The risk of high blood pressure increases as you age. Until about age 64, high blood
pressure is more common in men. Women are more likely to develop high blood pressure
after age 65.
 Race. High blood pressure is particularly common among people of African heritage,
often developing at an earlier age than it does in whites. Serious complications, such as
stroke, heart attack and kidney failure, also are more common in people of African
heritage.
 Family history. High blood pressure tends to run in families.
  Being overweight or obese. The more you weigh the more blood you need to supply
oxygen and nutrients to your tissues. As the volume of blood circulated through your
blood vessels increases, so does the pressure on your artery walls.
 Not being physically active. People who are inactive tend to have higher heart rates. The
higher your heart rate, the harder your heart must work with each contraction and the
stronger the force on your arteries. Lack of physical activity also increases the risk of
being overweight.
 Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood
pressure temporarily, but the chemicals in tobacco can damage the lining of your artery
walls. This can cause your arteries to narrow and increase your risk of heart disease.
Secondhand smoke also can increase your heart disease risk.
 Too much salt (sodium) in your diet. Too much sodium in your diet can cause your
body to retain fluid, which increases blood pressure.
 Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having
more than one drink a day for women and more than two drinks a day for men may affect
your blood pressure.
 Stress. High levels of stress can lead to a temporary increase in blood pressure. If you try
to relax by eating more, using tobacco or drinking alcohol, you may only increase
problems with high blood pressure.
 Certain chronic conditions. Certain chronic conditions also may increase your risk of
high blood pressure, such as kidney disease and diabetes.
 Sometimes pregnancy contributes to high blood pressure, as well.
Although high blood pressure is most common in adults, children may be at risk, too. For some
children, high blood pressure is caused by problems with the kidneys or heart. But for a growing
number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise,
contribute to high blood pressure.
Complications
Uncontrolled high blood pressure can lead to complications including:
 Heart attack or stroke. High blood pressure can cause hardening and thickening of the
arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
 Heart failure. To pump blood against the higher pressure in your vessels, the heart has to
work harder. This causes the walls of the heart's pumping chamber to thicken (left
ventricular hypertrophy). Eventually, the thickened muscle may have a hard time
pumping enough blood to meet your body's needs, which can lead to heart failure.
 Weakened and narrowed blood vessels in your kidneys. This can prevent these organs
from functioning normally.
 Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
 Metabolic syndrome. This syndrome is a cluster of disorders of your body's metabolism,
including increased waist circumference; high triglycerides; low high-density lipoprotein
(HDL) cholesterol, the "good" cholesterol; high blood pressure and high insulin levels.
These conditions make you more likely to develop diabetes, heart disease and stroke.
 Trouble with memory or understanding. Uncontrolled high blood pressure may also
affect your ability to think, remember and learn. Trouble with memory or understanding
concepts is more common in people with high blood pressure.
  Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading to a
certain type of dementia (vascular dementia). A stroke that interrupts blood flow to the
brain also can cause vascular dementia.

3. STROKE (Cardiovascular Accident-C.V. A)

A stroke occurs when a blood vessel in the brain ruptures and bleeds, or when there’s a blockage
in the blood supply to the brain. The rupture or blockage prevents blood and oxygen from
reaching the brain’s tissues.
Symptoms
Stroke symptoms can include:
 paralysis
 numbness or weakness in the arm, face, and leg, especially on one side of the body
 trouble speaking or understanding speech
 confusion
 slurring speech
 vision problems, such as trouble seeing in one or both eyes with vision blackened or
blurred, or double vision
 trouble walking
 loss of balance or coordination
 dizziness
 severe, sudden headache with an unknown cause
A stroke requires immediate medical attention. Prompt treatment is key to preventing the
following outcomes:
 brain damage
 long-term disability
 death
Types of stroke
The type of stroke affects the treatment and recovery process.
Ischemic stroke
During an ischemic stroke, the arteries supplying blood to the brain narrow or become blocked.
These blockages are caused by blood clots or blood flow that’s severely reduced. They can also
be caused by pieces of plaque blocking a blood vessel. The two most common types of ischemic
strokes are thrombotic and embolic. A thrombotic stroke happens when a blood clot forms in one
of the arteries supplying blood to the brain. The clot passes through the bloodstream and
becomes lodged, which blocks blood flow. An embolic stroke is when a blood clot or other
debris forms in another part of the body and then travels to the brain.

Transient ischemic attack (TIA)

A transient ischemic attack, often called a TIA or ministroke, occurs when blood flow to the
brain is blocked temporarily. Symptoms, which are similar to those of a full stroke, are typically
temporary and disappear after a few minutes or hours. A TIA is usually caused by a blood clot. It
serves as a warning of a future stroke, and if it is not treated immediately, a major stroke may be
experienced within a year.

Hemorrhagic stroke
A hemorrhagic stroke happens when an artery in the brain breaks open or leaks blood. The blood
from that artery creates excess pressure in the skull and swells the brain, damaging brain cells
and tissues.
Causes of stroke
The cause of a stroke depends on the type of stroke. The three main types of stroke are transient
ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke.
A TIA is caused by a temporary blockage in an artery that leads to the brain. The blockage,
typically a blood clot, stops blood from flowing to certain parts of the brain. A TIA typically
lasts for a few minutes up to a few hours, and then the blockage moves and blood flow is
restored.
Like a TIA, an ischemic stroke is caused by a blockage in an artery that leads to the brain. This
blockage may be a blood clot or plaque (a fatty substance) builds up on the walls of a blood
vessel. A piece of the plaque can break off and lodge in an artery, blocking the flow of blood and
causing an ischemic stroke.
A hemorrhagic stroke, on the other hand, is caused by a burst or leaking blood vessel. Blood
seeps
Risk factors:
Diet
An unhealthy diet that increases your risk of stroke is one that’s high in:
 salt
 saturated fats and trans fats
 cholesterol
Inactivity
Inactivity, or lack of exercise, can also raise your risk for stroke. Regular exercise has a number
of health benefits.
Alcohol consumption
Alcohol consumption should be done in moderation. This means no more than one drink per day
for women, and no more than two for men. More than that may raise blood pressure levels as
well as triglyceride levels, which can cause atherosclerosis.
Tobacco use
Using tobacco in any form also raises your risk for stroke, since it can damage your blood
vessels and heart. This is further increased when smoking, because your blood pressure rises
when you use nicotine.
Personal background
There are certain personal risk factors for stroke that you can’t control. Stroke risk can be linked
to your:
 Family history. Stroke risk is higher in some families because of genetic health issues,
such as high blood pressure.
 Sex. According to the, while both women and men can have strokes, they’re more
common in women than in men in all age groups.
 Age. The older you are, the more likely you are to have a stroke.
 Race and ethnicity. Caucasians, Asian Americans, and Hispanics are less likely to have
a stroke than African-Americans, Alaska Natives, and American Indians.
Health history
Certain medical conditions are linked to stroke risk. These include:
 a previous stroke or TIA
 high blood pressure
 high cholesterol
 heart disorders, such as coronary artery disease
 heart valve defects
 enlarged heart chambers and irregular heartbeats
 sickle cell disease
 diabetes
How to prevent a stroke
Prevention
 Quit smoking. If you smoke, quitting now will lower your risk for stroke.
 Consume alcohol in moderation. If you drink excessively, try to reduce your intake.
Alcohol consumption can raise your blood pressure.
 Keep weight down. Keep your weight at a healthy level. Being obese or overweight
increases your stroke risk. To help manage your weight:
o Eat a diet that’s full of fruits and vegetables.
o Eat foods low in cholesterol, trans fats, and saturated fats.
o Stay physically active. This will help you maintain a healthy weight and help
reduce your blood pressure and cholesterol levels.
 Get checkups. Stay on top of your health. This means getting regular checkups and
staying in communication with your doctor. Be sure to take the following steps to
manage your health:
o Get your cholesterol and blood pressure checked.
o Talk to your doctor about modifying your lifestyle.
o Discuss your medication options with your doctor.
o Address any heart problems you may have.
o If you have diabetes, take steps to manage it.
o Heart failure affects nearly 6 million Americans. Roughly 670,000 people are
diagnosed with heart failure each year. It is the leading cause of hospitalization in
people older than age 65.
4. HEART FAILURE
What Is Heart Failure?
Heart failure does not mean the heart has stopped working. Rather, it means that the heart
works less efficiently than normal. Due to various possible causes, blood moves through the
heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot
pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart may
respond by stretching to hold more blood to pump through the body or by becoming stiff and
thickened. This helps to keep the blood moving, but the heart muscle walls may eventually
weaken and become unable to pump as efficiently. As a result, the kidneys may respond by
causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet,
lungs, or other organs, the body becomes congested, and congestive heart failure is the term used
to describe the condition.
Causes of Heart Failure
Heart failure is caused by many conditions that damage the heart muscle, including:
Coronary artery disease.
Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the
heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or
severely narrowed, the heart becomes starved for oxygen and nutrients.
Heart attack.
A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of
blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area
that does not function properly.
Conditions that overwork the heart
Conditions including;
 High blood pressure
 Valve diseases
 Thyroid disease
 Kidney disease
 Diabetes
 Heart defects present at birth
Additionally, heart failure can occur when several diseases or conditions are present at once.
5. PERIPHERAL VASCULAR DISEASE (PVD)
Peripheral vascular disease (PVD) is a slow and progressive circulation disorder. Narrowing,
blockage, or spasms in a blood vessel can cause PVD. PVD may affect any blood vessel outside
of the heart including the arteries, veins, or lymphatic vessels. Organs supplied by these vessels,
such as the brain, and legs, may not get enough blood flow for proper function. However, the
legs and feet are most commonly affected. Peripheral vascular disease is also called peripheral
arterial disease.
Causes
The most common cause of PVD is atherosclerosis, the buildup of plaque inside the artery wall.
Plaque reduces the amount of blood flow to the limbs. It also decreases the oxygen and nutrients
available to the tissue. Blood clots may form on the artery walls, further decreasing the inner size
of the blood vessel and block off major arteries.
Other causes of PVD may include:
 Injury to the arms or legs
 Irregular anatomy of muscles or ligaments
 Infection
People with coronary artery disease (CAD) often also have PVD.

Risk factors
Risk factors that you can’t change:
 Age (especially older than age 50)
 History of heart disease
 Male gender
 Postmenopausal women
 Family history of high cholesterol, high blood pressure, or peripheral vascular disease
Risk factors that may be changed or treated include:
  Coronary artery disease
 Diabetes
 High cholesterol
 High blood pressure
 Overweight
 Physical inactivity
 Smoking or use of tobacco products
Those who smoke or have diabetes have the highest risk of complications from PVD because
these risk factors also cause impaired blood flow.
Symptoms
About half the people diagnosed with PVD are symptom free. For those with symptoms, the
most common first symptom is painful leg cramping that occurs with exercise and is relieved
by rest (intermittent claudication). During rest, the muscles need less blood flow, so the pain
disappears. It may occur in one or both legs depending on the location of the clogged or
narrowed artery.
Other symptoms of PVD may include:
 Changes in the skin, including decreased skin temperature, or thin, brittle, shiny skin on
the legs and feet
 Weak pulses in the legs and the feet
 Gangrene (dead tissue due to lack of blood flow)
 Impotence
 Wounds that won't heal over pressure points, such as heels or ankles
 Numbness, weakness, or heaviness in muscles
 Pain (described as burning or aching) at rest, commonly in the toes and at night while
lying flat
 Paleness when the legs are elevated
 Reddish-blue discoloration of the extremities
 Restricted mobility
 Severe pain when the artery is very narrow or blocked
 Thickened, opaque toenail
Prevention
To prevent PVD, take steps to manage the risk factors. A prevention program for PVD may
include:
 Quit smoking, including avoidance of second-hand smoke and use of any tobacco
products
 Dietary changes including reduced fat, cholesterol, and simple carbohydrates (such as
sweets), and increased amounts of fruits and vegetables, low-fat dairy, and lean meats
 Treatment of high blood cholesterol with medicine as determined by your healthcare
provider
 Weight loss
 Limiting or quitting alcohol intake
 Medicine to reduce your risk for blood clots, as determined by your healthcare provider
 Exercise 30 minutes or more daily
 Control of diabetes
 Control of high blood pressure
2. CANCER:
Meaning:
Cancer is also known as a malignant tumor or malignant neoplasm, is a group of diseases
involving abnormal cell growth with the potential to invade or spread to other parts of the body.
Not all tumors are cancerous. Possible signs and symptoms include a new lump, abnormal
bleeding, a prolonged cough, unexplained weight loss, and a change in bowel movements among
others. While these symptoms may indicate cancer, they may also occur due to other issues.
There are over 100 different known cancers that affect humans.
 The characteristics of cancer cells are:
 Cell growth and division without the proper signals to do so
 Continuous growth and division even when there are signals telling them to stop
 Avoidance of programmed cell death
 Limitless number of cell divisions
 Promoting blood vessel construction
 Invasion of tissue and formation of metastases

Causes:
Most cancers are related to environmental, lifestyle, or behavioral exposures. The term
"environmental", as used by cancer researchers, refers to everything outside the body that
interacts with humans. In this sense, the environment is not limited to the biophysical
environment (e.g. exposure to factors such as air pollution or sunlight, encountered outdoors or
indoors, at home or in the workplace), but also includes lifestyle, economic and behavioral
factors. Common environmental factors that contribute to cancer death include tobacco. It is
nearly impossible to prove what caused a cancer in any individual, because most cancers have
multiple possible causes. For example, if a person who uses tobacco heavily develops lung
cancer, then it was probably caused by the tobacco use, but since everyone has a small chance of
developing lung cancer as a result of air pollution or radiation, then there is a small chance that
the cancer developed because of air pollution or radiation. Cancer is generally not contagious in
humans, though it can be caused by oncoviruses and bacteria. It should be noted that aging has
been repeatedly and consistently regarded as an important aspect to consider when evaluating the
risk factors for the development of particular cancers; aging is considered a risk factor and this is
explained by the observation that many molecular and cellular changes are involved in the
development of cancer, so it is very likely that these changes accumulate during the aging
process. Cancers are potentially avoidable by reducing key risk factors, of which much the
significant is tobacco use, which is the cause for more cancer deaths. Another important reason is
obesity, a poor diet, lack of physical activity, and drinking alcohol. Other factors are
infections, exposure to ionizing radiation, and environmental pollutants. In the developing
world nearly 20% of cancers are due to infections such as hepatitis B, hepatitis C, and human
papilloma virus. These factors act, at least partly, by changing the genes of a cell. Typically,
many such genetic changes are required before cancer develops. Approximately 5–10% of
cancers are due to genetic defects inherited from a person's parents.

Types of Cancer
There are more than 100 types of cancer. Types of cancer are usually named for the organs or
tissues where the cancers form. For example, lung cancer starts in cells of the lung, and brain
cancer starts in cells of the brain. Cancers also may be described by the type of cell that formed
them, such as an epithelial cell or a squamous cell.
Carcinoma: Carcinomas are the most common type of cancer. They are formed by epithelial
cells, which are the cells that cover the inside and outside surfaces of the body.
Sarcoma: Sarcomas are cancers that form in bone and soft tissues, including muscle, fat, blood
vessels, lymph vessels, and fibrous tissue.
Leukemia: Cancers that begin in the blood-forming tissue of the bone marrow are called
leukemia. These cancers do not form solid tumors. Instead, large numbers of abnormal white
blood cells (leukemia cells and leukemic blast cells) build up in the blood and bone marrow,
crowding out normal blood cells. The low level of normal blood cells can make it harder for the
body to get oxygen to its tissues, control bleeding, or fight infections.
Lymphoma: Lymphoma is cancer that begins in lymphocytes (T cells or B cells). These are
disease-fighting white blood cells that are part of the immune system. In lymphoma, abnormal
lymphocytes build up in lymph nodes and lymph vessels, as well as in other organs of the body.
Brain and Spinal Cord Tumors: There are different types of brain and spinal cord tumors.
These tumors are named based on the type of cell in which they formed and where the tumor first
formed in the central nervous system. For example, an astrocytic tumor begins in starshaped
brain cells called astrocytes, which help keep nerve cells healthy. Brain tumors can be benign
(not cancer) or malignant (cancer).
Preventive measures:
 Avoid tobacco
 Healthy diet- Plenty of fruits and vegetables and other foods from plant sources, whole
grains and beans.
 Avoid obesity- Eating lighter and leaner by choosing fewer high-calorie foods, including
refined sugars and fat from animal sources.
 Limit processed meats- A report from the International Agency for Research on Cancer,
the cancer agency of the World Health Organization, concluded that eating large amounts
of processed meat can slightly increase the risk of certain types of cancer.
 Maintain a healthy weight and be physically active lower the risk of various types of
cancer, including cancer of the breast, prostate, lung, colon and kidney.

3. CHRONIC RESPIRATORY DISEASE

Chronic respiratory diseases are ailments affecting the airways and lung structures. Some of
these diseases have a genetic basis.
However, other causes include lifestyle choices such as smoking and environmental conditions
like exposure to air pollution, poor air quality, and poor ventilation.
While these diseases are incurable, they can be managed with medical treatment. The most
common chronic respiratory diseases include:
 chronic obstructive pulmonary disease (COPD)
 asthma
 occupational lung diseases, such as black lung
 pulmonary hypertension
 cystic fibrosis
CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
What is COPD?
Chronic obstructive pulmonary disease, commonly referred to as COPD, is a group of
progressive lung diseases. The most common of these diseases are emphysema and chronic
bronchitis. Many people with COPD have both of these conditions.
Emphysema slowly destroys air sacs in your lungs, which interferes with outward air flow.
Bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to
build up.
Untreated, COPD can lead to a faster progression of disease, heart problems, and worsening
respiratory infections.
What are the symptoms of COPD?
Early symptoms
At first, symptoms of COPD can be quite mild. You might mistake them for a cold.
Early symptoms include:
 occasional shortness of breath, especially after exercise
 mild but recurrent cough
 needing to clear your throat often, especially first thing in the morning
You might start making subtle changes, such as avoiding stairs and skipping physical activities.
Worsening symptoms
Symptoms can get progressively worse and harder to ignore. As the lungs become more
damaged, you may experience:
 shortness of breath, after even mild forms of exercise like walking up a flight of stairs
 wheezing, which is a type of higher-pitched noisy breathing, especially during
exhalations
 chest tightness
 chronic cough, with or without mucus
 need to clear mucus from your lungs every day
 frequent colds, flu, or other respiratory infections
 lack of energy
In later stages of COPD, symptoms may also include:
 fatigue
 swelling of the feet, ankles, or legs
 weight loss
Symptoms are likely to be much worse if you currently smoke or are regularly exposed to
secondhand smoke.
What causes COPD?
Most people with COPD are at least 40 years old and have at least some history of smoking. The
longer and more tobacco products you smoke, the greater your risk of COPD is.
In addition to cigarette smoke, cigar smoke, pipe smoke, and secondhand smoke can cause
COPD. Your risk of COPD is even greater if you have asthma and smoke.
Other causes
You can also develop COPD if you’re exposed to chemicals and fumes in the workplace. Long-
term exposure to air pollution and inhaling dust can also cause COPD.
In developing countries, along with tobacco smoke, homes are often poorly ventilated, forcing
families to breathe fumes from burning fuel used for cooking and heating.
There may be a genetic predisposition to developing COPD. Up to an estimated 5 percent
Trusted Source of people with COPD have a deficiency in a protein called alpha-1-antitrypsin.
This deficiency causes the lungs to deteriorate and also can affect the liver. There may be other
associated genetic factors at play as well.
Treatment for COPD
Treatment can ease symptoms, prevent complications, and generally slow disease progression.
Your healthcare team may include a lung specialist (pulmonologist) and physical and respiratory
therapists.
Oxygen therapy
If your blood oxygen level is too low, you can receive supplemental oxygen through a mask or
nasal cannula to help you breathe better. A portable unit can make it easier to get around.
Surgery
Surgery is reserved for severe COPD or when other treatments have failed, which is more likely
when you have a form of severe emphysema.
Lifestyle changes
Certain lifestyle changes may also help alleviate your symptoms or provide relief.
 If you smoke, quit. Your doctor can recommend appropriate products or support services.
 Whenever possible, avoid secondhand smoke and chemical fumes.
 Get the nutrition your body needs. Work with your doctor or dietician to create a healthy
eating plan.
 Talk to your doctor about how much exercise is safe for you.
ASTHMA
Asthma is an inflammatory disease of the airways to the lungs. It makes breathing difficult and
can make some physical activities challenging or even impossible.
According to the Centers for Disease Control and Prevention (CDC), approximately 25 million
Americans have asthma. It’s the most common chronic condition among American children: has
asthma. To understand asthma, it’s necessary to understand a little about what happens when you
breathe.
Normally, with every breath you take, air goes through your nose or mouth and down into your
throat and into your airways, eventually making it to your lungs.
There are lots of small air passages in your lungs that help deliver oxygen from the air into your
bloodstream.
Asthma symptoms occur when the lining of your airways swell and the muscles around them
tighten. Mucus then fills the airways, further reducing the amount of air that can pass through.
These conditions can then bring on an asthma “attack,” the coughing and tightness in your chest
that’s typical of asthma.
Symptoms
The most common symptom of asthma is wheezing, a squealing or whistling sound made when
you breathe.
Other asthma symptoms may include:
 coughing, especially at night, when laughing, or during exercise
 tightness in the chest
 shortness of breath
 difficulty talking
 anxiousness or panic
 fatigue
The type of asthma that you have can determine which symptoms you experience.
Not everyone with asthma will experience these particular symptoms. If you think the symptoms
you’re experiencing could be a sign of a condition such as asthma, make an appointment to see
your doctor.
The first indication that you have asthma may not be an actual asthma attack.
Types
There are many different types of asthma. The most common type is bronchial asthma, which
affects the bronchi in the lungs.
Additional forms of asthma include childhood asthma and adult-onset asthma. In adult-onset
asthma, symptoms don’t appear until at least age 20.
Other specific types of asthma are described below.
Allergic asthma (extrinsic asthma)
Allergens trigger this common type of asthma. These might include:
 pet dander from animals like cats and dogs
 food
 mold
 pollen
 dust
Allergic asthma is often seasonal because it often goes hand-in-hand with seasonal allergies.
Nonallergic asthma (intrinsic asthma)
Irritants in the air not related to allergies trigger this type of asthma. These irritants might
include:
 burning wood
 cigarette smoke
 cold air
 air pollution
 viral illnesses
 air fresheners
 household cleaning products
 perfumes
Occupational asthma
Occupational asthma is a type of asthma induced by triggers in the workplace. These include:
 dust
 dyes
 gases and fumes
 industrial chemicals
 animal proteins
 rubber latex
These irritants can exist in a wide range of industries, including:
 farming
 textiles
 woodworking
 manufacturing
Exercise-induced bronchoconstriction (EIB)
Exercise-induced bronchoconstriction (EIB) usually affects people within a few minutes of
starting exercise and up to 10–15 minutes after physical activity.
This condition was previously known as exercise-induced asthma (EIA).
Up to 90 percent of people with asthma also experience EIB, but not everyone with EIB will
have other types of asthma.
Aspirin-induced asthma
Aspirin-induced asthma (AIA), also called aspirin-exacerbated respiratory disease (AERD), is
usually severe. It’s triggered by taking aspirin or another NSAID (nonsteroidal anti-
inflammatory drug), such as naproxen (Aleve) or ibuprofen (Advil).
The symptoms may begin within minutes or hours. These patients also typically have nasal
polyps.About 9 percent of people with asthma have AIA. It usually develops suddenly in adults
between the ages of 20 and 50.
Nocturnal asthma
In this type of asthma, symptoms worsen at night.Triggers that are thought to bring on symptoms
at night include:
 heartburn
 pet dander
 dust mites
The body’s natural sleep cycle may also trigger nocturnal asthma.
Cough-variant asthma (CVA)
Cough-variant asthma (CVA) doesn’t have classic asthma symptoms of wheezing and shortness
of breath. It’s characterized by a persistent, dry cough.
Causes
No single cause has been identified for asthma. Instead, researchers believe that the breathing
condition is caused by a variety of factors. These factors include:
 Genetics. If a parent or sibling has asthma, you’re more likely to develop it.
 History of viral infections. People with a history of severe viral infections during
childhood (e.g. RSV) may be more likely to develop the condition.
 Hygiene hypothesis. This theory explains that when babies aren’t exposed to enough
bacteria in their early months and years, their immune systems don’t become strong
enough to fight off asthma and other allergic conditions.
Treatment
Treatments for asthma fall into three primary categories:
 breathing exercises
 quick-acting treatments
 long-term asthma control medications
Your doctor will recommend one treatment or combination of treatments based on:
 the type of asthma you have
 your age
 your triggers
Breathing exercises
These exercises can help you get more air into and out of your lungs. Over time, this may help
increase lung capacity and cut down on severe asthma symptoms.
Your doctor or an occupational therapist can help you learn these breathing exercises for asthma.
Quick-relief asthma treatments
These medications should only be used in the event of asthma symptoms or an attack. They
provide quick relief to help you breathe again.
Bronchodilators
Bronchodilators work within minutes to relax the tightened muscles around your airwaves. They
can be taken as an inhaler (rescue) or nebulizer.
First aid asthma treatment
If you think that someone you know is having an asthma attack, tell them to sit them upright and
assist them in using their rescue inhaler or nebulizer. Two to six puffs of medication should help
ease their symptoms.
If symptoms persist for more than 20 minutes, and a second round of medication doesn’t help,
seek emergency medical attention.
4. OSTEOPOROSIS &DEPRESSION

Causes:
Loss of bone mass is the leading cause of osteoporosis and bone fractures among the aged in
general and among post-menopausal women in particular. People with major depression
generally have a lower bone mass density. Depression may increase the risk of the bone disorder
osteoporosis in premenopausal women. Depressed women have overactive immune systems that
make too many inflammatory chemicals, one of which actually promotes bone loss. Depression
is a common chronic condition and that thinning of bones (osteopenia) is often “clinically silent”
(without signs or symptoms). Osteoporosis is a chronic illness with potentially life-altering
consequences when not managed properly. Osteoporosis is a disease characterized by low bone
mass and the deterioration of bone tissue. The bones weaken, putting those affected at greater
risk of suffering a broken bone or fragility fracture. Fragility fractures are those that occur
following a minor trauma, such as a fall from standing height, a sitting position or having missed
1-3 steps in a staircase.

Signs of depression:
 Depressed mood.
 Marked loss of interest or pleasure in activities which used to give you pleasure
 Significant weight loss or gain.
 Insomnia or difficulty sleeping (usually waking up in the early morning rather than
having difficulty falling asleep) or sleeping too much.
 Lack of interest or concern about what's going on around you.
 Feelings of agitation.
  Lack of energy.
 Feelings of worthlessness and/or guilt.
 Inability to concentrate or make decisions.
Prevention:
 Built a strong social support network
 Cultivate the habit of meditation
 Have a deep sleep for 6 to 8 hours.
 Make yourself physically fit
 Nurture your body, mind and spirit in a positive and enjoyable way.

5. INTENTIONAL AND UNINTENTIONAL INJURIES

Unintentional injuries are harmful acts that occurred without any intention of causing damage to
oneself or others. A large proportion of unintentional injuries occur in or around the home and
many of these injuries occur as a result of falls, like down the stairs or when someone uses a
ladder to fix something. Motor vehicle crashes, unintentional poisonings, suffocation, drowning,
accidental firearm discharges, and burns. For people aged 65 or older, unintentional falls are the
number one cause of unintentional injury death. Those in the age group of 25-64 should be wary
of unintentional poisonings with substances at home like chemicals, drugs, and so on. Children
and young adults aged 5-24 who die as a result of an unintentional injury mainly do so because
of problems sustained from motor vehicle related accidents. And children below the age of five
are most at risk for unintentional death via suffocation and drowning, hence the need to watch
the kiddies near the tub and pool.
Intentional Injuries: In contrast to unintentional injuries are intentional injuries, which are
injuries resulting from purposeful harmful actions upon oneself or others. Violence is a term that
describes the exercise of force to harm oneself or another person. It's similarly a very unfortunate
fact that the majority of these intentional injury deaths occur not by the hands of others, but when
a person commits suicide. The three major contributing factors to suicide deaths are firearms,
suffocation, and poisoning. Injuries are responsible for countless lost lives, decreased quality of
life, and substantial health care costs. While injuries afflict everyone, people of color and low-
income populations are particularly vulnerable.
Prevention:
  Begin a regular exercise program to increase the balance, strength, and flexibility.
 Consult with a health professional about getting a fall risk assessment
 Have all medications, prescription and over-the-counter, reviewed periodically for drug
interactions that could lead to falls.
 Get your vision checked at least annually by an eye doctor.
 Make your home safer by reducing tripping hazards, installing handrails and grab bars
and improving lighting.
6. DIABETES AND OBESITY
What are Diabetics?
Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high
blood glucose, also called high blood sugar or hyperglycemia. Diabetes is a disorder of
metabolism- the way the body uses digested food for energy. The digestive tract breaks down
carbohydrates, sugars and starches found in many foods into glucose, a form of sugar that enters
the bloodstream. With the help of the hormone insulin, cells throughout the body absorb glucose
and use it for energy. Diabetes develops when the body doesn’t make enough insulin or is not
able to use insulin effectively, or both. Insulin is made in the pancreas, an organ located behind
the stomach. The pancreas contains clusters of cells called islets. Beta cells within the islets
make insulin and release it into the blood. If beta cells don’t produce enough insulin, or the body
doesn’t respond to the insulin that is present, glucose builds up in the blood instead of being
absorbed by cells in the body, leading to prediabetes or diabetes. Over time, high blood glucose
damages nerves and blood vessels, leading to complications such as heart disease, stroke, kidney
disease, blindness, dental disease, and amputations. Other complications of diabetes may include
increased susceptibility to other diseases, loss of mobility with aging, depression, and pregnancy
problems. No one is certain about the causes for diabetes, but scientists believe genes and
environmental factors interact to cause diabetes in most cases. The two main types of diabetes
are type 1 diabetes and type 2 diabetes. A third type, gestational diabetes, develops only during
pregnancy. Other types of diabetes are caused by defects in specific genes, diseases of the
pancreas, certain drugs or chemicals, infections, and other conditions. Some people show signs
of both type 1 and type 2 diabetes.
Causes: Diabetes is caused by a lack of insulin due to the destruction of insulin producing beta
cells in the pancreas. In type 1 diabetes the body’s immune system attacks and destroys the beta
cells. Normally, the immune system protects the body from infection by identifying and
destroying bacteria, viruses, and other potentially harmful foreign substances. The immune
system attacks the body’s own cells. In type 1 diabetes, beta cell destruction may take place over
several years, but symptoms of the disease usually develop over a short period of time. Type 1
diabetes typically occurs in children and young adults, though it can appear at any age. In the
past, type 1 diabetes was called juvenile diabetes or insulin-dependent diabetes mellitus. Latent
autoimmune diabetes in adults (LADA) may be a slowly developing kind of type 1 diabetes.
Diagnosis usually occurs after age 30. In LADA, as in type 1 diabetes, the body’s immune
system destroys the beta cells. At the time of diagnosis, people with LADA may still produce
their own insulin, but eventually most will need insulin shots or an insulin pump to control blood
glucose levels.

Obesity and Physical Inactivity

Physical inactivity and obesity are strongly associated with the development of type 2 diabetes.
People who are genetically susceptible to type 2 diabetes are more vulnerable when these risk
factors are present. An imbalance between caloric intake and physical activity can lead to
obesity, which causes insulin resistance and is common in people with type 2 diabetes. Central
obesity, in which a person has excess abdominal fat, is a major risk factor not only for insulin
resistance and type 2 diabetes but also for heart and blood vessel disease, also called
cardiovascular disease (CVD). This excess “belly fat” produces hormones and other substances
that can cause harmful, chronic effects in the body such as damage to blood vessels.
Prevention:
 Get more physical activity
 Get plenty of fiber
 Choose whole grains and whole grain products over highly processed carbohydrates.
 Skip the sugary drinks, and choose water, coffee, or tea instead.
 Choose good fats instead of bad fats.
 Limit red meat and avoid processed meat; choose nuts, whole grains, poultry, or fish
instead.
 Avoid smoking
 Avoid alcohol content
 7. Back pain: causes, symptoms and prevention
Meaning: Pain felt in the low or upper back. Causes of pain in the low and upper back include
conditions affecting the bony spine, discs between the vertebrae, ligaments around the spine and
discs, spinal inflammation, spinal cord and nerves, muscles, internal organs of the pelvis, chest,
and abdomen, tumors, and the skin. The back is a complex structure made up of 33 vertebrae,
over 30 muscles, numerous ligaments, multiple joints, and inter-vertebral discs.
Types and its Causes:
1) Muscular Strains: The most common cause of back pain is due to muscular strains. This
happens when an unexpected force, twist, or pull is applied to one or several of the muscles in
the back. As a result, several tears occur in the muscle. These muscular tears cause pain felt in
the back.
2) Ligamentous sprains: This occurs when the ligaments of the back are stretched beyond their
means.
3) Spinal stenosis: It occurs more commonly in people over 50 years old. The term refers to a
narrowing of the spinal canal. Spinal stenosis has many causes including thickened ligaments
along the spinal canal, bony spurs, and enlarged joint cartilage from arthritic changes.
4) Osteoporosis: This occurs especially in women. It is a disease characterized by progressive
loss of bone density. This results in thinning of bone tissue making one more susceptible to
fractures, or broken bones. The bones of the spine are especially affected in this disorder. Injury
from falls, lifting of heavy objects, or even the force of sneezing can result in painful vertebral
compression fractures.
5) Fibromyalgia: It is a rheumatic condition characterized by widespread soft tissue pain,
fatigue, sleep disturbance, and the presence of evenly distributed areas of tenderness. A history
of at least three months of widespread pain and tenderness in eleven or more of the eighteen
designated tender point sites is required in diagnosing this disorder.
Symptoms:
· The large nerve roots in the low back that go to the legs may be irritated
· The smaller nerves that supply the low back may be irritated
· The large paired lower back muscles (erector spinae) may be strained
· The bones, ligaments or joints may be damaged
· An intervertebral disc may be degenerating
Prevention:
1) Bend your knees and keep your back straight. Don't bend at your waist.
2) Keep the object close to you. The farther away you hold it from your body, the more it
stresses your back.
3) Never hold an item higher than your armpit or lower than your knees.
4) Don't move something that weighs more than 20% of your body weight.
5) Don't pivot, twist, or turn while lifting. Point your feet at the item you're lifting and face it as
you pick it up. Change direction with your feet, not your waist.

TOPIC SIX
COMMUNICABLE DISEASES
In ancient time, people were not sufficiently aware of diseases. Hippocrates the father of
medicine was the first physician of Greece, who described the symptoms of diseases in detail.
After a long gap, Robert Koch a German scientist, studied the various causes of diseases and
concluded that diseases spread through germs. Since then medical scientists are engaged in
research work but we are still often attacked by new diseases.
The environment in which we live has a vital influence on us in spite of many scientific
achievements. We live in a highly competitive world where struggle for survival is acute. Our
internal environment is persistently under the influence of external forces of nature. Diseases
that can be passed or transmitted from one person to another are called infectious or contagious
diseases. That is;
An infectious disease is a “disease of man resulting from an infection” while, contagious disease
is “one that is transmitted through direct contact”. Thus, communicable disease is an infection
which can be transmitted from one person to another or from a reservoir to a susceptible host,
directly (or) indirectly.

A disease has an incubation period which is the time period required for the transmission of
infectious agent from a reservoir to a susceptible host. These infectious agents may be a virus,
bacteria, protozoa or fungi. Thus diseases may be directly or indirectly transmitted from man to
man, animal to animal, from the environment (dust, soil water, food, and insects) to man and to
animal. For instance;
1. Air borne Diseases-Tuberculosis, whooping cough, small pox.
2. Water & food borne diseases-Typhoid, Cholera, Dysentery, diarrhea.
3. Through Direct contact-sexual disease AIDS.
4. Through insects- Malaria.

A. AIR BORNE DISEASES

1. Whooping Cough
Whooping cough (Pertusis) is highly infectious disease of young children which causes
inflammation of the respiratory tract with severe attacks of cough. It is airborne in nature.
Symptoms
 Onset is sudden cold and, in the beginning, simple mild cough with fever
 Severe running of nose and sneezing
 Later sever bouts of coughing and that will become more severe at late night ending in
deep inspiration during which the characteristic whoop occurs.
 Face turns red and eyes bulges with tears and ends with vomiting.
 Lungs severely affected.
Treatment and Prevention
 Keep the child in a warm and ventilated room’
 Keep the infected child in a separate room
 Discharges from nose and throat should be disposed immediately and disinfection should
be done.
 Give light food to the infected.
 In early stage itself the child need to be immunized against whooping cough with DPT
vaccine at 2nd, 3rd, 4th months, 11/2 and 5years.
 As a treatment, erythromycin may be injected in consultation with a physician to reduce
the severity of the infection
2. Small-Pox
It is also known as a serious infectious disease. Even the grown up people also come under the
grip of this infection. This infection is caused by Typical Viruses. However, the spread of
infection is also caused by droplets floating in the air.
Symptoms
 There is chill and headache in the beginning
 Server pain in the back and limbs of the body
 Sometimes face becomes red.
 After three or four days eruptions appear on the forehead. Then they spread throughout
the body and become watery blisters, diminishing, eruption becomes dry and at last crust
starts falling.
 Itching feeling is also there is an eruption.
 Fever remains high for eight to nine days.

Precautions and Treatment

A child suffering from this disease should be segregated from others.
Child should be vaccinated against small pox
Patient should be kept in a clean place.
No medicine should be given except proper nursing.
Patient should not be given salt.
Treatment
 The stomach should be clean. Use soap water enemas as a purgative
 When temperature goes above 370C, place cold compress or ice bad over the head.
 Give light easily digestible food
 Use boric lotion for reducing pain in the eyes.
 Used greasy substance for removing scabs.

WATER & FOOD BORNE DISEASES

A. TYPHOID
Typhoid is an acute infectious disease that affects the gastrointestinal tract. In countries where
sanitation is poor and sub-standard, typhoid and paratyphoid may occur. The term enteric fever
includes both typhoid and paratyphoid.
It caused by Salmonella typhii. Incubation period is 10-15 days. It spreads through faecal-oral
route. Contamination of drinking water by way of sewage and food by way of flies are the main
reasons for the spread of this disease. It affects almost all age category.
Signs and Symptoms
 Onset of sudden fever of moderate to high degree with rigors and chills.
 Fever rises in step ladder fashion.
 Malaise with headache and pain in the limbs
 Tongue will be centrally coated
 Low pulse
 Diarrhea occurs
 Constipation and retention of urine will occur because the germs attack intestine and
cause ulcers.
 Small rose coloured spots will be seen in the middle part of the body and these spots fade
away later.
 If the patient has a relapse of typhoid, the same symptoms reappear.
Prevention and Treatment
 Early detection and notification, to health authority
 Active immunization by vaccines and inject other children with anti-typhoid injections.
 Isolation of the infected
 Proper disinfection of urine and stools is necessary and even burning after disinfection all
excreta will be the right choice.
 Boiled water and ensures safe water for drinking and administer light liquid food.
 If fever rises beyond 370C, apply cold compression to the head.
 Complete bed rest is recommended for the infected persons.
 Specific drugs on consultation with physician such as ciprofloxacin, choloromycetin
should be administered.
B. CHOLERA
It is an acute gastro-intestinal infection. It is epidemic as well endemic disease. The disease is
caused by a germ called ‘Vibrio cholera’. It spreads through contaminated drinking water, by
flies, insects and improper storage. It also spreads from infected patients to others. It affects all
age group. Incubation period is generally ranging from few hours to 5 days.
Signs and Symptoms
 It starts with diarrhea and the watery stools and vomiting leading to dehydration
 Pain in the muscles of hands and feet is observed and it causes muscle cramps.
 Too much thirst is felt
 Urine output is suppressed
 Fluid and electrolyte imbalance may occur
 Fatal death occurs, if left uncared.
Prevention and Treatment
 Strict personal hygiene.
 Boil water and safe water for drinking.
 Early detection may be made by testing stools and immediately it should be reported to
health authority.
 Disinfection of clothing is recommended.
 Disinfect surroundings with DDT and make it flies free.
 Cholera vaccination
 Adequate compensation of electrolytes and water by intravenous fluids and ORS
solutions should be undertaken.
 Provide antibiotics

C. DIARRHOEA
People suffer from this disease mostly in summer and rainy season. It is spread by flies. If it is
allowed to continue it may take the shape of dysentery.
Causes:
 It is caused due to the spread of bacteria by flies.
 It is caused by the presence of bacteria in unripe food.
 It may be caused due to taking of infected food, water and other drinks.
Symptoms
There is frequent movement of bowels
Remedies
 Food should be protected from flies.
 Water should be disinfected before it is used
  A person suffering from disease should take only very light food. During rainy or
summer season.
 During rainy or summer season light diet should be taken.

C. THROUGH INSECT VECTORS

A. MALARIA
Malaria is a common disease found in most of the tropical regions of the world. It is a protozoan
disease transmitted by the bite of anopheles mosquitoes. It is the most important parasitic disease
of the human beings. Mode of transmission is by two means.
1. Mosquito transmission (Asexual) - An infected female anopheles mosquito may infect several
persons. The mosquito is not infective unless the sporozoites are present in its salivary.
2. Human transmission (Asexual) – may be transmitted directly by injections of infected blood or
plasma.-Eg. Blood transfusion, drug addicts using same syringe.
Symptoms
There are three stages in the infection process:
 Cold stage- A sudden onset of fever with rigors and chills and sensation of extreme cold
& shivering which lasts about 15 minutes to one hour.
 Hot stage- Temperature rises up to 1000 F with intense head ache and the patient feels
burning hot and casts of his clothes. This stage lasts for 2-6 hours.
 Sweating stage- Fever decreases with profuse sweating. This is stage lasts for 2-4 hours.
 In some cases, nausea, vomiting and delirium are common.
 Mild anemia and a palpable spleen are also observed.
Prevention and Treatment
Protection against mosquito by using repellants, protective clothing, bed nets and Screening
Control of adult infected mosquito/larvae-intermittent drying water containers and using
larvicides to kill the mosquito larva sides. Spraying of insecticides will control also the mosquito.
To control human reservoir, mass drug administration should be undertaken in highly endemic
areas Management of environmental sanitation, water and drainage will reduce the source of
infection.
Keep the patient warm during the shivering stage
1. Rub him down with a towel, sponge with weak vinegar and change his clothes when he has
perspired.
2. Even after perspiration, if the temperature stays high, sponge the patient with cold water or
apply cold packs.
3. If he feels headache, keep a cold wet cloth on the forehead.
4. Give enough water to drink.
5. Give a very light diet and during the attacks only provide liquids foods.
6. Treat with drug on doctor’s advice.

Precautions to be taken School

1. Malaria spreads during the spring and autumn hence see that no water collects in the school
premises, or gardens, or about the compounds, which are breading places for mosquitoes.
2. Destroy the mosquito by sprinkling kerosene on stagnant drains.
3. Advice parents not to have cesspits or cesspools near their houses.
4. Sprinkle DDT, or BHC to control mosquitoes which may breed in the walls and the corners.

DIRECT CONTACT
These are spread through sexual contact or exchange of body fluids

HIV AND AIDS

Definition
Signs and Symptoms
Prevention and Treatment

TOPIC SEVEN
DRUG ABUSE
Drug abuse
Drug abuse is when you use legal or illegal substances in ways you shouldn't. You might take
more than the regular dose of pills or use someone else's prescription. You may abuse drugs to
feel good, ease stress, or avoid reality.
Drug abuse or substance abuse refers to the use of certain chemicals for the purpose of creating
pleasurable effects on the brain.
The main categories are:
a) Stimulants (e.g. cocaine)
 b) Depressants (e.g. alcohol)
c) Opium-related painkillers (e.g. heroin)
d) Hallucinogens (e.g. marijuana)
Symptoms of drug abuse
Symptoms of drug abuse include those of intoxication and those related to unfulfilled
responsibilities and the social consequences of drug use. They include;
a) Craving the drug despite difficulties obtaining it or wanting to quit
b) Deterioration of relationships
c) Deterioration of school or work performance
d) Difficulty holding a job
e) Disengagement from non–drug-related activities
f) Financial problems
g) High-risk sexual behavior
h) Increasing time spent thinking about, obtaining, using, and recovering from the drug
i) Leaving responsibilities unfulfilled
j) Legal problems
k) Needing higher doses to get the same effect (tolerance)
l) Using a drug to avoid its withdrawal symptoms
m) Using drugs before or during activities where safety is a concern
n) Balance problems, difficulty walking, and falls
o) Change in mental status
p) Changes in mood, personality or behavior
q) Diminished reflexes
r) Drowsiness or excessive energy
s) Impaired balance and coordination
t) Impaired judgment and memory
u) Impaired vision
v) Nausea with or without vomiting
w) Pupil size changes
x) Slurred speech; excessive talking
Serious symptoms that might indicate a life-threatening condition
Additionally, there are life-threatening symptoms hat include;
a) Being a danger to oneself or others, including threatening, irrational, or suicidal behavior
b) Overdose symptoms, such as rapid or slow pulse; respiratory or breathing problems, such
as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing,
choking; abdominal pain, vomiting, diarrhea; cool and clammy skin or hot skin;
sleepiness, chest pain, confusion or loss of consciousness for even a brief moment
c) Trauma, such as bone deformity, burns, eye injuries, and other injuries
Causes drug abuse
The cause of drug abuse is not known, nor is it understood why some people can abuse drugs
briefly and stop without difficulty, whereas others continue using drugs despite undesirable
consequences. Biological factors, such as genetics and the presence of other psychiatric
disorders, may play a role, as may environmental factors, such as peer pressure, history of abuse,
and stress, and developmental factors, such as the timing of drug exposure.
Risk factors for drug abuse
A number of factors increase a person’s risk of abusing drugs. Not all people with risk factors
will abuse drugs. Risk factors for drug abuse include:
a) Anxiety disorders or depression
b) Early drug use
c) Lack of parental supervision
d) Male gender
e) Parental substance abuse
f) Peer pressure
g) Personality disorders, such as antisocial behavioral disorder or borderline personality
disorder
h) Physical or sexual abuse
i) Poor family communication or bonding
j) Stress
Treatment of drug abuse
Treatment of drug abuse is often an extended process involving multiple components including:
a) Cognitive behavioral therapy to work on thought patterns and behavior
b) Family therapy to help the family understand the problem and to avoid enabling drug use
c) Identification and treatment of coexisting conditions
d) Medications to decrease cravings, block withdrawal symptoms, counteract drug effects,
or to cause unpleasant side effects if a drug is used
e) Motivational incentives to reinforce abstinence
f) Motivational interviewing to utilize a person’s readiness to change behaviors
g) Rehabilitation to assist those with severe addiction or coexisting mental illness through
the initial stages of quitting
h) Supervised withdrawal (detoxification) to prevent, recognize and treat physical symptoms
of withdrawal
i) Support groups
Complications of drug abuse
Complications of untreated drug abuse can be serious, even life threatening in some cases. You
can help minimize your risk of serious complications by following the treatment plan you and
your health care professional design specifically for you. Complications of drug abuse include:
a) Brain damage, memory loss, attention difficulties, and impaired judgment
b) Cancer
c) Cardiac arrest
d) Cardiovascular disease
e) Hepatitis, HIV and AIDS, and other infectious diseases
f) Legal, academic, work and social problems
g) Liver, lung or kidney disease
h) Malnutrition
i) Psychological changes, including aggression, paranoia, depression and hallucinations
j) Respiratory arrest
k) Stroke
l) Stupor or coma
m) Withdrawal symptoms
Alcoholism
A chronic disease characterised by uncontrolled drinking and preoccupation with alcohol.
Alcoholism is the inability to control drinking due to both a physical and emotional dependence
on alcohol. For women, it's having more than three drinks a day or seven in a week. For men, it's
four or more per day or 14 in a week. If you drink more than the daily or weekly limit, you're at
risk. However, that's not the only way to tell if you or someone you care about needs help.

Causes of Alcoholism
a) Stressful environments/ Environmental Factors
While not every person turns to alcohol to relieve stress, some people do. When a person has a
stressful job, for example, they may be more likely to drink heavily. This is often the case with
certain occupations such as doctors and nurses – their day-to-day lives can be extremely
stressful. To lower this risk factor, take the time to de-stress with healthy methods, like reading a
good book, exercising or taking a nap.
In recent years, studies have explored a possible connection between your environment and risk
of AUD. For example, many researchers have examined whether or not a person’s proximity to
alcohol retail stores or bars affect their chances of alcoholism. People who live closer to alcohol
establishments are said to have a more positive outlook on drinking and are more likely to
participate in the activity.
Additionally, alcohol manufacturers are bombarding the general public with advertisements.
Many of these ads show drinking as an acceptable, fun and relaxing pastime. In just four decades
– between 1971 and 2011 – alcohol advertising in the United States increased by more than 400
percent.
Another environmental factor, income, can also play a role in the amount of alcohol a person
consumes. Contrary to popular belief, individuals who come from affluent neighborhoods are
more likely to drink than those living below poverty. Gallup’s recent annual consumption habits
poll showed that roughly 78 percent of people with an annual household income $75,000 or more
consume alcohol. This is significantly higher than the 45 percent of people who drink alcohol
and have an annual household income of less than $30,000.

a) Drinking at an early age

According to the Mayo Clinic, those who begin drinking at an early age are more likely to have
an alcohol problem or a physical dependence on alcohol as they get older. Not only is this
because drinking may become a comfortable habit, but also because the body’s tolerance levels
may increase.
b) Mental health problems like depression /Psychological Factors
Anxiety, depression, bipolar disorder or other mental health issues can increase the risk of
alcoholism. It’s easy to turn to alcohol when a person is feeling anxious or depressed – and the
effects of alcohol may seem to temporarily ease those feelings. This can resort to drinking more
and more, leading to alcohol addiction.
Different psychological factors may increase the chances of heavy drinking. Every person
handles situations in their own unique way. However, how you cope with these feelings can
impact certain behavioral traits. For example, people with high stress, anxiety, depression and
other mental health conditions are more vulnerable to developing alcoholism. In these types of
circumstances, alcohol is often used to suppress feelings and relieve the symptoms of
psychological disorders.
Over time, drinking can become habitual and lead to an AUD. The more you turn to alcohol to
ease feelings of pain and hardship, the more your body becomes tolerant to the drug and relies on
its effects. Co-occurring alcohol abuse and mental health conditions, like depression, bipolar and
schizophrenia, can cause an array of serious side effects. In order to overcome these issues, each
one should be treated separately by a medical specialist.

c) Social Factors /Taking alcohol with medicine

Social factors can contribute to a person’s views of drinking. Your culture, religion, family and
work influence many of your behaviors, including drinking. Family plays the biggest role in a
person’s likelihood of developing alcoholism. Children who are exposed to alcohol abuse from
an early age are more at risk of falling into a dangerous drinking pattern.
Starting college or a new job can also make you more susceptible to alcoholism. During these
times, you’re looking to make new friends and develop relationships with peers. The desire to fit
in and be well-liked may cause you to participate in activities that you normally wouldn’t partake
in. Before you know it, you’re heading to every company happy hour, drinking more frequently
and even craving alcohol after a long workday – all warning signs of AUD.
Some medicines can increase the toxic effects of alcohol on the body. When a person continually
takes alcohol with their medications, they may become addicted to the effects that follow – some
of which have the capability to be very dangerous and even life-threatening.
d) Family history /Biological Factors
If you have a parent or other relative who is an alcoholic, your risk of alcoholism automatically
increases. Part of this is due to genetics, but the other part has to do with your environment.
Spending time around people who drink heavily or abuse alcohol can influence you to do the
same.
Multiple factors can play a role in a person’s risk of alcoholism. While the above may not
directly be considered “causes” of alcoholism, they can play a role in its development. It’s
important to understand your risk and do what you can to lower it as much as possible.
Research has shown a close link between alcoholism and biological factors, particularly genetics
and physiology. While some individuals can limit the amount of alcohol they consume, others
feel a strong impulse to keep going. For some, alcohol gives off feelings of pleasure,
encouraging the brain to repeat the behavior. Repetitive behavior like this can make you more
vulnerable to developing alcoholism.
There are also certain chemicals in the brain that can make you more susceptible to alcohol
abuse. For instance, scientists have indicated that alcohol dependence may be associated with up
to 51 genes in various chromosome regions. If these genes are passed down through generations,
family members are much more prone to developing drinking problems.
Risk Factors of Alcoholism
Several common alcohol abuse risk factors include:
Drinking at an Early Age
Experimenting with alcohol at a young age can lead to problems later on in life, especially in
your 20s and 30s. This is especially true when adolescents engage in frequent binge drinking.
While drinking early on can increase the likelihood of alcohol abuse, alcoholism can affect
anyone at any age.
Family History With Alcohol Addiction
Growing up around family members and close relatives that suffer from alcoholism increases the
risk of alcohol abuse for generations to come. When you’re surrounded by people who drink
excessively, you can look at alcohol use differently and fall victim to bad habits.
High Levels of Stress
Drinking in an effort to reduce stress can quickly turn problematic. Career paths that are more
likely to face high levels of stress due to long hours and strenuous tasks include doctors, nurses,
emergency rescue workers, construction workers and military. It’s important for professionals of
any industry to find other ways to de-stress in order to prevent alcohol abuse.
Peer Pressure
When a partner or close friend frequently drinks, you may be more inclined to join them. Giving
into peer pressure can lead to drinking problems down the road, as well as many health
complications that arise from excessive alcohol consumption. Rather than feel the need to drink,
offer to be designated driver.
Frequent Alcohol Consumption Over a Long Period
When drinking too much becomes a pattern, you greatly increase your chances of developing an
alcohol-related problem. The more you drink, the more your body builds a tolerance to alcohol.
Tolerance means you’ll need more alcohol to feel the same effects you used to feel with less.
Types of Treatment
Behavioral Treatments
Behavioral treatments are aimed at changing drinking behavior through counseling. They are led
by health professionals and supported by studies showing they can be beneficial.
Medications
Three medications are currently approved in the United States to help people stop or reduce their
drinking and prevent relapse. They are prescribed by a primary care physician or other health
professional and may be used alone or in combination with counseling.
Mutual-Support Groups
Alcoholics Anonymous (AA) and other 12-step programs provide peer support for people
quitting or cutting back on their drinking. Combined with treatment led by health professionals,
mutual-support groups can offer a valuable added layer of support.
Due to the anonymous nature of mutual-support groups, it is difficult for researchers to
determine their success rates compared with those led by health professionals.
Why People Relapse
Staying healthy and maintaining your sobriety takes time and dedication. Unfortunately, some
people relapse after alcohol treatment. Triggers, including a group of friends who drink, certain
activities or circumstances can lead someone to fall back into old drinking habits.
Relapsing does not mean you’ve failed and cannot overcome alcoholism. It makes you aware of
triggers and may motivate you to seek additional help from a counselor or support group.
Participating in on-going treatment methods provides you with a greater chance for long-term
sobriety than those who do not continue recovery with maintenance programs.
Reasons why some people relapse are:
a) Old habits
b) Stress and anxiety
c) Social pressures
d) Mental or emotional instability
e) Anger or frustration
f) Temptation to feel drunk again

Smoking
Tobacco smoking is the practice of burning tobacco and ingesting the smoke that is produced.
The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is
generally done with pipes and cigars
Factors influencing smoking
Research has identified a range of factors that influence uptake and patterns of smoking,
including:
a) low income, poor housing and unemployment
b) nicotine exposure during childhood
c) financial pressure and stress
d) anxiety and depression
e) parental and peer example
f) targeted and more intensive marketing by the tobacco industry; and
g) a lower likelihood of working indoors

The Effects of Smoking on the Body

No matter how you smoke it, tobacco is dangerous to your health. There are no safe substances
in any tobacco products, from acetone and tar to nicotine and carbon monoxide. The substances
you inhale don’t just affect your lungs. They can affect your entire body.
Smoking can lead to a variety of ongoing complications in the body, as well as long-term effects
on your body systems. While smoking can increase your risk of a variety of problems over
several years, some of the bodily effects are immediate. Learn more about the symptoms and
overall effects of smoking on the body below.
Tobacco smoke is incredibly harmful to your health. There’s no safe way to smoke. Replacing
your cigarette with a cigar, pipe, or hookah won’t help you avoid the health risks.
Cigarettes contain about 600 ingredients, many of which can also be found in cigars and
hookahs. When these ingredients burn, they generate more than 7,000 chemicals, according to
the American Lung Association. Many of those chemicals are poisonous and at least 69 of them
are linked to cancer.
In the United States, the mortality rate for smokers is three times that of people who never
smoked. In fact, the Centers for Disease Control and Prevention (CDC) says that smoking is the
most common “preventable cause of death” in the United States. While the effects of smoking
may not be immediate, the complications and damage can last for years. The good news is that
quitting smoking can reverse many effects.
Central nervous system
One of the ingredients in tobacco is a mood-altering drug called nicotine. Nicotine reaches your
brain in mere seconds and makes you feel more energized for a while. But as that effect wears
off, you feel tired and crave more. Nicotine is extremely habit-forming, which is why people find
smoking so difficult to quit.
Physical withdrawal from nicotine can impair your cognitive functioning and make you feel
anxious, irritated, and depressed. Withdrawal can also cause headaches and sleep problems.
Respiratory system
When you inhale smoke, you’re taking in substances that can damage your lungs. Over time, this
damage leads to a variety of problems. Along with increased infections, people who smoke are at
higher risk for chronic nonreversible lung conditions such as:
 emphysema, the destruction of the air sacs in your lungs
 chronic bronchitis, permanent inflammation that affects the lining of the breathing tubes
of the lungs
 chronic obstructive pulmonary disease (COPD), a group of lung diseases
 lung cancer
Withdrawal from tobacco products can cause temporary congestion and respiratory discomfort as
your lungs and airways begin to heal. Increased mucus production right after quitting smoking is
a positive sign that your respiratory system is recovering.
Children whose parents smoke are more prone to coughing, wheezing, and asthma attacks than
children whose parents don’t. They also tend to have higher rates of pneumonia and bronchitis.
Cardiovascular system
Smoking damages your entire cardiovascular system. Nicotine causes blood vessels to tighten,
which restricts the flow of blood. Over time, the ongoing narrowing, along with damage to the
blood vessels, can cause peripheral artery disease.
Smoking also raises blood pressure, weakens blood vessel walls, and increases blood clots.
Together, this raises your risk of stroke.
You’re also at an increased risk of worsening heart disease if you’ve already had heart bypass
surgery, a heart attack, or a stent placed in a blood vessel.
Smoking not only impacts your cardiovascular health, but also the health of those around you
who don’t smoke. Exposure to secondhand smoke carries the same risk to a nonsmoker as
someone who does smoke. Risks include stroke, heart attack, and heart disease.
Integumentary system (skin, hair, and nails)
The more obvious signs of smoking involve skin changes. Substances in tobacco smoke actually
change the structure of your skin. A recent study has shown that smoking dramatically increases
the risk of squamous cell carcinoma (skin cancer).
Your fingernails and toenails aren’t immune from the effects of smoking. Smoking increases the
likelihood of fungal nail infections.
Hair is also affected by nicotine. An older study found it increases hair loss, balding, and
graying.
Digestive system
Smoking increases the risk of mouth, throat, larynx, and esophagus cancer. Smokers also have
higher rates of pancreatic cancer. Even people who “smoke but don’t inhale” face an increased
risk of mouth cancer.
Smoking also has an effect on insulin, making it more likely that you’ll develop insulin
resistance. That puts you at increased risk of type 2 diabetes and its complications, which tend to
develop at a faster rate than in people who don’t smoke.
Sexuality and reproductive system
Nicotine affects blood flow to the genital areas of both men and women. For men, this can
decrease sexual performance. For women, this can result in sexual dissatisfaction by decreasing
lubrication and the ability to reach orgasm. Smoking may also lower sex hormone levels in both
men and women. This can possibly lead to decreased sexual desire.

Treatment for smoking

Nicotine replacement therapy (NRT)
a) skin patches.
b) chewing gum.
c) inhalators (which look like plastic cigarettes)
d) tablets, oral strips and lozenges.
e) nasal and mouth spray.
Patches release nicotine slowly. Some are worn all the time and some should be taken off at
night. Inhalators, gum and sprays act more quickly and may be better for helping with cravings.
There's no evidence that any single type of NRT is more effective than another. But there is good
evidence to show that using a combination of NRT is more effective than using a single product.
Often the best way to use NRT is to combine a patch with a faster acting form such as gum,
inhalator or nasal spray.
Treatment with NRT usually lasts 8-12 weeks, before you gradually reduce the dose and
eventually stop.
Who can use it
Possible side effects
Side effects of NRT can include:
a) skin irritation when using patches
b) irritation of nose, throat or eyes when using a nasal spray
c) difficulty sleeping (insomnia), sometimes with vivid dreams
d) an upset stomach
e) dizziness
f) headaches
Varenicline (Champix)
Varenicline (brand name Champix) is a medicine that works in 2 ways. It reduces cravings for
nicotine like NRT, but it also blocks the rewarding and reinforcing effects of smoking.
Evidence suggests it's the most effective medicine for helping people stop smoking.
It's taken as 1 to 2 tablets a day. You should start taking it a week or 2 before you try to quit.
A course of treatment usually lasts around 12 weeks, but it can be continued for longer if
necessary.
Possible side effects
Side effects of varenicline can include:
 feeling and being sick
 difficulty sleeping (insomnia), sometimes with vivid dreams
 dry mouth
 constipation or diarrhoea
 headaches
 drowsiness
 dizziness
Bupropion (Zyban)
Bupropion (brand name Zyban) is a medicine originally used to treat depression, but it has since
been found to help people quit smoking.
It's not clear exactly how it works, but it's thought to have an effect on the parts of the brain
involved in addictive behaviour. Bupropion is only available on prescription, so you'll usually
need to see your GP or contact an NHS stop smoking service to get it.
It's taken as 1 to 2 tablets a day. You should start taking it a week or 2 before you try to quit.
A course of treatment usually lasts around 7 to 9 weeks.
Possible side effects
Side effects of bupropion can include:
a) dry mouth
b) difficulty sleeping (insomnia)
c) headaches
d) feeling and being sick
e) constipation
f) difficulty concentrating
g) dizziness
E-cigarettes
An e-cigarette is an electronic device that delivers nicotine in a vapour. This allows you to inhale
nicotine without most of the harmful effects of smoking, as the vapour contains no tar or carbon
monoxide.
Research has found that e-cigarettes can help you give up smoking, so you may want to try them
rather than the medications listed above. As with other approaches, they're most effective if used
with support from an NHS stop smoking service.
There are no e-cigarettes currently available on prescription.
For now, if you want to use an e-cigarette to help you quit, you'll have to buy one. Costs of e-
cigarettes can vary, but generally they're much cheaper than cigarettes

TOPIC EIGHT
ENVIRONMENTAL POLLUTION
Meaning:
Pollution is the introduction of contaminants into the natural environment that causes adverse
change.
Pollutants are the components of pollution and can be either foreign substances/energies or
naturally occurring contaminants. Pollution is often classified as point source or nonpoint source
pollution. The point sources are easy to identify, monitor and control, whereas the non-point
sources are hard to control.
Types & Causes of Pollution
Air Pollution: Air pollution is the most prominent and dangerous form of pollution. It occurs
due to many reasons. Excessive burning of fuel which is a necessity of our daily lives for
cooking, driving and other industrial activities, releases a huge amount of chemical substances in
the air every day, these pollute the air. Smoke from chimneys, factories, vehicles or burning of
wood basically occurs due to coal burning, this releases sulphur dioxide into the air making it
toxic. The effects of air pollution are evident too. Release of sulphur dioxide and hazardous
gases into the air causes global warming and acid rain which in turn have increased temperatures,
erratic rains and droughts worldwide making it tough for the animals to survive. Breathing this
polluted particle from the air result is increase in asthma and cancer in the lungs.

Water Pollution: Water Pollution has taken toll of all the surviving species of the earth. Almost
60% of the species live in water bodies. It occurs due to several factors the industrial wastes
dumped into the rivers and other water bodies cause an imbalance in the water leading to its
severe contamination and death of aquatic species. If you suspect that nearby water sources have
been contaminated by a corporation then it might be a good idea to hire an expert to see your
options. Also spraying insecticides, pesticides like DDT on plants pollutes the ground water
system and oil spills in the oceans have caused irreparable damage to the water bodies. There is
also Eutrophication is another big source for water pollution. It occurs due to daily activities
like washing clothes, utensils near lakes, ponds or rivers. This forces detergents to go into water
which blocks sunlight from penetrating, thus reducing oxygen and making it inhabitable. Water
pollution not only harms the aquatic beings but it also contaminates the entire food chain by
severely affecting humans dependent on these.
Soil pollution: Soil Pollution occurs due to incorporation of unwanted chemicals in the soil due
to human activities. Use of insecticides and pesticides absorbs the nitrogen compounds from the
soil making it unfit for plants to derive nutrition from. Release of industrial waste, mining and
deforestation also exploits the soil. Since plants can’t grow properly, they can’t hold the soil and
this leads to soil erosion.

Noise Pollution: Noise pollution is caused when noise which is an unpleasant sound affects our
ears and leads to psychological problems like stress, hypertension, hearing impairment, etc. It is
caused by machines in industries, loud music, etc.

Radioactive pollution: Radioactive pollution is highly dangerous when it occurs. It can occur
due to nuclear plant malfunctions, improper nuclear waste disposal, accidents, etc. It causes
cancer, infertility, blindness, and defects at the time of birth; can sterilize soil and affect air and
water.

Thermal/heat pollution: Thermal pollution is due to the excess heat in the environment creating
unwanted changes over long time period. This is due to huge number of industrial plants,
deforestation and air pollution. It increases the earth’s temperature, causing drastic climatic
changes and extinction of wildlife.

Light pollution: Light pollution occurs due to prominent excess illumination of an area. It is
largely visible in big cities, on advertising boards and billboards, in sports or entertainment
events at the night. In residential areas the lives of the inhabitants are greatly affected by this. It
also affects the astronomical observations and activities by making the stars almost invisible.

Effects pollution on human health:

1. Environment Degradation: Environment is the first casualty for increase in pollution
weather in air or water. The increase in the amount of CO2 in the atmosphere leads to smog
which can restrict sunlight from reaching the earth. This prevents plants from the process of
photosynthesis. Gases like Sulfur dioxide and nitrogen oxide can cause acid rain. Water pollution
in terms of Oil spill may lead to death of several wildlife species.
2. Peoples Well-being: The decrease in quality of air leads to several respiratory problems
including asthma or lung cancer. Chest pain, congestion, throat inflammation, cardiovascular
disease, respiratory disease are some of the diseases that can be caused by air pollution. Water
pollution occurs due to contamination of water and may pose skin related problems including
skin irritations and rashes. Similarly, noise pollution leads to hearing loss, stress and sleep
disturbance.

3. Global Warming: The emission of greenhouse gases particularly CO2 is leading to global
warming. Every other day new industries are being set up, new vehicles come on roads and trees
are cut to make way for new homes. The increase in CO2 in the long term will affect the ozone
layer leading to global warming.

4. Depletion of Ozone Layer: Ozone layer is the thin shield high up in the sky that stops ultra
violet rays from reaching the earth. As a result of human activities, chemicals, such as
chlorofluorocarbons (CFCs), are released into the atmosphere which contributed to the depletion
of ozone layer.

5. Land infertility: Due to constant use of insecticides and pesticides, the soil may become
infertile. Plants may not be able to grow properly. Various forms of chemicals produced from
industrial waste are released into the flowing water which also affects the quality of soil.

Preventive measures:
Prevention of air pollution:
 Using smokeless sources of energy like smokeless stoves, which use biogas, solar energy,
 Using devices for filtering smoke in chimneys of factories and powerhouses.
 Planting more trees
 Locating industries away from residential areas.
 Strictly checking pollution levels in automobiles’ exhaust emission.
Prevention of water pollution:
  Adequate sewage and industrial waste treatment in sewage treatment plants before
dumping them into river bodies.
 Recycling-various products should be recycled instead of dumping them into rivers, e.g.,
biogas can be made from city waste.
Prevention of land pollution:
 Proper solid waste disposal like sanitary landfill.
 Using limited amounts of fertilizers and pesticides.
 Avoiding polythene bags.

TOPIC NINE
IMMUNE SYSTEM AND THE BODY DEFENSE MECHANISM
The immune system is a complex network of cells and protects the body from infections. It
protects the body from outside infections by bacteria, viruses and fungi. This system is able to
keep a record of every germ it has ever defeated so it can recognize and destroy the microbe as
fast as it enters the body again.

Humanity has three types of immunity;

a) Natural/Innate immunity,
b) Passive immunity/Adaptive immunity
c) Artificial immunity\

a) Innate immunity
It is also referred to as natural immunity: an immunity one is born with. It is the body's first line
of defense against germs that have entered the body. It include physical barriers such as skin,
chemicals in the blood, and immune. It acts as the body rapid response system in that it patrols
ones body and is the first to respond when it detects an infection. The innate immune system is
inherited and is active from the moment a child is born. The cells of this immune system
surround and engulf the invader that is killed inside the immune system cells, (phagocytes)
b) Passive immunity/Adaptive immunity
The adaptive or passive immunity immune system, which you develop when your body is
exposed to microbes or chemicals released by microbes. It can be naturally or artificially
acquired. Naturally, one obtains natural immunity through a person innate system. This is
possible in that a produces cells (antibodies) for protection from an invasion (infection). The
produced antibodies stay in ones body and may take several days to develop. However, after the
first exposure, the immune system will recognize the infection and defend itself against it. The
acquired immune system changes throughout your an individuals entire life. Additionally,
children acquire passive immunity from their mothers through the placenta. It can also be
provided to the child during pregnancy, and through breast feeding. Finally, passive immunity
can be artificially acquired through immunization by the transfer of antibodies, to a human body

Adaptive Immunity can be natural or artificial

Natural
Active – antibodies are produced as a result of an infection
Passive – antibodies are passed to foetus via placenta or colostrum

Artificial
Active – antibodies are produced as a result of an immunization with a vaccine
Passive – antibodies that have been produced by another animal or given artificially
c) Artificial immunity
Antibodies generated by receiving antigen in a vaccine/serum rather than a normal infection.
Generally does not last as long as when generate antibodies from a natural infection.

TOPIC TEN
FAMILY PLANNING
It can be defined as a method employed in spacing of children
• Family planning is a broad range of reproductive health services which include fertility,
birth control, sterilization, and regular exams.

• Family planning is basically helping people control when, how often, and how healthy
they are when they decide to have or not have a family

• Birth control is part of family planning that allows individuals to decide when to get
pregnant and have a child.

• It can help prevent pregnancies for a time or all through adulthood depending on an
individual’s desire to have children.

Contraception methods
a) long-acting reversible contraception - the implant or intra uterine device (IUD)
b) hormonal contraception - the pill or the Depo Provera injection.
c) barrier methods - condoms.
d) emergency contraception.
e) fertility awareness.
f) permanent contraception - vasectomy and tubal ligation.
Methods of contraception:
There are different methods of contraception, including:
Contraception options
 long-acting reversible contraception - the implant or intra uterine device (IUD)
 hormonal contraception - the pill or the Depo Provera injection
  barrier methods - condoms
 emergency contraception
 fertility awareness
 permanent contraception - vasectomy and tubal ligation.
Long-acting reversible contraception
Long-acting reversible contraception (LARC) lasts for a long time.
There are two types of LARC.
 the intra uterine device, which lasts for three, five or ten years
 the implant, which lasts for five years.
Once you have a LARC put in, you don’t need to remember to take contraception every day or
every month.
LARCs are the most effective types of contraception. They are more than 99% effective at
preventing pregnancy.
Hormonal contraceptives
These contraceptives use hormones to prevent pregnancy.
Hormonal contraceptives include the Pill and the Depo Provera injection.
There are two types of pill:
 combined oral contraceptive pill
 progestogen-only contraceptive pill
You take one pill each day. If you take the pill correctly, it is more than 99% effective at
preventing pregnancy.
The Depo Provera injection is an injection you get every three months. If you get your injections
on time, Depo Provera is more than 99% effective.
Barrier methods
Barrier methods stop sperm from entering the vagina. The two barrier methods are:
Condoms protect against sexually transmissible infections (STIs) and from unintended
pregnancy.
You can buy internal condoms from our website and from some pharmacies.
You can get a prescription for condoms from Family Planning or your doctor, or you can buy
them from this website, pharmacies, supermarkets, and other shops.
Emergency contraception
There are two options for emergency contraception: the emergency contraceptive pill (ECP) or
a copper IUD.
ECP can be taken up to three days after unprotected sex. If you are an average weight, the ECP is
98% effective. If you weigh more than 70kg, the ECP is less effective and a copper IUD is
recommended. If you weigh more than 70kg and you choose to take ECP, you should ask if
taking a double dose is the right option for you.
The copper IUD can be inserted up to five days after unprotected sex, and is more than 99%
effective at preventing pregnancy.
Emergency contraception can be used to prevent pregnancy if:
 you haven't used protection
 your normal contraception fails e.g. condom splits
  you have missed more than one contraceptive pill
 you have been vomiting or had diarrhoea while on the pill
 you have missed your injection
 you have been forced to have sex without contraception.
It is not a good idea to use ECP as your regular method of contraception - it is less effective than
if you were using a LARC or hormonal method.
Fertility awareness
Fertility awareness is learning the signs of fertility in your menstrual cycle to help you plan or
avoid a pregnancy.
Permanent contraception
Permanent contraception, sometimes called sterilisation, prevents all future pregnancies. It is
very difficult or impossible to reverse. Permanent contraception is either a vasectomy or a tubal
ligation.

Hormonal contraceptives
• As the name suggests, the Progestin-only pills (POPs) contain only one hormone,
progestin; they do not contain any oestrogen.

• Therefore they do not cause many of the side effects associated with COC use.

• Progestin's do not suppress production of breast milk, which makes POPs an ideal
contraceptive method for breastfeeding women.

Mode of action of POPS

• POPs prevent pregnancy by thickening the cervical mucus, which prevents the passage
of sperm,

• Suppressing ovulation in about 50 percent of cycles.

Types of POPs
• Microlut, Micronor, Microval, Ovrette, Norgeston, and Noriday.

Advantages of POPs
• They are effective.
• They are safe (POPs have no known health risks).
• Women return to fertility immediately upon discontinuation.
Pelvic exam not required to initiate use
• They can be given to a woman at any time to start later if not pregnant
• POPs does not affect milk production or breastfeeding.
• POPs add to the contraceptive effect of breastfeeding.
• Taking POPs does not increase blood clotting.

Limitations of POPs
• They provide a slightly lower level of contraceptive protection than COCs.
 • They require strict daily pill-taking, preferably at the same time each day.

• They do not protect against STIs, including hepatitis B and HIV/ AIDS. Therefore, at-risk
individuals should use a barrier method to ensure protection against STIs and HIV/AIDS.

• They may lower effectiveness when certain drugs are taken concurrently (e.g. anti-
tuberculosis, anti-retroviral and anti-epileptic drugs).

Side Effects of POPs

• Irregular spotting or bleeding, frequent or infrequent bleeding, prolonged bleeding,
amenorrhea (less common).

• Headaches, dizziness, nausea.

• Mood changes.

• Breast tenderness (although less common than with COCs).

Who can use POPs

• Women of any parity, including women who have never given birth (nulliparous women)

• Women immediately after birth

• Women of any age who are cigarette smokers

• Women who cannot use COCs as a result of oestrogen-related contraindications

• Post-abortion clients (no additional protection needed if method is initiated within five
days after abortion)

• Women with any of the following conditions:– Hypertension, Sickle cell disease, Benign
breast disease, Viral hepatitis, acute or chronic, or mild (compensated)cirrhosis,
Gestational trophoblastic disease (GTD) Migraine without aura, Obese women and girls
(individuals whose BMI is greater than 30 kg/m2)

• Women with a family history (first-degree relatives) of DVT or PE, and those who have
had minor or major surgery without prolonged immobilization

Women Who Should Not Use

• Women who have breast cancer or a history of breast cancer

• Women with severe (decompensated) cirrhosis, and liver tumours (benign hepatocellular
adenoma and malignancy hepatoma)

• Women with acute DVT or PE

• Women on any of the following: ARV regimen with ritonavir or ritonavir-boosted
protease inhibitors, Anticonvulsants, such as phenytoin, carbamazepine, barbiturates,
Rifampicin therapy for TB

• Women with SLE with positive or unknown antibodies