dr john insall new york using fixed bearing system dr frederick buechel dr michael pappas using mobile bearing system ref name hamelynck ref external fixation fractures refined american surgeons vietnam war major contribution made gavril abramovich ilizarov ussr sent without much orthopedic training look injured russian soldiers siberia equipment confronted crippling conditions unhealed infected misaligned fractures help local bicycle shop devised ring external fixators tensioned


completing residency training fellowship training orthopedic sub specialty typically one year duration sometimes two sometimes research component involved clinical operative training examples orthopedic subspecialty training united states hand upper extremity shoulder elbow total joint reconstruction arthroplasty pediatric orthopedics foot ankle surgery spine surgery orthopedic oncologist surgical sports medicine orthopedic trauma hip knee surgery osseointegration specialized areas medicine exclusive orthopedic surgery example hand surgery practiced plastic surgeons spine surgery practiced

Applied science
Medicine and health
Surgery
Orthopedic surgery


neurosurgeons additionally aspects foot ankle surgery also practiced board certified doctors podiatric medicine dpm united states family practice physicians practice sports medicine scope practice nonoperative completion specialty residency registrar training orthopedic surgeon eligible board certification american board medical specialties american osteopathic association bureau osteopathic specialists certification american board orthopedic surgery american osteopathic board orthopedic surgery means orthopedic surgeon met specified educational evaluation examination requirements


board process requires successful completion standardized written examination followed oral examination focused surgeon 's clinical surgical performance month period canada certifying organization royal college physicians surgeons canada australia new zealand royal australasian college surgeons united states specialists hand surgery orthopedic sports medicine may obtain certificate added qualifications addition board primary certification successfully completing separate standardized examination additional certification process exists


subspecialties practice radiography identify eventual bone fractures knee injury orthopedic implants repair fractures radius ulna note visible break ulna right forearm anterior lateral view x rays fractured left leg internal fixation surgery according applications board certification top common procedures order performed orthopedic surgeons knee arthroscopy meniscectomy shoulder arthroscopy decompression carpal tunnel release knee arthroscopy chondroplasty removal support implant knee arthroscopy anterior


repair trochanteric fracture typical schedule practicing orthopedic surgeon involves hours work per week divided among clinic surgery various administrative duties possibly teaching research academic setting arthroscopy use arthroscopic techniques particularly important injured patients arthroscopy pioneered early dr masaki watanabe japan perform minimally invasive cartilage surgery reconstructions torn ligaments arthroscopy allows patients recover surgery matter days rather weeks months required conventional open surgery


uni compartmental knee replacement one weight bearing surface arthritic knee replaced popular alternative joint replacements available joints variable basis notably hip shoulder elbow wrist ankle spine finger joints recent years surface replacement joints particular hip joint become popular amongst younger active patients type operation delays need traditional less bone conserving total hip replacement carries significant risks early failure fracture bone death one main problems


joint replacements wear bearing surfaces components lead damage surrounding bone contribute eventual failure implant use alternative bearing surfaces increased recent years particularly younger patients attempt improve wear characteristics joint replacement components include ceramics metal implants opposed original metal plastic plastic chosen usually ultra high molecular weight polyethylene also altered ways may improve wear characteristics epidemiology prevalence musculoskeletal procedures drastically


increased us operating room procedures performed hospital stays study hospitalizations united states spine joint procedures common among age groups except infants spinal fusion one five common procedures performed every age group except infants younger year adults years older laminectomy common among adults aged years knee arthroplasty hip replacement top five procedures adults aged years older see also outline


ability function efficiently effectively work leisure activities healthy resist hypokinetic diseases improve immune system meet emergency situations overview fitness defined quality state fit healthy around perhaps consistent industrial revolution treatise world war ii term fitness increased western vernacular factor ten modern definition fitness describes either person machine 's ability perform specific function holistic definition human adaptability cope various situations

Human physical performance and recreation


important part overall fitness often presented textbooks triangle made three points represent physical emotional mental fitness physical fitness also prevent treat many chronic health conditions brought unhealthy lifestyle aging working also help people sleep better building sleeping pressure possibly alleviate mood disorders certain individuals ref name ref developing research demonstrated many benefits exercise mediated role skeletal muscle endocrine organ contracting muscles release multiple substances


known myokines promote growth new tissue tissue repair various anti inflammatory functions turn reduce risk developing various inflammatory diseases activity guidelines physical activity guidelines americans released us department health human services provide science based guidance people ages years older improve health participating regular physical activity guidelines recommend adults move sit less throughout day improve health related quality life including mental emotional physical health substantial health


benefits adults perform least minutes moderate intensity minutes per week vigorous intensity aerobic physical activity equivalent combination spread throughout week recommendation physical activity occur bouts least minutes eliminated new research suggests bouts length contribute health benefits linked accumulated volume physical activity additional health benefits may achieved engaging minutes hours moderate intensity physical activity per week adults also muscle strengthening activities


moderate greater intensity involve major muscle groups two days week activities provide additional health benefits guidelines united kingdom released july include following points intensity person exercises key light activity strolling house work unlikely much positive impact health people aerobic exercise beneficial must raise heart rate cause perspiration person minimum minutes week moderate intensity aerobic


international tennis player barbora strycova cardiorespiratory fitness measured using vo sub sub max measure amount oxygen body uptake utilize ref name r ref name pmid ref aerobic exercise improves cardiorespiratory fitness increase stamina involves movement increases heart rate improve body 's oxygen consumption form exercise important part training regiments ranging professional athletes everyday person prominent examples aerobic exercises include jogging running steady gentle pace form exercise great maintaining weight building cardiovascular


base later perform intense exercises working elliptical trainer stationary exercise machine used perform walking running without causing excessive stress joints form exercise perfect people achy hips knees ankles walking moving fairly regular pace short medium long distance treadmill training many treadmills programs set offer numerous different workout plans one effective cardiovascular activity would switch running walking typically warm first walking switch walking


three minutes running three minutes swimming using arms legs keep oneself afloat water moving either forwards backward good full body exercise looking strengthen core improving cardiovascular endurance cycling riding bicycle typically involves longer distances walking jogging another low impact exercise joints great improving leg strength ref name r anaerobic exercise anaerobic exercise features high intensity movements performed short period time fast high intensity exercise


require body utilize oxygen produce energy helps promote strength endurance speed power used bodybuilders build workout intensity anaerobic exercises thought increase metabolic rate thereby allowing one burn additional calories body recovers exercise due increase body temperature excess post exercise oxygen consumption epoc exercise ended prominent examples anaerobic exercises include weight training common type strength training developing strength size skeletal muscles isometric exercise helps maintain strength muscle action


us military base sprint sprint athlete must trained work anaerobically throughout race example would interval training century ride cyclists must prepared aerobically bike ride miles middle distance running athletes require speed endurance gain benefit training hard working muscles peak longer period time used level longer period time marathon case athlete must trained


work aerobically endurance must built maximum many firefighters police officers undergo regular fitness testing determine capable physically demanding tasks required job members armed forces often required pass formal fitness test example soldiers us army must able pass army physical fitness test apft hill sprints requires high level fitness begin exercise particularly good leg muscles army often trains mountain climbing races plyometric isometric


exercises excellent way build strength increase muscular endurance sand running creates less strain leg muscles running grass concrete sand collapses beneath foot softening landing sand training effective way lose weight become fit effort needed one half times run soft sand hard surface aquajogging form exercise decreases strain joints bones water supplies minimal impact muscles bones good recovering injury


furthermore resistance water one jogs provides enhanced effect exercise deeper greater force needed pull leg swimming squatting exercise helps enhancing swimmer 's start physical fitness activity benefit individual exertion must trigger sufficient amount stimuli exercise correct amount intensity duration frequency produce significant amount improvement person may overall feel better physical effects human body take weeks months notice possibly years full development


training purposes exercise must provide stress demand either function tissue continue improvements demand must eventually increase little extended period time sort exercise training three basic principles overload specificity progression principles related health also enhancement physical working capacity ref name blair ref high intensity interval training high intensity interval training hiit consists repeated short bursts exercise completed high level intensity sets intense activity followed predetermined time rest low intensity activity studies


shown exercising higher intensity increased cardiac benefits humans compared exercising low moderate level one 's workout consists hiit session body work harder replace oxygen lost research benefits hiit shown successful reducing fat especially around abdominal region furthermore compared continuous moderate exercise hiit proves burn calories increase amount fat burned post hiit session lack time one main reasons stated


exercising hiit great alternative people duration hiit session short minutes making much quicker conventional workouts effects controlling blood pressure physical fitness proven support body 's blood pressure staying active exercising regularly builds stronger heart heart main organ charge systolic blood pressure diastolic blood pressure engaging physical activity raises blood pressure subject stops activity blood pressure returns normal physical activity easier


process becomes resulting fitter cardiovascular profile regular physical fitness becomes easier create rise blood pressure lowers force arteries lowers overall blood pressure cancer prevention centers disease control prevention provide lifestyle guidelines maintaining balanced diet engaging physical activity reduce risk disease wcrf american institute cancer research aicr published list recommendations reflect evidence found consistency fitness dietary factors directly relate cancer prevention wcrf aicr


one women day ref name auto alberts david hess lisa ''fundamentals cancer prevention'' berlin springer ref recommendations also widely supported american cancer society guidelines evaluated individuals higher guideline adherence scores substantially reduce cancer risk well help control multitude chronic health problems regular physical activity factor helps reduce individual 's blood pressure improves cholesterol levels two key components correlate heart disease type diabetes american cancer society encourages public adopt physically active


lifestyle meeting criteria variety physical activities hiking swimming circuit training resistance training lifting etc understood cancer disease cured physical fitness alone however multifactorial disease physical fitness controllable prevention large associations tied physically fit reduced cancer risk enough provide strategy reduce cancer risk ref name auto american cancer society asserts different levels activity ranging moderate vigorous clarify recommended time spent physical activity classifications


physical activity consider intentional exercise basic activities performed daily basis give public greater understanding fitness levels suffice future disease prevention inflammation studies shown association increased physical activity reduced inflammation produces short term inflammatory response long term anti inflammatory effect physical activity reduces inflammation conjunction independent changes body weight however mechanisms linking physical activity inflammation unknown immune system physical activity boosts immune system dependent concentration endogenous factors


directly affected engaging aerobic exercise strength training known increase amount muscle body however also reduce body fat ref name r sex steroid hormones insulin appropriate immune responses factors mediate metabolism relation abdominal fat therefore physical fitness provides weight control regulation bodily functions menopause physical fitness menopause often said occurred woman vaginal bleeding year since last menstrual cycle number symptoms connected menopause


affect quality life woman involved stage life one way reduce severity symptoms exercise keep healthy level fitness prior menopause female body changes physical physiological internal changes body changes reduced even prevented regular exercise changes include preventing weight gain around menopause women tend experience reduction muscle mass increase fat levels increasing amount physical exercise undertaken


help prevent changes reducing risk breast cancer weight loss regular exercise may offer protection breast cancer strengthening bones physical activity slow bone loss associated menopause reducing chance bone fractures osteoporosis reducing risk disease excess weight increase risk heart disease type diabetes regular physical activity counter effects boosting mood involved regular activities improve psychological health effect seen age menopause melbourne women 's midlife


health project followed women eight year period providing evidence showing even though physical activity associated vms cohort beginning women reported physically active every day beginning less likely reported bothersome hot flushes contrast women whose level activity decreased likely experience bothersome hot flushes mental health studies shown physical activity improve mental health well ref name callaghan ref improvement due increase blood flow brain


allowing release hormones well decrease stress hormones body eg cortisol adrenaline also stimulating human body 's mood boosters natural painkillers exercise release feel good hormones also remove one 's worries help build confidence trends improve physical activity performed consistent basis makes exercise effective relieving symptoms depression anxiety positively impacting mental health bringing several benefits example ref name sharma ref physical activity linked alleviation depression anxiety symptoms ref name callaghan


patients suffering schizophrenia physical fitness shown improve quality life decrease effects schizophrenia fit improve one 's self esteem working improve one 's mental alertness reduce fatigue studies shown reduction stress levels increased opportunity social interaction allowing improved social skills ref name sharma achieve benefits centers disease control prevention suggests least minutes exercise times week history ladies performing common th century fitness routine including climbing underside


ladder balancing gymnastics physical fitness always important part life theorized people left hunter gatherer lifestyle formed fixed communities based around agriculture physical fitness levels declined say levels physical labor decreased type work undertaken necessarily conducive general level fitness regimented fitness regimes either invented became common especially case classical civilizations ancient greece rome greece physical fitness considered


essential component healthy life norm men frequent gymnasium physical fitness regimes also considered paramount importance nation 's ability train soldiers effective military force partly reasons organized fitness regimes existence throughout known history evidence found many countries gymnasiums would seem familiar today began become increasingly common th century industrial revolution led sedentary lifestyle many people increased awareness


potential harmful health key motivating factor forming physical culture movement especially europe usa movement advocated increased levels physical fitness men women children sought various forms indoor outdoor activity education many ways laid foundations modern fitness culture education american council exercise ace national academy sports medicine nasm international sports science association issa see also references ref ref name r ref ref name r ref


external links physical exercise strength training


boy drinks tap newah wash water project http newahorgnp puware shikhar udayapur district nepal checking wells boy waterfall phu sang national park thailand dem novsk cave liberty emerald lake karst spring cuneo piemonte italy https alpioccidentaliwordpresscom valle pesio giugno '''hydrogeology''' ''hydro '' meaning water '' geology'' meaning study earth area geology deals distribution movement groundwater soil rocks earth 's crust commonly aquifers terms '''groundwater hydrology''' '''geohydrology''' '''hydrogeology''' often used interchangeably '''hydrogeology''' study laws governing

Natural science
Earth science
Hydrogeology


movement subterranean water mechanical chemical thermal interaction water porous solid transport energy chemical constituents particulate matter flow domenico schwartz groundwater engineering another name hydrogeology branch engineering concerned groundwater movement design wells pumps drains main concerns groundwater engineering include groundwater contamination conservation supplies water quality ref name principles walton william c november ''principles groundwater engineering'' p crc press ref wells constructed use developing nations well use


developed nations places connected city water system wells must designed maintained uphold integrity aquifer prevent contaminants reaching groundwater controversy arises use groundwater usage impacts surface water systems human activity threatens integrity local aquifer system introduction hydrogeology interdisciplinary subject difficult account fully chemical physical biological even legal interactions soil water nature society study interaction groundwater movement


geology quite complex groundwater always follow surface topography groundwater follows pressure gradients flow high pressure low often fractures conduits circuitous paths taking account interplay different facets multi component system often requires knowledge several diverse fields experimental theoretical levels following traditional introduction methods nomenclature saturated subsurface hydrology hydrogeology relation fields painting ivan aivazovsky hydrogeology stated branch earth sciences dealing


flow water aquifers shallow porous media typically less land surface shallow flow water subsurface upper pertinent fields soil science agriculture civil engineering well hydrogeology general flow fluids water hydrocarbons geothermal fluids etc deeper formations also concern geologists geophysicists petroleum geologists groundwater slow moving viscous fluid reynolds number less unity many empirically derived laws groundwater flow alternately


derived fluid mechanics special case stokes flow viscosity pressure terms inertial term piezometer device used measure hydraulic head groundwater mathematical relationships used describe flow water porous media darcy 's law diffusion laplace equations applications many diverse fields steady groundwater flow laplace equation simulated using electrical elastic heat conduction analogies transient groundwater flow analogous diffusion heat solid therefore solutions hydrological problems adapted heat transfer


literature traditionally movement groundwater studied separately surface water climatology even chemical microbiological aspects hydrogeology processes uncoupled field hydrogeology matures strong interactions groundwater surface water water chemistry soil moisture even climate becoming clear california washington require special certification hydrogeologists offer professional services public twenty nine states require professional licensing geologists offer services public often includes work within domains developing managing remediating groundwater resources example aquifer drawdown


water medium eg release water storage confined aquifers related storativity related specific yield unconfined aquifers aquifers px aquifer collection water underneath surface large enough useful spring well aquifers unconfined top aquifer defined water table confined aquifer exists underneath confining bed ref name ncdeq north carolina department environmental quality ''basic hydrogeology'' https wwwncwaterorg page ref three aspects control nature


aquifers stratigraphy lithology geological formations deposits stratigraphy relates age geometry many formations compose aquifer lithology refers physical components aquifer mineral composition grain size structural features elements arise due deformations deposition fractures folds understanding aspects paramount understanding aquifer formed professionals utilize groundwater engineering ref name birzeitaq birzeit university groundwater engineering ''groundwater potential discharge areas'' http wwwhweorgps education birzeit groundwaterengineering chapter groundwater potential discharge areaspdf ref hydraulic head differences hydraulic head


saturated aquifers ''z'' measured relative surveyed datum typically top well casing commonly wells tapping unconfined aquifers water level well used proxy hydraulic head assuming vertical gradient pressure often ''changes'' hydraulic head time needed constant elevation head term left '' h '' record hydraulic head time well hydrograph changes hydraulic head recorded pumping well test


called drawdown porosity left high porosity well sorted right low porosity poorly sorted porosity ''n'' directly measurable aquifer property fraction indicating amount pore space unconsolidated soil particles within fractured rock typically majority groundwater anything dissolved moves porosity available flow sometimes called effective porosity '''permeability''' expression connectedness pores instance unfractured rock unit may high ''porosity'' many ''holes'' constituent grains low ''permeability''


''k'' constant entire thickness properties measures aquifer 's ability transmit water intrinsic permeability '' '' secondary medium property depend viscosity density fluid ''k'' ''t'' specific water used petroleum industry specific storage specific yield illustration seasonal fluctuations water table specific storage ''s sub sub '' depth integrated equivalent storativity ''s sub sub b'' indirect aquifer properties cannot measured directly indicate amount groundwater released storage due unit


depressurization confined aquifer fractions specific yield ''s sub sub '' also ratio ''s sub sub '' porosity indicates amount water released due drainage lowering water table unconfined aquifer value specific yield less value porosity water remain medium even drainage due intermolecular forces often porosity effective porosity used upper bound specific yield typically ''s sub sub '' orders magnitude larger ''s sub sub '' fault zone


hydrogeology fault zone hydrogeology study brittlely deformed rocks alter fluid flows different lithological settings clastic igneous carbonate rocks fluid movements quantified permeability facilitated impeded due existence fault zone ref name faultzone ref different mechanism deformed rocks alter porosity hence permeability within fault zone fluids involved generally groundwater fresh marine waters hydrocarbons oil gas ref name faultzone ref contaminant transport properties often interested moving groundwater transport dissolved


contaminants around sub field contaminant hydrogeology contaminants man made eg petroleum products nitrate chromium radionuclides naturally occurring eg arsenic salinity besides needing understand groundwater flowing based hydrologic properties discussed additional aquifer properties affect dissolved contaminants move groundwater x px hydrodynamic dispersion hydrodynamic dispersivity sub l sub sub sub empirical factor quantifies much contaminants stray away path groundwater carrying contaminants behind ahead mean groundwater giving rise


water find preferential path one direction different direction contaminant spread completely irregular way like three dimensional delta river dispersivity actually factor represents ''lack information'' system simulating many small details aquifer effectively averaged using macroscopic approach eg tiny beds gravel clay sand aquifers manifest ''apparent'' dispersivity often claimed dependent


length scale problem dispersivity found transport nbsp sup sup aquifer different transport nbsp cm sup sup aquifer material molecular diffusion diffusion fundamental physical phenomenon albert einstein characterized brownian motion describes random thermal movement molecules small particles gases liquids important phenomenon small distances essential achievement thermodynamic equilibria time necessary cover distance diffusion proportional square distance


ineffective spreading solute macroscopic distances diffusion coefficient typically quite small effect often considered negligible unless groundwater flow velocities extremely low clay aquitards important confuse diffusion dispersion former physical phenomenon latter empirical factor cast similar form diffusion already know solve problem retardation adsorption retardation factor another important feature make motion contaminant deviate


average groundwater motion analogous retardation factor chromatography unlike diffusion dispersion simply spread contaminant retardation factor changes ''global average velocity'' much slower water due chemico physical effect adsorption soil holds contaminant back allow progress quantity corresponding chemical adsorption equilibrium adsorbed effect particularly important less soluble contaminants thus move even hundreds thousands times slower water


diffusion equation many analogs fields many solutions groundwater flow problems borrowed adapted existing heat transfer solutions often derived physical basis using darcy 's law conservation mass small control volume equation often used predict flow wells radial symmetry flow equation commonly solved polar cylindrical coordinates theis equation one commonly used fundamental solutions groundwater flow equation used predict transient evolution head


groundwater flow relative groundwater travel times use groundwater flow equation estimate distribution hydraulic heads direction rate groundwater flow partial differential equation pde must solved common means analytically solving diffusion equation hydrogeology literature laplace hankel fourier transforms reduce number dimensions pde similarity transform also called boltzmann transform commonly theis solution derived separation variables useful non cartesian coordinates green 's functions another common method deriving


analytical methods numerical methods something possibly typically analytic methods solve groundwater flow equation simplified set conditions ''exactly'' numerical methods solve general conditions ''approximation'' analytic methods analytic methods typically use structure mathematics arrive simple elegant solution required derivation simplest domain geometries quite complex involving non standard coordinates conformal mapping etc analytic solutions typically also simply equation give quick answer based basic parameters theis equation


simple yet still useful analytic solution groundwater flow equation typically used analyze results aquifer test slug test numerical methods topic numerical methods quite large obviously use fields engineering science general numerical methods around much longer computers richardson developed finite difference schemes still use today calculated hand using paper pencil human calculators become important availability


fast cheap personal computers quick survey main numerical methods used hydrogeology basic principles shown discussed groundwater model article two broad categories numerical methods gridded discretized methods non gridded mesh free methods common finite difference method finite element method fem domain completely gridded cut grid mesh small elements analytic element method aem boundary integral equation method biem sometimes also called bem boundary element method discretized


boundaries along flow elements line sinks area sources etc majority domain mesh free general properties gridded methods gridded methods like finite difference finite element methods solve groundwater flow equation breaking problem area domain many small elements squares rectangles triangles blocks tetrahedra etc solving flow equation element material properties assumed constant possibly linearly variable within element linking together elements using conservation mass across boundaries elements similar divergence theorem results


system overall approximates groundwater flow equation exactly matches boundary conditions head flux specified elements intersect boundaries finite differences way representing continuous differential operators using discrete intervals '' x'' '' t'' finite difference methods based derived taylor series example first order time derivative often approximated using following forward finite difference subscripts indicate discrete time location math frac partial h partial h' approx frac h h delta math forward finite difference approximation


unconditionally stable leads implicit set equations must solved using matrix methods eg lu cholesky decomposition similar backwards difference conditionally stable explicit used march forward time direction solving one grid node time possibly parallel since one node depends immediate neighbors rather finite difference method sometimes galerkin fem approximation used space different type fem often used structural engineering finite differences still used time


application finite difference models modflow well known example general finite difference groundwater flow model developed us geological survey modular extensible simulation tool modeling groundwater flow free software developed documented distributed usgs many commercial products grown around providing graphical user interfaces input file based interface typically incorporating pre post processing user data many models developed work modflow input output making linked models simulate several hydrologic processes possible flow


discrete places meshed geometry finite volume refers small volume surrounding node point mesh finite volume method volume integrals partial differential equation contain divergence term converted surface integrals using divergence theorem terms evaluated fluxes surfaces finite volume flux entering given volume identical leaving adjacent volume methods conservative another advantage finite volume method easily formulated allow unstructured meshes method


used many computational fluid dynamics packages porflow software package comprehensive mathematical model simulation ground water flow nuclear waste management developed analytic computational research inc acri fehm software package available free los alamos national laboratory versatile porous flow simulator includes capabilities model multiphase thermal stress multicomponent reactive chemistry current work using code includes simulation methane hydrate formation co sub sub sequestration oil shale extraction migration nuclear chemical contaminants environmental isotope migration unsaturated zone karst formation methods


bringing surface pump hand using buckets similar devices first historical instance water wells nd century bc modern day austria ref name pmid ref today wells used world developing nations suburbs united states three main types wells shallow deep artesian shallow wells tap unconfined aquifers generally shallow less meters deep shallow wells small diameter usually less centimeters deep wells access confined aquifers always drilled machine


design reliable aquifer providing continuous water supply quality accessible groundwater monitor well operating costs well expected yield well prior drilling aquifer five main areas considered planning constructing new water well along factors aquifer suitability well design considerations well drilling methods well screen design development well testing ref name well design matlock dan 'fundamentals water well design construction testing' pacific groundwater group ref aquifer suitability starts determining possible locations well using


usgs reports well logs cross sections aquifer information used determine aquifer properties depth thickness transmissivity well yield stage quality water aquifer also determined screening occur check contaminants ref name well design factors depth well yield determined well design drilling approach must established drilling method selected based soil conditions well depth design costs ref name well design stage cost estimates prepared plans adjusted


meet budgetary needs important parts well include well seals casings liners drive shoes well screen assemblies sand gravel pack optional components ensures well draws one aquifer leakage occurs stage process ref name well design several methods drilling used constructing water well include cable tool air rotary mud rotary flooded reverse circulation dual rotary drilling techniques ref name well design cable tool drilling inexpensive used types wells


alignment must constantly checked slow advance rate effective drilling technique consolidated formations provide small drilling footprint air rotary drilling cost effective works well consolidated formations fast advance rate adequate large diameter wells mud rotary drilling especially cost effective deep wells maintains good alignment requires larger footprint fast advance rate flooded reverse circulation dual rotary drilling expensive good large well designs


well aquifer several different tests completed well order test relevant qualities well ref name well design issues groundwater engineering hydrogeology contamination groundwater contamination happens fluids seep aquifer mix existing groundwater pesticides fertilizers gasoline common contaminants aquifers underground storage tanks chemicals gasoline especially concerning sources groundwater contamination tanks corrode leak contents contaminate nearby groundwater buildings connected wastewater treatment system


septic tanks used dispose waste safe rate septic tanks built maintained properly leak bacteria viruses chemicals surrounding groundwater landfills another potential source groundwater contamination trash buried harmful chemicals migrate garbage surrounding groundwater protective base layer cracked otherwise damaged chemicals road salts chemicals used lawns farms runoff local reservoirs eventually aquifers water goes water cycle contaminants


atmosphere contaminate water water also make way groundwater controversy fracking contamination groundwater due fracking long debated since chemicals commonly used hydraulic fracturing tested government agencies responsible determining effects fracking groundwater laboratories united states environmental protection agency epa hard time determining chemicals used fracking present nearby aquifers epa released report states drinking water contaminated fracking reversal previous policies


million study effects fracking local drinking water california california sees largest controversies groundwater usage due dry conditions california faces high population intensive agriculture conflicts generally occur pumping groundwater shipping area unfair use water commercial company contamination groundwater development projects siskiyou county northern california california superior court ruled poor groundwater regulations allowed pumping diminish flows scott river disturbed natural habitat salmon


owens valley central california groundwater pumped use fish farms resulted death local meadows ecosystems resulted lawsuit settlement fish companies development southern california threatening local aquifers contaminating groundwater construction normal human activity example solar project san bernardino county would allegedly threaten ecosystem bird wildlife species use million cubic meters groundwater could impact harper lake ref name grec groundwater rivers ecosystems conflicts http waterintheweststanfordedu groundwater conflicts indexhtml ref september california passed


sustainable groundwater management act requires users manage groundwater appropriately connected surface water systems ref name grec colorado due arid climate state colorado gets water underground issues regarding groundwater engineering practices many people affected high levels pfcs found widefield aquifer groundwater use colorado dates back th century nineteen colorado 's counties depend mostly groundwater supplies domestic uses colorado geological survey three significant reports


groundwater denver basin first report geology upper cretaceous paleocene eocene strata southwestern denver basin second report bedrock geology structure isopach maps upper cretaceous paleogene strata greeley colorado springs third publication cross sections freshwater bearing strata denver basin greeley colorado springs new trends groundwater engineering hydrogeology since first wells made thousands years ago groundwater systems changed human activity fifty years ago sustainability systems larger scale began come


consideration becoming one main focuses groundwater engineering new ideas research advancing groundwater engineering st century still considering groundwater conservation ref name newtrends ref topographical mapping new advancements arisen topographical mapping improve sustainability topographic mapping updated include radar penetrate ground help pinpoint areas concern addition large computations use gathered data maps knowledge groundwater aquifers recent years made highly complex individualized water cycle models possible helped make groundwater sustainability applicable


specific situations ref name newtrends role technology technological improvements advanced topographical mapping also improved quality lithosphere hydrosphere biosphere atmosphere simulations simulations useful however used together help give even accurate prediction future sustainability area changes made ensure stability area would possible without advancement technology technology continues progress simulations increase accuracy allow complex studies projects groundwater engineering ref


name newtrends growing populations populations continue grow areas using groundwater sustainable rate beginning face sustainability issues future populations size currently seen large cities taken consideration long term sustainability aquifers large population sizes beginning stress groundwater supply led need new policies urban areas known proactive land use management cities move proactively conserve groundwater brazil overpopulation caused municipally provided water run low due


name wellsandpopulation ref dependency groundwater united states united states drinking water comes groundwater supplies around rural population depends groundwater addition total groundwater country used irrigation used industrial processes recharge lakes rivers percent freshwater used us came groundwater percent came surface water groundwater important states n't access fresh water fresh groundwater percent


used irrigation percent used public purposes drinking mostly ref name gw groundwater foundation ''what groundwater'' http wwwgroundwaterorg get informed basics groundwaterhtml ref see also environmental engineering broad category hydrogeology fits flownet analysis tool steady state flow groundwater energy balance groundwater flow equations based energy balance fault zone hydrogeology field specifically analyzing hydrogeology fault zones hydrogeophysics field integrating hydrogeology geophysics hydrology agriculture isotope hydrology often used understand sources travel times groundwater systems list important publications geology hydrogeology important publications oscar edward meinzer


us filter johnson screens practical book illustrating actual process drilling developing utilizing water wells trade book material slanted towards products made johnson well screens freeze ra cherry ja ''groundwater'' prentice hall classic text like older version domenico schwartz de marsily g ''quantitative hydrogeology groundwater hydrology engineers'' academic press inc orlando florida classic book intended engineers mathematical background read hydrologists geologists well good accessible overview hydrogeological


little bit old methods still applicable anderson mary p woessner william w hunt randall j ''applied groundwater modeling nd edition'' academic press updates st edition new examples new material respect model calibration uncertainty online python scripts https githubcom applied groundwater modeling nd ed chiang w h kinzelbach w rausch r aquifer simulation model windows groundwater flow transport modeling integrated program p fig tab cd rom berlin stuttgart borntraeger elango l jayakumar r eds modelling hydrogeology unesco ihp publication allied publ chennai rausch r sch fer


w therrien r wagner c ''solute transport modelling introduction models solution strategies p fig tab berlin stuttgart borntraeger rushton kr ''groundwater hydrology conceptual computational models'' john wiley sons ltd wang h f theory linear poroelasticity applications geomechanics hydrogeology princeton press waltham foundations engineering geology nd edition taylor francis zheng c bennett gd ''applied contaminant transport modeling'' second edition john wiley sons analytic groundwater modeling haitjema henk ''analytic element modeling groundwater


flow'' academic press introduction analytic solution methods especially analytic element method aem harr milton e ''groundwater seepage'' dover civil engineering view groundwater includes great deal flownets kovacs gyorgy ''seepage hydaulics'' developments water science elsevier conformal mapping well explained series lee tien chang ''applied mathematics hydrogeology'' crc press great explanation mathematical methods used deriving solutions hydrogeology problems solute transport finite element inverse problems liggett james liu phillip l f ''the boundary integral equation method


groundwater free groundwater modeling software like modflow http waterusgsgov pubs twri us geological survey twri index series instructional manuals covering common procedures hydrogeology freely available online pdf files http typhoonminesedu international ground water modeling center igwmc educational repository groundwater modeling software offers support software free http timecapsuleecodevch hydrogeologist time capsule video collection interviews eminent hydrogeologists made material difference profession http wwwigracnet igrac international groundwater resources assessment centre http wwwagcarmymil us army geospatial center information oconus


x px '''gerontology''' study social cultural psychological cognitive biological aspects aging word coined ilya ilyich mechnikov greek ''geron'' old man '' logia'' study ref name harris ref field distinguished geriatrics branch medicine specializes treatment existing disease older adults gerontologists include researchers practitioners fields biology nursing medicine criminology dentistry social work physical occupational therapy psychology psychiatry sociology economics political science architecture geography pharmacy public health housing anthropology ref name hooyman ref multidisciplinary

Applied science
Social work 2
Gerontology


nature gerontology means number sub fields overlap gerontology policy issues example involved government planning operation nursing homes investigating effects aging population society design residential spaces older people facilitate development sense place home dr lawton behavioral psychologist philadelphia geriatric center among first recognize need living spaces designed accommodate elderly especially alzheimer 's disease academic discipline field relatively new


usc leonard davis school gerontology created first phd master 's bachelor 's degree programs gerontology history medieval islamic world several physicians wrote issues related gerontology avicenna 's ''the canon medicine'' offered instruction care aged including diet remedies problems including constipation ref name howell ref arabic physician ibn al jazzar al qayrawani algizar c wrote aches conditions elderly ammar p nbsp scholarly work covers sleep disorders forgetfulness strengthen memory causes mortality ref name al jazzar http wwwislamorgbr al jazzarhtm al jazzar ref ishaq ibn


hunayn died also wrote works treatments forgetfulness us national library medicine number aged humans life expectancy tended increase every century since th society tended consider caring elderly relative family issue coming industrial revolution ideas shifted favor societal care system early pioneers michel eug ne chevreul lived believed aging science studied lie metchnikoff coined term gerontology


ref name metchnikoff earlier usage however recorded german philosopher wilhelm traugott krug ''general dictionary philosophical sciences'' according krug term gerontologia found colloquies erasmus refers conversation old men colloquium senile see krug p ref modern pioneers like james birren began organizing gerontology field later involved starting us government agency aging ndash national institute aging ndash programs gerontology university southern california university california los angeles


past president gerontological society america founded population people years old expected world 's population assessment treatment methods age related disease burden ndash term ''geroscience'' emerged early st century aging demographics world forecast undergo rapid population aging next several decades million people aged years older living united states however population continued grow throughout th century reached


million people respectively notably united states across world baby boomer generation began turn recently population aged years older grown faster rate total population united states total population increased million million however population aged years older increased period ref name censusgov ref estimated population united states


canada aged years older moreover predicted first time united states history number individuals aged years older greater number children aged years ref name taylor ref aged years older oldest old projected increase million million adults aged years constituted greatest segment oldest old however largest percentage point increase among oldest old occurred


year old age group increased ref name censusgov rapid growth aging population social work education training specialized older adults practitioners interested working older adults increasingly demand gender differences age considerable disparity number men women older population united states women outnumbered men older population every single year age eg years


sex ratio measure used indicate balance males females population calculated taking number males divided number females multiplying therefore sex ratio number males per females males per females year old population however represented increase males per females sex ratio although gender gap men women narrowed women continue


greater life expectancy lower mortality rates older ages relative men example census reported approximately twice many women men living united states years age versus respectively ref name censusgov geographic distribution older adults united states number percentage older adults living united states vary across four different regions northeast midwest west south defined united states census south contained greatest number people aged years


older years older however proportionately northeast contains largest percentage adults aged years older followed midwest south west relative census geographic regions demonstrated positive growth population adults aged years older years older rapid growth population adults aged years older evident west showed increase million million likewise


population aged years older west also showed fastest growth increased million worth highlighting rhode island state experienced reduction number people aged years older declined conversely states exhibited increase population adults aged years older ref name censusgov sub fields gerontology many disciplines course th st century


field gerontology sub divided multiple specific disciplines focused increasingly narrow aspects aging process biogerontology hand older adult biogerontology special sub field gerontology concerned biological aging process evolutionary origins potential means intervene process aim biogerontology prevent age related disease intervening aging processes even eliminate aging per se argue aging fits criteria disease therefore aging disease treated disease aubrey de grey said case


suitable funding involvement specialists chance years humans technology saving people dying old age regardless age time ref name degreyrae ref idea repair inside cells repaired using modern technology allowing people live time technology progress allow cure deeper damage concept got name longevity escape velocity social gerontology social gerontology multi disciplinary sub field specializes studying working older adults social


gerontologists may degrees training social work nursing psychology sociology demography public health social science disciplines social gerontologists responsible educating researching advancing broader causes older people issues life span life extension need numbers quantify overlap demography study demography human life span differ study social demographics aging social theories aging several theories aging developed observe aging process older adults society well


processes interpreted men women age ref name phillipson ref activity theory activity theory developed elaborated cavan havighurst albrecht according theory older adults' self concept depends social interactions order older adults maintain morale old age substitutions must made lost roles examples lost roles include retirement job loss spouse ref name phillipson activity preferable inactivity facilitates well multiple levels improved general health prosperity older population remaining active feasible


theory first proposed havighurst nearly six decades ago activity theory applicable stable post industrial society offers older members many opportunities meaningful participation weakness aging persons cannot maintain middle aged lifestyle due functional limitations lack income lack desire many older adults lack resources maintain active roles society flip side elders may insist continuing activities late life pose danger others driving night low visual acuity


maintenance work house climbing severely arthritic knees denying limitations engaging unsafe behaviors ref name allnurses breakroomcom vickyrn august ' theories aging part sociological theories retrieved friday april http allnurses breakroomcom showthreadphpt ref disengagement theory disengagement theory developed cumming henry according theory older adults society engage mutual separation example mutual separation retirement workforce key assumption theory older adults lose ego energy become increasingly self absorbed additionally


disengagement leads higher morale maintenance older adults try maintain social involvement theory heavily criticized escape clause namely older adults remain engaged society unsuccessful adjusters old age ref name phillipson gradual withdrawal society relationships preserves social equilibrium promotes self reflection elders freed societal roles furnishes orderly means transfer knowledge capital power older generation young makes possible society continue functioning valuable older members die continuity theory


continuity theory elusive concept one hand exhibit continuity mean remain uniform homogeneous unchanging even humdrum static view continuity applicable human aging hand dynamic view continuity starts idea basic structure persists time allows variety changes occur within context provided basic structure basic structure coherent orderly logical relation parts recognizably unique allows us


differentiate structure others introduction concept time ideas direction sequence character development story line enter concept continuity applied evolution human theory dynamic concept continuity developed applied issue adaptation normal aging central premise continuity theory making adaptive choices middle aged older adults attempt preserve maintain existing internal external structures prefer accomplish objective using continuity ie applying familiar


strategies familiar arenas life middle later life adults drawn weight past experience use continuity primary adaptive strategy dealing changes associated normal aging extent change builds upon links person 's past change part continuity result perceptions pressures social environment individuals adapting normal aging predisposed motivated toward inner psychological continuity well outward continuity social behavior circumstances continuity theory views


internal external continuity robust adaptive strategies supported individual preference social sanctions continuity theory consists general adaptive principles people normally aging could expected follow explanations principles work specification general areas life principles could expected apply accordingly continuity theory enormous potential general theory adaptation individual aging age stratification theory according theory older adults born different time periods form cohorts define age strata two differences


among strata chronological age historical experience theory makes two arguments age mechanism regulating behavior result determines access positions power birth cohorts play influential role process social change ref name phillipson life course theory according theory stems life course perspective bengston allen ref name life life course theory historical development key principles concepts selected research applications http familyjrankorg pages life course theoryhtml ref aging occurs birth death aging involves social psychological biological processes additionally aging experiences shaped cohort period effects ref name phillipson also


reflecting life course focus consider implications societies might function age based norms vanish consequence deinstitutionalization life course suggest implications pose new challenges theorizing aging life course postindustrial societies dramatic reductions mortality morbidity fertility past several decades shaken organization life course nature educational work family leisure experiences possible individuals become old new ways configurations content life stages altered


middle adulthood direct influence economic health status later life ref name phillipson environmental gerontology environmental gerontology specialization within gerontology seeks understanding interventions optimize relationship aging persons physical social environments field emerged first studies behavioral social gerontology research confirmed importance physical social environment understanding aging population improved quality life old age studies environmental gerontology indicate older people prefer


age immediate environment whereas spatial experience place attachment important understanding process research indicates physical social environment related longevity quality life elderly precisely natural environment natural therapeutic landscapes therapeutic garden contributes active healthy aging place jurisprudential gerontology jurisprudential gerontology sometimes referred geriatric jurisprudence specialization within gerontology looks ways laws legal structures interact aging experience field started legal scholars field elder law


found looking legal issues older persons without broader inter disciplinary perspective provide ideal legal outcome using theories therapeutic jurisprudence jurisprudential scholars critically examined existing legal institutions eg adult guardianship end life care nursing homes regulations showed law look closely social psychological aspects real life operation streams within jurisprudential gerontology also encouraged physicians lawyers try improve cooperation better understand laws regulatory institutions affect health well older persons see also academic journals


gerontology aging memory aging portfolio biological clock bionics clinical geropsychology elderly care financial gerontology life extension list life extension topics old age oldest people silver alert timeline senescence research references external links ageing branches biology interdisciplinary subfields sociology neologisms


'''geriatrics''' '''geriatric medicine''' specialty focuses health care elderly people aims promote health preventing treating diseases disabilities older adults set age patients may care '''geriatrician''' '''geriatric physician''' physician specializes care elderly people rather decision determined individual patient 's needs availability specialist important note difference geriatrics care aged people gerontology study aging process

Applied science
Medicine and health
Geriatrics


term ''geriatrics'' comes greek ''geron'' meaning old man ''iatros'' meaning healer however geriatrics sometimes called '''medical gerontology''' scope elderly man nursing home norway differences adult geriatric medicine geriatrics differs standard adult medicine focuses unique needs elderly person aged body different physiologically younger adult body old age decline various organ systems becomes manifest previous health issues lifestyle choices produce different constellation diseases symptoms different


people appearance symptoms depends remaining healthy reserves organs smokers example consume respiratory system reserve early rapidly ref name pmid ref geriatricians distinguish diseases effects normal aging example renal impairment may part aging kidney failure urinary incontinence geriatricians aim treat diseases present achieve healthy aging geriatricians focus achieving patient 's highest priorities context multiple chronic conditions preserving function increased complexity decline physiological reserve organs makes elderly develop


kinds diseases complications mild problems dehydration mild gastroenteritis multiple problems may compound mild fever elderly persons may cause confusion may lead fall fracture neck femur broken hip elderly people require specific attention medications elderly people particularly subjected polypharmacy taking multiple medications elderly people multiple medical disorders self prescribed many herbal medications counter drugs polypharmacy may increase risk drug interactions adverse drug reactions one study found


words especially disease causing confusion cognitive impairment delirium elderly may caused minor problem constipation something serious life threatening heart attack many problems treatable root cause discovered geriatric giants called '''geriatric giants''' major categories impairment appear elderly people especially begin fail include immobility instability incontinence impaired intellect memory sarcopenia decline muscle mass age significant contributor fall risk


instability immobility disability geriatric population impaired vision hearing loss common chronic problems among older people hearing problems lead social isolation depression dependence person longer talk people receive information telephone engage simple transactions talking person bank store vision problems lead falls tripping unseen objects medicine taken incorrectly written instructions could read finances mismanaged practical concerns functional abilities independence quality life issues great


concern geriatricians patients elderly people generally want live independently long possible requires able engage self care activities daily living geriatrician may able provide information elder care options refers people home care services skilled nursing facilities assisted living facilities hospice appropriate frail elderly people may choose decline kinds medical care risk benefit ratio different example frail elderly women routinely stop screening mammograms breast cancer typically slowly growing disease would


cause pain impairment loss life would die causes frail people also significant risk post surgical complications need extended care accurate prediction based validated measures rather old patient 's face looks help older patients make fully informed choices options assessment older patients elective surgeries accurately predict patients' recovery trajectories ref name frailty ref one frailty scale uses five items unintentional weight loss muscle weakness exhaustion low physical activity slowed walking speed healthy person scores frail person


scores compared non frail elderly people people intermediate frailty scores twice likely post surgical complications spend time hospital three times likely discharged skilled nursing facility instead homes ref name frailty frail elderly patients score living home surgery even worse outcomes risk discharged nursing home rising twenty times rate non frail elderly people subspecialties related services diseases


commonly seen elderly rare adults eg dementia delirium falls societies aged many specialized geriatric geriatrics related services emerged including medical cardiogeriatrics geriatric dentistry geriatric dermatology geriatric diagnostic imaging geriatric emergency medicine geriatric nephrology geriatric neurology geriatric oncology geriatric physical examination interest especially physicians physician assistants geriatric psychiatry psychogeriatrics focus dementia delirium depression psychiatric disorders geriatric public health preventive geriatrics geriatric rehabilitation geriatric rheumatology focus joints soft tissue disorders elderly geriatric sexology focus sexuality aged people geriatric subspeciality medical clinics


geriatric anticoagulation clinic geriatric assessment clinic falls balance clinic continence clinic palliative care clinic elderly pain clinic cognition memory disorders clinic surgical orthogeriatrics close cooperation orthopedic surgery focus osteoporosis rehabilitation geriatric cardiothoracic surgery geriatric urology geriatric otolaryngology geriatric general surgery geriatric trauma geriatric gynecology geriatric ophthalmology geriatrics subspecialties geriatric anesthesia focuses anesthesia perioperative care elderly geriatric intensive care unit special type intensive care unit dedicated critically ill elderly geriatric nursing focuses nursing elderly patients aged geriatric nutrition geriatric occupational


therapy geriatric pain management geriatric pharmacy geriatric physical therapy geriatric podiatry geriatric psychology geriatric speech language pathology focuses neurological disorders dysphagia stroke aphasia traumatic brain injury geriatric mental health counselor specialist focuses treatment assessment geriatric audiology history one eight branches traditional indian system medicine ayurveda ''jara'' ''rasayana'' similar geriatrics charaka described fatigue physical exhaustion caused premature aging result poor diet ''charaka samhita'' recommends elderly patients avoid excessive physical mental strain consume light nutritious


frequent bathing massaging rest low intensity exercise regimens ''the canon medicine'' written avicenna author concerned old folk need plenty sleep bodies anointed oil recommended exercises walking horse riding thesis iii ''canon'' discussed diet suitable old people dedicated several sections elderly patients become constipated arab physician algizar circa wrote book medicine health elderly ref name al jazzar http wwwislamorgbr al jazzarhtm al jazzar ref also wrote book sleep disorders


another one forgetfulness strengthen memory treatise causes mortality ref name al jazzar another arab physician th century ishaq ibn hunayn died son nestorian christian scholar hunayn ibn ishaq wrote ''treatise drugs forgetfulness'' george day published ''diseases advanced life'' one first publications subject geriatric medicine ref name history ref first modern geriatric hospital founded belgrade serbia doctor laza lazarevi term ''geriatrics'' proposed ilya ilyich mechnikov laurate nobel prize


care older people uk advanced implementation national service frameworks older people outlines key areas attention geriatrician training united states united states geriatricians primary care physicians md board certified either family medicine internal medicine also acquired additional training necessary obtain certificate added qualifications caq geriatric medicine geriatricians developed expanded expertise aging process impact aging illness patterns drug therapy seniors health maintenance rehabilitation


serve variety roles including hospital care long term care home care terminal care frequently involved ethics consultations represent unique health diseases patterns seen seniors model care practiced geriatricians heavily focused working closely disciplines nurses pharmacists therapists social workers united kingdom united kingdom geriatricians hospital physicians whereas others focus community geriatrics particular although originally distinct clinical specialty integrated specialization general medicine since late geriatricians


therefore accredited unlike united states geriatric medicine major specialty united kingdom single numerous internal medicine specialists canada canada two pathways followed order work physician geriatric setting doctors medicine md complete three year core internal medicine residency program followed two years specialized geriatrics residency training pathway leads certification possibly fellowship several years supplementary academic training royal college physicians surgeons canada doctors


medicine opt two year residency program family medicine complete one year enhanced skills program care elderly post doctoral pathway accredited college family physicians canada many universities across canada also offer gerontology training programs general public nurses health care professionals pursue education discipline order better understand process aging role presence older patients residents india india geriatrics relatively new speciality offering three year post graduate residency md


training joined completing year undergraduate training mbbs bachelor medicine bachelor surgery unfortunately eight major institutes provide md geriatric medicine subsequent training training institutes exclusive department geriatric medicine rotations internal medicine medical subspecialties etc certain institutions limited year training internal medicine subspecialities followed one year exclusive training geriatric medicine minimum geriatric competencies july association american medical colleges aamc john hartford foundation hosted national consensus


observable measurable competencies research hospital elder life program prominent clinical challenge geriatric medicine treatment prevention delirium condition hospitalized elderly patients become confused disoriented confronted uncertainty confusion hospital stay health patient decline result delirium increase length hospitalization lead health complications treatment delirium involves keeping patient mentally stimulated oriented reality well providing specialized care order ensure


needs met hospital elder life program help model hospital care developed yale university school medicine designed prevent delirium functional decline among elderly individuals hospital inpatient setting help uses core team interdisciplinary staff targeted intervention protocols improve patients' outcomes provide cost effective care unique program use specially trained volunteers carry majority non clinical interventions cases incident delirium prevented end help promotes interventions


designed maintain cognitive physical functioning older adults throughout hospitalization maximize patients' independence discharge assist transition hospital home prevent unplanned hospital readmissions customized interventions include daily visitors therapeutic activities provide mental stimulation daily exercise walking assistance sleep enhancement nutritional support hearing vision protocols help replicated hospitals across world although majority sites based united states located different states growing international presence international sites include australia canada netherlands taiwan


united kingdom pharmacology pharmacological constitution regimen older people important topic one related changing differing physiology psychology changes physiology aging may alter absorption effectiveness side effect profile many drugs changes may occur oral protective reflexes dryness mouth caused diminished salivary glands gastrointestinal system delayed emptying solids liquids possibly restricting speed absorption distribution drugs changes body fat muscle drug elimination psychological considerations include fact


short term correctable problem delirium fever geriatricians must respect patients' privacy seeing receive appropriate necessary services specialties must consider whether patient legal responsibility competence understand facts make decisions must support informed consent resist temptation manipulate patient withholding information dismal prognosis condition likelihood recovering surgery home elder abuse physical financial emotional sexual type abuse older dependent adequate training


services support reduce likelihood elder abuse proper attention often identify elderly people unable care geriatricians may recommend legal guardianship conservatorship care person estate elder abuse occurs increasingly caregivers elderly relatives suffer mental illness instances abuse prevented engaging individuals mental illness mental health treatment additionally interventions aimed decreasing elder reliance relatives may help decrease conflict abuse family education support programs conducted mental health professionals may also


education http eceuropaeu health eu health elderly index enhtm health eu portal care elderly eu http wwwamericangeriatricsorg american geriatrics society ageing


'''special education''' known '' 'special needs education''' '''aided education''' '''exceptional education''' '''exceptional student education''' '' 'special ed''' '''sen''' '''sped''' practice educating students way provides accommodations address individual differences disabilities special needs ideally process involves individually planned systematically monitored arrangement teaching procedures adapted equipment materials accessible settings interventions designed help individuals special needs achieve higher level personal self sufficiency success school community may available student given access

Applied science
Education
Curriculum and instruction
Special education


typical classroom education special education separate plan plan allows students disabilities participate general education classroom special education services involve special classroom resource room class students disabilities receive special education services students iep go special classroom students iep participate general education classes accommodations modifications special education aims provide accommodated education students disabilities learning disabilities dyslexia communication disorders emotional


behavioral disorders adhd physical disabilities osteogenesis imperfecta cerebral palsy muscular dystrophy spina bifida friedreich 's ataxia developmental disabilities autistic spectrum disorders including autism asperger syndrome intellectual disability many disabilities students kinds disabilities likely benefit additional educational services different approaches teaching use technology specifically adapted teaching area resource room separate classroom scholars education may categorize gifted education umbrella special education pedagogical approach much different based students'


war developed countries educators modify teaching methods environments maximum number students served general education environments therefore special education developed countries often regarded service rather place integration reduce social stigmas improve academic achievement many students opposite special education ''general education'' general education standard curriculum presented without special teaching methods supports students receiving special education services sometimes enroll general education setting learn along students without disabilities identifying students learners special needs


children easily identified candidates special needs due medical history example may diagnosed genetic condition associated intellectual disability may various forms brain damage may developmental disorder may visual hearing disabilities disabilities hand students less obvious disabilities learning difficulties two primary methods used identifying ' 'discrepancy model'' ' 'response intervention model'' discrepancy model depends teacher noticing students' achievements


noticeably expected teacher may make decision student receive support special education specialist teacher must show documentation low academic achievement response intervention model advocates earlier intervention discrepancy model student receives special education services specific learning difficulty sld student least normal intelligence student 's academic achievement expected student iq although discrepancy model dominated school system many years


substantial criticism approach eg aaron flanagan mascolo among researchers one reason criticism diagnosing slds basis discrepancy achievement iq predict effectiveness treatment low academic achievers also low iq appear benefit treatment much low academic achievers normal high intelligence alternative approach response intervention identifies children difficulties school first second year starting school receive additional assistance participating


reading remediation program response children intervention determines whether designated learning disability still trouble may receive designation assistance sternberg argued early remediation greatly reduce number children meeting diagnostic criteria learning disabilities also suggested focus learning disabilities provision accommodations school fails acknowledge people range strengths weaknesses places undue emphasis academics insisting students supported area


music sports individual needs six year old boy norway syndrome ready first day school special education program customized address student 's needs special educators provide continuum services students various disabilities receive multiple degrees support based individual needs crucial special education programs individualized address unique combination needs given student ref name goodman ref united states canada uk educational professionals use student 's individualized education program iep


another name student 's individualized education plan student 's individual learning plan ilp iep meant address child unique learning issues include specific educational goals legally binding document us school must provide everything promises iep us children yet three years old individual family service plan ifsp contains information child 's present level development areas outcomes child family services child family receive help achieve outcomes


united states individuals disabilities education act idea federal law requires every school system provide free appropriate public education every child ages regardless seriously child may disabled ref name ref ensure federal law obeyed government requires every school system provide type education student order receive federal funding ref name changed little individuals disabilities education act idea decided update law law


equipment provision specialized physical adaptations allow students participate educational environment much possible students may need help access subject matter physically gain access school meet emotional needs example assessment determines student cannot write hand physical disability school might provide computer typing assignments allow student answer questions verbally instead school determines student severely distracted normal activities large busy classroom student


might placed smaller classroom separate classroom resource room parents students learning disability must aware type disability child get access accommodations speech therapy occupational therapy adaptive physical education example student takes academic test indicates student struggles reading comprehension parents request speech language support classroom accommodations extra time complete reading writing tasks methods provision procedure person must follow order


receive special education accommodationsschools use different approaches providing special education services students approaches broadly grouped four categories according much contact student special needs non disabled students using north american terminology ''inclusion '' approach students special needs spend school day students special needs due fact inclusion require substantial modification general curriculum schools use selected students mild moderate special needs accepted best


practice specialized services may provided inside outside regular classroom depending type service students may occasionally leave regular classroom attend smaller intensive instructional sessions separate classroom resource room receive related services might require specialised equipment might disruptive rest class speech language therapy occupational therapy physical therapy rehabilitation counseling might also leave regular classroom services require privacy counseling sessions social worker ref name bowe ref ''mainstreaming'' refers practice educating students


criminal justice system students may receive one one instruction group instruction students suspended expelled considered excluded sense co teaching setting students disabilities placed general education classroom learn along disabled peers non disabled peers general education teacher special education teacher work partners instruction types co teaching include one teaching one helping one teacher instructs circulates around class evaluate offer help parallel teaching teachers teach content two


groups students equal size station teaching teachers present differing content different groups students simultaneously students rotate station alternative teaching one teacher works smaller group individual students works rest class team teaching teachers plan teach lesson together effective instruction students disabilities ''goal directed'' child must individualized education program iep distinguishes particular needs child must get services designed services


allow reach annual goals assessed end term along short term goals assessed every months ''research based methods'' lot research done students disabilities best way teach testing iqs interviews discrepancy model etc used determine place child determined next step best way child learn plenty different programs wilson reading program direct instruction ''guided


student performance'' iep goals may assessed every months year constant informal assessments must take place assessments guide instruction teacher teacher able determine material difficult easy ref name bos c bos c vaughn strategies teaching students learning behavior problems th ed upper saddle river nj pearson ref special schools ps special school brooklyn new york exclusively education students special needsa ' 'special school'' school catering students


special educational needs due learning difficulties physical disabilities behavioral problems special schools may specifically designed staffed resourced provide appropriate special education children additional needs students attending special schools generally attend classes mainstream schools special schools provide individualized education addressing specific needs student teacher ratios kept low often lower depending upon needs children special schools also facilities children special needs soft play areas sensory rooms swimming pools necessary treating students


certain conditions recent times places available special schools declining children special needs educated mainstream schools however always children whose learning needs cannot appropriately met regular classroom setting require specialized education resources provide level support require example disability may require student attend special school intellectual disability however practice often frowned upon school districts us light least restrictive environment mandated individuals


disabilities education act alternative '' 'special unit''' '' 'special classroom''' also called '' 'self contained classroom''' separate classroom dedicated solely education students special needs within larger school also provides general education classroom typically staffed specially trained teacher provide specific individualized instruction individuals small groups students special needs separate classrooms located general education school may students remain separate classroom full time students mainstreamed certain general education classes alternative


separate classroom full time student would one one aide general education setting united states part time alternative appropriate students sometimes called resource room another alternative would attending separate classroom specific subject social studies history special schools one first special schools world institut national des jeunes aveugles paris founded first school world teach blind students first school uk deaf


established edinburgh thomas braidwood education visually impaired people beginning edinburgh bristol th century people disabilities inhumane conditions supposedly housed educated addressed literature charles dickens dickens characterized people severe disabilities compassion insight ''bleak house'' ''little dorrit'' attention downtrodden conditions people disabilities brought resulted reforms europe including evaluation special schools united states reform came slowly


throughout mid half th century special schools termed institutions accepted encouraged students disabilities housed people mental illnesses educated much deinstitutionalization proceeded us beginning following exposes institutions taken sometime education handicapped children 's act individuals disabilities education act idea individuals disabilities educational improvement act ideia come fruition school integration supported early teacher preparation


programs higher education carefully taught instructed graduates inclusion classroom individual school district levels decades resulting dual certification regular teachers amendments individuals disabilities education act school districts united states began slowly integrate students moderate severe special needs regular school systems changed form function special education services many school districts special schools subsequently saw steady decrease enrollment districts weighed cost per student also posed general funding dilemmas


certain local schools districts changed schools view assessments formally introduced concept inclusion many educators students parents instructional strategies student taught either classroom outside environment environments interactive student engage better subject different instructional techniques used students special educational needs instructional strategies classified either ''accommodations'' ''modifications'' ''accommodation'' reasonable adjustment teaching practices student learns material format accessible


student reading difficulties substituting shorter easier book student may receive accommodations modifications examples modifications skipping subjects students may taught less information typical students skipping material school deems inappropriate student 's abilities less important subjects example students poor fine motor skills may taught print block letters cursive handwriting simplified assignments students may read literature peers simpler version shakespeare original text modern paraphrase available shorter


assignments students may shorter homework assignments take shorter concentrated tests extra aids students deficiencies working memory list vocabulary words called ''word bank'' provided tests reduce lack recall increase chances comprehension students might use calculator students extended time students slower processing speed may benefit extended time assignments tests order time comprehend questions recall information synthesize knowledge students offered flexible setting take tests


settings new location provide minimal distractions examples accommodations response accommodations ref name ofqual typing homework assignments rather hand writing considered modification subject learning write hand someone else write answers given verbally presentation accommodations ref name ofqual examples include listening audiobooks rather reading printed books may used substitutes text supplements intended improve students' reading fluency phonetic skills similar options include designating person read student providing text speech software considered


modification purpose assignment reading skills acquisition presentation accommodations may include designating person take notes lectures using talking calculator rather one visual display setting accommodations ref name ofqual taking test quieter room moving class room physically accessible eg first floor building near elevator arranging seating assignments benefit student eg sitting front classroom scheduling accommodations ref name ofqual students may given rest breaks extended time tests


may considered modification speed factor test use timer help time management developed countries permit require degree accommodation students special needs special provisions usually made examinations take place end formal schooling ref name ofqual addition student taught academic curriculum schools may provide non academic services student intended ultimately increase student 's personal academic abilities related services include developmental corrective supportive services required assist


student learning disabilities includes speech language pathology audiology psychological services physical therapy occupational therapy counseling services including rehabilitation counseling orientation mobility services medical services defined regulations parent counseling training school health services school social work assistive technology services appropriate developmental corrective support services appropriate access recreation appropriate support services ref name related services ref countries related services provided schools others provided normal healthcare social services systems example students autistic spectrum disorders poor impulse control


students educational needs associated disability often placed classes students disabilities critics assert placing risk students classes students disabilities may impede educational progress people disabilities special education classes separate classroom resource room criticized watered curriculum practice inclusion mainstream classrooms criticized advocates parents children special needs students require instructional methods differ dramatically typical classroom methods critics assert


possible deliver effectively two different instructional methods classroom result educational progress students depend different instructional methods learn often fall even behind peers ref name breckenridge ref parents typically developing children sometimes fear special needs single fully included student take critical levels attention energy away rest class thereby impair academic achievements students ref name breckenridge linked debate extent students special needs


whether mainstream special settings specific pedagogy based scientific study particular diagnostic categories whether general instructional techniques relevant students including special needs parents advocates students concerns eligibility criteria application cases parents students protest students' placement special education programs example student may placed special education programs due mental health condition obsessive compulsive disorder depression anxiety panic attacks adhd student parents believe


condition adequately managed medication outside therapy cases students whose parents believe require additional support special education services denied participation program based eligibility criteria whether useful appropriate attempt educate severely disabled children children persistent vegetative state debated many severely disabled children learn simple tasks pushing buzzer want attention children may incapable learning parents advocates say children would better


national coalition personal shortages survey almost teachers said able give proper rights children disabilities teachers getting cut work due budget cuts financial debate covers use allotment special education government funding three views topic spend much money enough money put money given n't spent properly argument first


amount money spent one special needs child enough cover large group general education students sometimes even causes several students suffer budget cuts general programs support one child evidence special education enough money lack teachers burnt teachers limited variety teaching tools student argument spend money differently states lot money set aside wasted spending much time paperwork inefficient iep meetings spending money


income countries people working age disabilities one third less likely completed primary school example bangladesh people disabilities completed primary school compared disabilities corresponding shares zambia paraguay ref name ref name unesco shown children higher risk disability far likely denied chance go school bangladesh bhutan iraq children mental impairments likely denied right


individual attention instructors according united nations centre human rights children disabilities access services without access services excluded education unable attend school due need certain services facilities estimated cost providing education child disabilities times higher child without disabilities given poverty levels variety developing countries education children disabilities become priority children physical disabilities less likely


attend school comparison students disability children intellectual ability even less likely children physical disabilities global south children form disability receive form structured education current initiatives toward inclusive education internationally implemented education program countries global south still challenge lack ability provide children disabilities access education due issues lack resources schools overcrowded national approaches africa south


africa white papers discuss special education country local schools given independent authority ref name ofqual modifications accommodations recommended depending student 's individual needs nigeria federal ministry education constituted committee develop exclusively first broad based national policy special needs education sne nigeria constitution drafting committee mandate formulate national policy special needs education gave birth national situation analysis report implies status changed national policy special education


expanded version thereby widening scope activities asia china china holds largest system education world features state run public school system order ministry education japan japanese students special needs placed one four different school arrangements special schools special classrooms another school resource rooms called ''tsukyu'' regular classrooms ref name ofqual local areas koto ward tokyo expanding tsukyu ''tsubasa classrooms'' cover junior high schools within


mainstream classroom accommodations modifications needed ref name ofqual depending local authority state elementary schools may also hold ''naka yoshi'' close friends class group addition grades students struggle adapt mainstream classrooms gathered given life skills well completing studies adaptable pace different tsukyu although school activities regularly held together majority time spent class training disabled students particularly upper secondary level emphasizes vocational education enable students


independent possible within society vocational training varies considerably depending student 's disability options limited clear government aware necessity broadening range possibilities students advancement higher education also goal government struggles institutions higher learning accept disabled students pakistan independence pakistan face serious challenges due proper emphasis given special education even education among reasons lack resources financial


well human major one context need importance special education felt different educational policies pakistan different times first time report commission national education highlighted importance special education education policy national policy implementation programme gave importance sector also reflected different medium term five year plans felt seriously directorate general special education islamabad formulated draft national policy special education


revised bring line emerging needs special disabled population special education policy launched recently government pakistan launched new national policy persons disabilities dynamically implemented singapore special education regulated centrally singapore ministry education ref name ofqual special schools integration mainstream schools options students special educational needs students disabilities placed special schools ref name ofqual students special education wish accommodations national exams must


provide appropriate documentation prove disabled ref name ofqual accommodations modifications eg simpler questions normally approved similar accommodations already used everyday schoolwork goal maintaining exam 's integrity students unfairly disadvantaged factors unrelated tested accommodations listed primary school leaving exam ref name ofqual australia australian association special education inc aase 's position informed disability standards education require students disabilities treated basis


students regards enrollment participation education respect standardized tests special consideration procedures place states students disabled ref name ofqual students must provide documentation desired forms accommodations available example students cannot read even inability read due disability cannot exam read exam results accurately show student unable read reports matriculation exams mention whether student received accommodations taking test ref name ofqual


europe country europe special education support structures european countries covered european agency special needs inclusive education bulgaria czech republic schools must take students' special education needs account assessing achievements ref name ofqual students disabilities normally included neighborhood school although may placed special schools denmark denmark students specific learning difficulties like dyslexia educated alongside students without learning challenges finland schools adapt national guidelines needs individual students students special educational needs


given individualized plan may exempted parts school examinations students hearing impairments taking listening comprehension tests student receives modifications school leaving exams noted certificate achievement ref name ofqual following national core curriculum tested according goals individual educational program ref name ofqual france french students disabilities normally included neighborhood school although children may placed special schools personalized plan calls ref name ofqual student 's


personalized school plan describes teaching methods psychological medical paramedical services school provide student germany special school children special emotional needs k titz germany students special needs germany attend special school serves children special needs include ''f rderschule f r lernbehinderte'' special school learning disabilities children challenges impair learning ''f rderschule mit dem f rderschwerpunkt geistige entwicklung'' school cognitive development children severe learning challenges ''f rderschule schwerpunkt emotionale und soziale entwicklung'' school emotional social development children