B2 lesson part two

B2 Keeping healthy Route map Over the next 12 lessons you will study : Friday 21 October 2011 B2.1 What’s up Doc? B2.2 Microbe attack! B2.3 Antibodies – not antibiotics! B2.4 Vaccines End of module test B2.5 Vaccination and the government B2.6 The end for antibiotics ? B2.7 Where do new medicines come from ? B2.8 Clinical trials B2.9 Circulation B2.10 Causes of disease B2.11 Health studies 1 B2.12 Health studies 2

B2.7 The end for antibiotics ? Decide whether the following statements are true or false: Lesson objectives: Understand how antibiotics work and help the human body to fight an infection. Understand how the over use of antibiotics like penicillin and amoxicillin have led to the rise of the ‘superbug’ Friday 21 October 2011 First activity: The Egyptians were the first society to use antibiotics although they did not know it they use to put mouldy bread directly onto wounds which would help the wound heal. What was this mould called ? Literacy: Antibiotics, penicillin, amoxicillin, microbes, bacteria, vaccine, antibiotic resistant, superbug, mutations, genes, colonies and MRSA. Numeracy: Superbugs or super viruses have DNA that makes them resistant to antibiotics like penicillin. A single gene change is sometime enough to make them resistant PLTS Independent enquirers Creative thinkers Reflective learners We will focus on working well in groups Team workers Effective participators Self managers

B2.7 The end for antibiotics? Extension questions: 1: Write a short account of how the over use of antibiotics has led to the appearance of so-called ‘superbugs’ ? 2: What options do we have for treating someone who is infected by a superbug ? 3: How can we reduce the risk of infection for MRSA in UK hospitals ? 4: What is a gene mutation and how has happened in MRSA? Friday 21 October 2011 Introduction: Prior to the discovery of antibiotics, bacterial infections killed many millions of people worldwide. Even an infected cut could have been potential life threatening. Antibiotics are cheap wonder drugs that stopped bacteria multiplying inside your blood or infected tissue. Because we have overused these drugs, superbugs (microbes) that are resistant to a whole range of antibiotics. They come about through gene mutation and mass reproduction. The mutation occurs due to people taking antibiotics they don’t need and not finishing a course of antibiotics. Examples of a superbug would be MRSA which was found as the cause of death of nearly 10,000 patients in UK hospitals in 2010 alone. Know this: a: Know how antibiotics work to stop bacteria multiplying in the human body b: Know that super bugs can mutate to overcome these antibiotics making them resistant.

key concepts B2.7 a Look at the photograph and information and answer all the questions: The Ancient Egyptians were the first people to use antibiotics! They used to put mouldy bread on to infected wounds. Scientists now know that the mould is a fungus that makes penicillin a well known antibiotic which can help heal bacterial infections. The chemical stops bacterial cell making new cell wall which is an essential step when cloning itself What why the Egyptians used mouldy bread to treat infected wounds ? Name a type of antibiotic found in the bread mould ? If you had 50 different herbal extracts and you though some might have antibiotic properties, how would you test each one ?

Key concepts Look at the photograph and information and answer all the questions: Penicillin was discovered accidentally by Dr. Alexander Fleming. Fleming was examining a bactaeria culture when he noticed that it had become contaminated by Penicillium . He observed that it was inhibiting the bacterial growth and assumed that it could be used to control infections in humans. Many humans are alive today because of his work. Who discovered penicillin and how do antibiotics like penicillin work inside the human body ? Has the overuse of antibiotics caused any problems in recent years ? If you extracted a compound form a plant and you thought it was antiseptic how could you test to see if you were wrong or right ? B7.11 b Pencillium mould

B2.7 b Look at the photograph and information and answer all the questions: In any infection, in any super colony there are millions of bacteria. In just one op the bacteria, a single gene mutation in just one bacteria that conveys some resistance to an antibiotic. If the patient then feels better and stops taking the antibiotic, then that bacteria will survive producing a new antibiotic resistant bacterial population. Look at the diagram opposite left, explain how the whole bacterial population becomes resistant to antibiotics ? Explain why you always finish a course of antibiotics ? Explain why giving two different anitbitoics would reduce the chance of bacteria becoming antibiotic resistant ? How bacteria replicates and multiplies Key concepts

B2.7 c Look at the photograph and information and answer all the questions: Explain why it is the young, old and ill that are at most risk form MRSA ? If the infection rate in UK hospitals are 94,000 and 10,000 of those died what is the probability of death one ce infected with MRSA ? Each year, at least 100,000 people who go into hospital gets an infection there. MRSA in 2010 killed 10,000 people. Many people naturally carry it in their throats, and it can cause a mild infection in a healthy patient. In ill patients in can be life threatening. MRSA will continue to be a problem until we develop new antibiotics. Although new antibiotics are being developed all the time, pessimistic experts believe it is only a matter of time at current rates until virtually every weapon in the pharmaceutical arsenal is nullified. Key concepts

B2.7 Plenary Lesson summary: finish MRSA deaths hospitals Friday 21 October 2011 Scientists are now desperately trying t find chemical that will act as antibiotics so that we can continue to treat patients with life threatening infections. Once source could be chemicals found in reptile blood. Crocodiles heal without infect despite living in mud and swamps. Scientists are now trying to find the chemical that fights off infection when they are wounded or even lose a limb. How Science Works: Research into how new medicines are developed and how clinical trials are aimed at ensuring a drug prescribed by doctors are both safe and effective Preparing for the next lesson: Super-bugs like ________ are hear to stay , but we can reduce the risk of _______ from infection and the risks of other super-bugs appearing in our _________. We can clean our hospitals, reduce the use of antibiotics and make sure that a person ________ the course once the antibiotic is prescribed. Decide whether the following statements are true or false : False True 3: Deaths from MRSA are higher in the UK compared to France or Germany False True 2: Antibiotics are also used by livestock farmers to reduce infection ? False True 1: Most of us carry the MRSA bug in our noses ?

B2.8 Developing new medicines Decide whether the following statements are true or false: Lesson objectives: Understand how new drugs are developed Understand how drugs are tested for both safety and efficacy in both animals and human Friday 21 October 2011 First activity: Before drugs are used by healthy male volunteers in phase one clinical trials, they have to be tested in animals to determine their toxicity. Why is it unethical to trial the drug in humans straight away ? Literacy: Drugs, prescription drugs, efficacy trials, toxicity testing, clinical trials, human volunteers, placebo, double blind trials and phase 1 to 4 trails . Numeracy: Before a new drug can be prescribed by doctors to treat a disease, it has to undergo toxicity testing and clinical trials. This can take between 7 to 12 years and cost upwards of 150 million pounds. PLTS Independent enquirers Creative thinkers Reflective learners We will focus on Team workers Effective participators Self managers

Decide whether the following statements are true or false: Introduction: Take any drug, from a simple aspirin to very complex anti cancer drug. All drugs haves to be firstly effective in treating a disease and secondly safe to take without causing serious side effects. Finding, developing and testing new drugs, before they are sold to us the consumer takes many years, many hundreds of scientists and many millions of pounds. The drugs themselves can be synthetically manufactured by chemists or extracted from a living organism, for example a plant or even a mould Extension questions: 1: Name a drugs that is a) extracted from and plant and b) extracted form a mould ? 2: Why must all drugs be first tested in animal before clinical trials involving healthy male volunteers ? 3: Why are new drugs tested on health young male volunteers before being tested on real patients ? 4: Explain why during phase 2 and 3 clinical trials, both patients and doctors are not told what they are taking or prescribing during a double blind study ? Know this: a: Know how new drugs and developed by the pharmaceutical industry. b: Know that all drugs are tested for the efficacy and their safety using clinical trials. Friday 21 October 2011 B2.8 Developing new medicines

B2.8 a Look at the photograph and information and answer all the questions: Chemists and hospitals are filled with thousands of prescription drugs sourced or extracted from plants or other organism of even synthetically manufactured to treat diseases from the common cold to cancer. All drugs must be both safe and effective, which can cost millions of pound to prove. Although now produced synthetically, aspirin was first extracted from willow bark. Explain how some drugs are found, for example a plant extract ? So called ‘herbal remedies’ are sold as safe effective remedies for certain illnesses and diseases. Why is it not a good idea to place all your faith in these remedies ? Explain why drugs have to tried on humans before doctors can prescribe tem as ‘effective cures’ ? Key concepts

B2.8 b Look at the photograph and information and answer all the questions: Risks of medicines Benefits of medicine Explain why there are concerns about using medicines from members of the general public ? Do they actually work for all in a population ? Are they all safe to take or will the side effects cause serious health problems ? Are the drugs affordable for all the population ? Are they alternatives which are cheaper, more safe and already proved to work ? The drug gas been shown to work during clinical trails It has been shown to be safe in three different species of animals The cost of not taking this drug may be higher than taking the drug Although medicines are an important part of all our lives in helping you feel better and help you get well, it's important to know that all medicines, both prescription and over-the-counter, have risks as well as benefits. There are several types of risks from medicine use: The possibility of a harmful interaction between the medicine and or another medicine. The chance that the medicine may not work as expected. The possibility that the medicine may cause additional problems. 5000 in 100,000 patients have an adverse risk to over the counter painkillers like aspirin whereas about 50 in 100,000 people will have serious health effects from aspirin. Do you think benefits outweigh the risks ? Drugs are effective, safe and work for most people that take them Key concepts

B2.8 Plenary Lesson summary: animals effective law clinical Friday 21 October 2011 Sadly despite safety testing in animals and extensive clinical trial, not all drugs are safe. Thalidomide, a drug prescribed to alleviate morning sickness in pregnant females cause birth effects in the children of the pregnant mothers that took the drug. The drug was only tested in healthy male volunteers and not in pregnant females, so the effects on the foetus were not known until too late. How Science Works: Research into clinical trial and how blind and double blind trials ensure that a clinical trial is performed without the interference pf the doctor, the company that is developing the drug or the patient. Preparing for the next lesson: All drugs are required by ____ to be tested on __________ first and then in humans during _________ trials. The British medical association states that experimentation animals helps drug companies produce and sell safe and __________ medicines for the treatment of human disease. Decide whether the following statements are true or false : False True 3: Drugs are tested on human cultures cells before they are given to animals ? False True 2: A double blind clinical trials where the doctor only knows what is prescribed ? False True 1: Clinical trails is where new drugs are tested in animals ?

B2.9 Clinical trials Decide whether the following statements are true or false: Friday 21 October 2011 PLTS Independent enquirers Creative thinkers Reflective learners We will focus on Team workers Effective participators Self managers First activity: Imagine taking an aspirin to stop a headache, explain why you may need two aspirin to stop the pain where as other people may require less or more. Explain also why some people could be allergic to the drug ? Literacy: Drugs, prescription, drug safety, drug toxicity, genome, genetic testing, blind trial, double blind trials, clinical trails, data, safety, clinical development and efficacy Numeracy: Almost 5% of the population have an intolerance to the common aspirin. It is thought that this intolerance is directly attributable to genetic difference in those 5% of the population Lesson objectives: Understand how drugs are tested for both safety and efficacy in both animals and human Understand how the blind trial and ensure that a drug is tested without interference from patients, doctors and eve the drug company

B2.9 Extension questions: 1: Explain why phase I clinical trial sonly uses healthy male volunteers ? 2: Explain the difference between a blind and double blind clinical trial and which study will provide the most reliable data ? 3: Explain why drugs are first tested in animals for their toxicity before trials in humans ? 4: Describe a example where it would be wrong to use a placebo instead of a drug treatment ? Know this: a: Know how drugs are tested for safety and efficiency. b: Know how the blind and double blind trial ensure drugs are tested without possible interference form doctors or patients. Friday 21 October 2011 Introduction: After a new drug has been tested for efficacy using human cultured cells and toxicity using animals, phase 2 and 3 clinical trials will use both ‘Blind trials’ and ‘Double blind trials’ to determine whether the drug is effective in patients. Blind trial: A blind trial is a trial where the patients taking part do not know whether they are getting a) new drug, b) an existing drug or c) no drug at all (placebo) Double blind trials: A double blind trial is a trial where neither the doctors nor the patients know what they are getting. The allocation of treatment (a, b or c) is decide completely randomly by a computer. Therefore the results cannot be changed because neither the patient, nor your doctor knows whether it is the new treatment or not. Clinical trials

Key concepts B2.9 a Look at the photograph and information and answer all the questions: Finding that wonder drug that treats a disease safely and effectively is the aim of all doctors, clinical trails specialists and of course drug companies. We all rely on the integrity of clinical trial to provide us with drugs that treat a disease without serious side effects or worse still a drug that could shorten our lives. Explain why using your DNA to design a drug treatment may make that drug a) more effective and b) safer ? Why do people response to drugs differ ? Would the cost of drugs designed specially for you be less or more than regular drugs ? phase 1 phase 2 phase 3 phase4 After toxicity testing, clinical trials are done to see if the drug is both effective and safe. These four phases can cost upwards of £100,000,000 and take between 8 to 15 years What happens during a clinical trial ?

B2.9 b Look at the photograph and information and answer all the questions: Double-blind trials, in which neither the researcher nor the patient know who is receiving the a new drug, an existing drug or nothing (placebo) are the gold standard for medical research. Many scientists and medical people argue that all new drugs should undergo these test to ensure that the drug is both effective and safe for the patients taking it. Why is it important do test the new drug against an existing drug ? Why do doctors include a placebo treatment in the double blind trial ? Why are double blind trails more reliable than other trials like the blind trial ? New drug What happens during a clinical trial ? Old drug Placebo During phase 3 clinical trials, three treatments are given randomly without the knowledge of both the patient and doctor. These treatments include, the new drug, the old drug and a placebo (usually chalk powder.) All data is then assessed and if the new drug is safe and more effective than the old drug and placebo a licence of sale is granted Key concepts

Key concepts B2.9 c Look at the photograph and information and answer all the questions: T Before phase I clinical trials, new drugs are tested in animals to asses their toxicity. Explain why scientists use animals before the drugs is tested by healthy male volunteers ? All drugs must follow a four phase clinical trail procedure (as described above) to ensure that they are both effective and safe for humans to take Phases of clinical trials

Plenary Lesson summary: doctors clinical safe blind ___________ trials allows both scientists and ________ to test a new drug on patient volunteers to determine if the drug is effective and ______ to take. A double ______ trial ensure that neither the doctor nor the patient know which treatment they are receiving keeping the trial reliable and free from intervention. Double-blind trials, in which neither the researcher nor the patient know who is receiving the real treatment and who a placebo, are the gold standard for medical research. Many scientists and medical people argue that complementary therapies (alternative medicine or integrative medicine) haven’t stood up to these tests at all well, and so should not be treated with respect . How Science Works: Friday 21 October 2011 Research into The circulation and how the heart function. Also look into the life factors that can case heart disease in humans Preparing for the next lesson: B2.9 Decide whether the following statements are true or false : False True 3: A placebo (chalk or sugar tablet) can sometimes produce a beneficial effect ? False True 2: Drugs designed around your DNA will be more effective ? False True 1: All drugs are both effective and safe for the entire population ?

B2.10 The circulation and clotting Decide whether the following statements are true or false: Lesson objectives: Understand the anatomy of the circulatory system Understand how blood acts as transport system for oxygen around the entire body Understand what life style factors can cause heart disease in humans Friday 21 October 2011 First activity: Discuss in pairs the percentage of blood that you think flows to the a) legs b) brain c) kidneys and d) intestines and e) heart Literacy: Circulation, clotting, blood, heart, blood cells, veins, arteries, capillaries, red blood cells, plasma, white blood cells, clotting, platelets, nutrients and hormones. Numeracy: The human heart is an amazing example of bio-engineering. Beating 70 times a minute it pumps a staggering 50,000 litres of blood per day. Over a lifetime that an amazing 1500,000,000 or 1.5 trillion litres of blood PLTS Independent enquirers Creative thinkers Reflective learners We will focus on Team workers Effective participators Self managers

Friday 21 October 2011 B2.10 The heart Introduction: The heart, a four chambered pump which pumps blood to the lungs, picking up oxygen and excreting carbon dioxide and then to the body delivering oxygen and nutrients to every respiring cell, via a network of arteries, veins and capillaries. The ventricles create sufficient pressure by squeezing to send blood either to the lungs (right ventricle) or the rest of the body (left ventricle). Lifestyle including a high fat and salt diet, smoking excessive alcohol intake and irregular exercise can lead to the development of heart disease particualr in men aged between 40 and 60. Extension questions: 1: Which arteries supply the heart with its own blood supply ? 2: There are three types of muscle. Which type of muscle is found in the heart ? 3: Explain why the heart atria are very thin walled and the heart ventricles are very thick walled ? 4: Name the artery that leaves the left ventricle and supply blood to the body 5: Name the vein that brings blood from the body to the right atria ? 6: Explain how you could take a resting pulse of a patient ? Know this: a: Know the anatomy and function of the circulatory system. b: Know that certain lifestyle factors like smoking and salt intake can cause heart disease particularly in men

Look at the photograph and information and answer all the questions: The cardiovascular system’s role is to transport useful substance like oxygen and nutrients to respiring cells whilst removing waste substances like carbon dioxide and urea. Your blood also transports hormones produced by the endocrine glands, for example adrenalin. White blood cells, antibodies and platelets are also transported by the blood and help prevent infection caused by viruses and bacteria. The heart pumps blood to which organs to pick up oxygen ? Arteries take blood away from the heart...which blood tubes take blood towards the heart ? Explain how red blood cells are adapted to carry oxygen around the entire circulatory system ? Red blood cell Cardiovascular system Key concepts B2.10 a

Key concepts B2.10 b Look at the photograph and information and answer all the questions: The human heart’s function is to pump blood to the lungs (RA, RV) and to the the body (LA, LV). Valves between the four chambers (Atria and Ventricles) open and close to prevent blood from being forced backed when the ventricles contract. The difference in blood pressure in the arties and veins allows blood to flow around the body. What is unique about the pulmonary artery and the pulmonary vein ? True or false if you remove a small piece of heart muscle it would twitch or contract about 72 times a minute ? Explain why the left ventricle is far large and muscular when compared to the hearts right ventricle ? Anatomy of the heart

Key concepts B2.10 c Look at the photograph and information and answer all the questions: The heart does not work alone to deliver oxygen and nutrients to the entire body. Blood is pumped around a highly complex system of blood vessels measuring over 40,000 km in the average human. There are three types of blood vessels: Arteries, Veins and Capillaries. Arteries carry blood at the highest pressure away from the heart and therefore have the thickest elastic muscle wall of all of the different types of blood tubes. All arteries carry blood away from the heart, but do all arteries carry oxygenate blood ? Veins carry blood at low pressure (80 mm Hg) and arteries carry blood at high pressure (120 mm Hg). Explain the differences in their anatomy ? Capillaries are single celled narrow tubes that allow oxygen and nutrients to reach all cells. Explain why they are one cell thick ? Elastic fibres Outer wall Valve Thin muscle Outer wall Thick muscle Elastic fibres Capillaries Artery Vein

Key concepts B2.10 d Look at the photograph and information and answer all the questions: Atherosclerosis is the result of an atheroma forming in an artery or the hardening of the arteries, which is the build up of fat deposits forming on the walls of the artery. This causes a reduction in blood-flow in one or more of the arteries and blood clots are more likely to form as the lumen progressively becomes narrower. Heart cells are dependent on blood flow to provide oxygen and nutrients for the heart muscle to be able to function properly. Without the right conditions and coronary arteries becoming blocked, a myocardial infarction can occur. List 3 lifestyle factors that are associated with the early onset of arthrosclerosis in humans ? How would you reduce deaths from CHD in working class males ? (Tackle at least three lifestyle factors though various ways ie. Education, taxes and NHS e.t.c. )

B2.10 Plenary Lesson summary: double cardiac body blood The heart contains _______ muscle which contracts to pump _______ a moving tissue around a closed ______ circuit. The first loop oxygenates blood, with the second loop pumping the blood around the entire _______. The heart is a unique piece of bioengineering beating 72 times a minuet until you die. The average volume of an adult heart is about 200 cm 3 . This means the heart pumps 0.2 litres x 72 x 60 x 24 x 365 x 84 = 635,765,760 or about 650 million litres of blood in a single life. How Science Works: Friday 21 October 2011 Research into how scientists determine the life style factors that cause disease like for example linking smoking with the incidence of lung cancer. Preparing for the next lesson: Decide whether the following statements are true or false : False True 3: Tendons and valves which prevent backflow o blood inside the heart ? False True 2: The left side of the heart is more muscular than the right side of the heart ? False True 1: The heart has three chambers ?

B2.11 Causes of disease in humans Decide whether the following statements are true or false: Lesson objectives: Understand how scientists can identify lifestyle factors for lifestyle disease Understand the evidence required to prove a causal link between a lifestyle factor and a lifestyle disease Literacy: Lifestyle factors, disease, risk, disease, lung cancer, stroke, heart attack, diabetes, obesity, atherosclerosis, high blood pressure, strokes and fatty deposits. Friday 21 October 2011 Numeracy: It is estimated that over 35,000 deaths here in the UK every year are caused by heart disease alone. Scotland with its ‘deep fried mars bars’ culture, heavy drinking and smoking has the worst death rate of all...not surprising ! First activity: Atherosclerosis is a condition where fatty deposits build up on the inside of the arteries and veins. Give three lifestyle factors that promote the development of these fatty deposits. PLTS Independent enquirers Creative thinkers Reflective learners We will focus on Team workers Effective participators Self managers

B2.11 Friday 21 October 2011 Causes of disease in humans Introduction: In the 1950s two scientists tracked data from over 25,000 UK doctors reporting the causes of death of over 3 million people. The data collected by doctors also contained lifestyle choices like whether the deceased smoked or lived with a partner that smoked. The main findings of their study were: Smokers on average die 14 years younger than a non smoker One in two life long smokes will contract lung cancer Stopping smoking reduces the risk of either dying young or contracting lung cancer At the same time molecular biologists showed how cancer causing chemical in cigarette smoked alter a lung cells DNA that led to the formation of cancerous cells. Extension questions: 1: Give one example of a positive correlation and one example of a negative correlation ? 2: Showing that smokers die younger and have a higher incidence of lung cancer is not sufficient evidence to link smoking with lung cancer. Give another form of evidence that further proves the link ? 3: In the 1950 and 60s many scientists disagreed with the link between smoking and lung cancer. Give two reasons why ? 4: Explain why non smokers who liver with people that smoke have a higher than expected risk of developing lung cancer ? 5: Explain why all cigarette packets must be now sold with a ‘health warning’ including a photo ? Know this: a: Know how scientists link lifestyle factors to lifestyle disease. b: Know the different forms of evidence required to prove a link between a risk factor and a disease

B2.11 a Look at the photograph and information and answer all the questions: Your lungs exchange oxygen for carbon dioxide between the alveoli tissue and your red blood cells. In addition to smoking, your lungs can be damaged by your place of work or even where you live. Our lungs take in over fifty litres of air every minute of the day. The quality of the air we breathe at work, where we live and play affects how our lungs perform over our lifetimes. The alveoli tissue exchanges oxygen for carbon dioxide...explain what this process of gas molecules moving is called ? Lungs and smoking Normal Cancerous Anatomy of lungs Smokers die on average 14 years younger than non smokers...do you think we should ban the sale of all cigarettes ? Give three ways you could discourage people to take up smoking an three ways you could support people giving up smoking ? Key concepts Capillaries Bronchioles Alveolus Alveoli

B2.11 b Look at the photograph and information and answer all the questions: Dr Richard Doll in 1947 investigated the causes of death in 3500 people admitted to St. Thomas Hospital where he worked. He presented a summary (table above) of his findings. This was the first study to link tobacco smoke and cause of death. Smoke contains carbon monoxide, tars and nicotine, they all have different effects on the body most of all on the respiratory and cardiovascular system. Nicotine is a stimulant and promotes the release of adrenalin in the body. What effects would nicotine have on a) heart rate b) diameter of blood vessels and c) blood pressure ? Did Dr. Doll in 1948 prove a link conclusively between smoking and an increased risk of death from a) lung cancer b) heart attack c) stroke and d) atherosclerosis (fatty deposits in arteries ? Deaths in smokers and non smokers Cause of death Non smokers Smokers Lung cancer 114 922 Heart attack 285 1865 Stroke 26 136 Atherosclerosis 33 119 Total 458 3042 Key concepts

Look at the photograph and information and answer all the questions: Studies of deaths from disease associated with lifestyle factors show that the probability of death form risk factors including smoking, high blood pressure and high blood cholesterol amongst the population is not evenly distributed. Poor lifestyle choices mean that people often make bad choices in not one but two and sometimes three risk factors, for example they often smoke, do no exercise and have a high fat and salt diet casing high blood pressure and high blood cholesterol levels. Should NHS funding be used to treat people who are in the groups that have 2 or more risk factors for disease that cause death in humans ? If you were a pension company would you prefer lots of group A or lots of group D people and if you were a medical insurance company which group would you prefer ? Risk factors 400 300 200 100 0 A B C D Group (risk factors) Total risk 77 120 236 384 Average risk Smokers Blood Blood Group Yes/No Pressure Cholesterol A No Normal Normal B Yes Normal Normal C Yes High Normal D Yes High High B2.11 c Key concepts

B2.11 Plenary Lesson summary: lung smoking younger data The link between __________ and _________ cancer was first suggested by looking a _______ and cause of deaths in the 1950s. Dr. R Doll look at the causes of death in over 3000 patients and showed that smokers died on average 14 years younger and have a 50% of chance of contracting lung cancer A comprehensive study of female lung cancer mortality trends in Europe shows rates are still rising. This is because women are smoking in higher numbers when compared to men who are now begging to give up, It seems that men now understand the link between smoking and lung cancer. How Science Works: Friday 21 October 2011 Research into what makes a good study. Preparing for the next lesson: Decide whether the following statements are true or false : False True 3: The link between smoking and lung cancer is now firmly established ? False True 2: When smokers give up they reduce their risk of contracting lung cancer ? False True 1: Smoke contain over 300 chemicals that are known to cause cancer ?

B2.12 What makes a good study Decide whether the following statements are true or false: Lesson objectives: Understand what makes a good study Understand what factors make a study reliable and unreliable Understand how we can begin to know and manage risk form life style factors We will focus on. Friday 21 October 2011 First activity: A friend started of yours starts to smoke and they are unconvinced that smoking causes lung cancer. How would you convince them that smoking increase your risk of dying early or from contracting lung cancer ? PLTS Independent enquirers Creative thinkers Reflective learners We will focus on Team workers Effective participators Self managers Literacy: Lifestyle factors, disease, risk, disease, lung cancer, stroke, heart attack, diabetes, obesity, atherosclerosis, high blood pressure, strokes and fatty deposits. Numeracy: It is estimated that over 100,000 deaths here in the UK every year are caused by stokes, lung cancer, heart disease and liver failure These disease are largely caused by life style factors like diet, smoking and alcohol.

Friday 21 October 2011 B2.12 What makes a good study Extension questions: 1: Why do scientists conduct research on the safety of new devices like mobile phones or the risk of a lifestyle factor like drinking or smoking ? 2: Why do a) sample sizes have to be large b) the people chosen have to be c) similar age d) similar ethnicity and e) have similar medical histories ? 4: Would you trust the findings of a study paid for and reached by scientists employed by a mobile phone company saying that mobiles are risk free and completely safe to use ? Know this: a: Know how studies are carried out to provide data that is reliable, repeated and trusted by other scientists. b: Know that large samples of people of similar ages are researched. Introduction: Scientists will look for any causal link between lifestyle factors like smoking and lifestyle diseases link lung cancer. Showing a correlation between a lifestyle factor and a lifestyle disease also needs further confirmation by how a factor leads to that disease for example chemicals in cigarette smoke change lung cell DNA. Good studies also need to consider: sample size (sample should be as large as possible with people being selected randomly to avid bias. people from both groups, should be of similar age and matched for as many other factors as possible) Funding for the study should be independent of interested parties like the government or mobile phone companies. Above the data reported should be reviewed by other scientists and be repeatable.

B2.12 a Look at the photograph and information and answer all the questions: Probability and risk: We calculate risk and probability all the time in our lives. The government also calculate risk and risk factors for many disease including heart disease and lung cancer. Knowing the risk profile of a population or even a sub-population helps you allocated resources for treatment and moreover education. Why is it important to educate people in understanding and avoiding risk factors in diseases like lung cancer, stroke and heart disease ? Work out the probability of guessing a) the right number followed by the right colour on a roulette table and b) throwing a six and then another six using a six sided dice ? If a person smokes, consumes a high fat and salt diet and is overweight are they subject to more risk than someone who just smokes ? Key concepts

B2.12 b Look at the photograph and information and answer all the questions: What to check Health surveys and even clinical trials are scientific and medical research studies designed to find better ways to treat or prevent diseases. The survey or trial itself must study a large enough sample to be meaningful and ensure that the findings can be repeated by other scientists. A survey or trail must also be free of any interested parties. Why are people and governments interested in health risks and lifestyle factors like smoking and diet ? Consuming a high fat diet has been proved to increase your risk of dying from heart disease. Do you think high fat foods should carry government health warning ? Many studies have show a ‘cast iron’ link between smoking and lung cancer. Why do you think the government still allow their sale in shops ? Sample size Who’s in the sample group Are the outcomes different Who conducted the survey Is the sample size big enough to represent the population you are trying to study ? People in both sample should be matched for age, sex, lifestyle. When you compare the findings for the two groups are the differences significant ? Why to check Was the survey independent and free from pressure from governments or companies ? Key concepts

Key concepts B2.12 c Look at the photograph and information and answer all the questions: Myocardial infarction is where a part of the heart muscle suddenly loses its blood supply. If you have an MI, a coronary artery or one of its smaller branches is suddenly blocked. The part of the heart muscle supplied by this artery loses its blood (and oxygen) supply. This part of the heart muscle is at risk of dying unless the blockage is quickly undone. 'infarction' means death of some tissue. Explain what happens to the heart tissue that in downstream of the blocked arteries ? Explain why a blockage that occurs toward the aorta is more life threatening than if the blockage occurs at the very bottom ? What advise would you give if you had a friend who has male relatives that have died from CVD between the ages of 45 and 56 ? Myocardial infarction

B2.12 d Look at the photograph and information and answer all the questions: Consuming foods high in sugar and fat and low in bulk tend to upset the right balance. Excess chemical energy in your diet leads to greater assimilation, weight gain and eventually obesity. Some individuals who are grossly obese, store upwards of a million additional kilojoules in their body as fat. Look at the information opposite. It records the number of men who fall into different groups for blood serum cholesterol and the death rates per 1000 from heart disease. Answer the following questions what the range in humans for blood serum cholesterol levels Which levels has the most number of men Is there a firm link between blood serum cholesterol levels and risk of death from heart disease. 14 12 10 8 6 4 4.1 4.9 4.9 5.7 5.7 6.5 6.5 7.3 7.3 8.1 8.1 8.8 Serum cholesterol levels mmol -1 Deaths per 1000 Heart disease Key concepts

B2.12 e Look at the photograph and information and answer all the questions: Look at the graph left, the association between saturated fat in the diet and death from heart disease is show, but no causal link is proved. After more analysis and further studies, a firmer link between saturated fat and deaths from heart disease can be shown. These studies involved clinical trials and clinical intervention. If you treated a large mixed group of people from the US and Finland with statins which lower blood cholesterol and they showed a reduce incidence of deaths from heart disease would that allow you to make a definite link between the two factors ? A second study looked at the effects of intervention for vulnerable (at risk) people and show that by buying them low fat products and giving them free membership to a gym reduced their risk of heart disease...what would this study tell you ? 800 600 400 200 0 0 5 10 15 20 25 CVD Deaths per 10,000 lives Sat Fat intake (5) Japan Greece Italy Yugo US Finland Dutch France Negative correlation No correlation Key concepts

B2.12 Plenary Lesson summary: aneurism lungs three fatty Arteries and (veins) can become blocked by ______ deposits that build up over time in a _______ stage process. This blockage can cause high blood pressure and results in a arterial rupture or __________. The fatty deposits can also break off and block a key artery to the heart, _______ or brain. If you’re male have family members who have died or suffer from heart disease, are unfit and eats lots of animal fats including cholesterol your are not likely to make it to 60. Taking statins, drugs that lower blood cholesterol, exercising and of course eating less fats will prolong your life by about 20 years. How Science Works: Friday 21 October 2011 Revise for end of module test. Preparing for the next lesson: Decide whether the following statements are true or false : False True 3: A high fat diet leads to high blood fat levels which cause narrowed arteries ? False True 2: A high salt and fat diet are risk factors for lung cancer ? False True 1: Death from heart disease increase with age and pose a higher risk for males ?

B2 lesson part two

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B2 lesson part two