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Recreational Drug Use

Recreational drug use

Recreational drug use is the use of psychoactive drugs for recreational rather than for working or for medical or spiritual purposes, although the distinction is not always clear. Regardless of medical supervision, this label does not apply to the use of drugs for utilitarian purposes, such as the relief of fatigue or insomnia, or the control of appetite. A distinction must be made between (recreational) drug use and drug abuse, although there is much controversy on where the dividing line lies on the spectrum from a drug user to a drug abuser. Some say that abuse begins when the user begins shirking responsibility in order to afford drugs or to have enough time to use them. Some say it begins when a person uses "excessive" amounts, while others draw the line at the point of legality. Some think that any intoxicant consumption is an inappropriate activity.

History

The recreational use of drugs has existed throughout human history. The most widespread recreationally used drug used to be alcohol. Beer and wine were produced in Persia and in the Mediterranean before recorded history. Popular theory seems to agree that people first consumed and enjoyed the effect of overripe fruit, which would contain some alcohol. Modern research in the wild has shown this to be the case among many modern animals [http://www.utexas.edu/opa/news/00newsreleases/nr_200003/nr_fruit000301.html] [http://www.save-the-elephants.org/Elephant%20News%20Items/Of%20Drunken%20Elephants.htm]. Nicotine, the psychoactive constituent of tobacco, was first used by Europeans in the sixteenth century, but was used ritually in the Americas centuries prior. Caffeine has a long history of human consumption as well, and may have overtaken alcohol as the most popular recreational drug. Despite relatively recent proscription as an illegal drug in much of the world, cannabis retains its historical popularity. Cannabis, like alcohol, has been used in many cultures throughout history. Recreational use of opium (extracted from the immature seed pods of a species of poppy) was once common in Asia, and from there spread to the West. Its use peaked in the nineteenth century, when the British Empire and other Western powers used military power to force China to legalize its importation from India and other British colonies (see Opium Wars). Coca has been chewed by natives and peasants long prior to its refinement into cocaine. Similarly, khat and many other substances have long histories of recreational use. Many other substances were once commonly used as recreational drugs, but fell from favor for various reasons. Islam forbids the consumption of alcoholic beverages, and many religions discourage the recreational use of drugs. In the 20th century some Western countries, notably the United States, have criminalized the use of many recreational drugs, and used diplomatic, economic and military pressure on other countries to do the same. Thus, for example, the Japanese hemp plant — once widely grown as a source of textile fiber — was wiped out during the American occupation after World War II, and today only survives in a handful of strictly controlled bio-conservation plots.

Legal aspects

In many cases, the possession and use of common recreational drugs violates the law. This attitude is less prevalent in western Europe—see Drug policy of the Netherlands—and more recently in Canada, where enforcement of extant legal penalties for possession of small amounts of marijuana and other so-called "soft drugs" such as hallucinogenic mushrooms is increasingly ignored or given a low priority by law enforcement officials. This attitude stands in marked contrast to the official policy of the United States government, which declared a "War on Drugs" under President Richard Nixon in 1972 which later intensified under Ronald Reagan, but saw its greatest increases (in budget, and in the number of arrests and prosecutions) under President Bill Clinton. The United States is far more stringent about enforcing penalties for "soft drug" use. The Drug Enforcement Administration, or DEA, is primarily responsible for illegal drug interdiction at the federal level. Despite the application of billions of dollars to eliminate the use of illegal drugs, recreational drug use remains common in the United States, and according to some studies is actually more common than in Europe where the laws are more relaxed. Millions of illicit drug users exist in the United States who have never faced prosecution. Many American police officers don't bother enforcing possession laws on those holding small quanities of soft drugs. Some theorize that the taboos on recreational drugs adds an aura of mystique to their use, and encourages experimentation (i.e., the "forbidden fruit" phenomenon). This phenomenon was prevalent in the 1930s during the American alcohol prohibition. Many societies have abandoned what they feel are unsuccessful attempts to prohibit recreational drugs, and instead turned to a policy of harm reduction by informing users of ways to reduce common risks associated with popular drugs, and providing medical assistance for drug users who wish to stop using drugs. Harm reduction is the official policy of the Netherlands, Brazil, and some areas of Canada such as Vancouver, which have stopped actively prosecuting end users of recreational drugs. Instead, law enforcement efforts focus on capturing illegal dealers of "hard drugs" such as heroin and cocaine, passing out clean needles to intravenous (IV) drug users, and providing medical assistance for addicted users who wish to stop taking drugs. Many currently legal recreational drugs (examples: alcohol, tobacco and caffeine) have been subject to prohibition throughout history, and likewise most of the currently illegal recreational drugs have been legal as recently as the early twentieth century.

Drugs popularly used for recreation

The drugs most popular for recreational use worldwide are alcohol, cannabis, caffeine and nicotine. Other substances often used for recreational purposes follow:
- 2C-B
- 2C-I
- AMT
- Anti-impotence drugs such as Sildenafil
- Benzodiazepines
- Betel nut
- DMT
- DXM
- Ecstasy
- GHB
- Ketamine
- LSA
- LSD
- Mescaline (Peyote)
- Nitrous oxide
- Ololiuqui
- Opiates, including:
- Heroin
- Opium
- Oxycodone and other prescription painkillers
- PCP
- Psilocybin (Psychedelic Mushrooms)
- Research chemicals such as phenethylamines and tryptamines
- Salvia
- Stimulants, including:
- Amphetamine
- Cocaine (and crack cocaine)
- Ephedrine
- Khat
- Methamphetamine
- Methylphenidate (Ritalin)

References

- Dale Pendell, PharmakoDynamis: Stimulating Plants, Potions and Herbcraft: Excitantia and Empathogenica, San Francisco: Mercury House, 2002.
- Pharmako/Poeia: Plant Powers, Poisons, and Herbcraft, San Francisco: Mercury House, 1995.

External links

- [http://www.drugs-plaza.com/ Drugs-plaza website about recreational drug use]
- [http://www.thegooddrugsguide.com/ The Good Drugs Guide]
- [http://www.lycaeum.org/ Lycaeum]
- [http://www.erowid.org/ Erowid]
- [http://www.bluelight.ru/ Bluelight]
- [http://www.idthispill.com/ ID This Pill]
- [http://www.pubmed.org/ PubMed]
- [http://www.druginfonet.com/ DrugInfoNet]
- [http://www.geopium.org/ Geopium: Geopolitics of Illicit Drugs in Asia]
- [http://www.weeddealer.com/dopelist/a.htm Full A to Z Drug Terminology]
- Category:Ethics Category:Moral panics Category:Psychoactive drugs tokipona:ilo nasa ms:Dadah rekreasi

Psychoactive drug

A psychoactive drug or psychotropic substance is a chemical that alters brain function, resulting in temporary changes in perception, mood, consciousness, or behaviour. Such drugs are often used for recreational and spiritual purposes, as well as in medicine, especially for treating neurological and psychological illnesses. Many of these substances (especially the stimulants and depressants) can be habit forming, and lead to abuse. Conversely, others (namely the psychedelics) can help to treat and even cure such addictions. addiction

Psychoactive drug chart

The following Venn diagram attempts to organize the most common psychoactive drugs into intersecting groups and subgroups based upon pharmacological classification and method of action. Items within each subgroup are proximitied close to those of most similar action, and also follow a general placement in accordance with the legend below the diagram. Primary intersections are represented via color mixing. (Note: this is a work in progress. Please discuss errors, changes and suggestions on the talk page).

Image:BlankDrugChart.png

STIMULANTS

Sympathomimetic Amines

Psychomotor Stimulants

Aminoketones

Methylxanthines

Atypical antipsychotics

Quetiapine

Olanzapine

Typical antipsychotics

SSRIs

Cholinergics

Sedative Hypnotics

Benzodiazepines

Narcotic Analgesics

Psychedelics

MDMA MDA

Dissociatives

Ibotenic acid Muscimol

Deliriants

Legend

- Blue: Stimulants generally increase in potency to the upper left.
- Red: Depressants generally increase in potency to the lower right.
- Green: "Hallucinogens" are psychedelic to the left, dissociative to the right, generally less predictable down and to the right, and generally more potent towards the bottom.
- Pink hue: The so called "antipsychotics". A new and controversial addition to the chart.

Sub-sections

- White: Overlap of all three main sections (Stimulants, Depressants and Hallucinogens) — Example: cannabis exhibits effects of all three sections.
- Magenta (purple): Overlap of Stimulants (Blue) and Depressants (Red) — Example: nicotine exhibits effects of both.
- Cyan (light blue): Overlap of Stimulants (Blue) and Psychedelics (Green) — Primary psychedelics exhibit a stimulant effect
- Yellow : Overlap of Depressants (Red) and Dissociatives (Green) — Primary dissociatives exhibit a depressant effect

A brief history of drug use

Drug use is not a new phenomenon by any means. There is archaeological evidence of the use of psychoactive substances dating back at least 10,000 years, and historical evidence of cultural use over the past 5,000 years. While medicinal use plays a very large role, it has been suggested that the urge to alter one's consciousness is as primary as the drive to satiate thirst, hunger or sexual desire. Some may point a finger to marketing, availability or the pressures of modern life as to why we are such a pill-popping, coffee-swilling, beer-guzzling society, but one only has to look back at history, or even to children with their desire for spinning, swinging, sliding amongst other activities to see that the drive to alter one's state of mind is universal. This relationship is not limited to humans. A surprising number of animals consume different psychoactive plants and animals, berries and even fermented fruit, clearly becoming intoxicated. Traditional legends of sacred plants often contain references to animals that introduced man to their use. Biology suggests an evolutionary connection between psychoactive plants and animals, as to why these chemicals and their receptors exist within the nervous system.

Other psychoactive drugs

- Aphrodisiacs
- PT-141
- In a broader sense also:
- Antiemetics
- Analgesics
- Antiepileptics

Ways psychoactive drugs affect the brain

There are many ways in which psychoactive drugs can affect the brain. While some drugs affect neurons presynaptically, others act postsynaptically and some drugs don't even attack the synapse, working on neural axons instead. Here is a general breakdown of the ways psychoactive drugs can work. # Prevent The Action Potential From Starting #
- Lidocaine, TTX (they bind to voltage-gated sodium channels, so no action potential begins even when a generator potential passes threshold) # Neurotransmitter Synthesis #
- Increase - L-Dopa, tryptophan, choline (precursors) #
- Decrease - PCPA (inhibits synthesis of 5HT) #
- Causes increased sensitivity to the five senses, due to an increasing number of signals being sent to the brain. # Neurotransmitter Packaging #
- Increase - MAO Inhibitors #
- Decreasing - Resperine (pokes holes in the synaptic vesicles of catecholamines) # Neurotransmitter Release #
- Increase - Black Widow Spider (Ach) #
- Decrease - Botulinum Toxin (Ach), Tetanus (GABA) # Agonists - Mimic the original NTs and activate the receptors #
- Muscuraine, Nicotine (Ach) #
- AMDA, NMDA (Glu) #
- Alcohol, Benzodiazepines (GABA) # Antagonists - Bind to the receptor sites and block activation #
- Atropine, Curare (Ach) #
- PCP (Glu) # Prevent Ach Breakdown - #
- Insecticides, Nerve Gas # Prevent Reuptake #
- Cocaine (DA), Amphetamines (E) #
- Tricyclics, SSRIs - based on information taught in NSC 201, Vanderbilt University

Work

Work may mean:
- Work (project management), the effort applied to produce a deliverable or accomplish a task.
- Work (fine arts), a creation, such as a song or a painting.
- Work (professional wrestling), a staged event – that is, one that enforces kayfabe. The term originates from "working a crowd."
- Work (Charlie Chaplin film), a 1915 Charlie Chaplin silent film co-starring Edna Purviance.
- Mechanical work, defined in Physics as the integral of dot product of force times infinitesimal translation: ::

W = \int \mathbf \cdot \mathrm\mathbf

- Manual labour, effort expended by people on productive activities in the home, school, or employment, or, by extension, one's place of employment or employer.
- In the context of career, "work" refers to a wide range of paid and unpaid productive activities, including full-time, part-time, casual and fixed-term employment, family responsibilities, voluntary and community service, education including school, further education and training, and cultural activities.
- In the context of spiritual development, "The Work" (generally capitalized) refers, in general, to "any way, school, or method that recognizes the fact of suffering and the cause of unnecessary suffering and works to lead a person back to his true nature, which will eliminate the unnecessary suffering." (A. H. Almaas, Diamond Heart-Book One, p. 32) Specific spiritual schools, such as the The Fourth Way, often refer to their own method of development as "The Work."
- In the context of textile arts, "work" may refer to any type of hand sewing or embroidery, as in needlework, Berlin wool work, blackwork, work basket, worked buttons.
- Work, a painting by Ford Madox Brown. ms:Kerja simple:Work

Medicine

Medicine is a branch of health science concerned with maintaining human health and restoring it by treating disease and injury; it is both an area of knowledge, a science of body systems and diseases and their treatment, and the applied practice of that knowledge. The practice of medical care is shared between the medical profession—physicians or doctors—and other groups of professionals, such as nurses or pharmacists (sometimes called allied health professions). Historically, only members of the medical profession proper have been considered to actually practice medicine in the strictest sense, in contrast to the allied fields of health care professionals. Clinicians can be physicians, nurses, or physician assistants -- those who provide health care or otherwise tend to their patients. The medical profession is the social and occupational structure of the group of people formally trained and authorized to apply medical knowledge. Many countries and legal jurisdictions have legal limitations on who may practice medicine or the allied medical fields. Medicine is typically seen as composed of various specialized sub-branches, such as pediatrics, gynecology, neurology, dealing with particular body systems, diseases, or areas of health. Systems of medical and healthcare practices have existed among human societies since at least the dawn of recorded history. These systems have developed in various ways in different cultures and regions. Medicine as understood in the modern period has historically been considered to be the mainstream tradition which developed in the Western world since the early modern age. Many other traditions of medicine and healthcare are still widely practiced throughout the world, most of which are still considered to be separate and distinct from Western medicine, also called biomedicine or the Hippocratic tradition. The most highly developed systems of medicine outside the Western system are the Ayurvedic tradition of India and traditional Chinese medicine. Various non-mainstream traditions of health care have also developed in the Western world distinct from mainstream medicine. The various other systems practiced among various cultures are sometimes practiced alongside or in cooperation with Western medicine, while sometimes being seen as competing traditions. Medicine is also often used amongst medical professionals as shorthand for Internal Medicine. Veterinary medicine is the practice of health care specialized for other animal species.

History of medicine

Medicine as it is practiced now is rooted in various traditions, but developed mainly in the late 18th and early 19th century in Germany (Rudolf Virchow) and France (Jean-Martin Charcot, Claude Bernard and others). The new, "scientific" medicine replaced earlier Western traditions of medicine, mostly based on the "four humours" and other pre-modern theories. The focal points of development of clinical medicine shifted to the United Kingdom and the USA by the early 1900s (Sir William Osler, Harvey Cushing). Evidence-based medicine is the recent movement to link the practice and the science of medicine more closely through the use of the scientific method and modern information science. Genomics and knowledge of human genetics is already having a large influence on medicine, as the causative genes of most monogenic genetic disorders have now identified, and the development of techniques in molecular biology and genetics are influencing medical practice and decision-making.

Practice of medicine

The practice of medicine combines both science and art. Science and technology are the evidence base for many clinical problems for the general population at large. The art of medicine is the application of this medical knowledge in combination with intuition and clinical judgment to determine the proper diagnoses and treatment plan for this unique patient and to treat the patient accordingly. Central to medicine is the patient-doctor relationship established when a person with a health concern or problem seeks the help of a physician (i.e. the medical encounter). Other health professionals similarly establish a relationship with a patient and may perform interventions from their perspective, e.g. nurses, radiographers and therapists. As part of the medical encounter, the doctor needs to:
- develop a relationship with the patient
- gather data (medical history and physical examination combined with laboratory or imaging studies)
- analyze and synthesize that data (assessment and/or differential diagnosis), and then
- develop a treatment plan (further testing, therapy, watchful observation, referral and follow-up)
- treat the patient accordingly
- assess the progress of treatment and alter the plan as necessary. The medical encounter is documented in a medical record, which is a legal document in many jurisdictions. One method that is used is called the problem-oriented medical record (POMR), which includes a problem list of diagnoses and a "SOAP" method of documentation for each visit:
- S - Subjective, the medical history of the problem from the point-of-view of the patient.
- O - Objective, the physical examination and any laboratory or imaging studies.
- A - Assessment, is the medical decision-making process including the differential diagnoses and most probable diagnoses.
- P - Plan, the way resolve the problem and monitor progress

Medical systems

Medicine is practiced within the medical system of a particular culture or government. Leaving aside tribal cultures, the most significant divide in developed countries is that between universal health care and the market based health care (such as practiced in the U.S.).

Patient-doctor relationship

The doctor-patient relationship and interaction is a central process in the practice of medicine. There are many perspectives from which to understand and describe it. An idealized physician's perspective, such as is taught in medical school, sees the core aspects of the process as the physician learning from the patient his symptoms, concerns and values; in response the physician examines the patient, interprets the symptoms, and formulates a diagnosis to explain the symptoms and their cause to the patient and to propose a treatment. In more detail, the patient presents a set of complaints or concerns about his health to the doctor, who then obtains further information about the patient's symptoms, previous state of health, living conditions, and so forth, and then formulates a diagnosis and enlists the patient's agreement to a treatment plan. Importantly, during this process the doctor educates the patient about the causes, progression, outcomes, and possible treatments of his ailments, as well as often providing advice for maintaining health. This teaching relationship is the basis of calling the physician doctor, which originally meant "teacher" in Latin. The patient-doctor relationship is additionally complicated by the patient's suffering (patient derives from the Latin patiens, "suffering") and limited ability to relieve it on his own. The doctor's expertise comes from his knowledge about, or experience with, other people who have suffered similar symptoms, and his presumed ability to relieve it with medicines or other therapies about which the patient may initially have little knowledge. The doctor-patient relationship can be analyzed from the perspective of ethical concerns, in terms of how well the goals of non-maleficence, beneficence, autonomy, and justice are achieved. Many other values and ethical issues can be added to these. In different societies, periods, and cultures, different values may be assigned different priorities. For example, in the last 30 years medical care in the Western World has increasingly emphasized patient autonomy in decision making. The relationship and process can also be analyzed in terms of social power relationships (e.g., by Michel Foucault), or economic transactions. Physicians have been accorded gradually higher status and respect over the last century, and they have been entrusted with control of access to prescription medicines as a public health measure. This represents a concentration of power and carries both advantages and disadvantages to particular kinds of patients with particular kinds of conditions. A further twist has occurred in the last 25 years as costs of medical care have risen, and a third party (an insurance company or government agency) now often insists upon a share of decision-making power for a variety of reasons, reducing freedom of choice of both doctors and patients in many ways. The quality of the patient-doctor relationship is important to both parties. The better the relationship in terms of mutual respect, knowledge, trust, shared values and perspectives about disease and life, and time available, the better will be the amount and quality of information about the patient's disease transferred in both directions, enhancing accuracy of diagnosis and increasing the patient's knowledge about the disease. In some settings, e.g. the hospital ward, the patient-doctor relationship is much more complex, and many other people are involved when somebody is ill: relatives, neighbors, rescue specialists, nurses, technical personnel, social workers and others.

Clinical skills

Main articles: Medical history, Physical examination. A complete medical evaluation includes a medical history, a physical examination, appropriate laboratory or imaging studies, analysis of data and medical decision making to obtain diagnoses, and treatment plan. The components of the medical history are:
- Chief complaint (CC) - the reason for the current medical visit.
- History of present illness (HPI) - the chronological order of events of symptoms. A mnemonic PQRST is sometimes helpful in obtaining the history:
- Provocative-palliative factors - what makes a symptom worse or better.
- Quality - description of the symptom
- Region - which part of the body is affected
- Severity - what is the intensity of the symptom; using a scale of 0-10 (10 worst)
- Timing - what is the course of the symptom
- Current activity - occupation, hobbies, what the patient actually does.
- Medications - what drugs including OTCs, and home remedies, as well as herbal remedies such as St. John's Wort. Allergies are recorded.
- Past medical history (PMH/PMHx) - other medical diagnoses, past hospitalizations and operations, injuries, past infectious diseases and/or vaccinations, history of known allergies.
- Review of systems (ROS) - an outline of additional symptoms to ask which may be missed on HPI, generally following the body's main organ systems (heart, lungs, digestive tract, urinary tract, etc).
- Social history (SH) - birthplace, residences, marital history, social and economic status, habits (including diet, medications, tobacco, alcohol).
- Family history (FH) - listing of diseases in the family that may impact the patient. A family tree is sometimes used. The physical examination is the examination of the patient looking for signs of disease. The doctor uses his senses of sight, hearing, touch, and sometimes smell (taste has been made redundant by the availability of modern lab tests). Four chief methods are used: inspection, palpation, percussion, and auscultation; smelling may be useful (e.g. infection, uremia, diabetic ketoacidosis). The clinical examination involves study of:
- Vital signs include height, weight, body temperature, blood pressure, pulse, respiration rate, hemoglobin oxygen saturation
- General appearance of the patient
- Skin
- Head, eye, ear, nose, and throat (HEENT)
- Cardiovascular - heart and blood vessels
- Respiratory - lungs
- Abdomen and rectosigmoid
- Genitalia
- Spine and extremities - musculoskeletal
- Neurological and psychiatric Laboratory and imaging studies results may be obtained, if ncessary. The medical decision-making (MDM) process involves analysis and synthesis of all the above data to come up with a list of possible diagnoses (the differential diagnoses), along with an idea of what needs to be done to obtain a definitive diagnosis that would explain the patient's problem. The treatment plan may include ordering additional laboratory tests and studies, starting therapy, referral to a specialist, or watchful observation. Follow-up may be advised. This process is used by primary care providers as well as specialists. It may take only a few minutes if the problem is simple and straightforward. On the other hand, it may take weeks in a patient who has been hospitalized with multi-system problems, with involvement by several specialists. On subsequent visits, the process may be repeated in an abbreviated manner to obtain any new history, symptoms, physical findings, and lab or imaging results or specialist consultations.

Settings where medical care is delivered

See also clinic, hospital, and hospice Medicine is a diverse field and the provision of medical care is therefore provided in a variety of locations. Primary care medical services are provided by physicians or other health professionals who has first contact with a patient seeking medical treatment or care. These occur in physician's office, clinics, nursing homes, schools, home visits and other places close to patients. About 90% of medical visits can be treated by the primary care provider. These include treatment of acute and chronic illnesses, preventive care and health education for all ages and both sex. Secondary care medical services are provided by medical specialists in their offices or clinics or at local community hospitals for a patient referred by a primary care provider who first diagnosed or treated the patient. Referrals are made for those patients who required the expertise or procedures performed by specialists. These include both ambulatory care and inpatient services, emergency rooms, intensive care medicine, surgery services, physical therapy, labor and delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers, etc. Some primary care providers may also take care of hospitalized patients and deliver babies in a secondary care setting. Tertiary care medical services are provided by specialist hospitals or regional centers equipped with diagnostic and treatment facilities not generally available at local hospitals. These include trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants, high-risk pregnancy, radiation oncology, etc. Modern medical care also depends on information - still delivered in many health care settings on paper records, but increasingly nowadays by electronic means.

Branches of medicine

Working together as an interdisciplinary team, many highly trained health professionals besides medical practitioners are involved in the delivery of modern health care. Some examples include: nurses, laboratory scientists, pharmacists, physiotherapists, speech therapists, occupational therapists, dietitians and bioengineers. The scope and sciences underpinning human medicine overlap many other fields. Dentistry and psychology, while separate disciplines from medicine, are sometimes also considered medical fields. Physician assistants, nurse practitioners and midwives treat patients and prescribe medication in many legal jurisdictions. Veterinary medicine applies similar techniques to the care of animals. Medical doctors have many specializations and subspecializations which are listed below.

Basic sciences

- Anatomy is the study of the physical structure of organisms. In contrast to macroscopic or gross anatomy, cytology and histology are concerned with microscopic structures.
- Biochemistry is the study of the chemistry taking place in living organisms, especially the structure and function of their chemical components.
- Biostatistics is the application of statistics to biological fields in the broadest sense. A knowledge of biostatistics is essential in the planning, evaluation, and interpretation of medical research. It is also fundamental to epidemiology and evidence-based medicine.
- Cytology is the microscopic study of individual cells.
- Embryology is the study of the early development of organisms.
- Epidemiology is the study of the demographics of disease processes, and includes, but is not limited to, the study of epidemics.
- Genetics is the study of genes, and their role in biological inheritance.
- Histology is the study of the structures of biological tissues by light microscopy, electron microscopy and immunohistochemistry.
- Immunology is the study of the immune system, which includes the innate and adaptive immune system in human, for example.
- Microbiology is the study of microorganisms, including protozoa, bacteria, fungi, and viruses.
- Neuroscience is a comprehensive term for those disciplines of science that are related to the study of the nervous system. A main focus of neuroscience is the biology and physiology of the human brain.
- Nutrition is the study of the relationship of food and drink to health and disease, especially in determining an optimal diet. Medical nutrition therapy is done by dietitians and is prescribed for diabetes, cardiovascular diseases, weight and eating disorders, allergies, malnutrition and neoplastic diseases.
- Pathology is the study of disease - the causes, course, progression and resolution thereof.
- Pharmacology is the study of drugs and their actions.
- Physiology is the study of the normal functioning of the body and the underlying regulatory mechanisms.
- Toxicology is the study of hazardous effects of drugs and poisons.

Diagnostic specialties

- Clinical laboratory sciences are the clinical diagnostic services which apply laboratory techniques to diagnosis and management of patients. In the United States these services are supervised by a Pathologist. The personnel that work in these medical laboratory departments are technically trained staff, each of whom usually hold a medical technology degree, who actually perform the tests, assays, and procedures needed for providing the specific services.
- Transfusion medicine is concerned with the transfusion of blood and blood component, including the maintenance of a "blood bank".
- Cellular pathology is concerned with diagnosis using samples from patients taken as tissues and cells using histology and cytology.
- Clinical chemistry is concerned with diagnosis by making biochemical analysis of blood, body fluids and tissues.
- Hematology is concerned with diagnosis by looking at changes in the cellular composition of the blood and bone marrow as well as the coagulation system in the blood.
- Clinical microbiology is concerned with the in vitro diagnosis of diseases caused by bacteria, viruses, fungi, and parasites.
- Clinical immunology is concerned with disorders of the immune system and related body defenses. It also deals with diagnosis of allergy.
- Radiology is concerned with imaging of the human body, e.g. by x-rays, x-ray computed tomography, ultrasonography, and nuclear magnetic resonance tomography.
- Interventional radiology is concerned with using imaging of the human body, usually from CT, ultrasound, or fluoroscopy, to do biopsies, place certain tubes, and perform intravascular procedures.
- Nuclear Medicine uses radioactive substances for in vivo and in vitro diagnosis using either imaging of the location of radioactive substances placed into a patient, or using in vitro diagnostic tests utilizing radioactive substances.

Clinical disciplines

- Anesthesiology (AE), Anaesthesia (BE), is the clinical discipline concerned with providing anesthesia. Pain medicine is often practiced by specialised anesthesiologists.
- Dermatology is concerned with the skin and its diseases.
- Emergency medicine is concerned with the diagnosis and treatment of acute or life-threatening conditions, including trauma, surgical, medical, pediatric, and psychiatric emergencies.
- General practice, Family practice, family medicine or primary care is, in many countries, the first port-of-call for patients with non-emergency medical problems. Family doctors are usually able to treat over 90% of all complaints without referring to specialists.
- Hospital medicine is the general medical care of hospitalized patients. Doctors whose primary professional focus is hospital medicine are called hospitalists.
- Internal medicine is concerned with systemic diseases of adults, i.e. those diseases that affect the body as a whole , (restrictive ,current meaning) or with all adult non-operative somatic medicine (traditional , inclusive meaning) , thus excluding pediatrics , surgery , gynaecology & obstetrics and psychiatry. There are several subdisciplines of internal medicine:
- Cardiology is concerned with the heart and cardiovascular system and their diseases.
- Critical care medicine is concerned with the therapy of patients with serious and life-threatening disease or injury. Intensive care medicine employs invasive diagnostic techniques and (temporary) replacement of organ functions by technical means. Also known as Intensive care medicine. This field is often associated with Pulmonology.
- Endocrinology is concerned with the endocrine system, i.e. endocrine glands and hormones, usually Diabetes or Thyroid diseases.
- Gastroenterology is concerned with the alimentary tract.
- Geriatrics is concerned with medical care of the elderly.
- Hematology (or haematology) is concerned with the blood and its diseases.
- Hepatology is concerned with the liver and biliary tract, and is usually a part of Gastroenterology
- Infectious diseases is concerned with the study, diagnosis and treatment of diseases caused by biological agents.
- Nephrology is concerned with diseases of the kidneys.
- Oncology is devoted to the study, diagnosis and treatment of cancer and other malignant diseases, and is often grouped with Hematology.
- Pulmonology (or chest medicine, respiratory medicine or lung medicine) is concerned with diseases of the lungs and the respiratory system.
- Rheumatology is devoted to the diagnosis and treatment of inflammatory diseases of the joints and other organ systems, such as arthritis.
- Neurology is concerned with the diagnosis and treatment of nervous system diseases.
- Obstetrics and Gynecology (often abbreviated as Ob/Gyn) are concerned respectively with childbirth and the female reproductive and associated organs. Reproductive medicine and fertility medicine are generally practiced by gynecological specialists.
- Palliative care is a relatively modern branch of clinical medicine that deals with pain and symptom relief and emotional support in patients with terminal diseases (cancer, heart failure).
- Pediatrics (or paediatrics) is devoted to the care of infants, children, and adolescents. Like internal medicine, there are many pediatric subspecialities for specific age ranges, organ systems, disease classes and sites of care delivery. Most subspecialities of adult medicine have a pediatric equivalent such as pediatric cardiology, pediatric endocrinology, pediatric gastroenterology, pediatric hematology, and pediatric oncology, pediatric ophthalmology, and neonatology.
- Physical medicine and rehabilitation (or physiatry) is concerned with functional improvement after injury, illness, or congenital abnormality.
- Preventive medicine is the branch of medicine concerned with preventing disease.
- Community health care or public health is an aspect of health services concerned with threats to the overall health of a community based on population health analysis.
- Occupational medicines principal role is the provision of health advice to organisations and individuals to ensure that the highest standards of health and safety at work can be achieved and maintained.
- Psychiatry is a branch of medicine that studies and treats mental disorders. Related non-medical fields are psychotherapy and clinical psychology. There are several subdisciplines of Psychiatry:
- Child & adolescent psychiatry focuses on the care of children and adolescents with mental/emotional/learning problems (i.e., ADHD, Autism, family conflicts).
- Geriatric psychiatry focuses on the care of elderly people with mental illnesses (i.e., dementias, post stroke cognitive changes, depression).
- Addiction psychiatry focuses on substance abuse and its treatment.
- Forensic psychiatry focuses on the interface of psychiatry and the Law.
- Radiation therapy is concerned with the therapeutic use of ionizing radiation and high energy elementary particle beams in patient treatment.
- Surgical specialties - there are many medical disciplines that employ operative treatment. Some of these are highly specialized and are often not considered subdisciplines of surgery, although their naming might suggest so.
- General surgery is traditionally defined as the specialty of surgery of the skin, endocrine glands, and abdomen (and, sometimes, the mammary glands). In some countries, it is still deemed a pre-requisite training prior to progression to training in certain sub-specialties, but lately has evolved into its own sub-specialty.
- Cardiovascular surgery is the surgical specialty that is concerned with the heart and major blood vessels of the chest.
- Neurosurgery is concerned with the operative treatment of diseases of the nervous system.
- Maxillofacial surgery (technically a subspeciality of dentistry)
- Ophthalmology deals with the diseases of the eyes and their treatment.
- Orthopedic surgery consists on surgery of the locomotor system.
- Otolaryngology (or otorhinolaryngology or ENT/ear-nose-throat) is concerned with treatment of ear, nose and throat disorders. The term head and neck surgery defines a closely related specialty which is concerned mainly with the surgical management of cancer of the same anatomical structures.
- Pediatric surgery treats a wide variety of thoracic and abdominal (and sometimes urologic) diseases of childhood.
- Plastic surgery includes aesthetic surgery (operations that are done for other than medical purposes) as well as reconstructive surgery (operations to restore function and/or appearance after traumatic or operative mutilation).
- Surgical oncology is concerned with curative and palliative surgical approaches to cancer treatment.
- Urology focuses on the urinary tracts of males and females, and on the male reproductive system. It is often practiced together with andrology ("men's health").
- Vascular surgery is surgery of "peripheral" blood vessels, i.e. those outside of the chest (usually operated on by cardiovascular surgeons) and of the central nervous system (treated by neurosurgery).
- Urgent Care focuses on delivery of unscheduled, walk-in care outside of the hospital emergency department for injuries and illnesses that are not severe enough to require care in an emergency department.
Interdisciplinary fields
Interdisciplinary sub-specialties of medicine are:
- Aerospace medicine deals with medical problems related to flying and space travel.
- Bioethics is a field of study which concerns the relationship between biology, science, medicine and ethics, philosophy and theology.
- Clinical pharmacology is concerned with how systems of therapeutics interact with patients.
- Conservation medicine studies the relationship between human and animal health, and environmental conditions. Also known as ecological medicine, environmental medicine, or medical geology.
- Diving medicine (or hyperbaric medicine) is the prevention and treatment of diving-related problems.
- Evolutionary medicine is a perspective on medicine derived through applying evolutionary theory.
- Forensic medicine deals with medical questions in legal context, such as determination of the time and cause of death.
- Medical humanities includes the humanities (literature, philosophy, ethics, history and religion), social science (anthropology, cultural studies, psychology, sociology), and the arts (literature, theater, film, and visual arts) and their application to medical education and practice.
- Medical informatics and medical computer science are relatively recent fields that deal with the application of computers and information technology to medicine.
- Nosology is the classification of diseases for various purposes.
- Sports medicine deals with the treatment and preventive care of athletics, amateur and professional. The team includes specialty physicians and surgeons, athletic trainers, physical therapists, coaches, other personnel, and, of course, the athlete.
- Therapeutics is the field, more commonly referenced in earlier periods of history, of the various remedies that can be used to treat disease and promote health [http://2.1911encyclopedia.org/T/TH/THERAPEUTICS.htm] [http://www.britannica.com/eb/article-9106176?query=Therapeutics&ct=].
- Travel medicine or emporiatrics deals with health problems of international travelers or travelers across highly different evironments.
Medical education
See also Medical doctor (BE), Physician (AE), and Medical school. Medical training involves several years of university study followed by several more years of residential practice at a hospital. Entry to a medical degree in some countries (such as the United States) requires the completion of another degree first, while in other countries (such as the United Kingdom, Australia and New Zealand) medical training can be commenced as an undergraduate degree immediately after secondary education. The name of the medical degree gained at the end varies: some countries (e.g. the US) call it "Doctor of Medicine" (abbreviated 'M.D.'), while other countries (mostly following the British Oxbridge system) call it "Medicinæ Baccalaureus & Baccalaureus Chirurgiæ" (Latin for "Bachelor of Medicine/Bachelor of Surgery", Old English: "Chirurgie"); this is technically a double degree, frequently abbreviated 'MB BChir', 'MB ChB', 'MB BS' (or variations thereof), dependent on the medical school. In either case, graduates of a medical degree may call themselves physician. In the US and some other countries there is a parallel system of medicine which is equal in all aspects of education, legality, and practice to M.D.'s. It is called osteopathic medicine (generic term: "osteopathy") which awards the degree of "Doctor of Osteopathic Medicine" (abbreviated 'D.O.'). In many countries, a doctorate of medicine does not involve original research as does, in distinction, a Ph.D.. Once graduated from medical school most physicians (both M.D.'s and D.O.'s) begin their residency/house post training, where skills in a speciality of medicine are learned, supervised by more experienced doctors. The first year of residency is known as the "intern" year (USA) or "junior/pre-registration house officer" year (UK). The duration of residency training depends on the speciality. A medical graduate can then enter general practice and become a general practitioner (or primary care internist in the USA); training for these is generally shorter, while specialist training is typically longer. Medical education is a never ending endeavor. In addition to continually reading relevant medical journals, physicians require a number of continuing medical education (CME)credits annually to be recertified. These can be acquired by attending conferences, lectures, online, and through other sources.
Medical devices
See also the main articles: implant, artificial limbs, corrective lenses, cochlear implants, ocular prosthetics, facial prosthetics, somato prosthetics, surgical prosthetics, maxillo-facial prosthetics and dental implants Medical devices are devices used by health professionals as tools in diagnosis, treatment, or other aspects of patient care.
Legal restrictions
In most countries, it is a legal requirement for medical doctors to be licensed or registered. In general, this entails a medical degree from a university and accreditation by a medical board or an equivalent national organization, which may ask the applicant to pass exams. This restricts the considerable legal authority of the medical profession to doctors that are trained and qualified by national standards. It is also intended as an assurance to patients and as a safeguard against charlatans that practice inadequate medicine for personal gain. While the laws generally require medical doctors to be trained in "evidence based", Western, or Hippocratic Medicine, they are not intended to discourage different paradigms of health and healing, such as alternative medicine or faith healing.
Criticism
Criticism of medicine has a long history. In the Middle Ages, it was not considered a profession suitable for Christians, as disease was considered Godsent, and interfering with the process a form of blasphemy. Barber-surgeons generally had a bad reputation that was not to improve until the development of academic surgery as a speciality of medicine, rather than an accessory field. Through the course of the twentieth century, doctors focused increasingly on the technology that was enabling them to make dramatic improvements in patients' health. The ensuing development of a more mechanistic, detached practice, with the perception of an attendent loss of patient-focused care led to further criticisms. This issue started to reach collective professional consciousness in the 1970s and the profession had begun to respond by the 1980s and 1990s. Perhaps the most devastating criticism of modern medicine came from Ivan Illich, in his 1976 work Medical Nemesis. In his view, modern medicine only medicalises disease, causing loss of health and wellness, while generally failing to restore health by eliminating disease. The human being thus becomes a lifelong patient. Other less radical philosophers have voiced similar views, but none were as virulent as Illich. (Another example can be found in Technopoly: The Surrender of Culture to Technology by Neil Postman, 1992, which criticises overreliance on technological means in medicine.) Criticism of modern medicine has led to some improvements in the curricula of medical schools, which now teach students systematically on medical ethics, holistic approaches to medicine, the biopsychosocial model and similar concepts. The inability of modern medicine to properly address many common complaints continues to prompt many people to seek support from alternative medicine. Although most alternative approaches lack scientific validation, some report improvement of symptoms after obtaining alternative therapies. The bioscience medical paradigm and the alternative / complementary healthcare paradigms may differ to such an extent that what constitutes scientific evidence is contested. Many medical doctors also practice alternative medicine alongside the orthodox. Medical errors are also the focus of many complaints and negative coverage. Practitioners of human factors engineering believe that there is much that medicine may usefully gain by emulating concepts in aviation safety, where it was long ago realized that it is dangerous to place too much responsibility on one "superhuman" individual and expect him or her not to make errors. Reporting systems and checking mechanisms are becoming more common in identifying sources of error and improving practice. Radical critics of certain medical traditions may hold that whole fields or traditions of medicine are intrinsically harmful or ineffective. They would reject any use or support of practices belonging to that tradition. However, generally, there is spectrum of efficacy on which all traditions lie; some are more effective, some are less effective, but nearly all contain some harmful practices and some effective ones. Naturally, though, most individuals or groups seeking a healthcare practice to improve their own health would seek a tradition with the maximum degree of efficacy.
See also

- Academic conference
- Big killers
- Complementary and alternative medicine
- Health profession
- Healthcare system
- Iatrogenesis (ill health caused by medical treatment)
- List of diseases
- List of medical abbreviations
- List of medical schools
- Important publications in medicine
- Medical equipment
- Rare diseases
External links

- [http://home.planet.nl/~hend2438/MOTW/index.htm Medicine on the Web]
- [http://www.nlm.nih.gov NLM] (National Library of Medicine, contains resources for patients and healthcare professionals)
- [http://www.vh.org Virtual Hospital] (digital health sciences library by the University of Iowa)
- [http://cancerweb.ncl.ac.uk/omd/index.html Online Medical Information]- medical news, links and resources.
- [http://www.medmark.org Online Medical Directory]
- [http://www.wikimd.org/index.php?title=Free_Medical_Resources Collection of links to free medical resources] fiu-vro:Arstitiidüs als:Medizin zh-min-nan:I-ha̍k ko:의학 ja:医学 simple:Medicine th:แพทยศาสตร์

Spirituality

Spirituality is, in a narrow sense, a concern with matters of the spirit, however that may be defined; but it is also a wide term with many available readings. It may include belief in supernatural powers, as in religion, but the emphasis is on personal experience. It may be an expression for life perceived as higher, more complex or more integrated with one's worldview, as contrasted with the merely sensual.

The spiritual and the religious

An important distinction needs to be made between spirituality in religion and spirituality as opposed to religion. In recent years, spirituality in religion often carries connotations of the believer's faith being more personal, less dogmatic, more open to new ideas and myriad influences, and more pluralistic than the faiths of established religions. It also can connote the nature of a believer's personal relationship with Deity, as opposed to the general relationship with Deity understood to be shared by all members of that faith. Those who speak of spirituality as opposed to religion generally believe that there are many "spiritual paths" and that there is no objective truth about which is the best path to follow. Rather, adherants of this definition of the term emphasize the importance of finding one's own path to Deity, rather than following what others say works. The best way to describe this view is: the path which makes the most sense is the correct one (for oneself). Many adherents of orthodox religions who consider spirituality to be an aspect of their religious experience are more likely to contrast spirituality with secular "worldliness" than with the ritual expression of their religion. Others of a more New Age disposition hold that spirituality is not religion, per se, but the active and vital connection to a force, spirit, or sense of the deep self. As cultural historian and yogi William Irwin Thompson put it, "Religion is not identical with spirituality; rather religion is the form spirituality takes in civilization." (1981, 31)

Directed spirituality

One aspect of 'Being spiritual' is goal-directed, with aims such as: simultaneously improve one's wisdom and willpower, achieve a closer connection to Deity/the universe, and remove illusions or false ideas at the sensory, feeling and thinking aspects of a person. The 'Plato's cave' analogy in book VII of The Republic is one of the most well known descriptions of the spiritual development process, and thus, an excellent aid in understanding what "spiritual development" exactly entails. Others say that spirituality is a two-stroke process: the "upward stroke" is inner growth, changing oneself as one changes his/her relationship with God, and the "downward stroke" is manifesting improvements in the physical reality around oneself as a result of the inward change.

Spirituality and personal well-being

Due to its broad scope and individual nature, spirituality is perhaps better understood by highlighting a number of key concepts that arise for people when asked to describe what spirituality means to them. Research by Martsolf & Mickley (1998) highlighted the following areas as worthy of consideration:
- Meaning – significance of life; making sense of situations; deriving purpose.
- Values – beliefs, standards and ethics that are cherished.
- Transcendence – experience and appreciation of a dimension beyond self.
- Connecting – increased awareness of a connection with self, others, God/Spirit/Divine, and nature.
- Becoming – an unfolding of life that demands reflection and experience; includes a sense of who one is and how one knows. Spirituality, according to most adherants, is an essential part of an individual's holistic health and well-being, by developing an awareness of a "transcendent dimension" to life.

The Spiritual and Science

Analysis of spiritual qualities in science is bedeviled by the imprecision of spiritual concepts, the subjectivity of spiritual experience, and the amount of work required to translate and map observable components of a spiritual system into empirical evidence. Hackwrench 03:07, 6 November 2005 (UTC)

Spiritual traditions and communities

- Bahá'í Faith
- Buddhism, Jainism
- Catholic Spirituality
- Feminist spirituality
- Gnosticism
- Hinduism
- Humanism
- Islam, Sufism
- Judaism
- Neo-confucianism, Taoism
- Paganism, Neopaganism, Modern_Gallae
- New Age, New Thought, Spiritualism, The Dances of Universal Peace
- Shamanism
- Sikhism
- Subud
- Surat Shabda Yoga
- Unitarian Universalism

References

- Azeemi,K.S.Muraqaba: The Art and Science of Sufi Meditation. Houston: Plato, 2005.(ISBN 0975887548)
- Bolman, L. G., and Deal, T. E. Leading With Soul. San Francisco: Jossey-Bass, 1995.
- Borysenko, J. A Woman's Journey to God. New York: Riverhead Books, 1999.
- Cannon, K. G. Katie's Canon: Womanism and the Soul of the Black Community. New York: Continuum, 1996.
- Deloria, V., Jr. God is Red. 2d Ed. Golden, Co: North American Press, 1992.
- Dillard, C. B.; Abdur-Rashid, D.; and Tyson, C. A. "My Soul is a Witness." International Journal of Qualitative Studies in Education 13, no. 5 (September 2000): 447-462.
- Dirkx, J. M. "Nurturing Soul in Adult Learning." in Transformative Learning in Action. New Directions for Adult and Continuing Education No. 74, edited by P. Cranton, pp. 79-88. San Francisco: Jossey-Bass, 1997.
- Eck, D. A New Religious America. San Francisco: Harper, 2001.
- Elkins D.N. et al (1998)Toward a humanistic-phenomenological spirituality: definition, description and measurement. Journal of Humanistic Psychology 28(4), 5-18
- English, L., and Gillen, M., eds. Addressing the Spiritual Dimensions of Adult Learning. New Directions for Adult and Continuing Education, No. 85. San Francisco: Jossey-Bass, 2000.
- Holtje, D. (1995). [http://www.masterpath.org/masterpath_books/index.htm From Light to Sound: The Spiritual Progression]. Temecula, CA: MasterPath, Inc. ISBN 1885949006
- Martsolf D.S. & Mickley J.R. (1998) "The concept of spirituality in nursing theories: differing world-views and extent of focus" Journal of Advanced Nursing 27, 294-303
- Perry, W. [http://www.fonsvitae.com/treasury.html A Treasury of Traditional Wisdom - An Encyclopedia of Humankind’s Spiritual Truth]. Louisville: Fons Vitae books, 2000
- Thompson, William Irwin, The Time Falling Bodies Take to Light: Mythology, Sexuality, and the Origins of Culture (New York: St. Martin's Press, 1981).

External links

- [http://www.fonsvitae.com/MG1.html Resources/Books on World Spirituality]
- [http://www.sahajayoga.org/ sahajayoga.org: a place to experience self realisation for free]
- [http://www.lifetheory.com/ LifeTheory.com: An online forum on life and spirituality]
- [http://www.gnosticweb.com/ Gnosticweb] Providing Free Global Access to Spiritual Information.
- [http://www.edgelife.net/glossary/spirituality.htm A new definition of spirituality]
- [http://www.avatarsearch.com/ AvatarSearch.com: A search engine for spiritual-related topics]
- [http://www.kheper.net/ Kheper.net: An overview of everything spiritual]
- [http://www.ias.org/ International Association of Sufism]
- [http://www.gatheringlight.com/ Long Term (monthly) Private Spiritual Riverside Retreats]
- [http://www.sufiblog.com/ Multi-faith Spirituality]
- [http://www.new-age-spirituality.com/ New Age Spirituality]
- [http://www.sos.org/ Science of Spirituality]
- [http://www.acu-cell.com/sh.html Spiritual aspects of Health and Healing]
- [http://www.masterpath.org/sriGaryOlsen/index.htm Spiritual Awakening and Spiritual Growth]
- [http://www.onespirit.com Spiritual Book Club]
- [http://www.spiritualcinemacircle.com/ Spiritual Cinema Circle]
- [http://www.spiritualforums.com/ Spiritual Forums]
- [http://www.quranichealing.com/bp.asp?caid=53 Spiritual Purification and Wellness]
- [http://www.level-of-consciousness.org/ Spirituality and consciousness forum]
- [http://www.rudraksha-ratna.com Spirituality and Rudraksha]
- [http://www.srcm.org/articles/srcmintro.html Spirituality begins where religion ends - Shri Ram Chandra Mission]
- [http://www.ericdigests.org/2002-3/adult.htm Spirituality in Adult and Higher Education]
- [http://amanecerespiritual.tripod.com/index_en.htm Spiritual Dawn - Morality and Philosophy Essay]
- [http://www.arches.uga.edu/~godlas/Sufism.html Sufism -- Sufis -- Sufi Orders] by Dr. Alan Godlas, University of Georgia
- [http://www.sufiblog.com/ SufiBlog ]Sufism online spiritual magazine of Sufi Meditation (Muraqaba) and Healing
- [http://www.thespiritual.org The Spiritual: Journal of Natural Spirituality] An on-line resource of rare texts and reflections on natural spirituality, thoughtless-ness, egoless-ness and mind-brain duality.
- [http://www.spiritualwisdom.org.uk/ Spiritual Wisdom] There is a universal spirituality which can be expressed in many ways, but this site uses the insights of Emanuel Swedenborg to help explain the meaning of our lives.
- [http://www.spirituality.com Spirituality.com] Christian Science perspective on spirituality and healing. simple:Spirituality

Appetite

The appetite is the desire to eat food, felt as hunger. Appetite exists in all higher lifeforms, and serves to regulate adequate energy intake to maintain metabolic needs. It is regulated by a close interplay between the digestive tract, adipose tissue and the brain. Decreased desire to eat is termed anorexia, while polyphagia (or "hyperphagia") is increased eating. Dysregulation of appetite contributes to anorexia nervosa and cachexia on one side, and obesity on the other side of the spectrum.

Regulation

The regulation of appetite has been the subject of much research in the last decade. Breakthroughs included the discovery, in 1995, of leptin, a hormone that appeared to provide negative feedback. Later studies showed that appetite regulation is an immensely complex process involving the gastrointestinal tract, many hormones, and both the central and autonomic nervous systems.

Effector

The hypothalamus, a part of the brain, is the main regulatory organ for appetite. The neurones that regulate appetite appear to be mainly serotonergic, although neuropeptide Y (NPY) and Agouti-related peptide (AGRP) also play a vital role. Hypothalamocortical and hypothalamolimbic projections contribute to the awareness of hunger, and the somatic processes controlled by the hypothalamus include vagal tone (the activity of the parasympathic autonomic nervous system), stimulation of the thyroid (thyroxine regulates the metabolic rate), the hypothalamic-pituitary-adrenal axis and a large amount of other mechanisms.

Sensor

The hypothalamus senses external stimuli mainly through a number of hormones such as leptin, ghrelin, PYY 3-36, orexin and cholecystokinin; all modify the hypothalamic response. They are produced by the digestive tract and by adipose tissue (leptin). Systemic mediators, such as tumor necrosis factor alpha (TNFα), interleukins 1 and 6 and corticotropin-releasing hormone (CRH) influence appetite negatively; this mechanism explains why ill people often eat less. In addition, the biological clock (which is regulated by the hypothalamus) modifies hunger. Processes from other cerebral loci, such as from the limbic system and the cerebral cortex, project on the hypothalamus and modify appetite. This explains why in clinical depression and stress, energy intake can change quite drastically.

Role in disease

A limited or excessive appetite is not necessarily pathological. Abnormal appetite could be defined as eating habits causing malnutrition on the one site or obesity and its related problems on the other. Both genetic and environmental factors may regulate appetite, and abnormalities in either may lead to abnormal appetite. Poor appetite (anorexia) may have numerous causes, but may be a result of physical (infectious, autoimmune or malignant disease) or psychological (stress, mental disorders) factors. Likely, hyperphagia (excessive eating) may be a result of hormonal imbalances, mental disorders (e.g. depression) and others. Dysregulation of appetite lies at the root of anorexia nervosa, bulimia nervosa and binge eating disorder. In addition, decreased response to satiety may promote development of obesity. Various hereditary forms of obesity have been traced to defects in hypothalamic signalling (such as the leptin receptor and the MSH-4 receptor), or are still awaiting characterisation (Prader-Willi syndrome).

Pharmacology

Mechanisms controlling appetite are a potential target for weight loss drugs. Early anorectics were fenfluramine and phentermine. A more recent addition is sibutramine (Reductil®, Meridia®), which increases serotonin and noradrenaline levels in the central nervous system. In addition, recent reports on recombinant PYY 3-36 suggest that this agent may contribute to weight loss by suppressing appetite. Given the epidemic proportions of obesity in the Western world, developments in this area are expected to snowball in the near future, as dieting alone is ineffective in most obese adults.

Controversy

A controversy is a contentious dispute, a disagreement in opinions over which parties are actively arguing. Controversies can range from private disputes between two individuals to large-scale social upheavals. Controversies in mathematics and the sciences are generally eventually solved. It is the nature of controversies in the humanities that they cannot generally be conclusively settled and may be accompanied by the disruption of peace and even quarreling. In some cases, this may be because the two sides to a dispute differ so much in their "givens" that in effect they are not having the same argument. In other cases, culture moves on, and the subject of the controversy becomes quaint in retrospect and increasingly irrelevant. Present-day areas of controversy include religion, politics, war, property, social class, and taxes. Controversy in matters of theology has traditionally been particularly heated, giving rise to odium theologicum.

In law

In jurisprudence, a controversy differs from a case, which includes all suits criminal as well as civil; a controversy is a purely civil proceeding. In the Constitution of the United States, the judicial power shall extend to controversies to which the United States shall be a party (Article 2, Section 1). The meaning to be attached to the word controversy in the constitution is that given above.

In propaganda

The term is not always used in a purely descriptive way. The use of the word tends itself to create controversy where none may have authentically existed, acting as a self-fulfilling prophecy. Propagandists, therefore, may employ it as a "tar-brush," pejoratively, and thus create a perceived atmosphere of controversy, discrediting the subject: ::"Beatrix Potter's creation, Peter Rabbit..." ::vs. ::"Beatrix Potter's controversial creation, Peter Rabbit..." Thus controversy may itself be judged controversial.

In advertising

On the other hand, controversy is also used in advertising to try to draw attention to a product or idea by labeling it as controversial, even if the idea has become widely accepted to a given segment of the population. This strategy has been known to be especially successful in promoting books and films.

In early Christianity

Many of the early Christian writers, among them Irenaeus, Athanasius, and Jerome, were famed as "controversialists"; they wrote works against perceived heresy or heretical individuals, works whose titles begin "Adversus..." such as Irenaeus' Adversus haeresis. The Christian writers inherited from the classical rhetors the conviction that controversial confrontations, even over trivial matters, were a demonstration of intellectual superiority.

Alcohol

In general usage, alcohol (from Arabic al-ghawl الغول) refers almost always to ethanol, also known as grain alcohol, and often to any beverage that contains ethanol (see alcoholic beverage). This sense underlies the term alcoholism (addiction to alcohol). Other forms of alcohol are usually described with a clarifying adjective, as in isopropyl alcohol or by the suffix -ol, as in isopropanol. In chemistry, alcohol is a more general term, applied to any organic compound in which a hydroxyl group (-O H) is bound to a carbon atom, which in turn is bound to other hydrogen and/or carbon atoms. The general formula for a simple acyclic alcohol is C_nH_2n+1OH. As a drug, common alcohol (ethanol) is known to have a depressing effect that decreases the responses of the central nervous system.

Structure

central nervous system The functional group of an alcohol is a hydroxyl group bonded to an sp³ hybridized carbon. It can therefore be regarded as a derivative of water, with an alkyl group replacing one of the hydrogens. If an aryl group is presen

Recreational drug use

History

Legal aspects

Drugs popularly used for recreation

See also

References

External links

Psychoactive drug

Psychoactive drug chart

Legend

Sub-sections

A brief history of drug use

Other psychoactive drugs

Ways psychoactive drugs affect the brain

See also

Work

Medicine

History of medicine

Practice of medicine

Medical systems

Patient-doctor relationship

Clinical skills

Settings where medical care is delivered

Branches of medicine

Basic sciences

Diagnostic specialties

Clinical disciplines

Interdisciplinary fields

Medical education

Medical devices

Legal restrictions

Criticism

See also

External links

Spirituality

The spiritual and the religious

Directed spirituality

Spirituality and personal well-being

The Spiritual and Science

Spiritual traditions and communities

See also

References

External links

Appetite

Regulation

Effector

Sensor

Role in disease

Pharmacology

Further reading

Controversy

In law

In propaganda

In advertising

In early Christianity

See also

Alcohol

Structure