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WaterSense is a U.S. Environmental Protection Agency program designed to encourage water efficiency in the United States through the use of a special label on consumerproducts. It was launched in June, 2006.
WaterSense is a partnership program sponsored by the U.S. Environmental Protection Agency (EPA) with the goal of protecting the future of the US's water supply. By promoting and enhancing the market for water efficient products and services, WaterSense makes every drop count by leveraging relationships with key utility, manufacturer and retail partners across the U.S.
WaterSense is not a regulatory program, but rather a voluntary program. EPA develops specifications for water efficient products through a public process. If a manufacturer makes a product that meets those specifications, the product is eligible for third-party testing to ensure the stated efficiency and performance criteria have been met. If the product passes the test, the manufacturer is rewarded with the right to put the WaterSense label on that product.
WaterSense makes it easy for consumers to differentiate among products that use less water and reinforces that saving water is easy and does not require a major lifestyle change.
Toilets (HETs), bathroomsinkfaucets (and accessories), flushing urinals, single family new homes, showerheads and irrigation professionals who have undergone training by WaterSense-labeled certification programs are all products/services that are readily available to consumers.
Products that seek the WaterSense label must:
-Achieve national water savings
-Provide measurable results
-Perform as well as or better than similar products in the same category
-Be water efficient, using at least 20 percent less water than EPA's fixture specific water use baseline
To help get products on shelves and spread the word about WaterSense, EPA recruits partners in several different categories including:
-Utilities, communities, state and local governments
-Organizations that provide qualified certification programs
-Non-profits and trade associations
Partner responsibilities include:
-Promoting WaterSense as well as water efficiency
-Adhering to WaterSense partner logo guidelines
-Providing annual data
-Granting EPA rights to use partner name on the EPA web site or alongside other program promotional efforts.
WaterSense also utilizes promotional partners who endorse and publicize the program among their constituents. Promotional partners include utilities, state and local governments, trade associations, and other non-governmental organizations.
Landscape irrigation professionals who are certified by WaterSense-labeled certification programs can also become partners.
EPAâ€™s first specification, released in January, 2007, was written for WaterSense labeled Toilets. To date, final specifications have also been written for bathroom sink faucets, flushing urinals, new single family homes, showerheads and certification programs for irrigation professionals.
A draft specifications has been issued for landscape irrigation controllers.
Specifications for pre-rinse spray valves and water softeners are currently under development.
- [http://www.epa.gov/watersense The Official WaterSense Web Site]
- [http://www.epa.gov/watersense/products Available WaterSense-Labeled Products]
Liver disease (also called hepatic disease) is a broad term describing any single number of diseases affecting the liver. Many are accompanied by jaundice caused by increased levels of bilirubin in the system. The bilirubin results from the breakup of the hemoglobin of dead red blood cells; normally, the liver removes bilirubin from the blood and excretes it through bile. Diseases Hepatitis, inflammation of the liver, caused mainly by various viruses but also by some poisons (e.g. alcohol), autoimmunity (autoimmune hepatitis) or hereditary conditions. Diagnosis is done by checking levels of Alanine transaminase Non-alcoholic fatty liver disease, a spectrum in disease, associated with obesity and characterized as an abundance of fat in the liver; may lead to a hepatitis, i.e. steatohepatitis and/or cirrhosis. Cirrhosis is the formation of fibrous tissue in the liver from replacing dead liver cells. The death of the liver cells can be caused by viral hepatitis, alcoholism or contact with other liver-toxic chemicals. Diagnosis is done by checking levels of Alanine transaminase and Asparatine transaminase (SGOT). Haemochromatosis, a hereditary disease causing the accumulation of iron in the body, eventually leading to liver damage. Cancer of the liver (primary hepatocellular carcinoma or cholangiocarcinoma and metastatic cancers, usually from other parts of the gastrointestinal tract). Wilson's disease, a hereditary disease which causes the body to retain copper. Primary sclerosing cholangitis, an inflammatory disease of the bile duct, likely autoimmune in nature. Primary biliary cirrhosis, autoimmune disease of small bile ducts. Budd-Chiari syndrome, obstruction of the hepatic vein. Gilbert's syndrome, a genetic disorder of bilirubin metabolism, found in about 5% of the population. Glycogen storage disease type II, the build-up of glycogen causes progressive muscle weakness (myopathy) throughout the body and affects various body tissues, particularly in the heart, skeletal muscles, liver and nervous system. There are also many pediatric liver disease, including biliary atresia, alpha-1 antitrypsin deficiency, alagille syndrome, and progressive familial intrahepatic cholestasis, to name but a few. Diagnostic Symptoms of a diseased liver The external signs include a coated tongue, itchy skin, excessive sweating, offensive body odor, dark circles under the eyes, red swollen and itchy eyes, acne rosacea, brownish spots and blemishes on the skin, flushed facial appearance or excessive facial blood vessels. Other symptoms include jaundice, dark urine, pale stool, bone loss, easy bleeding, itching, small, spider-like blood vessels visible in the skin, enlarged spleen, fluid in the abdominal cavity, chills, pain from the biliary tract or pancreas, and an enlarged gallbladder. The symptoms related to liver dysfunction include both physical signs and a variety of symptoms related to digestive problems, blood sugar problems, immune disorders, abnormal absorption of fats, and metabolism problems. The malabsorption of fats may lead to symptoms that include indigestion, reflux, deficit of fatsoluble vitamins, hemorrhoids, gall stones, intolerance to fatty foods, intolerance to alcohol, nausea and vomiting attacks, abdominal bloating, and constipation. Nervous system disorders include depression, mood changes, especially anger and irritability, poor concentration and "foggy brain", overheating of the body, especially the face and torso, and recurrent headaches (including migraine) associated with nausea. The blood sugar problems include a craving for sugar, hypoglycaemia and unstable blood sugar levels, and the onset of type 2 diabetes. Abnormalities in the level of fats in the blood stream, whether too high or too low levels of lipids in the organism. Hypercholesterolemia: elevated LDL cholesterol, reduced HDL cholesterol, elevated triglycerides, clogged arteries leading to high blood pressure heart attacks and strokes, build up of fat in other body organs (fatty degeneration of organs), lumps of fat in the skin (lipomas and other fatty tumors), excessive weight gain (which may lead to obesity), inability to lose weight even while dieting, sluggish metabolism, protuberant abdomen (pot belly), cellulite, fatty liver, and a roll of fat around the upper abdomen (liver roll) etc. Or too low levels of lipids: hypocholesterolemia: low total cholesterol, low LDL and VLDL cholesterol, low triglyderides. Liver function tests A number of liver function tests are available to test the proper function of the liver. These test for the presence of enzymes in blood that are normally most abundant in liver tissue, metabolites or products. Imaging Treatment of liver diseases The only real treatment for chronic liver disease at present is a liver transplant. However, there are some promising drugs currently being tested such as Sulfasalazine which have the potential to aid regeneration by blocking special proteins that stop liver regeneration. This can enable the liver to partially or totally regenerate. Unfortunately at present, this drug is not being used as it is in clinical trials. Other treatments involve using stem cells that could be injected into the patient's damaged liver and regenerate the organ, but this is in its infancy as well.
An infectious disease is a clinically evident illness resulting from the presence of pathogenicbiological agents, including pathogenic viruses, pathogenic bacteria, fungi, protozoa, multicellular parasites, and aberrant proteins known as prions. These pathogens are able to cause disease in animals and/or plants. Infectious pathologies are also called communicable diseases or transmissible diseases due to their potential of transmission from one person or species to another by a replicating agent (as opposed to a toxin).
Transmission of an infectious disease can occur through one or more of diverse pathways including physical contact with infected individuals. These infecting agents may also be transmitted through liquids, food, body fluids, contaminated objects, airborne inhalation, or through vector-borne spread. Transmissible diseases which occur through contact with an ill person or their secretions, or objects touched by them, are especially infective, and are sometimes referred to as contagious diseases. Infectious (communicable) diseases which usually require a more specialized route of infection, such as vector transmission, blood or needle transmission, or sexual transmission, are usually not regarded as contagious, and thus are not as amenable to medical quarantine of victims.
The term infectivitydescribes the ability of an organism to enter, survive and multiply in the host, while the infectiousness of a disease indicates the comparative ease with which the disease is transmitted to other hosts. Aninfection however, is not synonymous with an infectious disease, as an infection may not cause important clinical symptoms or impair host function.
Among the almost infinite varieties of microorganisms, relatively few cause disease in otherwise healthy individuals. Infectious disease results from the interplay between those few pathogens and the defenses of the hosts they infect. The appearance and severity of disease resulting from any pathogen depends upon the ability of that pathogen to damage the host as well as the ability of the host to resist the pathogen. Infectious microorganisms, or microbes, are therefore classified as either primary pathogens or as opportunistic pathogens according to the status of host defenses.
Primary pathogens cause disease as a result of their presence or activity within the normal, healthy host, and their intrinsic virulence (the severity of the disease they cause) is, in part, a necessary consequence of their need to reproduce and spread. Many of the most common primary pathogens of humans only infect humans, however many serious diseases are caused by organisms acquired from the environment or which infect non-human hosts.
Organisms which cause an infectious disease in a host with depressed resistance are classified as opportunistic pathogens. Opportunistic disease may be caused by microbes that are ordinarily in contact with the host, such as pathogenic bacteria or fungi in the gastrointestinal or the upper respiratory tract, and they may also result from (otherwise innocuous) microbes acquired from other hosts (as in Clostridium difficilecolitis) or from the environment as a result of traumatic introduction (as in surgical wound infections or compound fractures). An opportunistic disease requires impairment of host defenses, which may occur as a result of genetic defects (such as Chronic granulomatous disease), exposure to antimicrobial drugs or immunosuppressive chemicals (as might occur following poisoning or cancerchemotherapy), exposure to ionizing radiation, or as a result of an infectious disease with immunosuppressive activity (such as with measles, malaria or HIV disease). Primary pathogens may also cause more severe disease in a host with depressed resistance than would normally occur in an immunosufficient host.
One way of proving that a given disease is "infectious", is to satisfy Koch's postulates (first proposed by Robert Koch), which demands that the infectious agent be identified only in patients and not in healthy controls, and that patients who contract the agent also develop the disease. These postulates were first used in the discovery that Mycobacteria species cause tuberculosis. Koch's postulates cannot be met ethically for many human diseases because they require experimental infection of a healthy individual with a pathogen produced as a pure culture. Often, even diseases that are quite clearly infectious do not meet the infectious criteria. For example, Treponema pallidum, the causativespirochete of syphilis, cannot be
Disease registries are collections of secondary data related to patients with a specific diagnosis, condition, or procedure. Registries are different from indexes in that they contain more extensive data.
In its most simple form, a disease registry could consist of a collection of paper cards kept inside "a shoe box" by an individual physician. Most frequently registries vary in sophistication from simple spreadsheets that only can be accessed by a small group of physicians to very complex databases that are accessed online across multiple institutions.
They can provide health providers (or even patients) with reminders to check certain tests in order to reach certain quality goals.
Disease Registries versus Electronic Medical Records
Registries are less complex and simpler to setup than Electronic Medical Records that according to a recent survey are only used by 9% of small offices where almost half of the US doctors work.
An electronic medical record keeps track of all the patients a doctor follows but a registry only keeps track of a small sub population of patients with a specific condition.
Types of medical conditions tracked by Disease Registries
More than 130 million Americans live with chronic diseases and chronic diseases account for 70% of all deaths in the US."The medical care costs of people with chronic diseases account for more than 75% of the nationâ€™s $2 trillion medical care costs."
Registries target certain conditions because medical expenses are unevenly distributed: most health care expenses are spent treating patients with a few chronic conditions.
For example, the 2002 expenses with diabetes in the US was $132 billion in 2002, and this was around 12% of the US medical budget. Diabetes accounts for 25% of the Medicare budget. Given this - diabetes is one of the conditions targeted by registries. Diabetes is also amenable to this because there is a target population that can be defined according to certain rules and there is evidence that certain tests like retina exams, LDL levels, HgbA1c levels can correlate with quality of care in diabetes.
Because of the diabetes impact, the New York City created a HgA1C Registry (NYCAR) to help health providers keep track of patients with diabetes.
Another example of disease registry is the New York State CABG Registry that tracks all cardiac bypass surgery performed in the state of New York
On a survey of 1040 US physician organizations published in Journal of the American Medical Association , diabetes registries are used by 40.3%, asthma registries are used by 31.2% of physician organizations, CHF registries are used by 34.8% and depression registries are used by 15.7%.
Other tests like pap smears are also useful to keep track in registries because there is evidence that when done annually in women of certain ages groups can detect and prevent cervical cancer.
Medical Devices Registries
Countries like Australia, Britain, Norway and Sweden have national patient registries that track patients with artificial joints. "But the United States lacks such a national database, called a joint registry, that tracks how patients with artificial hips and knees fare. The risk in the United States that a patient will need a replacement procedure because of a flawed product or technique can be double the risk of countries with databases, according to Dr. Henrik Malchau of Massachusetts General Hospital.
"The use of joint registries has proven beneficial abroad. In Australia, regulators use such data to force manufacturers to justify why poorly performing hips or knees should remain available, and products have been withdrawn as a result. In Sweden several years ago, surgeons alerted by their national registry stopped using a badly flawed hip long before their American counterparts did. A few medical organizations here, like Kaiser Permanente, operate their own registries to good effect and the Hospital for Special Surgery in New York has recently set up a registry. Experts say that the United States wastes billions of dollars annually on medical treatments which may not work. But the financial and human consequences are also large when evidence exists but is not collected."
Cost-Effectiveness of Disease Registries
The cost-effectiveness of a disease registry is related with the cost-effectiveness of prevention of specific medical conditions. Increasing compliance through a registry with preventive measures like children vaccination or colonoscopy screening can actually be a cost-saving measure. "A mammogram every 2 years for women aged 50â€“69 costs only about $9,000 per year of life saved. This cost compares favorably with other widely used clinical preventive services."
Disease registries and Pay-for-Performance (P4P)
Registries can be associated with pay-for-performance (P4P) quality based contracts for individual doctors, groups of doctors or even all doctors in a country. For example the United Kingdom, rewards physicians according to 146 quality measures related with 10 chronic diseases that are tracked electronically.
In the United States, Medicare also started a 1.5% P4P contract based on health measures that can be tracked by disease registries.
Technical Aspects of Data Tracking
The quality of a disease registry is based on the quality of data fed into it and all the processes involved in updating it and keeping its integrity. In every registry there is always a risk of "Garbage In, Garbage Out". Issues that can affect a registry and its acceptance by a physician group:
- Is the registry only updated centrally or can a physician update or correct it? For example, a physician doesn't want to get reminders from a registry regarding diabetes patients that died, moved to another state or left her/his practice.
- Most frequently, a list of patients with a certain condition (e.g. diabetes) is generated based on certain criteria. In the U.S., Healthcare Effectiveness Data and Information Set (HEDIS) criteria are set annually by the National Committee for Quality Assurance (NCQA). These criteria, in order to avoid paper charts reviews are in most cases based on insurance claims. For example for diabetes, HEDIS selects an eligible population based on Age (18-75 years), continuous enrollment with a certain health insurer and certain "Events/diagnosis" from Pharmacy data (electronic), Insurance Claims data (electronic) or from medical records. Pharmacy data is based on a list of medications prescribed for diabetes Claims data is based on having two outpatient visits with a doctor or one inpatient hospital admission or one Emergency Room visit with the diagnosis of diabetes. Patients are excluded if they have polycystic ovaries or just gestational diabetes. Despite the strict criteria it is possible for physicians to have patients on their registries that are not truly diabetic.
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Answers:You could think of the brain as the "master" sensory organ. The eyes, ears, skin, etc. are all sensory organs that transmit information about the environment to the brain, but the brain interprets the signals and combines them into a coherent representation of the physical world. Without the brain, you would just have a bunch of meaningless, useless signals (and you would be dead...;) In some ways this is a philosophical question, but I don't believe the physical world is "not at all like" what we perceive it to be. Rather, we perceive only a small portion of the real world, but the part we can perceive is indeed accurate. If that WASN'T the case, we wouldn't be able to interact effectively with the physical world. For example, we can see, with our naked eyes, where an illuminated light bulb is. This is because receptors in our eyes react to part of the radiation emitted by the filament in the light bulb, and our brains know how to interpret this information to tell us where the light bulb is, what shape it is, how far we have to reach out to touch it, etc. Thus, we can accurately throw something at the light bulb and hit it, reach out to unscrew it, aim it so we can see the book we're reading, etc. Of course, the light bulb also emits a lot of radiation that we can't perceive without the aid of technology; "visible" light is only a small part of the electromagnetic spectrum. Does this mean the light bulb is not at all like how we perceive it? Of course not. Our perception of the light bulb is related to, and based upon, the actual light bulb. Just because we can't perceive every single bit of information about the light bulb doesn't mean the bits we CAN perceive are baseless. Just as a side note: we actually have many sensory modalities and sub-modalities on which to base our perceptions, not just five. In addition to touch, taste, smell, sight, and hearing, we have a sense of balance and acceleration (vestibular system), a sense of our body's position in space (proprioception), a sense of heat and cold, pressure and pain. We perceive the physical world through all of these modalities, and the brain is really quite good at synthesizing these very different kinds of information into a single coherent perception.
Answers:No need to beg any one. They should all contribute. Ovaries: Ovarian cysts. Atrophy. Fallopian duct: Salpingitis. Uterus: Endometritis Testicle; Orcitis. General: Venereal diseases. ADS.
Answers:Because some people are born with a certain gene, that makes them addictive to alcohol. Thus, the disease. More and more research indicates that genes and chemical make-up may contribute and possibly trigger addictive behaviors. A true alcoholic doesn't have the choice of whether or not to drink; it's a physical addiction. Alcoholism is now accepted as a disease. It is a chronic and often progressive disease. Like many diseases, it has symptoms that include a strong need to drink despite negative consequences, such as serious job or health problems. Like many diseases, it has a generally predictable course and is influenced by both genetic (inherited) and environmental factors. Alcoholism is inherited. Alcoholism tends to run in families and genetic factors partially explain this pattern. The genes that influence the vulnerability to alcoholism are under investigation Alcoholism is an environmental disease. A person's environment, such as the influence of friends, stress levels, and the ease of obtaining alcohol, may influence their drinking and the development of alcoholism. Still other factors, such as social support, may help to protect even high-risk people from alcohol problems. Alcoholics tend to solve emotional problems by drinking. Alcohol addiction is also a physical disease, probably of an allergic nature, . . . consider the main cause to be emotional maladjustment. It is an atttempt on the part of the alcoholics to solve emotional problems by drinking. An alcoholic should be regarded as a sick person, just as one who is suffering from tuberculosis, cancer, heart disease, or other serious chronic disorder. The body of the alcoholic is quite as abnormal as his mind.There is a sense of powerlessness over alcohol, the surrender to hopelessness and desperation. .and a sense of out of self- control. The term alcoholic may trouble some, but we need not get into distinctions between alcohol abuse and alcohol dependence, problem drinking or chronic alcoholism. Drinkers who can stop drinking but who apparently cannot stay stopped. They want to stop getting drunk. They mean to stop getting drunk. They resolve to stop getting drunk. But their experience tells them, time and time and time again, that they cannot stop getting drunk. They are not looking here for scientific precision: but the goal is rather human experience At times, scientists, clinicians and others debate whether or not to call alcoholism a disease. Usage of the term is usually acceptable if it is properly defined. When one considers the wide scope of damage that alcoholism does to the human body, mind and spirit, the condition can, indeed, be legitimately described as having become a disease. Over a period of time, alcohol abuse alters brain-cell function, induces nerve damage, shrinks the cerebral cortex, imbalances the hormonal system and damages vital organs. Scientists have found that repetitive alcohol abuse wreaks a certain common havoc on the psyche that is perhaps even more insidious than the damage sustained by the liver, the heart and other vital organs. During early and middle stages, alcoholics may be able to function, but their productivity will be progressively hampered; their psychological disequilibrium will magnify small problems and render them unable to cope effectively with stress. This altered state of psyche will prevent them from seeing the reality of a situation and thwart the normal process of emotional maturing that enables people to assimilate and learn from lessons of experience. The condition of alcoholics changes them into people who think, act and feel differently than they should. Because alcohol blurs effective insight into the way alcoholics look on things, it is commonly impossible for others to reach them about what their drinking is doing until they hit the bottom or are confronted with a serious problem. Victims are so dependent upon alcohol to function or feel well that they feel there is nothing abnormal about their drinking. They delude themselves (perhaps one should say, lie to themselves) that they don t have a drinking problem. Many feel this way because they aren t derelicts or Skid Row types. Some of the most serious diseases associated with chronic alcohol abuse include cancer of the liver, larynx, esophagus, stomach, colon and breast. Alcoholism may also lead to high blood pressure, stroke and heart attack; damage to the brain, pancreas and kidney; produce stomach and duodenal ulcers, colitis, birth defects and fetal alcohol syndrome, impotence and infertility, premature aging, sleep disturbances, muscle cramps, diminished immunity and other diseases.such as cirrhosis of the liver, hepatitis; pancreatitis, GI bleeding; and liver and kidney failure.and DT's( delirium tremens) Alcohol abuse and cigarettes are one of the worst possible combinations, greatly increasing the risk of heart disease and cancer. Calling the condition of alcoholism a disease is not a cop-out for alcoholics. To the contrary, when alcoholics become aware of the far-reaching damaging effects of their condition to their own minds, lives, families and society, they have more responsibility, not less, for seeking treatment. My answer is well supported by a lot of reading materials and my very own nursing experience with alcoholics.