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These interact with the spindle to assure that each daughter cell ultimately has a full set of chromosomes buy bupropion 150mg cheap mood disorder dsm 5 code. The chromatids start to migrate toward the equatorial plane, an imaginary line between the poles. Dividing at the equator: Metaphase After the chromosomes are lined up and attached along the cell’s newly formed equa- tor, metaphase officially debuts. The chromatids line up exactly along the center line of the cell (or the equatorial plane), attaching to the mitotic spindle by the centromere. Packing up to move out: Anaphase In anaphase, the centromeres split, separating the duplicate chromatids and forming two chromosomes. The spindles attached to the divided centromeres shorten, pulling the chromosomes toward the opposite poles. In late anaphase, as the chromosomes approach the poles, a slight furrow develops in the cytoplasm, showing where cytokinesis will eventually take place. Chapter 3: Divide and Conquer: Cellular Mitosis 39 Pinching off: Telophase Telophase occurs as the cell nears the end of division. The spindles and asters of early mitosis disappear, and each newly forming cell begins to synthesize its own structure. There’s a more pronounced pinching, or furrowing, of the cytoplasm into two separate bodies, but there continues to be only one cell. The furrow intended to divide the newly formed sister nuclei at last gets to finish the job. Each new cell is smaller and contains less cytoplasm than the mother cell, but the daughter cells are genetically identical to each other and to the original mother cell. Use the terms that follow to identify the stages and cell structures shown in Figure 3-1. Metaphase What Can Go Wrong With the millions upon millions of cell divisions that happen in the human body, it’s not surprising that sometimes things go wrong. In this muta- tion, newly formed chromosomes don’t quite divide, leaving one daughter cell with one more chromosome than normal and the other daughter cell one chromosome shy of a full complement. The rate of division usually restricts itself to replac- ing worn out or injured cells, but with accelerated mitosis, the cells don’t know when to stop dividing. Use the space provided to draw a basic illustration of each of the six stages inside a cell during mitosis. Late interphase (1) Prophase (2) Metaphase (3) Anaphase (4) Telophase (5) Cytokinesis (6) Part I: Building Blocks of the Body 44 Answers to Questions on Mitosis The following are answers to the practice questions presented in this chapter. With all that organelle-growing, metabolizing, and protein-synthesizing that takes place during G1, this isn’t surprising. As the cell nears the end of division, it makes sense that duplicate packages move to opposite ends of the cell. These structures disap- pear because they’re no longer needed at the end of mitosis. That means, of course, that cytokinesis takes place during the final stage of mitosis. Chapter 3: Divide and Conquer: Cellular Mitosis 45 C Any change in a cell’s genetic information is known as b. Telophase H Chromosomes attached to spindles, moving to opposite ends of a molecule: a. Anaphase I Check your answers to the fill-in-the-blanks in questions 13 through 24 (Figure 3-1), and then compare your drawings to that figure. Part I: Building Blocks of the Body 46 Chapter 4 The Study of Tissues: Histology In This Chapter Checking out the skin Keeping things together with connective tissues Flexing muscle tissues Sending signals through nerve tissue h, what tangled webs we weave! As the chapter title says, histology is the study of tis- Osues, but you may be surprised to find out that the Greek histo doesn’t translate as “tissue” but instead as “web. The four different types of tissue in the body are as follows: Epithelial, or skin, tissue (from the Greek epi– for “over” or “outer”) Connective tissue Muscle tissue Nerve tissue In this chapter, you find a quick review of the basics of each of these types of tissues along with practice questions to test your knowledge of them. Getting Under Your Skin Perhaps because of its unique job of both protecting the outer body and lining internal organs, epithelial tissue comes in more varieties than any other tissue. Epithelial tissues, which generally are arranged in sheets or tubes of tightly-packed cells, always have a free, or apical, surface that can be exposed to the air or to fluid.
The Stanford-Binet is a measure of general intelligence made up of a wide variety of tasks including vocabulary order bupropion 150mg online depression symptoms fatigue, memory for pictures, naming of familiar objects, repeating sentences, and following commands. Although there is general agreement among psychologists that g exists, there is also evidence for specific intelligence (s), a measure of specific skills in narrow domains. One empirical result in support of the idea of s comes from intelligence tests themselves. Although the different types of questions do correlate with each other, some items correlate more highly with each other than do other items; they form clusters or clumps of intelligences. One distinction is between fluid intelligence, which refers to the capacity to learn new ways of solving problems and performing activities, and crystallized intelligence, which refers to the accumulated knowledge of the world we have acquired throughout our lives (Salthouse, [4] 2004). These intelligences must be different because crystallized intelligence increases with age—older adults are as good as or better than young people in solving crossword puzzles— whereas fluid intelligence tends to decrease with age (Horn, Donaldson, & Engstrom, 1981; [5] Salthouse, 2004). Thurstone [6] (1938) proposed that there were seven clusters of primary mental abilities, made up of word fluency, verbal comprehension, spatial ability, perceptual speed, numerical ability, inductive reasoning, and memory. But even these dimensions tend to be at least somewhat correlated, showing again the importance of g. One advocate of the idea of multiple intelligences is the psychologist Robert Sternberg. Sternberg has proposed a triarchic (three-part) theory of intelligence that proposes that people Attributed to Charles Stangor Saylor. As Sternberg proposed, research has found that creativity is not highly correlated with analytical [8] intelligence (Furnham & Bachtiar, 2008), and exceptionally creative scientists, artists, mathematicians, and engineers do not score higher on intelligence than do their less creative [9] peers (Simonton, 2000). Furthermore, the brain areas that are associated with convergent thinking, thinking that is directed toward finding the correct answer to a given problem, are different from those associated with divergent thinking, the ability to generate many different [10] ideas for or solutions to a single problem (Tarasova, Volf, & Razoumnikova, 2010). On the other hand, being creative often takes some of the basic abilities measured by g, including the abilities to learn from experience, to remember information, and to think abstractly (Bink & [11] Marsh, 2000). Studies of creative people suggest at least five components that are likely to be important for creativity: Expertise. Creative people have carefully studied and know a lot about the topic that they are [12] working in. Creative people often view a problem in a visual way, allowing them to see it from a new and different point of view. Creative people tend to work on projects because they love doing them, not because they are paid for them. In fact, research has found that people who are paid to be [13] creative are often less creative than those who are not (Hennessey & Amabile, 2010). Simonton [14] (1992) found that the most creative people were supported, aided, and challenged by other people working on similar projects. The last aspect of the triarchic model, practical intelligence, refers primarily to intelligence that cannot be gained from books or formal learning. Practical intelligence represents a type of “street smarts‖ or “common sense‖ that is learned from life experiences. Although a number of tests have been devised to measure practical intelligence (Sternberg, Wagner, & Okagaki, 1993; [15] Wagner & Sternberg, 1985), research has not found much evidence that practical intelligence is distinct from g or that it is predictive of success at any particular tasks (Gottfredson, [16] 2003). Practical intelligence may include, at least in part, certain abilities that help people perform well at specific jobs, and these abilities may not always be highly correlated with [17] general intelligence (Sternberg, Wagner, & Okagaki, 1993). On the other hand, these abilities or skills are very specific to particular occupations and thus do not seem to represent the broader idea of intelligence. Another champion of the idea of multiple intelligences is the psychologist Howard Gardner [18] (1983, 1999). Gardner argued that it would be evolutionarily functional for different people to have different talents and skills, and proposed that there are eight intelligences that can be differentiated from each other (Table 9. Gardner noted that some evidence for multiple intelligences comes from the abilities ofautistic savants, people who score low on intelligence tests overall but who nevertheless may have exceptional skills in a given domain, such as math, music, art, or in being able to recite statistics [19] in a given sport (Treffert & Wallace, 2004). The idea of multiple intelligences has been influential in the field of education, and teachers have used these ideas to try to teach differently to different students. For instance, to teach math problems to students who have particularly good kinesthetic intelligence, a teacher might encourage the students to move their bodies or hands according to the numbers. On the other hand, some have argued that these “intelligences‖ sometimes seem more like “abilities‖ or “talents‖ rather than real intelligence.
In developed regions buy generic bupropion 150 mg fayum depression definition, the ‘baby-boomers’ are starting to retire to a total of elderlywouldoutnumberyoungchildrenby8:1,for 86. In addition, with survival rates, only 2% of the population would be more time on their hands to lobby, they are more five years or younger, but 40% would be 65 years likely to vote, and can be expected to use their and older. The governments will respond in the usual United Nations International Population Division knee-jerk reaction – ‘more regulations and con- (1996). They projected life expectancy in the trols’ on industry – while increasing funding for Principles and Practice of Pharmaceutical Medicine, 2nd Edition Edited by L. It will is 1–4 months in general (1–18 months for be interesting to see whether a more extended life Alzheimer’s patients) and, even with what would expectancy, over and above the current projections, normally be an adequate pension, this burden can will reverse the depopulation trend. In the United States alone, Alzheimer’s disease will affect 16 million people by 2050 (Tauzin, 1995). This is already happening in Europe and in population aged 15–65 years will fall from 22% the United States. In the United States, 60 years ago, the and intestinal disease, endemic to many of their retirement age for Social Security ‘pension’ was home countries. In 1997, 39% of tuberculosis cases designed for an expected average lifespan of in the United States were in foreign-born parents; 65 years. Already this has been pushed back to in California, this rose to 67% (Satcher, 1999) and 67 years by year 2004, and additional legislation the annual cost of diagnosis and treatment of the will probably push the age requirements back to 70 1 million immigrants was $40 million (Muenning in 10 years’ time, when the ‘baby-boomers’ swell et al. To encourage the healthy older person to con- tinue working beyond 65 years, legislation was passed to remove the penalty (in workers 65–70 15. In 1999, it was proposed that, because of the high Studies of drug utilization in the elderly showed cost of medication and because the older people that older people receive disproportionate amounts were the greatest users, they be eligible for drug of medication (Rochon and Gurwitz, 1995). The elderly current situation is that the government will not use comprised 18% of the population but received 45% this volume to drive prices down. One in 10 admissions to acute geriatric units Of great concern is the social and financial was caused or partly caused by adverse drug reac- impact of Alzheimer’s disease, whose incidence tions. The drugs involved most commonly were per capita increases to 32% of the surviving popu- benzodiazepines, warfarin, digoxin and nonster- lation at ages 80–85 (and declines rapidly after age oid anti-inflammatories (Denham and Barnet, 85). This causes enormous cited reports of adverse events causing 5–23% of detriment to the surviving spouse and family and hospitalizations, nearly 2% of ambulatory visits to family finances, and must eventually impact and 1 in 1000 deaths in the general population. In perceived concerns of both investigators and phar- addition, 31% take alcohol frequently (Conn, 1992). There are very increase the bleeding tendency, and not just from fit 80-year-olds who climb mountains, and young the stomach. Antacids can decrease the excretion children dying from genetic advanced aging (pro- of antidepressant tricyclics, quinidine, pseudoe- geria). So many of the above concerns can be the absorption of digoxin and b-blocker hyperten- reduced by selecting ‘uncomplicated, healthy’ sive medication. These are only a few of the older patients in phase I studies, who are increas- multitude of interactive drug effects. This is ingly available due to the success of medicines and imposed on the reduced efficacy of hepatic meta- preventative medicine. For the elderly, of equal importance to life exten- sion and cure is improvement or preservation of their activities. Traditionally, elderly subjects were frequently excluded from clinical drug development (unless 15. The reasons given were that the By the 1980s, most of the new medicines still had elderly suffer from too many other diseases, little or no information on elderly dosing or con- require concomitant medicines, are more frail tained disclaimers. All that 30% of prescription drugs by then were con- these can cause ‘static’ in the interpretation of the sumed by just 12% of the population (those over data, and give undue weightage to adverse events 65 years), a new guideline was issued. The tripartite guidance, Studies in Support of Special patients must be in ‘steady state’. The agency followed up with specific requirements on content and format of labeling 6. Usually, differences in the therapeutic response or adverse events are too small to detect at an equivalent plasma level between ordinary adult 15.
These products are usually not as potent as the traditional extemporaneous Traditional Chinese medicine | 157 preparation of decoction described above generic 150mg bupropion depression fracture definition. They are not ‘patented’ in the western sense of the word because there are no exclusive rights to the formula. All Chinese patent medicines of the same name have the same proportions of ingredients. A medicine known as ‘four gentleman decoction’ (si jun zi tang) is an example of such a product. The formula comprises: • Main herb: Radix panax ginseng (ren shen), to enhance spleen qi • Associate: Rhizoma atractylodis macrocephalae (bai zhu), to strengthen the spleen and dry off the ‘dampness’ • Adjuvant: Sclerotium poriae cocos (fu ling), to assist the main and associate herbs • Guide: Radix glycyrrhizae uralensis (zhi gan cao), to harmonise the other three herbs and regulate spleen qi. Under the Drug Administration Act 2001 post-marketing surveillance of adverse drug reactions is mandatory in China. Whenever an adverse reaction event occurs, the manufacturer, the medical institutions and the seller are obliged to report it. The main legislation requires that medicines placed on the market must have a licence, which requires meeting standards of safety, quality and efficacy. These licensing conditions pose inappropriate demands on most herbal medicines, because plants are chemically complex and variable, active constituents are not always known and the huge costs cannot be recouped through patenting. Under the 1968 Act, herbal remedies are exempt from the licensing requirement if either the herbal remedy is made up on the premises from which it is supplied, after a one-to-one consultation (Section 6. These exemptions only apply to plant remedies, so medicines containing non-plant ingredients require a medicine licence. In recent years these provisions, which provide no specific regulation for herbal medicines, have been considered inadequate to ensure their safety and quality. There are a number of reasons including: adverse effects from some herbal ingredients (natural does not mean safe); misidentification of some Figure 6. Traditional Chinese medicine | 159 herbs and occasional substitution of toxic for safe species; illegal inclusion of prescription-only drugs or heavy metals in some ‘herbal’ medicines; microbial contamination; and discovery of problematic herb–drug interactions. This establishes a registration scheme for industrially produced over-the-counter herbal medicines, under which manufacturers have to demonstrate safety and quality, but not efficacy. Quality is guided by European good manufacturing practice, and safety is protected by requiring evidence of at least 30 years of safe use, of which at least 15 years must be within the European Community. There is a lead-in time to allow manufacturers and suppliers to make the necessary adjustments, but after 2011 any over-the-counter herbal product that is not registered under this scheme will be illegal. This lead time is, however, only for products that were on the market before April 2004. Such medicines will not have to be licensed and, because they are not industrially produced, will not have to be registered under the European Directive. There are, however, concerns about the quality and safety of herbal medicines supplied by this route. The issue is how to strengthen the public’s protection while preserving their access to herbal medicines. First, members of the statutory register can be tied, through a codes of practice, to suppliers that have been audited and demonstrated satisfactory standards of quality assurance. The Register of Chinese Herbal 160 | Traditional medicine Medicine has provided a good model for such an arrangement through its Approved Suppliers scheme. As it will be illegal to practise under the title of herbalist or Chinese medicine practitioner without membership of the register, the public will have stronger assurance about the quality of Section 6. Second, some more potent items in the materia medica can be restricted to use by registered practitioners. These are unlicensed medicines that would be considered industrially produced and thus, once the European directive is in force, would have to be registered under that scheme in order to remain legal. However, it seems likely that most of these patents would be considered unsuitable for registration under the European directive, because even if they met the tough quality assurance standards, most would not be suitable for over-the-counter use. On the other hand, they are industrially produced, so they could not be supplied under the normal Section 6.
