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Disabled

Disabled

The term "disability", as it is applied to humans, refers to any condition that impedes the completion of daily tasks using traditional methods. National governments and global humanitarian agencies have narrowed this definition for their own purposes.

Demographics of disability

Many books on disability and disability rights point out that the disabled community is one of very few groups of people that one doesn't have to be born into, as disability can develop later in life as well. Some disability rights activists use an acronym, TAB, humorously to point this out: TAB stands for "temporarily able-bodied" as a reminder that many become disabled as they join the ranks of the elderly. In most areas of the world, but especially in developed countries, the number of people with disabilities is growing and becoming a more significant percentage of the population because medicine is allowing more people to live who might have otherwise died in less advanced times.

Types of disability

"Disability" can be broken down into a number of broad sub-categories, which can include the following:
- Physical impairments affecting movement, such as muscular dystrophy, post-polio syndrome, spina bifida and cerebral palsy.
- Sensory impairments, such as visual or hearing impairments.
- Neurological impairments, such as epilepsy or dysautonomia.
- Cognitive impairments such as Autism or Down Syndrome.
- Psychiatric conditions such as depression and Schizophrenia. Some disabilities are not obvious to outside observers; these are termed invisible disabilities. A person may be impaired either by a correctable condition such as myopia, or by an unchangeable one such as cerebral palsy. For those with mild conditions, related impairments can improve or disappear with the application of corrective devices. More serious impairments call for adaptive equipment. A list of disabilities can never be complete or finalized because individuals, organizations, and governments define disabilities differently.

The evolution of a movement

Historically, disabilities have often been cast in a negative light. An individual thus affected was seen as being a “patient” subject either to cure or to ongoing medical care. His condition is seen as disabling; the social reactions to it are justified, and the barriers unavoidable. This position is known as the medical model of disability. Over the past 20 years, a competing view known as the social model of disability has come to the fore. In this model, disability is seen more as a social construction than a medical reality. Disabled activists, such as Tom Shakespeare (2002), argue that although their impairments may cause them pain or discomfort, what really dis-ables people as members of society is a socio-cultural system which does not recognise their right to genuine equality. Both the medical and social models agree, to a point, that facilities and opportunities should be made as accessible as possible to individuals who require adaptations. Dismantling physical barriers, or setting up adaptations such as wheelchair ramps, is known as "fostering accessibility". A human rights based approach has been adopted by many organizations of and for people with disabilities. In 2000, for example, the United Nations Assembly decided to start working on a comprehensive convention for the rights of people with disabilities. Since 2002 the "UN Ad-Hoc meeting" gathers every six months to discuss the content of this UN convention. These meetings are open for Non-Government-Organisations and Disabled Peoples' Organisations. An approach that has led to tangible improvements in the lives of people with disabilities in many countries has been the Independent Living Movement. The term "Independent Living" was taken from 1959 California legislation that enabled people disabled by polio to leave hospital wards and move back into the community with the help of cash benefits for the purchase of personal assistance with the activities of daily living. With its origins in the US civil rights and consumer movements of the late 1960s, the movement and its philosophy have since spread to other continents influencing disabled people's self-perception, their ways of organizing themselves and their countries' social policy. The disability rights movement began in the 1970s and is largely responsible for the shift toward independent living and accessibility.

The language and terminology of disability

Many people use the term disability to replace the designation handicapped. While these two designations are often used interchangeably, proponents of the social model of disability use the latter term to describe the social and economic consequences of the former; i.e., an individual with a physical or intellectual disability is said to be "handicapped" by the bias of society towards ability (e.g., a building without an elevator handicaps a person who uses a wheelchair). Similarly, in the United Kingdom, people within the disability rights movement commonly use the term "disabled" to denote someone who is "disabled by society's inability to accommodate all of its inhabitants." The Person First Movement has added another layer to this discourse by asking that people with disabilities be identified first as individuals. For example, within this movement the term “woman who is blind” is preferred over "blind woman." Some people with disabilities support the Person First Movement, while others do not. People who are Deaf in particular may see themselves as members of a specific community, properly called the Deaf culture, and so will reject efforts designed to distance them from the central fact of their identity. This is a view that is becoming increasingly prevalent within other disabled communities, that are becoming self-aware and self defining by seeing their impairments as a central part of their upbringing, education, personality & Lifestyle. The American Psychological Association style guide devotes a large section to the discussion of individuals with disabilities, and states that in professional writing following this style, the person should come first, and nominal forms describing the disability should be used so that the disability is being described, but is not modifying the person. For instance, "people with autism," "man with schizophrenia," "girl with paraplegia." Similarly, a person's adaptive equipment should be described functionally as something that assists a person, not as something that limits a person. "A woman who uses a wheelchair" -- she is not "in" it or "confined" to it, and she leaves it at the very least for sleeping and bathing. "A communication aid user." "A girl who uses a ventilator." "A man who takes antipsychotic medications to optimize his daily functioning." Many people with disabilities especially dislike "disabled person" or "the disabled," as this implies that one's overall "personness" is defective, while "person with a disability" acknowledges the disability without implying anything about the overall person. However, according to the "social model", as it is society that disables a person, the reality of being a "person with a disability" is not really possible because it is impossible for an individual to "have" a society, therefore the term "disabled person" does not signify the lack of one's own "person-ness" but points an accusing finger at society for excluding those with impairments. See also List of disability-related terms with negative connotations

Well-known people with disabilities

Many people with disabilities have contributed to society. These include:
- American president Franklin Roosevelt (impaired movement as the result of polio),
- classical composer Ludwig von Beethoven (deaf in later years),
- King Richard III of England (childhood sickness allowed bones to malform, resulting in severe curvature of the back and extremely uneven legs)
- musician Stevie Wonder (blind)
- jazz pianist Marcus Roberts (blind)
- musician Ray Charles (blind)
- Def Leppard drummer Rick Allen (lost left arm in a car accident),
- comedian, actor, author, and monologist Greg Walloch (cerebral palsy),
- civil rights activist Helen Keller (deaf and blind),
- Cole Porter, musical theater composer (lost legs after riding accident)
- Classical actress Sarah Bernhardt (lost leg after a nasty fall)
- Stephen Hawking (who has Motor Neurone Disease and uses a wheelchair and speech synthesizer),
- Deng Pufang - has paraplegia
- British rock and roll singer/songwriter Ian Dury
- Nicaraguan guitar player, singer and songwriter Tony Melendez (born without arms)
- Major league pitcher Jim Abbott (born without a right hand)
- Actress Marlee Matlin (deaf)
- Joseph Merrick ("the Elephant Man", severe neurofibromatosis)
- Christopher Reeve, actor famous for portraying Superman who became a quadriplegic after a horse-riding accident,
- for others see list of people with disabilities.

References

- Tom Shakespeare, Genetic Politics: from Eugenics to Genome, with Anne Kerr (New Clarion Press, 2002).

External links

- [http://www.aapd.com/ American Association of People With Disabilities]
- [http://www.wapd.org/ World Association of Persons with Disabilities]
- [http://www.disabilityhistory.org/ The Disability Social History Project]
- [http://www.independentliving.org/ Independent Living Institute]
- [http://www.un.org/esa/socdev/enable/rights/adhoccom.htm UN Enable]
- [http://www.nad.org/ National Association of the Deaf (United States)]
- [http://www.icdri.org/ The International Center for Disability Resources on the Internet]
- [http://www.disabledcommunity.org/ DisabledCommunity.Org (United States)]
- [http://www.disabilitysecrets.com/questions.html Social Security Disability FAQ (United States)]
- [http://www.disabled-world.com/ Disabled World Disability news and articles]
- [http://www.officecentralcardiff.co.uk/index.php?action=disability_act OfficeCentral: Disability In The Workplace]
- [http://www.dlf.org.uk/ Disabled Living Foundation (UK)]
- [http://www.asksource.info/res_library/disability.htm Source - International Information Support Centre]
- [http://www.iddc.org.uk International Disability and Development Consortium]
- [http://health.groups.yahoo.com/group/Friends_of_Precious_People/ Friends of Precious People - Friendship and support forum for people with various disabilities, illnesses or conditions and their relatives and friends.] Category:Disability ja:障害者 th:คนพิการ

Human

Humans or human beings define themselves in biological, social, and spiritual terms. Biologically, humans are classified as the species Homo sapiens (Latin for "wise man" or "thinking man"): a bipedal primate of the superfamily Hominoidea, together with the other apes: chimpanzees, gorillas, orangutans, and gibbons. Humans have an erect body carriage that frees their upper limbs for manipulating objects and a highly developed brain capable of abstract reasoning, speech, language, and introspection. Bipedal locomotion appears to have evolved before the development of a large brain. The origins of bipedal locomotion and of its role in the evolution of the human brain are topics of ongoing research. The human mind has several distinct attributes. It is responsible for complex behaviour, especially language. Curiosity and observation have led to a variety of explanations for consciousness and the relation between mind and body. Psychology attempts to study behaviour from a scientific point of view. Religious perspectives emphasise a soul, qi or atman as the essence of being, and are often characterised by the belief in and worship of God, gods, spirits, or other people. Philosophy, especially philosophy of mind, attempts to fathom the depths of each of these perspectives. Art, music and literature are often used in expressing these concepts and feelings. Like all primates, humans are inherently social. They create complex social structures composed of co-operating and competing groups. These range from nations and states down to families. Seeking to understand and manipulate the world around them has led to the development of technology and science. Artifacts, beliefs, myths, rituals, values, and social norms have all helped to form humanity's culture.

Terminology

In general, the word "people" is a collective or plural term for any specific group of individual persons. However, when used to refer to a group of humans possessing a common ethnic, cultural or national unitary characteristic or identity, "people" is a singular count noun, and as such takes an "s" in the plural (examples: "the English-speaking peoples of the world", "the indigenous peoples of Brazil"). ethnic Juvenile males are called boys, adult males men, juvenile females girls, and adult females women. Humans are commonly referred to as persons or people, and collectively as Man (capital M), mankind, humankind, humanity, or the human race. Until the 20th century, "human" was only used adjectivally ("pertaining to mankind"). Nominal use of "human" (plural "humans") is short for "human being", and not considered good style in traditional English grammar. As an adjective, "human" is used neutrally (as in "human race"), but "human" and especially "humane" may also emphasise positive aspects of human nature, and can be synonymous with "benevolent" (versus "inhumane"; cf. humanitarian). A distinction is maintained in philosophy and law between the notions "human being", or "man", and "person". The former refers to the species, while the latter refers to a rational agent (see, for example, John Locke's Essay concerning Human Understanding II 27 and Immanuel Kant's Introduction to the Metaphysic of Morals). The term "person" is thus used of non-human animals, and could be used of a mythical being, an artificial intelligence, or an extraterrestrial. An important question in theology and the philosophy of religion concerns whether God is a person. In Latin, "humanus" is the adjectival form of the noun "homo", translated as "man" (to include males and females). The Old English word "man" could also have this generic meaning, as demonstrated by such compounds as "wifman" ("female person") → "wiman" → "woman". For the etymology of "man" see mannaz.

Biology

Anatomy and physiology

mannaz] Humans exhibit fully bipedal locomotion. This leaves the forelimbs available for manipulating objects using opposable thumbs. Humans vary substantially around the mean height and mean weight. Some of this variation is explained by locality and historical factors. Although body size is largely determined by genes, it is also significantly influenced by diet and exercise. The mean height of a North American adult female is 162 centimetres (5 feet 4 inches) and the mean weight is 62 kilograms (137 pounds). North American adult males are typically larger: 175 centimetres (5 feet 9 inches) and 78 kilograms (172 pounds). Human skin appears to be relatively hairless in comparison to other primates; however, most humans have a larger number of hairs on their body than a chimpanzee. The main difference is that human hairs are shorter, finer, and less coloured then the average chimpanzee's, thus rendering them harder to see. The colour of human hair and skin is determined by the presence of coloured pigments called melanins. Most researchers believe that skin darkening was an adaptation that evolved as a defence against UV solar radiation; melanin is an effective sunblock. The skin colour of contemporary humans can range from very dark brown to very pale pink. It is geographically stratified and in general correlates with the environmental level of UV. Human skin and hair colour is controlled in part by the MC1R gene. For example, the red hair and pale skin of some Europeans is the result of mutations in MC1R. Human skin has a capacity to darken (sun tanning) in response to UV exposure. Variation in the ability to sun tan is also controlled in part by MC1R. sun tanning] Because humans are bipedal, the pelvic region and spinal column tend to become worn, creating locomotion difficulties in old age. The individual need for regular intake of food and drink is prominently reflected in human culture, and has led to the development of food science. Failure to obtain food leads to hunger and eventually starvation, while failure to obtain water leads to dehydration and thirst. Both starvation and dehydration cause death if not alleviated. In modern times, obesity amongst humans has increased to almost epidemic proportions, leading to health complications and increased mortality in some developed countries, and is becoming problematic elsewhere. The average sleep requirement is between seven and eight hours a day for an adult and nine to ten hours for a child. Elderly people usually sleep for six to seven hours. It is common, however, in modern societies for people to get less sleep than they need, leading to a state of sleep deprivation. The human body is subject to an ageing process and to illness. Medicine is the science that explores methods of preserving bodily health.

Life cycle

health] The human life cycle is similar to that of other placental mammals. New human life develops from conception. An egg is usually fertilised inside the female by sperm from the male through sexual intercourse, though in vitro fertilisation methods are also used. The fertilised egg is called a zygote. The zygote divides inside the female's uterus to become an embryo which over a period of thirty-eight weeks becomes the fetus. At birth, the fully grown fetus is expelled from the female's body and breathes independently as a baby for the first time. At this point, most modern cultures recognise the baby as a person entitled to the full protection of the law, though some jurisdictions extend personhood to human fetuses while they remain in the uterus. Compared with that of other species, human childbirth is relatively complicated. Painful labours lasting twenty-four hours or more are not uncommon, and may result in injury to the child or the death of the mother, although the chances of a successful labour increased significantly during the twentieth century in wealthier countries. Natural childbirth remains an arguably more dangerous ordeal in remote, underdeveloped regions of the world, though the women who live in these regions have argued that their natural childbirth methods are safer and less traumatic for mother and child. Natural childbirth Human children are born after a nine-month gestation period, with typically 3–4 kilograms (6–9 pounds) in weight and 50–60 centimetres (20–24 inches) in height in developed countries. [http://www.childinfo.org/eddb/lbw] Helpless at birth, they continue to grow for some years, typically reaching sexual maturity at twelve to fifteen years of age. Boys continue growing for some time after this, reaching their maximum height around the age of eighteen. These values vary too, depending on genes and environment. The human lifespan can be split into a number of stages: infancy, childhood, adolescence, young adulthood, maturity and old age, though the lengths of these stages, especially the later ones, are not fixed. There are striking differences in life expectancy around the world. The developed world is quickly getting older, with the median age around 40 years (highest in Monaco at 45.1 years), while in the developing world, the median age is 15–20 years (the lowest in Uganda at 14.8 years). Life expectancy at birth is 77.2 years in the U.S. as of 2001. [http://www.cdc.gov/nchs/fastats/lifexpec.htm] The expected life span at birth in Singapore is 84.29 years for a female and 78.96 years for a male, while in Botswana, due largely to AIDS, it is 30.99 years for a male and 30.53 years for a female. One in five Europeans, but one in twenty Africans, is 60 years or older, according to The World Factbook. [http://www.cia.gov/cia/publications/factbook] African.]] The number of centenarians in the world was estimated by the United Nations [http://www.un.org/ageing/note5713.doc.htm] at 210,000 in 2002. The maximum life span for humans is thought to be over 120 years. Worldwide, there are 81 men aged 60 or over for every 100 women, and among the oldest, there are 53 men for every 100 women. The philosophical questions of when human personhood begins and whether it persists after death are the subject of considerable debate. The prospect of death may cause unease or fear. People who are near death sometimes have a near-death experience, in which they have visions. Burial ceremonies are characteristic of human societies, often inspired by beliefs in an afterlife. Institutions of inheritance or ancestor worship may extend an individual's presence beyond his physical lifespan (see immortality).

Genetics

Humans are a eukaryotic species. Each diploid cell has two sets of 23 chromosomes, each set received from one parent. There are 22 pairs of autosomes and one pair of sex chromosomes. At present estimate, humans have approximately 20,000–25,000 genes and share 95% of their DNA with their closest living evolutionary relatives, the two species of chimpanzees. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12368483] Like other mammals, humans have an XY sex determination system, so that females have the sex chromosomes XX and males have XY. The X chromosome is larger and carries many genes not on the Y chromosome, which means that recessive diseases associated with X-linked genes affect men more often than women. For example, genes that control the clotting of blood reside on the X chromosome. Women have a blood-clotting gene on each X chromosome so that one normal blood-clotting gene can compensate for a flaw in the gene on the other X chromosome. But men are hemizygous for the blood-clotting gene, since there is no gene on the Y chromosome to control blood clotting. As a result, men will suffer from haemophilia more often than women.

Race and ethnicity

haemophilia, Black, White (Hispanic), and Asian. Top row males, bottom row females.]] Humans often categorise themselves and others in terms of race or ethnicity. In the United States, racial categories are primarily based on language and ethnicity, although biological qualities, such as skin colour, blood type, facial features, ancestry, and other genetic variances are also key factors. Self identification with an ethnic group is usually based on kinship and descent, as well as presumed advantage. When race and ethnicity lead to variant treatment it is thought to impact social identity, giving rise to the theory of identity politics. Although most humans recognise that variances occur within a species, it is often a point of dispute as to what these differences entail, and if discrimination based on race (racism) is acceptable in the early twenty-first century. Race and intelligence, scientific racism, xenophobia and ethnocentrism are just a few of the many basis' for such practices.

Habitat

The view most widely accepted by the anthropological community is that the human species originated in the African savanna between 100 and 200 thousand years BCE, colonised the rest of the Old World and Oceania by 40,000 years BCE, and finally colonised the Americas by 10,000 years BCE. Homo sapiens displaced groups such as Neanderthals and Homo floresiensis through more successful reproduction and competition for resources, and/or extermination. (See Human evolution, Vagina gentium, and Environment of Evolutionary Adaptedness.) Technology has allowed humans to colonise all of the continents and adapt to all climates. Within the last few decades, humans have been able to explore Antarctica, the ocean depths, and space, although long-term habitation of these environments are not yet possible. Humans, with a population of about six thousand million, are one of the most numerous mammals on Earth. Most humans (61%) live in the Asian region. The vast majority of the remainder live in the Americas (14%), Africa (13%) and Europe (12%), with 5% in Oceania. (See list of countries by population and list of countries by population density.) list of countries by population density (The arctic is at the centre of the map and the numbers are millennia before present).]] The original human lifestyle is hunting-gathering, which is adapted to the savanna. Other human lifestyles are nomadism (often linked to animal herding) and permanent settlements made possible by the development of agriculture. Humans have a great capacity for altering their habitats by various methods, such as agriculture, irrigation, urban planning, construction, transport, and manufacturing goods. Permanent human settlements are dependent on proximity to water and, depending on the lifestyle, other natural resources such as fertile land for growing crops and grazing livestock, or seasonally by populations of prey. With the advent of large-scale trade and transport infrastructure, immediate proximity to these resources has become unnecessary, and in many places these factors are no longer the driving force behind growth and decline of population. Human habitation within closed ecological systems in hostile environments (Antarctica, outer space) is expensive, typically limited in duration, and restricted to scientific, military, or industrial expeditions. Life in space has been very sporadic, with a maximum of thirteen humans in space at any given time, starting with Yuri Gagarin's space flight in 1961. Between 1969 and 1974, up to two humans at a time spent brief intervals on the Moon. As of 2005, no other celestial body has been visited by human beings, although there has been a continuous human presence in space since the launch of the initial crew to inhabit the International Space Station on October 31, 2000.

Population

2000 From 1800 to 2000, the human population increased from one to six billion. It is expected to crest at around ten billion during the 21st century. In 2004, around 2.5 billion out of 6.3 billion people lived in urban centres, and this is expected to rise during the 21st century. Problems for humans living in cities include various forms of pollution, crime, and poverty, especially in inner city and suburban slums. Geneticists Lynn Jorde and Henry Harpending of the University of Utah have concluded that the variation in the total stock of human DNA is minute compared to that of other species; and that around 74,000 years ago, human population was reduced to a small number of breeding pairs, possibly as small as 1000, resulting in a very small residual gene pool. Various reasons for this bottleneck have been postulated, the most popular, called the Toba catastrophe theory, being the eruption of a volcano at Lake Toba.

Human evolution

The study of human evolution encompasses many scientific disciplines, but most notably physical anthropology and genetics. The term "human", in the context of human evolution, refers to the genus Homo, but studies of human evolution usually include other hominids and hominines, such as the australopithecines. Biologically, humans are defined as hominids of the species Homo sapiens, of which the only extant subspecies is Homo sapiens sapiens (Latin for "very wise man"); Homo sapiens idaltu (roughly translated as "elderly wise man") is the extinct subspecies. Modern humans are usually considered the only surviving species in the genus Homo, although some argue that the two species of chimpanzees should be reclassified from Pan troglodytes (Common Chimpanzee) and Pan paniscus (Bonobo/Pygmy Chimpanzee) to Homo troglodytes and Homo paniscus respectively, given that they share a recent ancestor with man. [http://news.nationalgeographic.com/news/2003/05/0520_030520_chimpanzees.html] Full genome sequencing resulted in these conclusions: "After 6 [million] years of separate evolution, the differences between chimp and human are just 10 times greater than those between two unrelated people and 10 times less than those between rats and mice." [http://news.ft.com/cms/s/43445728-1a44-11da-b279-00000e2511c8.html Chimp and human DNA is 96% identical] It has been estimated that the human lineage diverged from that of chimpanzees about five million years ago, and from gorillas about eight million years ago. However, in 2001 a hominine skull approximately seven million years old, classified as Sahelanthropus tchadensis, was discovered in Chad and seems to indicate an earlier divergence. Two prominent scientific theories of the origins of contemporary humans exist. They concern the relationship between modern humans and other hominids: The single-origin or "out of Africa" hypothesis proposes that modern humans evolved in Africa and later replaced hominids in other parts of the world. The multiregional hypothesis proposes that modern humans evolved at least in part from independent hominid populations. Human evolution is characterised by a number of important physiological trends:
- expansion of the brain cavity and brain itself, which is typically 1,400 cm³ in volume, over twice that of a chimpanzee or gorilla. The pattern of human postnatal brain growth differs from that of other apes (heterochrony), allowing for an extended period of social learning in juvenile humans. Physical anthropologists argue that a reorganisation of the structure of the brain is more important than cranial expansion itself;
- canine tooth reduction;
- bipedal locomotion;
- descent of the larynx, which makes speech possible. Humans are classified as Homo sapiens sapiens. A camp of physical anthropologists see neanderthalensis as a subspecies and classify the neanderthals as Homo sapiens neanderthalensis. A second camp of physical anthropologists see the neanderthals as a distinct species diverging from the modern human lineage over 500,000 years ago. Under this classification, neaderthals are Homo neanderthalensis. Recent DNA analysis suggests that neanderthalensis were not a subspecies. How these trends are related and what their role is in the evolution of complex social organisation and culture are matters of ongoing debate. larynx]]

Intelligence

Most humans consider their species to be the most intelligent in the animal kingdom. Certainly, humans are the only technologically advanced animal. Along with the brain's internal complexity, the brain to body mass ratio is generally assumed to be a good indicator of relative intelligence. Humans have the second highest ratio, with the tree shrew having the highest [http://www.hindustantimes.com/news/181_935198,00300006.htm], and the bottlenose dolphin very similar to humans. The human ability to abstract may be unparalleled in the animal kingdom. Human beings are one of five species to pass the mirror test — which tests whether an animal recognises its reflection as an image of itself — along with chimpanzees or bonobos, orangutans, and dolphins. Human beings under the age of four usually fail the test.

Culture

dolphin]] Culture is defined here as a set of distinctive material, intellectual, emotional, and spiritual features of a social group, including art, literature, lifestyles, value systems, traditions, rituals, and beliefs. Culture consists of at least three elements: values, social norms, and artifacts. A culture's values define what it holds to be important. Norms are expectations of how people ought to behave. Artifacts — things, or material culture — derive from the culture's values and norms together with its understanding of the way the world functions.

Origins

Essentially every culture has its characteristic origin beliefs. Creationism or creation theology is the belief that humans, the Earth, the universe and the multiverse were created by a supreme being or deity. The event itself may be seen either as an act of creation (ex nihilo) or the emergence of order from preexisting chaos (demiurge). Many who hold "creation" beliefs consider such belief to be a part of religious faith, and hence compatible with, or otherwise unaffected by scientific views while others maintain the scientific data is compatible with creationism. Proponents of evolutionary creationism may claim that understood scientific mechanisms are simply aspects of supreme creation. Otherwise, science-oriented believers may consider the scriptural account of creation as simply a metaphor.

Language

metaphor, Chinese, Korean, Hebrew and Greek]] Values, norms and technology are dependent on the capacity for humans to share ideas. The faculty of speech may be a defining feature of humanity, probably predating phylogenetic separation of the modern population. (See Proto-World language, Origins of language.) Language is central to the communication between humans. Some scientists argue that non-human animals are able to use some form of language too, and that non-human primates are able to learn human sign language [http://www.mnsu.edu/emuseum/cultural/language/chimpanzee.html] [http://www.msubillings.edu/asc/PDF-WritingLab/3-Minute%20Spr05/APA%20sample%20paper.pdf] (pdf). Language is central to the sense of identity that unites cultures and ethnicities. The invention of writing systems some 5000 years ago, allowing the preservation of speech, was a major step in cultural evolution. Language, especially written language, is sometimes thought to have supernatural status or powers. (See Magic, Mantra, Vac.) The science of linguistics describes the structure of language and the relationship between languages. There are estimated to be some 6,000 different languages, including sign languages, used today.

Music

Music is a natural intuitive phenomenon operating in the three worlds of time, pitch, and energy, and under the three distinct and interrelated organisation structures of rhythm, harmony, and melody. Composing, improvising and performing music are all art forms. Listening to music is perhaps the most common form of entertainment, while learning and understanding it are popular disciplines. There are a wide variety of music genres and ethnic musics.

Emotion and sexuality

Human emotion has a significant influence on, or can even be said to control, human behaviour. Emotional experiences perceived as pleasant, like love, admiration, or joy, contrast with those perceived as unpleasant, like hate, envy, or sorrow. There is often a distinction seen between refined emotions, which are socially learned, and survival oriented emotions, which are thought to be innate. Human exploration of emotions as separate from other neurological phenomena is worth note, particularly in those cultures were emotion is considered separate from physiological state. In some cultural medical theories, to provide an example, emotion is considered so synonymous with certain forms of physical health that no difference is thought to exist. The Stoics believed excessive emotion was harmful, while some Sufi teachers (in particular, the poet and astronomer Omar Khayyám) felt certain extreme emotions could yield a conceptual perfection, what is often translated as ecstasy. ecstasy"]] In modern scientific thought, certain refined emotions are considered to be a complex neural trait of many domesticated and a few non-domesticated mammals, developed commonly in reaction to superior survival mechanisms and intelligent interaction with each other and the environment; as such, refined emotion is not in all cases as discrete and separate from natural neural function as was once assumed. Still, when humans function in civilised tandem, it has been noted that uninhibited acting on extreme emotion can lead to social disorder and crime. Human sexuality, besides ensuring reproduction, has important social functions, creating physical intimacy, bonds and hierarchies among individuals, and that may be directed to spiritual transcendence, and/or to the enjoyment of activity involving sexual gratification. Sexual desire, libido, is experienced as a bodily urge, often accompanied by strong emotions, both positive (such as love or ecstasy) and negative (such as jealousy). As with other human self-descriptions, humans propose it is high intelligence and complex societies of humans that have produced the most complex sexual behaviors of any animal. Human sexual choices are usually made in reference to cultural norms, which vary widely. Restrictions are largely determined by religious beliefs.

Body image

norms, Japan]]The physical appearance of the human body is central to culture and art. In every human culture, people adorn their bodies with tattoos, cosmetics, clothing, and jewellery. Hairstyles and hair colour also have important cultural implications. The perception of an individual as physically beautiful or ugly can have profound implications for their lives. This is particularly true of women, whose external appearance is highly valued in most, if not all, human societies. Anthropologists believe this to be an important factor in the development of personality and social relations in particular physical attractiveness. There is a relatively low sexual dimorphism between human males and females in comparison with other mammals.

Trade and economics

sexual dimorphism.]] Trade is the voluntary exchange of goods, services, or both, and a form of economics. A mechanism that allows trade is called a market. The original form of trade was barter, the direct exchange of goods and services. Modern traders instead generally negotiate through a medium of exchange, such as money. As a result, buying can be separated from selling, or earning. The invention of money (and later credit, paper money and non-physical money) greatly simplified and promoted trade. Trade exists for many reasons. Due to specialisation and division of labor, most people concentrate on a small aspect of manufacturing or service, trading their labour for products. Trade exists between regions because different regions have an absolute or comparative advantage in the production of some tradable commodity, or because different regions' size allows for the benefits of mass production. As such, trade between locations benefits both locations. Economics is a social science that studies the production, distribution, trade and consumption of goods and services. Economics, which focuses on measurable variables, is broadly divided into two main branches: microeconomics, which deals with individual agents, such as households and businesses, and macroeconomics, which considers the economy as a whole, in which case it considers aggregate supply and demand for money, capital and commodities. Aspects receiving particular attention in economics are resource allocation, production, distribution, trade, and competition. Economic logic is increasingly applied to any problem that involves choice under scarcity or determining economic value. Mainstream economics focuses on how prices reflect supply and demand, and uses equations to predict consequences of decisions.

Artifacts, technology, and science

supply and demand.]] Human cultures are both characterised and differentiated by the objects that they make and use. Archaeology attempts to tell the story of past or lost cultures in part by close examination of the artifacts they produced. Early humans left stone tools, pottery and jewellery that are particular to various regions and times. Improvements in technology are passed from one culture to another. For instance, the cultivation of crops arose in several different locations, but quickly spread to be an almost ubiquitous feature of human life. Similarly, advances in weapons, architecture and metallurgy are quickly disseminated. Such techniques can be passed on by oral tradition. The development of writing, itself a type of artifact, made it possible to pass information from generation to generation and from region to region with greater accuracy. Together, these developments made possible the commencement of civilisation and urbanisation, with their inherently complex social arrangements. Eventually this led to the institutionalisation of the development of new technology, and the associated understanding of the way the world functions. This science now forms a central part of human culture. In recent times, physics and astrophysics have come to play a central role in shaping what is now known as physical cosmology, that is, the understanding of the universe through scientific observation and experiment. This discipline, which focuses on the universe as it exists on the largest scales and at the earliest times, begins by arguing for the big bang, a sort of cosmic explosion from which the universe itself is said to have erupted ~13.7 ± 0.2 billion (10⁹) years ago. After its violent beginnings and until its very end, scientists then propose that the entire history of the universe has been an orderly progression governed by physical laws.

Mind

physical laws Consciousness is a state of mind, said to possess qualities such as, self-awareness, sentience, sapience, and the ability to perceive the relationship between oneself and one's environment. The way in which the world is experienced is the subject of much debate and research in philosophy of mind, psychology, brain biology, neurology, and cognitive science. Humans (and often others as well) are variously said to possess consciousness, self-awareness, and a mind, the fruition of being our senses and perceptions. Each of us has a subjective view of existence, the passage of time, and free will. There are many debates about the extent to which the mind constructs or experiences the outer world, and regarding the definitions and validity of many of the terms used above. Cognitive scientist Daniel Dennett, for example, argues that there is no such thing as a narrative centre called mind, but that instead there is simply a collection of sensory inputs and outputs: different kinds of software running in parallel (Dennett, 1991).

Psychology and human ethology

Psychology (Classical Greek: psyche = "soul" or "mind", logos = "study of") is the study of behaviour, mind and thought and the neurological basis for them. Psychoanalysis, the examination of the subconscious was, devised by Sigmund Freud and expanded and refined by the Swiss psychiatrist Carl Gustav Jung (initially one of Freud's followers and friends) and others. Carl Gustav Jung Freud divided the mind into the id (an individual's basic needs and instincts), the superego (personal and cultural values and norms), and the ego (the central, organising self, whose job it is to satisfy the id but not upset the superego). [http://allpsych.com/psychology101/ego.html] C. G. Jung founded the school of analytical psychology and introduced the notion of the collective unconscious, a term taken from philosophy and used by Jung to describe symbols or archetypes that he believed might be common to all cultures. There are also the Conscious, Subconscious, and Superconsciousness, a related but not identical set of categories. The behaviour and mental processes of animals (human and non-human) can be described through animal cognition, ethology, and comparative psychology as well. Human ecology is an academic discipline that investigates how humans and human societies interact with their environment, nature and the human social environment.

Philosophy

social environment in detail from Raphael's School of Athens]] Philosophy is a discipline or field of study involving the investigation, analysis, and development of ideas at a general, abstract, or fundamental level. It is the discipline searching for a general understanding of values and reality by chiefly speculative rather than observational means comprising as its core logic, ontology or metaphysics, epistemology, and axiology which includes the branches of ethics and aesthetics. The term covers a very wide range of approaches, and is also used to refer to a worldview, to a perspective on an issue, or to the positions argued for by a particular philosopher or school of philosophy. Metaphysics is a branch of philosophy concerned with the study of "first principles" and "being" (ontology). Problems that were not originally considered metaphysical have been added to metaphysics. Other problems that were considered metaphysical problems for centuries are now typically relegated to their own separate subheadings in philosophy, such as philosophy of religion, philosophy of mind, philosophy of perception, philosophy of language, and philosophy of science. In rare cases subjects of metaphysical research have been found to be entirely physical and natural. The mind is the term most commonly used to describe the higher functions of the human brain, particularly those of which humans are subjectively conscious, such as personality, thought, reason, memory, intelligence and emotion. Other species of animals share some of these mental capacities, and it is also used in relation to supernatural beings, as in the expression "the mind of God." The term is used here only in relation to humans. There are many Philosophies of mind, the most common relating to the nature of being, and ones way of being, or purpose. Adi Shankara in the East proposed Advaita Vedanta, a popular argument for monism (the metaphysical view that all is of one essential essence, substance or energy). Another type of monism is physicalism or tribalism and ethnic nationalism. Humanitarians abhor slavery, cannibalism, and discrimination on the basis of features such as color of skin, ancestry, place of birth, etc. Humanitarianism is embraced by movements and people across the political spectrum, and particularly (but not exclusively) by leftists. Humanitarianism was probably most publicly seen in the social reforms of the late 1800s and early 1900s, following the economoic turmoil of the Industrial Revolution in England. Many of the women in Great Britain who were involved with feminism during the 1900s also pushed humanitarianism. The atrocious hours and working conditions of children and unskilled laborers were made illegal by pressure on Parliament by humanitarians. The Factory Acts of 1833 and 1844 were some of the most significant humanitarian bills passed in Parliament following the Industrial Revolution. A Humanitarian is one who is devoted to human welfare.

Noteable Humanitarians of Modern Times

- Bono - Rock Star Activist involved in lobbying for poverty reduction.
- Clint Borgen - Head of the Borgen Project and one of the world's most recognized figures in poverty reduction.
- Jeffrey Sachs - Economist and leading figure in poverty reduction.

Sources

- [http://dictionary.reference.com/search?q=Humanitarian Dictionary.com: Humanitarian]

Disability rights

The disability rights movement aims to improve the quality of life of people with disabilities. Accessibility and safety are primary issues that this movement works to reform. Access to public areas such as city streets and public buildings and restrooms are some of the more visible changes brought about in recent decades. A noticeable change in some parts of the world is the installation of elevators, transit lifts, wheelchair ramps and curb cuts, allowing people in wheelchairs and with other mobility impairments to use public sidewalks and public transit more easily and more safely. These improvements have also been appreciated by parents pushing strollers or trolleys, bicycle users, and travelers with rolling luggage. Access to education and employment have also been a major focus of this movement. Adaptive technologies, enabling people to work jobs they could not have previously, help create access to jobs and economic independence. Access in the classroom has helped improve education opportunities and independence for people with disabilities. The right to have an independent life as an adult, sometimes using paid assistant care instead of being institutionalized, is a major goal of this movement, and is the main goal of the similar Independent Living movement. These movements have allowed more people with disabilities to be active participants in mainstream society.

History

The disability rights movement began in the 1970s, encouraged by the examples of the African-American civil rights and women’s rights movements, which began in the late 1960s.

The Anti-Euthanasia Movement

Some disability rights advocates have also become active in the anti-euthanasia movement for various reasons. Some disagree with some euthanasia advocates who defend euthanasia on the utilitarian ground that it conserves public resources which would otherwise be used to care for disabled people. Others are concerned about society's double standard with respect to suicide: non-disabled people who are suicidal are strongly discouraged from taking their own lives, while disabled suicidal people are encouraged or even helped to do so. They point out that non-disabled or newly disabled people are apt to underestimate the quality of life that is possible for people with disabilities. Not Dead Yet is a disability rights organization that is well-known for orchestrating protests at public appearances of euthanasia advocates.

Sex

The question of whether severely mentally disabled persons should be allowed to have sex is a controversial one. In Germany, this topic is brought to the fore by Nina de Vries who offers paid sexual services to these persons.

Personalities

John Tyler, born in the twentieth century, was an advocate for the rights of the disabled. He parked his wheelchair in front of Metro buses in Seattle, WA in the late 1970s and performed other actions to make sure that the proper wheelchair lifts, not the "folding camel" lifts, would be put onto the public transit buses. The original lifts, which could potentially dump people in wheelchairs and which also broke down more easily, were put onto the buses. Being that he had severe polio, he was quite fortunate in being able to do so. He was in all probability named after President Tyler. That may have given him some of his own strength and ability to confront such serious issues as "disabled" lifts put onto the buses and his own fading battle with polio. He died from suicide on December 24th of 1984, after having lead a lonely life -- but a good one. And he is remembered to this day at Center Park in Seattle, Washington, the very first apartment building ever built in the United States, specifically for people in wheelchairs.

External links

- [http://www.notdeadyet.org Not Dead Yet]
- [http://www.utilitarian.net/singer/about/20030216.htm Unspeakable Conversations] An article written by a disabled disability lawyer about her debates with controversial philosopher Peter Singer Category:Rights of the disabled Category:Social movements Category:Political movements Category:Cultural movements

Muscular dystrophy

The muscular dystrophies are a group of genetic and hereditary muscle diseases; characterized by progressive skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue. In some forms of muscular dystrophy, cardiac and smooth muscles are affected. The muscular dystrophies are the most common hereditary diseases.

Cause

The most common form is Duchenne muscular dystrophy. This form is caused by mutations of the gene for the dystrophin protein. The dystrophin is the second largest gene in mammals. The dystrophin gene is located on the X chromosome (Thus making it a 'sex-linked' disorder. Accordingly, muscular dystrophies are much more common in males, as females have two copies of that chromosome, males have only one). These two facts explain why Duchenne muscular dystrophy is the most common form.

Types

The major types of muscular dystrophy include:
- Becker's muscular dystrophy
- Congenital muscular dystrophy
- Distal muscular dystrophy
- Duchenne muscular dystrophy
- Emery-Dreifuss muscular dystrophy
- Facioscapulohumeral dystrophy
- Fukuyama congenital muscular dystrophy (FCMD)
- Limb-girdle muscular dystrophy
- Myotonic muscular dystrophy
- Oculopharyngeal muscular dystrophy
- Severe childhood autosomal recessive muscular dystrophy Duchenne MD is the most common form of muscular dystrophy affecting children, and myotonic muscular dystrophy is the most common form affecting adults. Muscular dystrophy can affect people of all ages. Although some forms first become apparent in infancy or childhood, others may not appear until middle age or later. The most frequent symptoms are muscle weakness (frequent falls, walking problems, eyelid drooping), skeletal and muscle deformities. Neurologic examination often reveals loss of muscle tissue (wasting), muscle contracture, pseudohypertrophy and weakness. Diagnosis is usually established by muscle biopsy, elevated serum CK levels and electromyography examination, which is consistent with myogenic involvement. Some types of muscular dystrophy may present with additional cardiac disease, intellectual deterioration and infertility. There is no known cure for muscular dystrophy. Inactivity (such as bedrest and even sitting for long periods) can worsen the disease. Physical therapy and orthopedic instruments (e.g. wheelchairs) may be helpful.

Treatment

There is no specific treatment for any of the forms of muscular dystrophy. Physical therapy to prevent contractures (a condition in which shortened muscles around joints cause abnormal and sometimes painful positioning of the joints), orthoses (orthopedic appliances used for support) and corrective orthopedic surgery may be needed to improve the quality of life in some cases. The cardiac problems that occur with Emery-Dreifuss muscular dystrophy and myotonic muscular dystrophy may require a pacemaker. The myotonia (delayed relaxation of a muscle after a strong contraction) occurring in myotonic muscular dystrophy may be treated with medications such as quinine, phenytoin or mexiletine.

Prognosis

The prognosis of muscular dystrophy varies according to the type of muscular dystrophy and the progression of the disorder. Some cases may be mild and very slowly progressive, with normal lifespan, while other cases may have more marked progression of muscle weakness, functional disability and loss of ambulation. Life expectancy may depend on the degree of progression and late respiratory deficit. In Duchenne muscular dystrophy, death usually occurs in the late teens to early 20s, however there are many young men living into the mid 30's. The use of mechanical ventilation and heart medications have been shown to prolong life in DMD.

Current research

The Muscular Dystrophy Association is one of the most prominent disease advocacy organizations in the world, pumping millions of dollars every year into MD research. Jerry Lewis has made a name for himself supporting the organization for over 50 years, and has hosted an annual nationwide telethon every Labor Day since 1966. The NINDS supports a broad program of research on muscular dystrophy. The goals of these studies are to increase understanding of muscular dystrophy and its cause(s), develop better therapies, and, ultimately, find ways to prevent and cure the disorder. One promising approach for treatment of muscular dystrophy involves the blocking of myostatin. Another area of research involves modifying the splicing of the dystrophin RNA using steric blocking oligos such as 2'-O methyl phosphorothioates or Morpholinos[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16285002&query_hl=1].

External links

- [http://www.ninds.nih.gov/disorders/md/md.htm NIH] (a source for this article)
- [http://www.mdausa.org MDA]
- [http://www.mdff.org/ Muscular Dystrophy Family Foundation]
- [http://www.muscle.ca/ Muscular Dystrophy Canada]
- [http://www.muscular-dystrophy.org/ Muscular Dystrophy Campaign (UK)]
- [http://www.ppuk.org/ Parent Project UK]
- [http://www.cardiff.ac.uk/medicine/medical_genetics/research/md/ Cardiff University Muscular Dystrophy Research Group]
- ja:筋ジストロフィー

Spina bifida

Spina bifida describes birth defects caused by an incomplete closure of one or more vertebral arches of the spine, resulting in malformations of the spinal cord. The spinal membranes and spinal cord may protrude through the absence of vertebral arches (called a cleft). These malformations fall into three categories: spina bifida occulta, spina bifida cystica (myelomeningocele) and meningocele. Spina bifida is a type of neural tube defect. Neural tube defects can usually be detected during pregnancy by AFP screening or a detailed fetal ultrasound. Spina bifida may be associated with other malformations as in dysmorphic syndromes, often resulting in spontaneous miscarriage. However, in the majority of cases spina bifida is an isolated malformation. Spina bifida has varying prevalence in different human populations. This and extensive evidence from mouse strains with spina bifida suggests a genetic basis. As with other human diseases such as cancer, hypertension and atherosclerosis (coronary artery disease), spina bifida likely results from the interaction of multiple genes and environmental factors. Despite much research on spina bifida we still do not know what causes the majority of human cases. Nevertheless, there is substantial evidence supporting a significant protective effect of Folic acid (0.4mg/day) when taken by women early in pregnancy. It is important to note that spina bifida occurs by the 4th week of pregnancy before many women will be aware of a pregnancy, thus it is generally recommended that women of child-bearing age take a folic acid supplement (most multivitamins contain 0.4mg folic acid) if they are sexually active. Genetic counseling and further genetic testing, such as amniocentesis, may be offered during the pregnancy as some neural tube defects are associated with genetic disorders such as trisomy 18. The most common locations of the malformations are in the lumbar and sacral areas. The lumbar nerves control the muscles in the hip, leg, knee and foot, and help to keep the body erect. The sacral nerves control some of the muscles in the feet, bowel and bladder and the ability to have an erection. Some degree of impairment can be expected in these areas. Spina bifida is a Latin term meaning "split spine." Occulta means "hidden."

Types of spina bifida

Spina bifida occulta

This is a mild form of spina bifida. There is no opening on the back, but the outer part of some of the vertebrae are not completely closed. The split in the vertebrae is so small that the spinal cord does not protrude. The skin at the site of the lesion may be normal, or it may have some hairs growing from it; there may be a dimple in the skin, or a birthmark. People with this form may have incontinence, slight ambulatory problems, and slight loss of sensation.

Spina bifida cystica (myelomeningocele)

In this, the most serious form, the meningeal membranes that cover the spinal cord and part of the spinal cord protrude through a cleft, forming a sac or cyst, and are clearly visible. The opening is surgically repaired, shortly after birth. The sac or cyst not only contains tissue and cerebrospinal fluid but also nerves and part of the spinal cord. The spinal cord is damaged or not properly developed. As a result, there is usually some degree of paralysis and loss of sensation below the damaged vertebrae. The amount of disability depends very much on where the spina bifida is and the amount of nerve damage involved. Many children and adults with this condition experience problems with bowel and bladder control. In approximately 90% of the people with myelomeningocele, hydrocephalus, extra fluid in the ventricles of the brain, will also occur.

Meningocele

In this, the least common form, the outer part of some of the vertebrae are split and the meninges are damaged and pushed out through the opening, appearing as a sac or cyst, which contains both the meninges and cerebrospinal fluid. The nerves are not usually badly damaged and are able to function, therefore there is often little disability present. There are usually no long-term problems, although problems can arise.

Causes

Spina bifida is caused by the failure of the neural tube to close during embryonic development. Normally the closure of the neural tube occurs around the thirtieth day after fertilization. However, if something interferes and the tube fails to close properly, a neural tube defect will occur. Neural tube defects include the conditions of anencephaly, encephalocele, and spina bifida. Spina bifida occurs in the first month of pregnancy, often before the woman knows that she is pregnant. Spina bifida does not follow direct patterns of heredity like muscular dystrophy or haemophilia. Studies show that a woman who has had one child with a neural tube defects such as spina bifida, have about a 3% risk to have another child with a neural tube defect. This risk can be reduced to about 1% if the woman takes high doses of (0.4mg/day) folic acid before and during pregnancy. It is known that women taking certain medication for epilepsy and women with insulin dependant diabetes have a higher chance of having a child with a neural tube defect. It is also more common among those of Gaelic descent than any other ethnic group.

Effects

Spina bifida results in varying degrees of paralysis, absence of skin sensation, incontinence, and spine and limb problems depending on the severity and location of the lesion damage on the spine. In very rare cases, cognitive problems also result. Most babies born with the condition will need surgeries to correct spinal, foot or leg problems, shunt surgery to drain fluid from the brain, application of techniques to control bladder and bowel function (such as self-catherization or diapers), and braces and other equipment to assist in walking. Tethered cord, with symptoms such as lower body pain, leg weakness, incontinence, scoliosis, numbness, is a common problem associated with spina bifida. Indeed 100% of spina bifida myelomeningocele patients have tethered cord, caused by the spinal cord damage when it is repaired by surgery soon after birth, and the resulting natural scar tissue buildup. However many do not show symptoms of tethered cord until later in life or never at all. Before MRIs were invented Tethered Cord could only be detected through symptoms or surgery and therefore those born before the invention of the MRI, and without symptoms, may not know they have it, or even what it is. If, or when, symptoms show up later in life it can often be a difficult process to discover the correct diagnosis, by which time further damage has been done. According to the Spina Bifida Association of America ([http://www.sbaa.org SBAA]), over 73% of people with spina bifida develop an allergy to latex, ranging from mild to life-threatening. The prevalance of latex in medical facilities makes this a particularly serious concern.

Treatment

There is no cure for spina bifida. To prevent further drying and damage of the nervous tissue and to prevent infection, doctors operate as soon as possible to close the opening on the back, but there is no operation that can fix damaged nerves. During the operation, the spinal cord and its nerve roots are put into place and covered with skin. Doctors are now experimenting and evaluating the efficacy of in-utero surgery to correct the spina bifida lesion. The in-utero surgery occurs in the womb and before birth. In the 4th or 5th month, surgeons have a window of opportunity to perform in-utero surgery by opening the mother's abdomen, and entering the uterus to operate on the spina bifida lesion found on the fetus. Skin grafts are used to cover the exposed spinal cord and protect the spinal cord from further damage caused by prolonged exposure to amniotic fluid. It is believed that the in-utero surgery will decrease some of the damaging effects of the spina bifida lesion, but it is not a cure. The in-utero surgery is currently undergoing NIH clinical trials and the results of these trials and studies ([http://pediatrics.about.com/cs/specialneedskids/a/moms_study_2.htm MOMs study at About.com] and [http://www.spinabifidamoms.com/english/index.html Official MOMs Website]) will not be completed until 2008.

Rate of occurrence

In Canada, spina bifida occurs in about one in every 1,000 births. In Western Australia, up until 1996 around 2 children in every 1000 were born with a neural tube defect. Since 1996, as a result of the folic acid campaign, the figure has dropped to 1.3 children per 1000 births. In the United States, spina bifida occurs in about one in every 1-2,000 births. More children in the U.S. have spina bifida than have muscular dystrophy, multiple sclerosis, and cystic fibrosis combined.

Prevention

Doctors and scientists have found that folic acid can help to prevent spina bifida. It is recommended that all women of childbearing years as well as those women planning to become pregnant should take at least 0.4 mg of folic acid per day from at least one month before conception, and at least 1 mg of folic acid during at least the first three months of pregnancy. Women who have already had a baby with spina bifida or other type of neural tube defect should take extra folic acid - 4mg/day. As yet it is unknown how or why folic acid helps to prevent spina bifida. Sources of folic acid include: Whole grains, fortified breakfast cereals, dried beans, leaf vegetables, fruits.

People

People of note born with spina bifida:
- Olympian and eight-time Boston Marathon winner Jean Driscoll[http://www.jeandriscoll.com]
- 80s Rock Star John Mellencamp
- British Paralympian Tanni Grey-Thompson
- Country music legend Hank Williams

External link

- [http://www.canadian-health-network.ca/servlet/ContentServer2FSearchPageTemplate&c=Page&lang=En&searchStr=spina+bifida&orderBy=ORDER_RANK&searchType=EXACT&x=43&y=12&logSearch=true Canadian Health Network - Search Results for spina bifida]
- http://www.ifglobal.org, the International Federation for Spina Bifida and Hydrocephalus (IF), the umbrella organisation for national spina bifida and hydrocephalus organisations Category:Congenital disorders Category:obstetrics

Epilepsy

Epilepsy (often referred to as a seizure disorder) is a chronic neurological condition characterized by recurrent unprovoked seizures. The condition is named from the Greek epilepsia ("a taking hold of or seizing"). It is commonly controlled with medication, although surgical methods are used as well.

Causes

All the causes (or etiologies) of epilepsy are not known, but many predisposing factors have been identified, including brain damage resulting from malformations of brain development, head trauma, neurosurgical operations, other penetrating wounds of the brain, brain tumor, high fever, bacterial or viral encephalitis, stroke, intoxication, or acute or inborn disturbances of metabolism. Hereditary or genetic factors also play a role. Epileptic seizures may occur in any person under certain circumstances, including acute illness and drug overdoses, but these provoked seizures are not part of the definition of epilepsy. Epilepsy connotes that an individual has unprovoked seizures which recur over time. In about 50% of all cases, there is no cause for epilepsy that is currently detectable even with state of the art investigations. In about 50% of cases, evidence of a brain injury, scar or malformation is found, to which the epilepsy is attributed. In many, but not all cases, abnormal electrical activity can be detected in the brain with an electroencephalogram (EEG), either during or in between seizures. Some people (especially young children) have seizures when exposed to certain patterns of flashing/flickering lights. This is a special type of reflex epilepsy called photosensitive epilepsy and the seizures themselves are often informally called "Pokemon seizures," after an article was published describing an outbreak of photosensitive seizures due to broadcast of an episode of the popular children's television show Pokemon. While some of the children involved doubtless had photosensitive epilepsy, some investigators believe that the majority of the 12,000 affected in this outbreak actually were having psychogenic non-epileptic seizures. The most common ages of incidence are under the age of 18 and over the age of 65. It has been estimated that about 1% of the population meets the diagnostic criteria for epilepsy at any given time, but some theorize that the prevalence may be much higher in fact. A significant and measurable decline in cognitive function is known to be associated with epilepsy, although it has not been entirely clear to what extent this is due to the epilepsy itself or to the drugs used to treat it. Phenobarbital, in particular, has been shown to decrease IQ and classroom performance when used to treat epilepsy in children; the effects persist after the phenobarbital is stopped. Some newer anti-epileptic drugs are considered by some to have less severe cognitive effects than older drugs. On an individual level, a person's reaction to epileptic seizures and/or anti-epileptic drugs may be idiosyncratic, so it is difficult to predict how a particular person might be affected. Mutations in several genes have been linked to some types of epilepsy. Several genes that code for protein subunits of voltage-gated and ligand-gated ion channels have been associated with forms of generalized epilepsy and infantile seizure syndromes. Several ligand-gated ion channels have been linked to some types of frontal and generalized epilepsies. Epilepsy-related mutations in some non-ion channel genes have also been identified. One interesting finding in animals is that repeated low-level electrical stimulation to some brain sites can lead to permanent increases in seizure susceptibility: in other words, a permanent decrease in seizure "threshold." This phenomenon, known as kindling (by analogy with the use of burning twigs to start a larger fire) was discovered by Dr. Graham Goddard in 1967. Chemical stimulation can also induce seizures; repeated exposures to some pesticides have been shown to induce seizures in both humans and animals. One mechanism proposed for this is called excitotoxicity. The roles of kindling and excitotoxicity, if any, in human epilepsy are currently hotly debated.

Diagnosis

The diagnosis of epilepsy requires the presence of recurrent, unprovoked seizures; accordingly, it is usually made based on the medical history. EEG, brain MRI, SPECT, PET, and magnetoencephalography may be useful to discover an etiology for the epilepsy, discover the affected brain region, or classify the epileptic syndrome, but these studies are not useful in making the initial diagnosis. Long-term video-EEG monitoring for epilepsy is the gold standard for diagnosis, but it is not routinely employed owing to its high cost and inconvenience. It is, however, sometimes used to distinguish psychogenic non-epileptic seizures from epilepsy. Convulsive or other seizure-like activity, non-epileptic in origin, can be observed in many other medical conditions, including:
- psychogenic non-epileptic seizures (often wrongly called "pseudoseizures")
- tics
- syncope (fainting)
- narcolepsy
- cataplexy
- parasomnias
- breath-holding spells of childhood
- non-epileptic myoclonus
- hypoglycemia and associated neuroglycopenia
- opsoclonus
- hyperekplexia
- paroxysmal kinesiogenic dyskinesia
- infantile gratification / masturbation (onanism)
- repetitive behaviors Neurologists are often called upon to distinguish among the above diagnoses and epilepsy.

Types of seizure

Epileptic seizures are classified both by their patterns of activity in the brain and their effects on behaviour. In terms of their pattern of activity, seizures may be described as either partial (focal) or generalised. Partial seizures only involve a localised part of the brain, whereas generalised seizures involve the entire cortex. The term 'secondary generalisation' may be used to describe a partial seizure that later spreads to the whole of the cortex and becomes generalised. Partial seizures may be further subdivided into both simple and complex seizures. This refers to the effect of such a seizure on consciousness; simple seizures cause no interruption to consciousness (although they may cause sensory distortions or other sensations), whereas complex seizures interrupt consciousness to varying degrees. This does not necessarily mean that the person experiencing this sort of seizure will fall unconscious (like fainting). For example, a complex partial seizure may involve the unconscious repetition of simple actions, gestures or verbal utterances, or simply a blank stare and apparent unawareness of the occurrence of the seizure, followed by no memory of the seizure. Other patients may report a feeling of tunnel vision or dissociation, which represents a diminishment of awareness without full loss of consciousness. Still other patients can perform complicated actions, such as travel or shopping, while in the midst of a complex partial seizure. The effects of partial seizures can be quite dependent on the area of the brain in which they are active. For example, a partial seizure in areas involved in perception may cause a particular sensory experience (for example, the perception of a scent, music or flashes of light) whereas, when centred in the motor cortex, a partial seizure might cause movement in particular groups of muscles. This type of seizure may also produce particular thoughts or internal visual images or even experiences which may be distinct but not easily described. Seizures centred on the temporal lobes are known to produce mystical or ecstatic experiences in some people. These may result in a misdiagnosis of psychosis or even schizophrenia, if other symptoms of seizure are disregarded and other tests are not performed. Unfortunately for those with epilepsy, anti-psychotic medications prescribed without anti-convulsants in this case can actually lower the seizure threshold further and worsen the symptoms. When the effects of a partial seizure appear as a 'warning sign' before a more serious seizure, they are known as an aura: it is frequently the case that a partial seizure will spread to other parts of the brain and eventually become generalized, resulting in a tonic-clonic convulsion. The subjective experience of an aura, like other partial seizures, will tend to reflect the function of the affected part of the brain. Generalised seizures can be sub-classified into a number of categories, depending on their behavioural effects:
- Absence seizures (sometimes referred to as petit mal seizures) involve an interruption to consciousness where the person experiencing the seizure seems to become vacant and unresponsive for a short period of time (usually up to 30 seconds). Slight muscle twitching may occur.
- Tonic-clonic seizures (sometimes referred to as grand mal seizures), involve an initial contraction of the muscles (tonic phase) which may involve tongue biting, urinary incontinence and the absence of breathing. This is followed by rhythmic muscle contractions (clonic phase). This type of seizure is usually what is referred to when the term 'epileptic fit' is used colloquially.
- Myoclonic seizures involve sporadic muscle contraction and can result in jerky movements of muscles or muscle groups.
- Atonic seizures involve the loss of muscle tone, causing the person to fall to the ground. These are sometimes called 'drop attacks' but should be distinguished from similar looking attacks that may occur in narcolepsy or cataplexy.
- Status epilepticus refers to continuous seizure activity with no recovery between successive tonic-clonic seizures. This is a life-threatening condition and emergency medi