HEALTH MAINTENANCE OF THE BODY SYSTEM - HED 414


UNIT 1
            To ensure that the organs and systems perform their functions, maintenance and promotion is necessary. Promotion means enhancing health status while maintenance means preserving that which one has to enhance good health.     
BODY SYSTEMS OF FNXNS AND PHYSIOLOGICAL NEEDS THEY FULFILL
BODY SYSTEM                              FUNCTION
Respiratory system    gaseous exchange. Elimination of waste,    communication through the voice box.
Digestive system                  Food and nutrition. Elimination of waste.

Cardio-Vsacular System     Internal transportation and protection                                                                  against foreign bodies; protection by white                                                        corpuscles.
Lymphatic System               Internal transportation and protection                                                                  against foreign bodies. 
Urinary system                                 Elimination of waste and water
Nervous system                                Communication, protection through reflex                                                         action.                                   
Endocrine system                 Communication through adrenalin which                                                            helps the body be at alert; protection. 
Mucous membrane              Protection against dust in the air tract.
Productive System               Reproduction and continuity of life of specie
Skeletal system                                 movement and leverage through the joints
Muscular system                  Movement and locomotion.



CONCEPT OF HEALTH STATUS AND MEANING OF PERSONAL HEALTH              
            Health status describes one’s level of health or level of well being of an individual.
            It changes from time to time, day to day. Health status is an and social environments.
COMPONENTS OF WELL BEING      
            This is made up of 5 inter-related fitness dimensions. They are:-
1.                  Physical dimension or physical fitness
2.                  Emotional or mental fitness
3.                  Social fitness
4.                  Spiritual fitness
5.                  Cultural fitness
P                E                      S                      S                      C
H               M                    O                     P                      U
Y               O                     C                     I                       L
S                I                       I                       R                     T
I                 I                                               I                       U
C               O                     A                     T                      R
A               N                                             A                                
L                A                                             A                     L

These form a whole, not separate entities. The easiest to identify is the physical. It concerns the maintenance of body processes which facilitate the ability to resist infection. Emotional deals with feelings, through self identify of individuals. It facilitates a human approach to situations and sharing of interest.
Spiritual is concerned with aspirations and ideals; acknowledgment of a supreme being or creator.  
It facilitates a sense of worth and purpose of life cultural deals with identification with the community.
It facilitates responsible involvement in community affairs.
LEVELS OF WELL BEING    
The level of well being is determined by a number of factors. Such factors include heredity, environment or behaviour.
            The aim of health education, is to help each one reach his optional health. Level of health can be visualized as a step ladder with the lowest bottom and the highest of the top.


 
                        Optimal
                        Health
                        High Level
                        Moderate Level
                        Minor Illness
                        Major Illness
                        Critical Illness
                        Moribund State
                        Health maintenance       
      
Health maintenance is an aspect of health care.
It includes services/ measures directed at prevention of illness, and directed at maintenance of health as well as preventing conditions from getting worse.
            The services directed at health maintenance include:-
1.                  Primary care – which includes health counseling and health education.
2.                  emergency care – which includes first aid.
3.                  rehabilitation for chronic (asthma) and disabling (sickles cell anemia) conditions
4.                  health insurance which is pre-payment plan for unpredicted expenses of illness, accidents and medical care.
HEALTH PROMOTION         
            This aims at the attainment of health, i.e. enabling an individual to attain the highest possible level of health for which the person has potentials. They include measures and activities emerged upon to enhance or maximize the efficiency of organs and systems of the body. The measures include exercise. It include service measures directed at prevention of illness, nutrition.
UNIT III
SOURCES OF WELL-BEING 
1.         Homeostasis: This is term coined by a French physiologist called Claude Bernard. He was the one who discovered the principle of homeostasis, which is the state of equilibrium conditions and regular fluctuations that must be maintained in a state of equilibrium or constancy, in order that life may continue. Homeostasis means that there is a natural mechanism operates through the various body systems under the control of the nervous system aided by the hormones.
2.         Regulation of body Temperature: The body temperature is usually maintained at about 370C or 918.40F. for optimum health to operate, the body temperature must not vary too much or for a long time from the normal level, even though the temperature of the deeper lavers of the body is slightly higher then the temperature of the periphery of the body. There are many organs and activities involved in regulation of body temperature. They include:-
a.         The circulation of blood
b.         The skin
c.         The lungs
d.         The kidneys
            There are two mechanisms in the body that balance themselves to maintain body temperature. They are:-
Mechanism of heat production and mechanism of heat loss.
i.          Mechanism of heat production includes:-
            a.         the breaking down of food,
            b.         muscular activities (exercises)
            c.         nervous control initiated from the vasomotor centre of the     medulla oblongata          
ii.         Mechanism of heat loss includes:-
a.                  radiation by direct contact
b.                  evaporation of sweet causes heat loss and in addition water and salt
c.                  expired air
d.                  urine and stool.
3.         Hormonal System: Hormones are chemical substances produced by the endocrine glands. The pituitary gland has been described as the ‘master gland’ because it produces many hormones.
            The hormonal system serves as a source of well being through the following ways.
1.                  Coordination effect of the pituitary gland
2.                  Maintenance of blood sugar level
3.                  Maintenance of oestrogen level in female
4.                  the protective effect of adrenalin
5.                  effect of sex hormones on growth and development of secondary sex characteristics
6.                  effects of the thyroid gland on carbohydrate metabolism.

OXYGEN TRANSPORT EFFICIENCY
            The oxygen transport system of the body is responsible for oxidation. It is operated by the heart and the lungs.
            Oxidation involves the consumption of 02 for the production of energy. The red blood cells carry 02 in the form of oxy-haemoglobin to the tissues and cells of the body. The 02 carried by the RBC is given off to the cells and C0s combines with RBC to form carbinohaeolgobin.
            The C02 and water are released in the lungs. The 02 transport system is in control of the 02 transport system so that rapid charges environment can occur.
            Physical education pays a good deal of attention to the building up of reserve for the heart and lungs thereby contributes to the efficiency of the transport system.
FACTORS RESPONSIBLE FOR OXYGEN TRANSPORT SYSTEM                              
1.                  good muscle tone 
2.                  good posture
3.                  activity or exercise
4.                  deep breathing exercise
5.                  good ventilation
Factors that adversely affect 02 transport system
1.                  inactivity or lack of exercise
2.                  neglect of or poor posture
3.                  nicotine has direct effect on the heart and blood vessels as follows:
a.                  by producing rapid heart beat
b.                  by raising blood pressure
c.                  by impeding entrance of air through the lungs
d.                  compound that mixes with heamoglabin thereby reducing the oxygen carrying power of RBC.
5.         Body physique and posture  
            Another term for body physique is some to type. A gentleman known as Sheldon classified body forms or physique on the basis of three (3) primary phenotype:-
1.                  Ectomophy  
2.                  mesomrophy
3.                  primary phenotype
The ectomorph is thin and skinny and lanky. He has a predominance healthy disposition. He is good at sprints but he is prone to poor posture because of narrow skeletal frame work. He also feels cold easily because of maximal sub-coetaneous fat. The person lacks stamina and tries easily.
The esomorph has a predominance of muscular tissue. He has good posture and is good at throwing events or weight lofting. He is energetic and is generally healthy.
The endomorph has a predominance of visceral tissue. He tends to be obese and flabby. He is good at weight (shot) put and wrestling. He has a broad skeletal framework which facilitates balance but he is prone to poor muscle tone heart disease and diabetes mellitus.
Posture: Barlow (1956) defined postures as “the relationship of the different parts of the body which ensures the most efficient behavioural parts of the body which ensures the most efficient behavioural and physiological functioning both now and in the future. Posture includes activities such as reclining, sitting, standing, bending, squatting and other bodily positions and movements.
FACTORS WHICH DETERMINES POSTURE
1.                  Vertebral column- the carnation and the position makes the vertebral column an important factor in posture. 
2.                  Muscular efficiency
3.                  Efficiency of the nervour system
4.                  nutritional state of an individual
5.                  absence of pain and disease
6.                  habit – good and bad postures can be formed from habit.
Effects of good Posture  
1.                  Improved physical appearance and self impression/ image including the personality of the individual
2.                  Ensures appropriate positioning of organs for efficiency functioning e.g. the lungs, cardio cascular system, the digestive system etc.
3.                  Good posture fatigue and strain
4.                  Good posture aids mechanical use of the body.
Types of Posture      
1.                  ‘Slumped’- characterized by dropping shoulders, hunched back, protruding abdomen,
2.                  ‘Expanded’ – showing eased up and relaxed disposition
3.                  Contracted – stiff and erect with chest out abdomen pulled in, commonly found with the military
4.                  Specific posture for specific situations such as sitting, squatting, bending etc.

BODY DEFENCES AGAINST INFECTIONS AND DISEASES  
            There are certain factors that help the body resist infection. They are:-
1.         Physical barriers
a.         The skin: this must be intact, meaning that there is no wound or cut. The skin is aided by the production of antiseptic substances; such as swat and by the presence of hairs.
b.         the bony cages. They serve as barriers or protection for organs contained in the body cavities.
2.         Mucous membrane. It must also be intact.
This membrane has a layer of mucus on it which can strap substances and micro-organisms. 
In addition some mucous membrane possess cilia; the surface of the mucous membrane is moist.
3.         Glandular activities:
a.         Production of tears by the lachrymal glands which protect the eyes because tears contain an antiseptic substance which is capable of dissolving bacteria. This substance is called lysozyme.
b.         hydrochlor acid contained in gastric juice produced by the stomach and it ingests bacteria.
4.         Polymorphous clear leucocytes:
            They are a firm of white blood cells and are pharagogtic in action and some of them are amoeboid in action. Other cells that have phagocytic action in the body are the cells of the sinusoids in the liver and in the spleen.
5.         Connective tissue cells which multiply to form granulation tissue in cases of healing by secondary intention (healing following infection), and in case of healing of abscesses.
6.         lymphoid/Lymphatic tissue
a. Lymphoid tissue found in the pharynx (adenoids and tonsils) and is the small intertine (aggregate lymph nodes)     
b. lymph nodes – which filter lymph carrying harmful substances
c. lymphocytes – concerned with production of antibodies
7.         Antibodies and antifoxins contained in the plasma.
8.         Reflex responses: there are reflex centres situated in the medulla oblongata e.g reflex  centres situated in the medulla oblongata e.g the reflex centres for sneezing and coughing.
9.         Immunity. This is the capacity of the body to resist infection. It provides a protected state and it affords specific resistance to infections. These are two substances involved in immunity
i.          antigen is a substance that stimulates the formation of antibodies.
ii.         antibody is a protein or substance formed in the as a result of contact with an antigen.
CLASSIFICATION OF IMMUNITY  
Immunity
                                               
Natural of Genetic
Artificial or Acquired
Active
Passive
Active
Passive
- Through overt or’
- From mother’
- Injection of
‘Ready made
clinical attacks’
to child eg
antigen for
‘antibodies
or sub-clinical ‘
through breast
the production
‘e.g anti-
attacks e.g smallpox,
feedings
Of antibodies
‘tetanus
measles polio-mellitus‘
Placenta’
e.g tentanus
‘serum
etc
e.g malaria
toxoid
‘(ATS)

            In active artificial immunity an antigen is injected into the body to cause it to produce antibodies against a particular diseases. In this regard, the body plays an active part in the production of antibodies.  A typical example of an antigen is the tetanus toxoid.
            In the passive artificial immunity ready-made antibodies are injected into the body. A typical example of a ready-made antibodies is the antitetanus serum (ATS). The body does not take part in the production of the antibodies and so its effect lasts only for a few weeks or month.
            Immunization:- This is a purposeful introduction into the body of small does of antigen so that the body can produce antibodies against a specific disease. The antigen that is injected may be weakened or attenuated or even de-toxicated toxin. The body takes part in the production of the antibodies.

FACTORS THAT ENHANCE ORGAN EFFICIENCY   
1.         Nutrition:- Meaning and definition
            - function of nutrition
            - consequences of poor nutrition
Nutrition as the sum of the processes by which the body takes on, and utilizes food. It is the story of food, and the use the body makes of it. It includes diet, digestion and metabolism.
            Nutrition ensures that the cells are in perfect condition and so can withstand the attacks or effect of infection. Because the cells are in good condition, if they happen to suffer form any infection they can recover very quickly. When the cells are in good condition the organs will function effectively.
            Poor nutrition leads to deficiency diseases (kwashiokor) and malnutrition, and subs quietly to death.    
2.         Exercise and Activity
Read up: effects of exercise on the various organs of the body: the heart lungs and blood circulation.
3.         Rest and the Circadian cycle/ Rhythm  
            Rest is characterized by a period of inactivity, quiet and mediation. However, the conscious mind still functions.

            Relaxation is a change of place in activity:
It helps to reduce tension and reduce the stresses of living. The ability for relaxation can be cultivated or learnt through training. Relaxation result in improved efficiency and increased enjoyment or life.
            The circadian cycle/ Rhythm is a natural or normal and traditional pattern or rhythm of living which consists of work and other activities during daylight followed by sleep or rest during the hours of darkness, following roughly the “circadian” or 24hr. period.
            Christianity and Judaism and to some extent Islam introduced those favoruable pattern of living into civilization in the form of a rest-day every 7th day. Even seasonal variations and terrestrial environment dictated or directed human living e.g farming was done during the rainy season and harvest during the dry season.
            With the advent of industry and development of technology as well as economic necessity man has been led to break off from the natural expectation. In addition, economic and political considerations often determine dead-lines in contemporary  times.
            The use of artificial lighting and traits of rigid measurement of efficiency have made possible working and activities during the hours of darkness.
            Deliberate and persistent violation of the biological or circadian rhythm affect well-being and affect performance eg (a) they can create tension (b) irritability (c) poor timing (d) depression (e) loss of coordination (f) muscular fatigue (g) visual disturbances
4.         Physical Fitness
            This implies a condition of readiness and is an important ingredient for success. It is the ability to carry out one’s work without unnecessary fatigue and still have some reserve energy to enjoy social activities.
            A physically fit person is one who possesses adequate strength and endurance to carry out his daily activities without undue fatigue  and still have sufficient energy to enjoy leisure and to meet unforeseen circumstances (emergencies). The organic capacity of an individual to perform the normal task of daily living without undue tiredness or fatigue and yet have reserve strength and energy available to meet satisfactorily emergencies demands on physical fitness. Physical fitness facilitates ability to resist infection.
COMPONENTS OF PHYSICAL FITNESS                        
            There are 2 major components – health related and skill – related.
            The health related are eh fundamental components needed for good health. They consist of strength, endurances, flexibility, cardio-vascular efficiency and respiratory efficiency.
            The skill- related are the component that is necessary for performing physical work and activity. They include agility, coordination, balance, speed, reaction time, accuracy.
            Total fitness:- is a combination of physical fitness and inter-related qualities, and potentials eg heredity, emotional stability, social consciousness, attitudes etc.
            Among all these components strength, endurance and coordination are considered to be the basic elements for physical fitness because good performance on these elements for physical fitness. The performance of these elements depends on age, sex, health status, anatomical and biochemical conditions.
MEASUREMENT OF PHYSICAL FITNESS             
            There are no single standard that can be used to judge the physical fitness of everybody. However, it can be measured or estimated of pull-ups, still-ups ter-metre shuttle run, standing broad jump, 45m dash, 540m run – walk, basket ball throw for distance.
5.         HEALTH SERVICES AND MEDICAL CHECK-UPS  
            Health services provide opportunity for health appraisal, diagnosis, referral, treatment of illness, rehabilitation, prevention, monitoring or check up or control of diseases.
            There are health facilities that promote health they include:-
            Structures and equipment and operatic to facilitate functional health services and to promote desirable health habits. Health facilities include health institutions that is hospital, health centres immunization centre etc. They also include hand-washing basins, toilets etc.
6.         Social amentias: which include water supply, sanitation, disposal, nector control, protection of food, housing, water is essential to life. Water that is safe is called potable water. It is used in domestic activities, agriculture and recreation. It is an effective factor for good sanitation and sewage disposals.
7.         Health Education: A method of encouraging people to adopt measures which are beneficial to their health and to reject those that are harmful to their health.
            Health education provides knowledge about the position, structure and functions of organs so the individual can recognize when there is deviation from normal. It also provides an awareness of the position and role of organs. It helps in the acquisition of skills for handling emergencies and sudden illness and skills for forming desirable health habits. Health education sets acceptable standards of health behaviour. It also encourages values for things that promote health.
            Health education facilitates the prevention of diseases. It provides knowledge of the limitations and potentials of the different body types. It creates awareness of the consequences of undesirable behaviour.
8.         Health Insurance:- refers to the pre-payment plan/ scheme for unpredicted expenses of illness, accidents, and medical care over a period of time.
Types
1.         Hospital expense protection:
            This type of plan involves payment of hospital bills up to particular length of period or a particular amount of money.
2.         Regular medical care:- payment is made to cover routine medical care or check up over an unspecified period.
3.         Loss-of-income protection:-
            This may be from disability or indemnity. It is a plan that guarantees cash benefits for a portion of normal salary recuperation from illness or accidents. The payment accruing from the plan starts after a specified period of disability and continues up to maximum time.

AGENCIES THAT PROVIDE HEALTH INSURANCE                                                  
1.                  Government agencies 2 employers
2.                  Insurance  companies
3.                  Private  arrangement with a physician
The benefits of health insurance
1.                  Health insurance relieves anxiety
2.                  It promotes job satisfaction and happiness for the employed
3.                  It gives security
4.                  It facilitates utilization of appropriate health services.
5.                  It facilitates adoption of appropriate health action.

HEALTH MAINTENANCE OF THE RESPIRATORY SYSTEM               
            The aim of maintenance is to ensure that the system continues to perform its normal function effectively.
STRUCTURE OF THE RESPIRATORY SYSTEM  
The role of the respiratory system
1.                  The respiratory tract serves as a mechanism for communication this is a result of vocal cords in the larynx.
2.                  The transportation of oxygen
3.                  Removal of waste products to C02 and H20
4.                  Protection due to the presence of collie.
Maintenance of the system: 
1.                  Encouragement of nose breathing, because of the hair, mucous membrane etc.
2.                  Improved ventilation by ensuring cross ventilation, use of fans or air conditioner.
3.                  Installation of air filters and air conditioner
4.                  Isolation of cases of air-borne infections and restricting persons with cold and influenza
5.                  Proper disposal of sputum and controlled spitting.
6.                  Avoidance of over crowding
7.                  Damp dusting
8.                  Immunization against air borne infections such as measles, diphtheria, polio, meningitis.
9.                  eradication of air borne infections
10.             adaptation of proper posture: if one sits well the thoracic cavity will be large enough for proper respiration.
The cardio vascular system (cvs)
Structure:- 
1.                  Special muscle cells in the heart = they are branched and inter connected and so can contract simultaneously.
2.                  Length and position of the coronamy a branch of the aorta; and supplies blood to the musical of the heart.
3.                  Special structure of blood vessels, especially  artery
4.                  Resistance in the blood vessels especially artery which accounts for blood pressure.
5.                  presence of values in the veins of the legs.
6.                  presence of red blood cell (RBC), white blood cell (WBC) and platelets in the blood.
7.                  the presence of antibodies and antitoxins.
Role of cardio vsaculas system            
1.                  It is responsible for the transpiration of nutrients to the cells
2.                  transportation of 02 to the cells during circulation of blood round the body.
3.                  transportation of hormones
4.                  transportation of waste products
5.                  protection of the body through the presence of leucocytes and the mechanism of blood clothing.
Maintenance of C.V.S       
1.                  Regulated exercise which facilitates blood circulation
2.                  Encouragement or rest
3.                  avoidance of stress
4.                  avoidance of cardiac stimulants
5.                  medical check up especially blood pressure
6.                  avoidance of infections of the heart eg German measles.
7.                  Peristalsis
The role of the digestive system:   
1.                  digestion and absorption of digested food
2.                  removal of waste products in the form of H20 and faces
3.                  provision of nutrients
4.                  production of enzymes
5.                  protective role by the production of HCL and the presence of lymph nodes with small intestine.

MAINTENANCE OF THE DIGESTIVE SYSTEM 
1.                  Application of food hygiene and cleanliness of food both at the preparation and serving stages.
2.                  Avoidance of contaminated food
3.                  Avoidance of food that are potentially poisonous eg mushrooms
4.                  Encouragement to establish at regular intervals and to avoid irregular eating.
5.                  Avoid constipation and therefore encourage voiding regularly
6.                  Avoidance of very hot and peppery food.
7.                  inclusion of roughages and fruits in diets.
Urinary system
The structure
1.                  The presence of nephness
2.                  The bladder serves as a reservoir and has a limited capacity
3.                  the presence of prostrate gland in close relationship with the urinary system in the male
4.                  The urinary system in the male serves as a common passage of urine and semen.
5.                  The urethral opening in females is in close anatomical relationship to the vagina and anus.
6.                  The foreskin or prepuce in the male can serve as a site of infection.
7.                  The ureters have very narrow tracts
8.                  The length of the male urethral pre-disposes it to problems.
Maintenance of urinary system     
1.                  Encourage regulated exercise
2.                  encourage regulated exercise
3.                  avoidance of substances which are toxic to the kidneys
4.                  encourage cleanliness of the vulva in the female
5.                  encouragement of male circumcision or cleansing of the foreskin/ prepuce.
The role of the urinary system 
1.                  Formation of urine
2.                  responsible for water balance
3.                  responsible for alterlisity of blood
4.                  responsible for osmo-regulation
5.                  removal of nitrogenous wastes  
Reproductive System               
Structure:-
1.                  The organs of the male reproductive system are mainly external
2.                  The male reproductive system is closely related to the male urinary tract.
3.                  The organs of the female reproductive system are mainly internal
4.                  The vaginal orifix is in close anatomical relationship with the anus.
5.                  The lumen of the uterine tube in the female are obliterated
6.                  There is an access from the exterior into the peritoneal cavity through the uterine tubes (fallopian tubes).
Role of the reproductive system
1.                  Production of gamete (sex cells – or sperm)
2.                  Production of sex hormones (progesterone and testosterone)
3.                  Production of secondary sexual characteristics
4.                  responsible for menstrual cycle
5.                  responsible for pregnancy and child – birth
Maintenance      
1.                  Cleanliness of genital organs
2.                  avoidance of misuse and abuse of the genital organs
3.                  observance of privacy and respect for the genital organs during menstruation.
4.                  Care of the genital organs during post – natal period
5.                  Avoidance of illegal abortion
6.                  avoidance of tight clothing over the genital organs in the male.
7.                  avoidance of parotitis (mumps)
8.                  judicious use of contraceptive pills
9.                  avoidance of multination of the female external genital organs.
10.             provision of education.
Nervous System            
1.                  Nervous system has a special property of irritability
2.                  The cells of the nervous system cannot regenerate
3.                  the bran cortical areas which perform specific (functions
4.                  the spinal cord ends between the 1st and 2nd lumber vertebrae
5.                  carebio- spinal fluid surrounds the brain and spinal cord and it contains nutrients, inorganic salts etc.
6.                  the brain is delicate and complex

The Role of The Nervous System      
1.                  Coordination activities in the body
2.                  awareness of impulses in the environ
3.                  it is responsible for knowledge retention
4.                  the cortical areas in the brain perform specific functions such as vision, hearing, movement etc.
5.                  Intellectual activities are performed within the nervous system  
6.                  the nervous system is protective through relaying of aforementioned.
Maintenance of The Nervous System
1.                  Encouragement of relaxation
2.                  avoidance of stimulants
3.                  avoidance of injury to the nervous system
4.                  avoidance of stress
5.                  encourage adequate stimulation (or be active and think, engage in healthy arguments)
6.                  avoidance of wine, because it irritates the nervous system
7.                  periodic medical check up especially the blood pressure.
Maintenance of sense organs             
These include the eyes, ears and mouth.
The eyes:                   visual health
Structure:                   the lens is transparent
The cornea, aqueous humar, the vitreous reflect light rays.
            The cilismy muscles control the shape of the lens by contraction. The mod and cane cells situated in the retina are sensible to light rays and they also transmit the impulse of light the brain. The visual area is responsible for receiving and interpreting visual impulses. The vitreous humour cannot be replaced. The visual purple beaches is the sunlight and ‘Vitamin A’ is necessary for its replacement.
The role of the eye
1.                  The eyes are the receptors and transmitters of visual stimuli
2.                  The two eyes work in coordinated fashion
3.                  interpretation of visual impulses is done by the brain
4.                  perception  is a mental process which gives meaning through visual, auditory, olfactory and experiences.
5.                  vision used for reading, driving is a visual impression.
Maintenance of visual health   
1.                  Ensuring the cleanliness of the eyes by simple washing with soap and water but not with caustic soap.
2.                  avoidance of caustic materials on the eyes
3.                  encouraging routine check up
4.                  avoidance of visual fatigue
5.                  avoidance of reading in a moving vehicle
6.                  encouragement to read in clear light
7.                  avoidance of glare (harmful to the cells in the retina) or dim light
8.                  Avoidance of working directly at the sun because of the harmful effect of infra red on the retina
9.                  avoidance of eye injury
10.             recognition of symptoms of eye problems e.g persistent blinking, aversion to light, watery or discharging eyes blurred vision sports before the eye, inflammation of the eyes etc.
11.             avoidance of cheap, plastic sun glasses.
12.             seeking and obtaining expert care in case of eye injury
13.             adequate intake of vitamin A n the diet
14.             adoption of correct posture for reading.

Visual Abnormalities
Eye defects – refers to irregularities in the anatomical structure of the eyes which distort the reception of visual stimuli e.g myopia (near sightedness) – the viction sees near objects clearly but not far objects. The image of the point of focus of as object is “in front of” the retina instead of “on” the retina. 
The predisposing factors to myopic include:                               
1.                  Poor lighting or dim light
2.                  poor posture 3. pubertal changes
Correction of myopia requires a concave lens in front of the eyes 
Hyperopia- far sightedness
The victim sees far objects clearly, but not near objects. The light rays focus behind the retina at a normal distance. It is commonly associated with ageing because of loss of muscle tone of the ciliary muscles.  When hyperopia requires convex lens.
Astigmatism – distortion of light rays in a manner that they are not focused at a single point on the retina. It is due to unequal curvatures on the surface of the lens. The correction is cylindrical lens.
Strabismus – squint (cross- eyed). It is due to uncoordinated movement of the eyeballs due to unequal tension in the extrinsic muscles of the eye.   
Amblyopia – refer to seeing clearly only in one eye even though the other eye is free of diseases. It is due to lack of balance and coordination between the eyes. Colour blindness/ deficiency – the individuals is unable to distinguish between colours or certain colorus.
Eye Disorders          
Refers to ailment r disease conditions of the eye.
1.                  Glaucoma – increase in intra ocular fluid pressure within the eyeball due to blockage or constriction of the outflow duct.
2.                  Cataract – opacity (opaque) of the lens such that light cannot pass through
3.                  Retinal diseases which lead to blindness
4.                  Eye injuries of various types.

Hearing/ Auditory System 
Structure:
1.      Presence and position of the tympanic membrane which is very delicate.     
2.      The ear has a conducting ability
3.      the external auditory meatus is curved
4.      there is an anatomical connection between the middle ear and the pharynx at the pharyngeal tube or enstachia tube.
5.      the inner ear is embedded in the temporal bone

The role of the auditory system   
1.                  Organ of hearing
2.                  It is also the organ of balance because of the semicircular canals which have mere cells that transmit balance to the brain.
Maintenance of the auditory system  
1.                  Avoidance of poking object into the ear.
2.                  Medical check-up or screaming of the ear
3.                  Avoidance of noise
4.                  Avoidance of forceful blooming of nose
5.                  Avoidance of head injury because the inner ear is located in the head.
6.                  Adoption of safe swimming habits
Hearing Abnormities  
1.                  Conductive deafness: - Due to defect in the conducting mechanism in the ear: pina-tynpavia membrane ossicles – inner ear.
2.                  nervous deafness: Due to a defect in the cochles affecting the nerve endings, and subsequently transmission of sound waves to the brain.
3.                  otitis media- Infection of the middle ear and it can be associated with the infection of the nose and throat.
4.                  Presbycusis (heard at hearing) – It is the or decrease of the hearing acuity often due to old age or ageing. The victim may be able to hear the sound but may be unable to distinguish  what is being said. He can not discriminate between sounds. Psychologically, the victim seems isolated and inattentive. The condition may expose the victim to ridicule which may have emotional effect of on the relatives of the victim. Generally, deafness predisposes the victim to risk of accidents.
Dental Health             
·        Structure
·        Role of the teeth
·        Maintenance of dental health
·        Abnormalities of the teeth  eg dental carries (tooth decay) or hole in the teeth
2.   Periodontal diseases
3.   Malocclusion
4.   Non-eruption of the teeth
UNIT VII
FACTORS THAT UNDERMINE HEALTH
A.                DRUGS – are chemical substances which have the potential to alter the normal functioning of the body or of body organs. Drugs are beneficial for the treatment of prevention of ailment if used according to certain professional principles. Elements of drug or chemical substances are taken in many forms and in many settings e.g. there are chemical substance in alcohol and tobacco and alcohol is taken in social settings. Some drugs are poisonous or dangerous in the sense that they produce undesirable affect on the body systems, for example drugs that affect adversely the C.N.S include depressants, stimulants, narcotics and sedatives.
PSYCHOLOGICAL OUTCOMES OR BEHAVIOUR MODIFICATION DUE TO DRUGS
1.                  Dependence – An unreasonable compulsion to take a particular drug, usually to avoid psychic discomfort.
2.                  Addiction – A chronic intoxication produced by repeated excessive consumption of a particular drug.
3.                  Drug Abuse – The excessive or persistent taking of a drug without regard for accepted medical practice.
4.                  Drug misuse – Improper used of properly prescribed drug. E.g. giving your own prescribed drug to somebody else for an ailment, maybe similar to your own former ailment.
ADVERSE EFFECTS OF DRUGS
1.                  Derangement of cellular metabolism, whereby it alters the normal activities of the cell.
2.                  Impaired judgment – which manifests in faculty assessment due to influence of a particular drug.
B.        LACK OF SOCIAL AMENITIES
            Those services are supposed to promote comfort and enjoyment of life. They include: potable water, good roads, refuse disposal, recreational facilities, housing, electricity, etc. When these things are lacking, health is undermined because individuals cannot attain the level of health they ought to.
C.        LACK OF RECREATIONAL AMENITIES
1.         When recreational amenities are lacking they can predispose individuals to poor use of leisure.
2.         It can lead to discouragement f young ones in the involvement of spots and activities though they acquire some recreational and social skills like fair play, sprit of sportsmanship, making friends, greeting people.
3.         Personal failure to make constructive use of leisure may result is chronic physical inactivity.
4.         Pre-occupation – economic and domestic problem because of lack of other meaningful diversion.
5.         Failure of planning in personal life because of pre-occupation in social problems.
6.         Increased chances of psycho-somatic symptoms.
D.        SEXUALLING TRANSMITTED DISEASES
1.         They can adversely affect body organs
            2.         They can give rise to infertility
            3.         They can affect production of sex cells
4.         STD carries or social stigma (co-ordination by the public) The carried feels guilty all time.
5.         Some of them are destructive on body organs – Sydriles affects nervous system and visual system and can cause death of the unborn baby
e.         neglect, misuse and abuse of body organs and environment
Neglect – Inactivity of the body can cause damage to the body organs (law of use and disuse)
MISUSE – Using a body for a function which nature did not equip it for.
Abuse – Introducing into the body substances which are harmful – e.g. smoking. Using the sexual organs to raise money (prostitutes) 
The Environment
(1)       Excavation which rise to erosion and potholes and stagnant water which are veritable breeding places for insects and rodents which cause disease.
(2)       Indiscriminate erection of batchers causing over crowding
(3)       Slum formation – collection of make – shift shelters in an over crowded setting.
(4)       Indiscriminate disposal of refuse
(5)       Indiscriminate disposal of sewage
(6)       Emission of smoke into the atmospheres from factories, engines (auto mobiles)
(7)       Improper use of natural sources of water- stream and river
(8)       Discharge of factory wastes, some of which are poisonous.
(9)       Indiscriminate farming detracting from anesthetics and reducing open spaces for recreation.     
  
THE ROLE OF HEALTH EDUCATION IN THE PROMOTION AND MAINTENANCE OF HEALTH

1.                  Provision of knowledge about position of structure and functions of body organs.
2.                  Provision of awareness of position and roles of body organs
3.                  Enablement of acquisition of skills for maintenance of health hand washing, personal hygiene, brushing of teething etc.
4.                  health education sets acceptable standards of healthy behaviour
5.                  It encourages the inculcation of values and appreciation of values for things that promote health.
6.                  It facilitates prevention of infections.
7.                  It provides knowledge about body types and their potentials and limitations in relation to maintenance of health.
8.                  Health education provides knowledge of the role and importance of posture to health, facilitates the development of skills for dealing with emergency situations and sudden illness
9.                  It develops awareness of the consequences of undesirable behaviour.
The role of record keeping and research in the promotion and maintenance of health
            Health records refer to the documented information that pertains to health. It includes records of the health statistics showing birth and death rates. The records will also reveal the types of diseases that are sporadic, endemic or epidemic. It will also reveal the ages when people die, for example. Good statistics of this nature can show a government how many children die in infancy, a year, at school age, and the type of illness that causes great mortality at particular stages of life.
            Health records of treatment can inform drug distributors and manufactures which type of drug is used and the degree of its efficiency. Statistics of this nature collected from various clinics, hospitals etc are necessary to forecast what diseases a state or country could expect in the future if past records are reliable. The government uses these records to plan the medical and health services of the state.
            The role of record keeping in the promotion and maintenance of health cannot be over emphasized. This is because it is through these records that the effectiveness of health maintenance projects like the Expanded Programme on Immunization (EPI) and the extent of coverage is determined. This will help them to know the communities that need attention more than others thereby preventing the occurrence of certain childhood killer diseases.
            In a school set –up, health records such as hospital; records will help the school nurse to identify children who suffer from certain congenital or hereditary diseases such as sickle cell anaemia and heamophilia. This will help her to know the kind of attention to give these children in order to promote their health. it will also help the teacher to know children who have physical defects such as partial deafness or short sightedness and so on know how best to attend to them.
            The records on past epidemics will help the community or government involved to embark on some strategies to avoid future occurrences of such epidemics.
            Such records on the population distribution will help the government to know the type of health services to provide for the population. For example, where the population is dominated by infants, there will be more podiatrist hospitals or where old people dominate there will be more old people’s homes and rehabilitation centers.
The role of research in promotion and maintenance of health is very important. So many researches have been carried out over the years and have great impact on both community and personal health. Such researches include the following:
a.                  The nature of disease (pathology)
b.                  Organism that cause disease (microbiology)
c.                  The way in which disease – carry organism reach while population / groups (epidemiology)
d.                  Poisons and their sources (toxicology)
e.                  The chemical substances needed by the body maintain health (nutrition).
f.                   The function of hormones in maintaining health (endocrinology).
g.                  The ways in which heredity affects health (genetics) etc.
Through research, Johann Schole in (1939) showed that a mold-like plant was the cause of fervus, a fungal infection of the scalp. By knowing the cause of a disease, the curative and preventive measures become much easier to find.
Through research Louis Pasteur laid the foundation for the modern program of disease preventives. His studies showed that ‘diseases’ of beer and wine were produced by bacteria that led invaded the liquid and disturbed the usual alcoholic fermentation by producing undesirable fermentations of their own.
Basic methods of studying the bacteria are were developed by Robert Koch. He discovers how to kill and fix bacteria and strain them on a glass-slide for more effective study.
From such beginnings, the science of microbiology has developed with its many applications in industry, dairy, farming and food preservation as well as in public health and medicine.
The discovery of vaccination by Edward Jenner in 1796 has helped a great deal in the prevention of some deadly diseases like small pox. By introducing a mild form of small-pox into the body of a healthy person, he will have a mild attack and become immune t smallpox thereafter. Through vaccinations, so many diseases are being prevented today, thus helping to maintain health.
Through research the science of epidemiology was developed. The study of the cholera epidemic of the ‘Broad Street Wall’ by Dr. John Snow of London in 1854 may be regarded as the beginning of the science or epidemiology. Today, epidemiology gives information on the relationships of the various factors determining the frequency and distribution of diseases in a human community. This information will help the government and individuals to device means of protecting themselves against specific diseases, and the type of health facilities to provide in order to prevent a disease epidemic such as cholera. Epidemiology also provides information about the mode of transmission of specific diseases. This information will help individuals to form desirable health habits like closing their mouths while sneezing or coughing. This will help in health promotion.
Through research, new discoveries in genetics and in the development of new drugs to be used in the treatment of mental and emotional health are being made and mortality rates have declined greatly and more people are attaining higher levels of health.

THE ORGANIZATIONS/BODIES INVOLVED IN MAINTENANCE AND PROMOTION OF HEALTH INTERNATIONAL:
1.         World Health Organization (WHO):-
This organization was established by the United Nations in 1948. its main aim is to free humanity from diseases but it also seeks to promote health of the individual in body, mind and social adjustment. The main functions of WHO are as follows:
a.                  To assist the member nation will medical personnel during emergencies such as civil or international wars, earth-quakes, foods, epidemics or other natural catastrophier.
b.                  To assist in the training of medical and paramedical staff.
c.                  To encourage and promote good health by giving health education by means of all sorts of communication media.
d.                  To give immunization against various diseases e.g. tuberculosis, polio, smallpox etc. 
e.                  To give member countries information about epidemics.
2.         United Nations Children’s Emergency Fund (UNICEF):-
This is another international agency of the United Nations created to deal with children’s problems. The body provides various equipment. For school children, particularly those essential for their recreational facilities. It also provides them with free milk. The funds are also spent to provide hospitals with milk for infants and their mothers and for the training of midwives. This project mortality rate of children.
3.         Food and Agricultural Organization (FAO):-
The FAO is a United Nation’s (UN) agency established in 1943. It provides technical aids necessary for better production of food both plant and animal.
4.         The Red Cross – this is a voluntary organization.
Each country has its own national body of the Red Cross whose functions include:-
a.                  Training         of people during peace: in the methods of aiding the sick, particularly victims of various accidents at sports and games.
b.                  Performing first aid activities and training personnel in first aid.
c.                  The rehabilitation of victims of wars, floods, draught, earthquakes etc.
National:
1.                  Ministry of Health – responsible for the general health policy. It provides the funds to carry out the various projects including building programmes provision of medical personnel, equipment, and drugs.
2.                  Public Health Authority - It is the duty of this body to execute health schemes. It ensures that adequate and good water is supplied to all citizens. It also gives mass vaccination or inoculations against smallpox, measles etc.
3.                  Ministry of Information – It educates the public about government plans through the media of posters, loudspeakers, mobile cinemas.
4.                  Port Health Authority – Their functions include:-
a.      To see that passengers into or out of the country possess valid health certificates e.g. that they have been vaccinated against diseases such as yellow fever, smallpox, cholera and sometimes, typhoid fever.
b.      They prevent passengers from and epidemic zone from entering the country, imposing a quarantine regulation on such persons.
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