4.4: State and County Health Agencies
State and local health agencies play essential roles in protecting and promoting public health within their respective jurisdictions. These agencies are responsible for a wide range of public health activities and services to ensure the health and well-being of the communities they serve. Here are some of the key functions and responsibilities of state health agencies:
- Disease Surveillance and Control: State health agencies monitor the prevalence of diseases, conduct investigations, and implement control measures to prevent the spread of infectious diseases within the state.
- Health Regulations: They develop and enforce health regulations and guidelines related to areas such as food safety, environmental health, and healthcare facilities to protect public health.
- Immunization Programs: State health agencies administer immunization programs, ensuring that residents have access to vaccines to prevent vaccine-preventable diseases.
- Health Data Collection and Analysis: They collect, analyze, and report health data to inform public health policies, track health trends, and respond to emerging health issues.
- Emergency Preparedness and Response: State agencies coordinate and plan responses to public health emergencies, such as natural disasters, disease outbreaks, and bioterrorism threats.
- Health Education and Promotion: They engage in public health education and awareness campaigns to promote healthy behaviors and prevent chronic diseases.
- Maternal and Child Health Services: State agencies provide services and programs to support the health and well-being of mothers and children, including prenatal care and child health programs.
- Regulatory Oversight: They regulate healthcare facilities, healthcare providers, and health insurance to ensure quality and safety standards are met.
Local Health Departments are typically responsible for:
- Primary Care and Clinical Services: Local health departments offer primary care services, immunizations, family planning, and other clinical services to the local community.
- Community Health Assessment and Planning: They assess the health needs of the local community and develop health improvement plans in collaboration with community stakeholders.
- Health Inspections: Local health departments conduct inspections of restaurants, food establishments, swimming pools, and other public facilities to ensure compliance with health and safety regulations.
- WIC and Nutrition Programs: Many local health departments administer the Women, Infants, and Children (WIC) program, which provides nutrition support to low-income pregnant women and young children.
- Emergency Preparedness and Response: They play a critical role in local emergency preparedness, working with state and federal agencies to respond to public health emergencies.
- Health Promotion and Education: Local health departments engage in health promotion activities, including smoking cessation programs, substance abuse prevention, and injury prevention initiatives.
- Disease Investigation and Reporting: They investigate and report cases of notifiable diseases, collaborate with healthcare providers, and implement control measures as needed.
- Environmental Health Services: Local health departments address environmental health concerns such as water quality, air quality, and sanitation to protect public health.
State and local health agencies work in tandem to deliver essential public health services to the community. They collaborate with federal agencies, healthcare providers, non-profit organizations, and community partners to address a wide range of public health challenges and promote the overall health and well-being of their populations.


30.11: Plant Development - Meristems
- Discuss the attributes of meristem tissue and its role in plant development and growth
The adult body of vascular plants is the result of meristematic activity. Plant meristems are centers of mitotic cell division, and are composed of a group of undifferentiated self-renewing stem cells from which most plant structures arise. Meristematic cells are also responsible for keeping the plant growing. The Shoot Apical Meristem (SAM) gives rise to organs like the leaves and flowers, while the Root Apical Meristem (RAM) provides the meristematic cells for the future root growth. The cells of the shoot and root apical meristems divide rapidly and are considered to be indeterminate, which means that they do not possess any defined end fate. In that sense, the meristematic cells are frequently compared to the stem cells in animals, which have an analogous behavior and function.
Meristem tissue and plant development
Meristematic tissues are cells or group of cells that have the ability to divide. These tissues in a plant consist of small, densely packed cells that can keep dividing to form new cells. Meristematic tissue is characterized by small cells, thin cell walls, large cell nuclei, absent or small vacuoles, and no intercellular spaces.
Meristematic tissues are found in many locations, including near the tips of roots and stems (apical meristems), in the buds and nodes of stems, in the cambium between the xylem and phloem in dicotyledonous trees and shrubs, under the epidermis of dicotyledonous trees and shrubs (cork cambium), and in the pericycle of roots, producing branch roots. The two types of meristems are primary meristems and secondary meristems.
Meristem Zones
The apical meristem, also known as the “growing tip,” is an undifferentiated meristematic tissue found in the buds and growing tips of roots in plants. Its main function is to trigger the growth of new cells in young seedlings at the tips of roots and shoots and forming buds. Apical meristems are organized into four zones: (1) the central zone, (2) the peripheral zone, (3) the medullary meristem and (3) the medullary tissue.
The central zone is located at the meristem summit, where a small group of slowly dividing cells can be found. Cells of this zone have a stem cell function and are essential for meristem maintenance. The proliferation and growth rates at the meristem summit usually differ considerably from those at the periphery. Surrounding the central zone is the peripheral zone. The rate of cell division in the peripheral zone is higher than that of the central zone. Peripheral zone cells give rise to cells which contribute to the organs of the plant, including leaves, inflorescence meristems, and floral meristems.
An active apical meristem lays down a growing root or shoot behind itself, pushing itself forward. They are very small compared to the cylinder-shaped lateral meristems, and are composed of several layers, which varies according to plant type. The outermost layer is called the tunica, while the innermost layers are cumulatively called the corpus.
Key Points
- Mitotic cell division happens in plant meristems, which are composed of a group of self-renewing stem cells from which most plant structures arise.
- The cells of the shoot and root apical meristems divide rapidly and are “indeterminate”, which means that they are not designed for any specific end goal.
- The Shoot Apical Meristem (SAM) gives rise to organs like the leaves and flowers, while the Root Apical Meristem (RAM) provides cells for future root growth.
- Meristematic tissue has a number of defining features, including small cells, thin cell walls, large cell nuclei, absent or small vacuoles, and no intercellular spaces.
- The apical meristem (the growing tip) functions to trigger the growth of new cells in young seedlings at the tips of roots and shoots and forming buds.
- The apical meristem is organized into four meristematic zones: (1) central zone, (2) peripheral zone, (3) medullary meristem and (3) medullary tissue.
Key Terms
- meristem : the plant tissue composed of totipotent cells that allows plant growth
- undifferentiated : describes tissues where the individual cells have not yet developed mature or distinguishing features, or describes embryonic organisms where the organs cannot be identified
- apical : situated at the growing tip of the plant or its roots, in comparison with intercalary growth situated between zones of permanent tissue


10.7: Putting It Together- Motivating Employees
Synthesis
“You can’t make me.”
Have you ever heard the expression “stubborn as a mule” and heard it used to describe someone who won’t change their mind or way of doing things? What would it take to get such a mulish person to change, to work in a different way—say, more efficiently or effectively? Well, now that you have some motivational theories under your belt, you probably have some ideas. Being able to motivate people is obviously an invaluable skill—in business and in life—and it’s not surprising that the most effective leaders and managers are those who can inspire others to work hard and get things done.
At the beginning of this module you were asked what motivates you, how you motivate others, and which strategies have worked (or not worked) for you. Now that you have completed the module, reflect on your answers to those questions. Can you identify some of these motivational theories at work in your own motivations? Do you have a better understanding of where your own motivation comes from?
One last thought as we conclude the module. When you came up with your list of motivating factors, it was your list. What motivates you might not motivate the person working beside you. So, as you interact with people throughout your personal and professional life, keep in mind that motivation is highly variable. It doesn’t mean that the theories are wrong or completely irrelevant—it’s just that everyone, like you, is motivated by a different set of needs, wants, and aspirations, and you’ll need to understand those differences before creatively engaging with them. If you can, you’ll be well on your way to being an effective leader and achieving great things.
Summary
In this module you learned about motivation and how organizations can use motivation theory to achieve organizational goals and objectives. The following is a summary of the key points.
The Hawthorne Effect
Conducted at the Western Electric Hawthorne Works plant in Cicero, Illinois, Elton Mayo and his colleagues attempted to apply Taylor’s process of scientific management by conducting experiments in the workplace. What resulted is a phenomenon known as the “Hawthorne effect,” which occurs when subjects being studied change their behavior simply because they are being observed and treated differently.
Need-Based Theories
The first theories used to explain human motivation were need based. These theories proposed that people are mainly motivated by trying to meet certain needs and that if you can understand their needs, you can better motivate them. Among the need-based theories are Maslow’s hierarchy of needs, ERG theory, Herzberg’s two-factor theory, and McClelland’s acquired-needs theory.
Process-Based Theories
Process-based theories of motivation view motivation as a more rational, deliberate process. The three best-known process-based theories are equity, expectancy, and reinforcement theories.
Theory X, Theory Y, and Theory Z
Douglas McGregor theorized that worker motivation is closely linked to the way managers view and treat their workers and that all managers fall into one of two types—Theory X and Theory Y. Later, William Ouchi combined Eastern and Western management practices to develop Theory Z
Strategies for Motivating Employees
Two methods of applying motivation theory in the workplace are job models and goal setting. Beyond these two applications, companies have become very aware of the way motivated employees impact organizational effectiveness and efficiency.


8.2: Overview of Photosynthesis
- Explain the relevance of photosynthesis to other living things
- Describe the main structures involved in photosynthesis
- Identify the substrates and products of photosynthesis
- Summarize the process of photosynthesis
Photosynthesis is essential to all life on earth; both plants and animals depend on it. It is the only biological process that can capture energy that originates in outer space (sunlight) and convert it into chemical compounds (carbohydrates) that every organism uses to power its metabolism. In brief, the energy of sunlight is captured and used to energize electrons, which are then stored in the covalent bonds of sugar molecules. How long lasting and stable are those covalent bonds? The energy extracted today by the burning of coal and petroleum products represents sunlight energy captured and stored by photosynthesis almost 200 million years ago.
Plants, algae, and a group of bacteria called cyanobacteria are the only organisms capable of performing photosynthesis (Figure \(\PageIndex{1}\)). Because they use light to manufacture their own food, they are called photoautotrophs (literally, “self-feeders using light”). Other organisms, such as animals, fungi, and most other bacteria, are termed heterotrophs (“other feeders”), because they must rely on the sugars produced by photosynthetic organisms for their energy needs. A third very interesting group of bacteria synthesize sugars, not by using sunlight’s energy, but by extracting energy from inorganic chemical compounds; hence, they are referred to as chemoautotrophs .
The importance of photosynthesis is not just that it can capture sunlight’s energy. A lizard sunning itself on a cold day can use the sun’s energy to warm up. Photosynthesis is vital because it evolved as a way to store the energy in solar radiation (the “photo-” part) as high-energy electrons in the carbon-carbon bonds of carbohydrate molecules (the “-synthesis” part). Those carbohydrates are the energy source that heterotrophs use to power the synthesis of ATP via respiration. Therefore, photosynthesis powers 99 percent of Earth’s ecosystems. When a top predator, such as a wolf, preys on a deer (Figure \(\PageIndex{2}\)), the wolf is at the end of an energy path that went from nuclear reactions on the surface of the sun, to light, to photosynthesis, to vegetation, to deer, and finally to wolf.
Main Structures and Summary of Photosynthesis
Photosynthesis is a multi-step process that requires sunlight, carbon dioxide (which is low in energy), and water as substrates (Figure \(\PageIndex{3}\)). After the process is complete, it releases oxygen and produces glyceraldehyde-3-phosphate (GA3P), simple carbohydrate molecules (which are high in energy) that can subsequently be converted into glucose, sucrose, or any of dozens of other sugar molecules. These sugar molecules contain energy and the energized carbon that all living things need to survive.
The following is the chemical equation for photosynthesis (Figure \(\PageIndex{4}\)):
Although the equation looks simple, the many steps that take place during photosynthesis are actually quite complex. Before learning the details of how photoautotrophs turn sunlight into food, it is important to become familiar with the structures involved.
In plants, photosynthesis generally takes place in leaves, which consist of several layers of cells. The process of photosynthesis occurs in a middle layer called the mesophyll . The gas exchange of carbon dioxide and oxygen occurs through small, regulated openings called stomata (singular: stoma), which also play roles in the regulation of gas exchange and water balance. The stomata are typically located on the underside of the leaf, which helps to minimize water loss. Each stoma is flanked by guard cells that regulate the opening and closing of the stomata by swelling or shrinking in response to osmotic changes.
In all autotrophic eukaryotes, photosynthesis takes place inside an organelle called a chloroplast . For plants, chloroplast-containing cells exist in the mesophyll. Chloroplasts have a double membrane envelope (composed of an outer membrane and an inner membrane). Within the chloroplast are stacked, disc-shaped structures called thylakoids . Embedded in the thylakoid membrane is chlorophyll, a pigment (molecule that absorbs light) responsible for the initial interaction between light and plant material, and numerous proteins that make up the electron transport chain. The thylakoid membrane encloses an internal space called the thylakoid lumen . As shown in Figure \(\PageIndex{5}\), a stack of thylakoids is called a granum , and the liquid-filled space surrounding the granum is called stroma or “bed” (not to be confused with stoma or “mouth,” an opening on the leaf epidermis).
The Two Parts of Photosynthesis
Photosynthesis takes place in two sequential stages: the light-dependent reactions and the light independent-reactions. In the light-dependent reactions , energy from sunlight is absorbed by chlorophyll and that energy is converted into stored chemical energy. In the light-independent reactions , the chemical energy harvested during the light-dependent reactions drive the assembly of sugar molecules from carbon dioxide. Therefore, although the light-independent reactions do not use light as a reactant, they require the products of the light-dependent reactions to function. In addition, several enzymes of the light-independent reactions are activated by light. The light-dependent reactions utilize certain molecules to temporarily store the energy: These are referred to as energy carriers. The energy carriers that move energy from light-dependent reactions to light-independent reactions can be thought of as “full” because they are rich in energy. After the energy is released, the “empty” energy carriers return to the light-dependent reaction to obtain more energy. Figure \(\PageIndex{6}\) illustrates the components inside the chloroplast where the light-dependent and light-independent reactions take place.
Major grocery stores in the United States are organized into departments, such as dairy, meats, produce, bread, cereals, and so forth. Each aisle (Figure \(\PageIndex{7}\)) contains hundreds, if not thousands, of different products for customers to buy and consume.
Although there is a large variety, each item links back to photosynthesis. Meats and dairy link, because the animals were fed plant-based foods. The breads, cereals, and pastas come largely from starchy grains, which are the seeds of photosynthesis-dependent plants. What about desserts and drinks? All of these products contain sugar—sucrose is a plant product, a disaccharide, a carbohydrate molecule, which is built directly from photosynthesis. Moreover, many items are less obviously derived from plants: For instance, paper goods are generally plant products, and many plastics (abundant as products and packaging) are derived from algae. Virtually every spice and flavoring in the spice aisle was produced by a plant as a leaf, root, bark, flower, fruit, or stem. Ultimately, photosynthesis connects to every meal and every food a person consumes.
Summary
The process of photosynthesis transformed life on Earth. By harnessing energy from the sun, photosynthesis evolved to allow living things access to enormous amounts of energy. Because of photosynthesis, living things gained access to sufficient energy that allowed them to build new structures and achieve the biodiversity evident today.
Only certain organisms, called photoautotrophs, can perform photosynthesis; they require the presence of chlorophyll, a specialized pigment that absorbs certain portions of the visible spectrum and can capture energy from sunlight. Photosynthesis uses carbon dioxide and water to assemble carbohydrate molecules and release oxygen as a waste product into the atmosphere. Eukaryotic autotrophs, such as plants and algae, have organelles called chloroplasts in which photosynthesis takes place, and starch accumulates. In prokaryotes, such as cyanobacteria, the process is less localized and occurs within folded membranes, extensions of the plasma membrane, and in the cytoplasm.
Review Questions
Which of the following components is not used by both plants and cyanobacteria to carry out photosynthesis?
- chloroplasts
- chlorophyll
- carbon dioxide
- water
- Answer
-
Answer: A
What two main products result from photosynthesis?
- oxygen and carbon dioxide
- chlorophyll and oxygen
- sugars/carbohydrates and oxygen
- sugars/carbohydrates and carbon dioxide
- Answer
-
Answer: C
In which compartment of the plant cell do the light-independent reactions of photosynthesis take place?
- thylakoid
- stroma
- outer membrane
- mesophyll
- Answer
-
Answer: B
Which statement about thylakoids in eukaryotes is not correct?
- Thylakoids are assembled into stacks.
- Thylakoids exist as a maze of folded membranes.
- The space surrounding thylakoids is called stroma.
- Thylakoids contain chlorophyll.
- Answer
-
Answer: B
Free Response
What is the overall outcome of the light reactions in photosynthesis?
- Answer
-
Answer: The outcome of light reactions in photosynthesis is the conversion of solar energy into chemical energy that the chloroplasts can use to do work (mostly anabolic production of carbohydrates from carbon dioxide).
Why are carnivores, such as lions, dependent on photosynthesis to survive?
- Answer
-
Answer: Because lions eat animals that eat plants.
Why are energy carriers thought of as either “full” or “empty”?
- Answer
-
Answer: The energy carriers that move from the light-dependent reaction to the light-independent one are “full” because they bring energy. After the energy is released, the “empty” energy carriers return to the light-dependent reaction to obtain more energy. There is not much actual movement involved. Both ATP and NADPH are produced in the stroma where they are also used and reconverted into ADP, Pi, and NADP + .
Art Connections
Figure \(\PageIndex{5}\): On a hot, dry day, plants close their stomata to conserve water. What impact will this have on photosynthesis?
- Answer
-
Answer: Levels of carbon dioxide (a necessary photosynthetic substrate) will immediately fall. As a result, the rate of photosynthesis will be inhibited.
Glossary
- chemoautotroph
- organism that can build organic molecules using energy derived from inorganic chemicals instead of sunlight
- chloroplast
- organelle in which photosynthesis takes place
- granum
- stack of thylakoids located inside a chloroplast
- heterotroph
- organism that consumes organic substances or other organisms for food
- light-dependent reaction
- first stage of photosynthesis where certain wavelengths of the visible light are absorbed to form two energy-carrying molecules (ATP and NADPH)
- light-independent reaction
- second stage of photosynthesis, though which carbon dioxide is used to build carbohydrate molecules using energy from ATP and NADPH
- mesophyll
- middle layer of chlorophyll-rich cells in a leaf
- photoautotroph
- organism capable of producing its own organic compounds from sunlight
- pigment
- molecule that is capable of absorbing certain wavelengths of light and reflecting others (which accounts for its color)
- stoma
- opening that regulates gas exchange and water evaporation between leaves and the environment, typically situated on the underside of leaves
- stroma
- fluid-filled space surrounding the grana inside a chloroplast where the light-independent reactions of photosynthesis take place
- thylakoid
- disc-shaped, membrane-bound structure inside a chloroplast where the light-dependent reactions of photosynthesis take place; stacks of thylakoids are called grana
- thylakoid lumen
- aqueous space bound by a thylakoid membrane where protons accumulate during light-driven electron transport
Contributors and Attributions
-
Connie Rye (East Mississippi Community College), Robert Wise (University of Wisconsin, Oshkosh), Vladimir Jurukovski (Suffolk County Community College), Jean DeSaix (University of North Carolina at Chapel Hill), Jung Choi (Georgia Institute of Technology), Yael Avissar (Rhode Island College) among other contributing authors. Original content by OpenStax (CC BY 4.0; Download for free at<EMAIL_ADDRESS>).


3.2: Learning Objectives
Case 2 describes a patient’s experience of COPD exacerbation due to community acquired pneumonia. The patient in this case study has a complicated health history. The interprofessional collaboration is role modelled between nursing, medical radiology, medical laboratory, and health care workers in the emergency department.
Learners reviewing this case can consider how pneumonia affects COPD. Additionally this case offers opportunity for discussion on supporting families both in the Emergency Department and acute medicine areas. The interprofessional collaboration is ideal and offers opportunities for further discussion on why the collaboration works so well and what barriers would prevent ideal collaboration.
Note: The story told here is used in case 1 and case 2. The simpler version in case 1 can be used to teach novice students about health case studies. Case 2 reintroduces the patient from case 1 and expands her story with more details for more advanced study.
Learning Objectives
In this case, learners have an opportunity to:
- Review etiological factors (i.e., risk factors, prevalence, comorbidities) associated with respiratory disease
- Build knowledge related to the patient’s experience of respiratory insufficiency, including COPD and pneumonia
- Continue to develop comprehensive assessment and monitoring skills and abilities (e.g., relevant abnormal physical assessment findings, ABGs, lab, and diagnostic data)
- Consider the links between evidence-based knowledge and practice in the care of patients with pneumonia (e.g., CAP guidelines)
- Recommend interventions based on the risk factors, status, and progression of pneumonia (e.g., antibiotic therapy, oxygen therapy)
- Define the roles of health care professionals and the contributions they make to the healthcare team (or describe your own role and the roles of those in other professions)


15.2: Dealing with Technological Advances
Over the past several decades, we have experienced a boom in new technologies to make our lives easier, our work more efficient, and our lifestyles more sustainable. Conservation biologists have adopted many of these new technologies to great success (Pimm et al., 2015). Consider, for example, the use of unmanned aerial vehicles (UAVs) to monitor environmental changes (Box 15.1), freely-available satellite imagery to monitor ecosystems (Section 10.1.1) and wildlife (Section 11.1.1), and molecular methods to monitor for wildlife crimes (Section 12.3.1). Hand-held devices that capture and send field data in real time are also increasing in popularity, as they enable conservation and law enforcement agencies to learn of and respond to threats much quicker than before (Wilson et al., 2019). To better streamline these efforts, there are groups such as Wildlabs which specialise in connecting the conservation community with engineers and entrepreneurs who develop such new technologies.
Meg Boeni and Richard Primack
Biology Department, Boston University,
Boston, MA, USA.
Many of us have experienced the difficulty of following a moving herd of zebras, elephants, or any other large mammal from a vehicle or on foot. But what if this could be done from the sky? Efforts, such as mapping threatened species habitat, monitoring deforestation, and even fighting forest fires, have been aided for over 40 years with an “eye in the sky” using satellite and other aerial imagery (Pettorelli et al., 2013). The recent emergence of drones, or unmanned aerial vehicles (UAVs), has begun to make it even easier to facilitate conservation efforts from above.
Drone technology was originally developed for military applications but is fast becoming a vital resource to conservation biologists and natural resource managers. The increased popularity of drones in conservation is due to several distinct advantages. They are cheaper than airplanes or satellites; basic models that can fly up to 150 m high are available for around US $2,000. Because they operate from the ground, they are also less affected by weather conditions such as cloud cover. Drones can carry a range of sensors and equipment—video, thermal imaging, or sound—that allow them to detect organisms and ecological processes that would be impossible to study otherwise, especially at large scales. New organizations such as Conservation Drones have greatly facilitated discussions and innovations in this rapidly developing technology. Lastly, some governments are highly receptive to these new technologies. Leading the way is Rwanda, where regulators are setting the stage for an airport dedicated to civilian and commercial drones (Simmons, 2016).
While conservationists are just beginning to explore the flexibility and applicability of drones, they have already proven their worth in African conservation initiatives (Figure 15.A). With encouragement from national park officials, drones have been used to survey elephant populations in Burkina Faso (Vermuelen et al., 2013) and chimpanzee (Pan troglodytes, EN) nests and fruiting trees in Gabon (van Andel et al., 2015). In South Africa, drones assist anti-poaching patrols in remote areas of national parks (Mulero-Pázmány et al., 2014). There are even discussions of using drones to plant trees in reforestation efforts, and to directly manage wildlife, such as deploying noise-making drones to block an elephant herd from entering farming areas.
Despite progress, a range of obstacles still must be overcome. For example, drones are often prohibited from flying near government buildings (which often includes conservation infrastructure); many countries also continue to uphold strict and arduous legal requirements for drone use. It is also important to remember that drones will never replace the need for rangers and researchers on the ground. They do however hold great promise in their potential to overcome some of the fundamental challenges that conservation biologists have always faced.
While conservation biologists certainly benefit from new technologies, these advances sometimes pose new challenges. Hunters now use powerful guns and motorised vehicles where historically they used bows and arrows and walked on foot. Sea fishing industries have transformed from using small wind-powered and hand-powered boats to large motorised fleets with freezers that can stay at sea for months at a time. Some technologies are so powerful that they allow for the alteration of entire ecosystems in a relatively short span of time. Some of these transformations are intentional, such as the creation of dams and the conversion of new agricultural land; others, such as pollution, are negative by-products from human activities. The impacts of these developments on ecosystems and wildlife are enormous and ominous; they have also stimulated the growth, expansion, and evolution of conservation biology.
Renewable energy sources are needed to create a sustainable society. They must also be evaluated for their environmental impact, with systems developed to mitigate those impacts.
Technologies developed to achieve sustainable development may sometimes also present new conservation challenges. For example, to combat climate change, scientists and engineers are rushing to reduce our dependence on fossil fuels by developing carbon-neutral and energy efficient alternatives. As these renewable energy sources have become more assimilated into our everyday lives, their unintended consequences on the environment have also become better understood. We now know that large wind farms (Figure 15.2) pose a significant collision hazard to birds (Rushworth and Krüger, 2014) and bats (Frick et al., 2017), while large solar-panel arrays that concentrate sunlight can also expose wildlife to burning temperatures (Walston et al., 2016). The impacts of hydroelectric dams are cause for even more concern: in addition to harming local fisheries and freshwater biodiversity (Section 5.3.2), these and other artificial reservoirs also generate large amounts of greenhouse gases that contribute to climate change (Deemer et al., 2016). Bioenergy also seems to create more problems than solutions, since it has become an important driver of habitat loss (Kleiner, 2007; see also Box 6.1). Similarly, hydrological fracturing for natural gas extraction—not in itself a carbon-neutral energy alternative but claimed to do less damage than coal and petroleum—has turned out to be so damaging to the environment and human health that several governments have now banned the practice (Section 7.1.1).
Despite the challenges posed by emerging technologies, none have yet posed an insurmountable threat. For example, we have already solved the ozone crisis by banning harmful chemicals such as chlorofluorocarbons (CFCs) (Section 12.2.1). We have also come a long way toward a sustainable fossil-fuel free world by setting guidelines for reducing the impact of wind power generation on wildlife (Reid et al., 2015; Martin et al., 2017), reducing the negative impacts of bioenergy production (Correa et al., 2017), safeguarding nuclear power stations and reusing nuclear waste (Heard and Brook, 2017), and developing more affordable solar power (Randall, 2016). It is important, however, to note that none of these emerging threats were solved by people who defended the status quo or resisted change, but by individuals who were alert and rapidly responded to new challenges before they reached a crisis point.
Environmental challenges are not solved by defending the status quo or resisting change, but by being alert and rapidly responding to new challenges before they reach a crisis point.


15.14A: Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is an infection affecting the urinary tract; about 150 million people develop UTIs each year.
LEARNING OBJECTIVES
Summarize the various categories of urinary tract infection (UTI): complicated, uncomplicated, upper and lower UTIs
KEY TAKEAWAYS
Key Points
- About 150 million people develop a urinary tract infection each year, and they are more common in women than men.
- A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection ( cystitis ); when it affects the upper urinary tract it is known as kidney infection ( pyelonephritis ).
- UTIs are generally treatable with antibiotics, though resistance to some of the medications is growing.
Key Terms
- urinary tract infection : A bacterial infection that affects part of the urinary tract.
About 150 million people develop a urinary tract infection each year. They are more common in women than men. In women, they are the most common form of bacterial infection. Up to 10% of women have a urinary tract infection in a given year and half of women having at least one infection at some point in their lives. They occur most frequently between the ages of 16 and 35 years. Recurrences are common. Urinary tract infections have been described since ancient times with the first documented description in the Ebers Papyrus dated to c. 1550 BC.
A urinary tract infection (UTI) is an infection that affects part of the urinary tract. When it affects the lower urinary tract it is known as a bladder infection (cystitis); when it affects the upper urinary tract it is known as kidney infection (pyelonephritis). Symptoms from a lower urinary tract include pain with urination, frequent urination, and feeling the need to urinate despite having an empty bladder. Symptoms of a kidney infection include fever and flank pain usually in addition to the symptoms of a lower UTI. Rarely the urine may appear bloody. In the very old and the very young, symptoms may be vague or non-specific.
The most common cause of infection is Escherichia coli, though other bacteria or fungi may rarely be the cause.   Kidney infection, if it occurs, usually follows a bladder infection but may also result from a blood-borne infection. Diagnosis in young healthy women can be based on symptoms alone. In those with vague symptoms, diagnosis can be difficult because bacteria may be present without there being an infection. In complicated cases or if treatment fails, a urine culture may be useful.
Categories of UTI
Uncomplicated UTIs
In uncomplicated cases, a diagnosis may be made and treatment given based on symptoms alone without further laboratory confirmation, and treatment involves a short course of antibiotics such as nitrofurantoin or trimethoprim / sulfamethoxazole. Resistance to many of the antibiotics used to treat this condition is increasing.
Complicated UTIs
In complicated cases, it may be useful to confirm the diagnosis via urinalysis, looking for the presence of urinary nitrites, white blood cells ( leukocytes ), or leukocyte esterase. Another test, urine microscopy, looks for the presence of red blood cells, white blood cells, or bacteria. A longer course or intravenous antibiotics may be needed. If symptoms do not improved in two or three days, further diagnostic testing may be needed. Phenazopyridine may help with symptoms. In those who have bacteria or white blood cells in their urine but have no symptoms, antibiotics are generally not needed, although during pregnancy is an exception. In those with frequent infections, a short course of antibiotics may be taken as soon as symptoms begin or long term antibiotics may be used as a preventative measure.
Lower UTI
Lower urinary tract infection is also referred to as a bladder infection. The most common symptoms are burning with urination and having to urinate frequently (or an urge to urinate) in the absence of vaginal discharge and significant pain. These symptoms may vary from mild to severe and in healthy women last an average of six days. Some pain above the pubic bone or in the lower back may be present.
Upper UTI
People experiencing an upper urinary tract infection, or pyelonephritis, may experience flank pain, fever, or nausea and vomiting in addition to the classic symptoms of a lower urinary tract infection. Rarely the urine may appear bloody or contain visible pus in the urine.
Prevention
A number of measures have not been confirmed to affect UTI frequency including: urinating immediately after intercourse, the type of underwear used, personal hygiene methods used after urinating or defecating, or whether a person typically bathes or showers. There is similarly a lack of evidence surrounding the effect of holding one’s urine, tampon use, and douching. In those with frequent urinary tract infections who use spermicide or a diaphragm as a method of contraception, they are advised to use alternative methods. In those with benign prostatic hyperplasia urinating in a sitting position appears to improve bladder emptying which might decrease urinary tract infections in this group.
For those with recurrent infections, taking a short course of antibiotics when each infection occurs is associated with the lowest antibiotic use. A prolonged course of daily antibiotics is also effective. Medications frequently used include nitrofurantoin and trimethoprim/sulfamethoxazole (TMP/SMX). Methenamine is another agent used for this purpose as in the bladder where the acidity is low it produces formaldehyde to which resistance does not develop. Some recommend against prolonged use due to concerns of antibiotic resistance.


6.6: Group Decision-Making
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- What are the advantages and disadvantages of group decision-making, and how can a manager improve the quality of group decision-making?
Involving more people in the decision-making process can greatly improve the quality of a manager's decisions and outcomes. However, involving more people can also increase conflict and generate other challenges. We turn now to the advantages and disadvantages of group decision-making.
Advantages of Group Decisions
An advantage of involving groups in decision-making is that you can incorporate different perspectives and ideas. For this advantage to be realized, however, you need a diverse group. In a diverse group, the different group members will each tend to have different preferences, opinions, biases, and stereotypes. Because a variety of viewpoints must be negotiated and worked through, group decision-making creates additional work for a manager, but (provided the group members reflect different perspectives) it also tends to reduce the effects of bias on the outcome. For example, a hiring committee made up of all men might end up hiring a larger proportion of male applicants (simply because they tend to prefer people who are more similar to themselves). But with a hiring committee made up of an equal number of men and women, the bias should be canceled out, resulting in more applicants being hired based on their qualifications rather than their physical attributes.
Having more people involved in decision-making is also beneficial because each individual brings unique information or knowledge to the group, as well as different perspectives on the problem. Additionally, having the participation of multiple people will often lead to more options being generated and to greater intellectual stimulation as group members discuss the available options. Brainstorming is a process of generating as many solutions or options as possible and is a popular technique associated with group decision-making.
All of these factors can lead to superior outcomes when groups are involved in decision-making. Furthermore, involving people who will be affected by a decision in the decision-making process will allow those individuals to have a greater understanding of the issues or problems and a greater commitment to the solutions.
Disadvantages of Group Decisions
Group decision-making is not without challenges. Some groups get bogged down by conflict, while others go to the opposite extreme and push for agreement at the expense of quality discussions. Groupthink occurs when group members choose not to voice their concerns or objections because they would rather keep the peace and not annoy or antagonize others. Sometimes groupthink occurs because the group has a positive team spirit and camaraderie, and individual group members don’t want that to change by introducing conflict. It can also occur because past successes have made the team complacent.
Often, one individual in the group has more power or exerts more influence than others and discourages those with differing opinions from speaking up ( suppression of dissent ) to ensure that only their own ideas are implemented. If members of the group are not really contributing their ideas and perspectives, however, then the group is not getting the benefits of group decision-making.
How to Form a Quality Group
Effective managers will try to ensure quality group decision-making by forming groups with diverse members so that a variety of perspectives will contribute to the process. They will also encourage everyone to speak up and voice their opinions and thoughts prior to the group reaching a decision. Sometimes groups will also assign a member to play the devil’s advocate in order to reduce groupthink. The devil’s advocate intentionally takes on the role of critic. Their job is to point out flawed logic, to challenge the group’s evaluations of various alternatives, and to identify weaknesses in proposed solutions. This pushes the other group members to think more deeply about the advantages and disadvantages of proposed solutions before reaching a decision and implementing it.
The methods we’ve just described can all help ensure that groups reach good decisions, but what can a manager do when there is too much conflict within a group? In this situation, managers need to help group members reduce conflict by finding some common ground—areas in which they can agree, such as common interests, values, beliefs, experiences, or goals. Keeping a group focused on a common goal can be a very worthwhile tactic to keep group members working with rather than against one another. Table 6.3 summarizes the techniques to improve group decision-making.
| Summary of Techniques That May Improve Group Decision-Making | ||
|---|---|---|
|
Type of Decision |
Technique |
Benefit |
|
Group decisions |
Have diverse members in the group. |
Improves quality: generates more options, reduces bias |
|
Assign a devil’s advocate. |
Improves quality: reduces groupthink |
|
|
Encourage everyone to speak up and contribute. |
Improves quality: generates more options, prevents suppression of dissent |
|
|
Help group members find common ground. |
Improves quality: reduces personality conflict |
Conclusion
Decision-making is a crucial daily activity for managers. Decisions range from small and simple, with straightforward answers, to big and complex, with little clarity about what the best choice will be. Being an effective manager requires learning how to successfully navigate all kinds of decisions. Expertise, which develops gradually through learning and experience, generally improves managerial decision-making, but managers rarely rely solely on their own expertise. They also conduct research and collect information from others; they pay attention to their own biases and to ethical implications, and they think critically about the information that they have received to make decisions that will benefit the organization and its stakeholders.
concept check
- Explain why group decision-making can be more effective than individual decision-making.
- What are some things that can prevent groups from making good decisions?
- As a manager, what can you do to enhance the quality of group decision-making?


11.2: Renaissance
Map of Italian and Northern Renaissance cities. Retrieved from https://commons.wikimedia.org/wiki/F...issancemap.jpg
11.2.2 European Renaissance, Italian and Northern
Beginning in the 1300’s, a reawakened interest in classical art and knowledge emerged in the city-states of northern Italy inspired by humanist ideas. The era would witness an explosion of artistic and intellectual innovation and creativity.
The term Renaissance literally means "rebirth", and is recognized as the period in European civilization immediately following the Middle Ages. Lasting from approximately 1300 to 1600, this era marks the transition from medieval to modern times in Europe. It emerged first in the city-states of Italy, in particular, Florence, Rome, and Venice, and eventually spread north. The primary characteristic was a reawakened interest in the classical art and knowledge of the Greeks and Romans. Though the Western Roman Empire had suffered collapse during the Middle Ages, some Latin manuscripts survived within the monasteries, while scholars in the Eastern Roman empire, or Byzantium, had also managed to preserve classical writings. In addition, the Arab world was instrumental in helping to preserve and pass on classical texts.
According to a text from the period, the ideal Renaissance young man should be educated in the Greek and Roman classics, be charming, polite, and witty, be able to dance, write poetry, sing and play music. He should be physically graceful and strong and be a skilled rider, wrestler, and swordsman. Upper-class women were also expected to be well educated in classical literature and to be able to write well, paint, make music, dance, and be charming. The main difference in the expectations for men and women, however, was that a woman was not expected to seek fame as men did, and they were generally expected to inspire great poetry and art, not create it. All things considered, most Renaissance women had less political, economic, and social influence than medieval women, even though they were certainly better educated.
Renaissance interest in classical learning led to a new movement known as humanism, which focused on secular, or worldly, themes rather than on the religious ideas that had concerned medieval thinkers. Humanists believed in the idea of individualism that stressed the dignity and worth of the individual person and the importance of individual achievement.
Humanists encouraged the enjoyment of worldly goods and pleasures. Though most people remained devout Catholics, they believed a person could love and enjoy life without offending God, an attitude that would have shocked most people in medieval times. Medieval thinkers had often appeared to be consumed with guilt over sin and were constantly focused upon the need to obtain God's forgiveness for their "wicked" ways. Humanists, on the other hand, celebrated everything human. An individual's desire for fame and wealth was no longer considered sinful, but actually encouraged. People began to show greater interest in this world than in life hereafter.
Thus, a love for classical learning, the belief in self-improvement and achievement through many activities, especially education, and the enjoyment of secular pleasures are three important characteristics of the era. These three characteristics would be clearly reflected in the highly accomplished art of the period. Some more biased observers of the Renaissance would claim that the level of artistic achievement realized during this period has never been surpassed.
Italy’s Advantages
While England and France were locked in the Hundred Years War, Italy had three advantages that fostered the Renaissance there: thriving cities, a wealthy merchant class, and the classical heritage of Greece and Rome.
Italy was strategically located on the Mediterranean Sea where, ever since the Crusades, trade between Asia and Europe had increased. Italian cities emerged as centers of banking, commerce, and handicrafts. The Popes in Rome collected revenues from throughout Europe, and individual city-states ran their own affairs, collecting taxes and raising their own armies. While cities were emerging in northern Italy, the rest of Europe remained mostly rural. It is in cities where people have better opportunities to exchange new ideas, creating an ideal breeding ground for an intellectual revolution.
Merchants became the wealthiest, the most powerful class, and dominated politics. Unlike nobles who inherited their social rank, they had to rely on individual merit and wit. This idea helped spur the Renaissance value of individualism. Renaissance popes beautified Rome by spending large amounts of money on art. The wealthy merchant class and religious leaders became patrons of the arts by financially supporting artists. By having their portraits painted or by donating public art to the city, the wealthy demonstrated their own importance.
Another reason that the Renaissance began in Italy is that artists and scholars drew inspiration from the ruins of Rome that surrounded them. They were impressed by the achievements of pre-Christian artists, thinkers, writers, and engineers. Like the Greeks, Renaissance thinkers believed in the power of human reason, observation, and experience to explain the world rather than simply relying on traditional Church teachings.
A Revolution in Art
Before the Renaissance, art in Italy was greatly influenced by Byzantine styles. Religious paintings were typically flat and lifeless. In the 1300’s, the painter Giotto began creating an entirely new style that resulted in more depth and roundness to his figures. His figures showed emotion and gestures.
Masaccio and other artists experimented with ways to show three-dimensional space on a two-dimensional surface. They developed the rules of perspective to make objects appear to recede in the distance until they reached a vanishing point.
Cappella brancacci, San Pietro risana gli infermi con la sua ombra (restaurato) , Masaccio" by Masaccio - book: John T. Spike, Masaccio, Rizzoli libri illustrati, Milano 2002. Licensed under Public Domain via Wikimedia Commons- https://commons.wikimedia.org/wiki/F...,_Masaccio.jpg
Donatello made sculpture more realistic by carving natural postures and expressions that reveal personality. With his statue, David , he created the first large, free-standing nude since ancient times.
The first version of David (1408–1409 ). Museo Nazionale del Bargello , Florence . Height 191 cm. https://en.Wikipedia.org/wiki/David_...(marmo)_01.JPG
Leonardo Da Vinci was a painter, sculptor, inventor, engineer, and scientist. Thus, he is often referred to as the ideal “Renaissance man.” To understand human anatomy, he dissected human corpses. His notebooks include designs for a parachute, machine gun, war machines, and flying machines.
The original design of the giant crossbow (Codex Atlanticus, f. 149a) https://en.Wikipedia.org/wiki/Leonar...o_crossbow.JPG
Among his many masterpieces, Leonardo painted the Mona Lisa , which has been acclaimed as “the best known, the most visited, the most written about, the most sung about, the most parodied work of art in the world." The sitter’s mysterious smile and her unproven identity have made the painting a source of ongoing investigation and fascination.
Mona Lisa, by Leonardo da Vinc i, from C2RMF retouched.jpg
Leonardo also painted The Last Supper , which captures the individual personalities and expressions of Jesus’ disciples after Jesus has announced that one of them will betray him.
Late 15th-century mural painting by Leonardo da Vinci in the refectory of the Convent of Santa Maria delle Grazie, Milan
Like Leonardo, Michelangelo could be considered a true Renaissance man. He was a painter, sculptor, architect, and poet. Influenced by classical art, he created figures that are forceful and show heroic grandeur and power. By doing this, he explored the Renaissance theme of human potential. Three of his most famous works are his sculptings the Pieta and David and his fresco paintings showing biblical scenes on the ceiling of the Sistine Chapel . A fresco painting is a painting made on fresh plaster.
The Pietà (1498–1499) is a work of Renaissance sculpture by Michelangelo Buonarroti, housed in St. Peter's Basilica, Vatican. City. https://en.Wikipedia.org/wiki/Piet%C..._out_black.jpg
The painter, Raphael , studied the works of both Leonardo and Michelangelo. One of his favorite subjects was the Madonna and Child. He also filled the walls of Pope Julius II’s library with several paintings, one of these being the School of Athens which conveys classical influence on the Renaissance. In the painting influential teachers, thinkers, and artists from ancient, classical, and Renaissance figures are brought together.
The School of Athens, or Scuola di Atene in Italian, is one of the most famous frescoes by the Italian Renaissance artist Raphael. It was painted between 1509 and 1511.
Renaissance Writers Change Literature
Renaissance writers increasingly wrote in the vernacular , the everyday language of one’s homeland. While most serious poets of the age wrote in Latin, Dante Alighieri wrote The Divine Comedy in Italian. For this reason, he is sometimes called the creator of modern Italian. His example encouraged other poets to write in their own vernacular languages, such as England’s Geoffrey Chaucer, Spain’s Cervantes, and the English poet and dramatist, William Shakespeare.
Machiavelli wrote The Prince , a guidebook in how to secure and maintain political power. He argued that most successful rulers were not those who acted according to laws or conscience, but those who were willing to do whatever was necessary to hold and maintain power. In other words, “the end justifies the means.” The Prince is considered critical to the emergence of modern political science. His ideas mark the movement toward a more secular perspective of governing as opposed to the religious-based teachings of the Medieval Church.
Renaissance writers were able to command a much wider audience because of a remarkable technological breakthrough, the printing press . Johann Gutenberg published the first full-size book printed with movable type around 1455. For the first time, books were cheap enough that many Europeans could buy them. This action encouraged the spread of new ideas, and more people began to learn to read.


1.7: Week 7 - Rhetorical Fallacies
A rhetorical fallacy is a flaw in reasoning. Rhetorical fallacies are like tricks or illusions of thought, and they’re often very sneakily used by politicians and the media to fool people. They are not always easy to spot and frequently we commit them accidentally. Spotting them in our own arguments and in the arguments of others is a superpower that can help you strengthen your analytical tool kit.
Rhetorical fallacies, or fallacies of argument, don’t allow for the open, two-way exchange of ideas upon which meaningful conversations depend. Instead, they distract the reader with various appeals instead of using sound reasoning. They can be divided into three categories:
- Emotional fallacies unfairly appeal to the audience’s emotions.
- Ethical fallacies unreasonably advance the writer’s own authority or character.
- Logical fallacies depend upon faulty logic.
Keep in mind that rhetorical fallacies often overlap. Regardless, we need to develop our skills in recognizing rhetorical fallacies in our work and the work of others and correcting them with clear, fair and well-supported reasons. This unit is intended to help you explore and develop these very skills. Don’t worry so much about trying to memorize the individual names of all of the various rhetorical fallacies. Spend your time and energy, rather, learning to identify when someone (yourself included) is using them in an argument and how best to correct them and keep the discussion on track.
- View the video: Logical Fallicies (Logos) https://www.youtube.com/watch?v=6brsxUsnhBo
- View the video: Logical Fallacies (Ethos) https://www.youtube.com/watch?v=z-u3j4aHDBg
- View the video: Logical Fallacies (Pathos) https://www.youtube.com/watch?v=O0QYRSy6c-o
- View the video: Top Ten Logical Fallacies https://www.youtube.com/watch?v=IawIjqOJBU8&feature=youtu.be
- View the video: Five Fallacies in Ads https://www.youtube.com/watch?v=ZNWCDh1XRN0&feature=youtu.be
- View the handout: Logical Fallacies #1
- View the handout: Logical Fallacies #2
- View the handout: Logical Fallacies #3
- View the outside link: Your Logical Fallacy Is? https://yourlogicalfallacyis.com
- View the outside link: 15 Logical Fallacies You Should Avoid https://thebestschools.org/magazine/15-logical-fallacies-know/
Our use of logical support in arguments is subject to several possible corruptions along the way to a sound argument. Sometimes an arguer will commit these fallacies on purpose with the intent of fooling or manipulating the audience. But more often, we make these mistake accidentally, with the best of intentions. Regardless, if we are to evaluate and make sound arguments, we need to be able to spot the presence of logical fallacies, in our own arguments and in the arguments of others. The presence of a logical fallacy does not mean the entire argument is invalid, just that the particular reasoning is flawed or lacking in this one place. Finding and correcting logical fallacies can actually lead to making an argument stronger and easier to accept. We have not abandoned the use of Logos , Pathos and Ethos in our evaluation of arguments, but rather now added the concept of rhetorical fallacies to the mix. As we go forward in the class, try to continue to use all of the tools we are exploring in your analysis of the arguments we write and read.


4.2.1: READ- Open Enrollment Requirements
Open Enrollment: Employer Requirements
Prior to implementation of the Patient Protection and Affordable Care Act (PPACA), open enrollment periods were not required under the Employee Retirement Income Security Act (ERISA) but may have been required by:
- Health insurance contracts.
- Collective bargaining agreements.
- Section 125 cafeteria plans under which participants must be given a reasonable period of time to make elections each year.
Now, under the PPACA, an "applicable large employer," that does not offer an annual open enrollment may be subject to penalties under the health care reform's employer shared responsibility requirements. According to the Internal Revenue Service (IRS), an ALE will not be treated as having "offered" coverage unless employees and dependents are given at least an annual opportunity to accept or decline coverage. For this purpose, "dependent" means an employee's children as defined who are under 26 years of age. This includes sons, daughters, stepsons, stepdaughters, adopted children or eligible foster children. Notably, the dependent definition does not include individuals other than the employee's children, such as the employee's spouse, so a plan may continue to not make an annual offer of coverage to spouses (and, in fact, may entirely exclude non-employee spouses from coverage) without incurring employer penalties.
See Questions and Answers on Employer Shared Responsibility Provisions Under the Affordable Care Act.
The PPACA regulations clarify that an employee's election of coverage from a prior year that continues for every succeeding plan year unless the employee affirmatively elects to opt out of the plan constitutes an offer of coverage. "Rolling" or "evergreen" elections would be permissible for purposes of complying with the requirement to make an offer of coverage. Plans with these types of elections would still have an annual open enrollment period and employees wishing to make changes to their elections would do so at that time. Otherwise, their previous elections will rollover to the next plan year. To implement this design, the employer should explain the election process in all the plan materials. Additionally, the employer should disclose any premium increases and whether the participant elections will automatically be changed to reflect the increase. Best practice is for the employer to distribute a copy of the participants' current elections during open enrollment so that they are aware of what elections would carry forward if no action is taken.
Some employers allow employees only one chance to join their employer-sponsored health plan, or only give them what is called "one bite of the apple." Failure to enroll when first eligible results in permanent loss of eligibility under the plan. This approach offers coverage to the employee and dependents only once, which violates the PPACA and could result in penalties for large employers. However, because the PPACA excludes spouses as dependents, the one-bite-of-the-apple approach could still be used for spousal coverage.
Employers that do not employ an average of at least 50 full-time employees are not subject to the PPACA's shared responsibilities requirements and do not have to offer an open enrollment period unless required to do so under one or more of the three circumstances stated above.
Source: Q&A "Is an annual open enrollment period for employee health insurance benefits required?" Society for Human Resource Management (SHRM), 2024.