Disease Seminar Handbook W12

Disease Seminar Handbook BIOL*1080: Biological Concepts of Health

Winter 2012

UNIVERSITY OF GUELPH

2

Table of Contents

INTRODUCTION: DISEASE SEMINARS 3

INTRODUCTION 3 OVERVIEW OF ASSIGNMENT 4 IMPORTANT DATES 5

DISEASE CATEGORIES -‐ “THE NORMAL /BACKGROUND” 6

WHAT IS HEALTH? WHAT IS DISEASE? 6 BREAST CANCER 7 DEPRESSION 10 H. PYLORI 13 TYPE 2 DIABETES 16 INFLAMMATORY BOWEL DISEASE 19 OSTEOARTHRITIS 21

EVALUATION 24

RUBRIC: ORAL PRESENTATION 25 RUBRIC: WRITTEN ASSIGNMENT 26 RUBRIC: PEER EVALUATION 27

REFERENCE SHEETS FOR HOMEWORK 28

RESOURCES 28 PRIMARY ARTICLES 28 TEMPLATE FOR SEMINAR SLIDES 29 ORGANIZING INFORMATION 32 TIPS FOR POWER POINT 33 TIPS FOR ORAL PRESENTATION 34

3

Introduction: This seminar activity for BIOL*1080 involves independent and group research into multiple diseases by following a common disease template provided for you. Each week’s activity and assignment builds towards the next. As you progress through your individual research, you will meet weekly with your disease group to discuss your findings and learn from your group members’ perspective. This time will allow you to think of your assigned disease as a whole – not just as your individual component. You will also have the opportunity to discuss your topic with students researching a different disease allowing you to compare similarities and differences between diseases. You might be surprised to see similar trends across disease categories! The primary learning objectives of the disease seminars are:

1. Learn about diseases using a standard template. 2. Practice and improve oral communication skills.

More specifically, by the end of the disease seminars, successful students will be able to:

1. Logically organize information to effectively communicate ideas orally. 2. Research a subject in the written literature, distill, convert and organize the information

into a clear, concise story for oral presentation. 3. Describe and participate in the process of preparing a presentation. 4. Identify and perform the skills necessary for an effective presentation. 5. Demonstrate the importance of language, voice, gestures, and visual aids in an effective

presentation. 6. Illustrate, through a public presentation, the ability to share information and increase

audience understanding about a chosen topic. 7. Gain a functional appreciation and an increased awareness for their own oral

presentation style. 8. Use feedback to enhance their presentation skills for future presentations.

This handbook will serve as a helpful guide as you start your research on your assigned disease and topic. When we study a disease, it is best to start by understanding the ‘normal’. That is – how does the body or system operate under non-‐disease conditions? Only once we understand the normal function of the body can we start to uncover the changes that occur during the course/progression of a disease. Then, when we understand what changes lead to disease itself (i.e.: disease pathology) we can begin to ask – how can we prevent these changes? How significant do these changes need to be to cause clinical manifestation of disease? What can we do to manage, treat or reverse the changes? What impact do these changes have on an individual, their family, our society? These will be the main questions explored in the disease seminars. The information provided in this handbook will serve 2 main functions.

1. It will help you understand the basic underlying ‘normal’ physiology of the body systems relevant to your assigned disease so that you can start to build on it and uncover disease specific concerns.

2. It will serve as a reference guide with helpful tips and suggestions for completing your independent research, written assignment and oral presentation.

4

Overview of Assignment As part of the BIOL*1080 course, the large lectures are complemented with weekly, small group seminars. These seminars are a mandatory component of the course and will account for 25% of your final mark. In the weekly seminars, you will be working in small groups to research an assigned disease, and then present it orally in a short PowerPoint presentation. The selected diseases for the W’12 semester are:

1. Breast cancer 2. Depression 3. H. Pylori 4. Type 2 diabetes 5. Inflammatory bowel disease (IBD) 6. Osteoarthritis

Within each seminar section, students will be assigned to a research group of 5 and then each group will be assigned one of the 6 diseases. Using a 5-‐category research template (see below), each group member will be responsible for covering a distinct aspect of their assigned disease. These areas have been divided as follows:

1. anatomy, physiology and pathology – the natural course of the disease 2. individual well being, familial and societal impact 3. risk factors, causes and preventive interventions 4. diagnosis: clinical and sub-‐clinical categorizations 5. therapeutic treatments and post-‐treatment management

Basic background information on each disease category is found in this manual as it applies to normal physiological function to help you get started. All additional information that you need to complete your research will be gathered independently. During the first 6 seminar sessions, you will attend your seminar to meet with your groups and work on the assignment. Each class will begin with a different lesson by your TA to help you progress in your research and work through challenges. A significant part of each seminar will be reserved for group work on the assigned disease. Weekly attendance of all group members is crucial in order to succeed at the seminar assignment. Please note: 3% of the final mark is based on peer-‐evaluation! In addition, homework assignments will be given at the end of seminars 2, 3, 4 and must be handed in to the TA at the beginning of the following week’s seminar. These weekly assignments are worth 3% each. In addition, you will have an in class assignment in seminar #5 which will be worth 1% of your final mark, so the homework assignments together count for 10% of your final mark. By the end of the 6 weeks, each student will have prepared 3 power point slides to be put into a group presentation of ~15 power point slides total. In seminars # 7-‐9, students will give a group PowerPoint presentation on their disease (3-‐4 minutes per student, with each student talking about their assigned research topic). The schedule of presentations for W12 will be as follows:

Seminar #7 (Week of Feb. 27): Breast cancer & Depression Seminar #8 (Week of Mar. 5): H. Pylori & Type 2 diabetes

5

Seminar #9 (Week of Mar. 12): IBD and Osteoarthritis In addition to oral communication of the research, all students are to hand in 3 pages of additional text to accompany their slides on the day of their presentation. More information will be provided about this (i.e. level of detail etc.) from your TA during seminar. Evaluation: The seminar activities are worth 25% of your final mark, divided as follows: 10% weekly homework assignments (3 at 3% and 1 at 1%) 3% peer evaluation 6% oral communication 6% text and additional information (to be handed in with PowerPoint slides) NOTE: if a student misses the group presentation for an unapproved reason –a grade of ZERO (0) will be assigned for both the oral communication and additional text (i.e. loss of 10% of the final grade). Approved absences will be dealt with on a case-‐by-‐case basis. Important Dates: NOTE: Please see the course schedule for the specific dates of given seminars, as they change depending on which day of the week your seminar falls. Seminar #1:

- assignment of groups, overview of assignment & expectations Seminar #2

- homework given Seminar #3

- homework due, homework given Seminar #4

- homework due, homework given Seminar #5

- homework due, in-‐class assignment Seminar #6

- peer evaluations due Seminar #7, #8, #9

- group presentations (see schedule at top of page) - slides and accompanying text to be handed in on the day of your presentation

6

What is health? What is disease? For the entirety of the seminar exercise, keep in mind that health can be defined as ‘physical, mental or social well-‐being’ and illness is defined as ‘physical, mental and social harmful dysfunction’. These are fairly broad definitions, but it is important to recognize the multiple components that contribute to health. Disease occurs when the normal function/physiology of the body is disrupted. This disruption could be caused by several things, including genetic complications, viral or bacterial invaders long-‐term accumulation of smaller challenges/insults to the body, or often a combination of factors (eg: genetic susceptibility coupled with lifestyle challenges) etc. Regardless of cause, the main similarity between all diseases is that the normal state is altered such that the control and communication network (or the defense system) cannot correct the problem, the system shifts from homeostasis and disease ensues. The diseases selected for the fall semester are divided into the following categories:

1. Neoplastic Disease – Breast Cancer 2. Mental Illness -‐ Depression 3. Infectious Disease – H. Pylori 4. Metabolic Disease – Type 2 diabetes 5. Auto-‐Immune Disease – Inflammatory bowel disease 6. Trauma/Anatomical Disease – Osteoarthritis

In order to learn about these diseases, together with your group you will follow the template below to address numerous aspects of your assigned disease.

1. anatomy, physiology and pathology – the natural course of the disease 2. individual well being, familial and societal impact 3. risk factors, causes and preventive interventions 4. diagnosis: clinical and sub-‐clinical categorizations 5. therapeutic treatments and post-‐treatment management

7

BREAST CANCER You have been assigned breast cancer for your independent research project. Although many of you may be familiar with the disease in a general sense, it is important to start with the basics of a healthy biological system before we can properly understand the onset, development, diagnosis and treatment of breast cancer. It is always important to understand healthy biology before we can understand a diseased state! The following information has been compiled from general health websites (the National Cancer Institute (NCI), the National Institute for Health (NIH)) and reflects a basic level of detail. As well, reference to the course text has been included. Be sure to read and understand this information before beginning your research. 1) Basic Anatomy and Histology (non-diseased state): In order to understand changes that occur in breast cancer, it is first important to understand the anatomy of healthy breast tissue. The following section will discuss key structural features of breast tissue and immune response. (a) Histology and development of the breast Positioned over the pectoral muscles of the chest wall and attached by fibrous strands called Cooper’s ligaments, the breast is a mass of glandular, fatty, and fibrous tissues. A layer of fatty tissue surrounds the breast glands and extends throughout the breast. The fatty tissue gives the breast a soft consistency. The breast consists of:

• milk glands (lobules) that produce milk • ducts that transport milk from the milk glands (lobules) to the nipple • the nipple • areola (pink or brown pigmented region surrounding the nipple) • connective (fibrous) tissue that surrounds the lobules and ducts • fat

Figure 1: Components of the breast. Image courtesy of NCI/NIH

8

The glandular tissues of the breast house the lobules and the ducts (milk passages). Toward the nipple, each duct widens to form a sac (ampulla). During lactation, the bulbs on the ends of the lobules produce milk, which is then transferred through the ducts to the nipple.

Breast development

For information on the basics of the endocrine system, please refer to your textbook Chapter 3a(iv), The Endocrine System, pages 162-166 and pages 174-175 (Adrenal Glands). By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of breast cancer.

Human breast tissue begins to develop in the sixth week of fetal life. Breast tissue initially develops along the lines of the armpits and extends to the groin (this is called the milk ridge). By the ninth week of fetal life, it regresses to the chest area, leaving two breast buds on the upper half of the chest. In females, columns of cells grow inward from each breast bud, becoming separate sweat glands with ducts leading to the nipple. Both male and female infants have very small breasts and actually experience some nipple discharge during the first few days after birth.

Female breasts do not begin growing until puberty. Puberty usually begins for women around age 10 or 11. After pubic hair begins to grow, the breasts will begin responding to hormonal changes in the body. Specifically, the production of two hormones, estrogen and progesterone, signal the development of the glandular breast tissue. During this time, fat and fibrous breast tissue becomes more elastic. The breast ducts begin to grow and this growth continues until menstruation begins (typically one to two years after breast development has begun). Menstruation prepares the breasts and ovaries for potential pregnancy.

All women experience changes in their breasts throughout the life cycle. Fluctuating hormone levels during the menstrual cycle can cause changes in the look, feel, and tenderness of the breasts (Fig. 2).

Figure 2. Fluctuating hormone levels of the female adult over a 28 day period. Image courtesy of Medscape CME

9

(b) The Normal Immune Response For information on the basics of the healthy immune system, please refer to pages 182-187. (C) Cancer development For information on cancer development, please refer to page 433 of your text.

10

DEPRESSION You have been assigned depression for your independent research project. Before you can begin to uncover how depression develops or how it can be treated, you must first understand the normal function of the brain. A simplified overview of general biology pertinent to this complex disease has been compiled for you so that you may become familiarized with some of the terminology and key aspects of the disease. The information was gathered primarily from the National Institute for Health and the National Institute for Ageing and reflects a basic level of detail. Be sure to read and understand this information before beginning your research.

The Non-Diseased (Normal) State of the Brain and Central Nervous System (a) The Healthy Brain: For information on the basics of the normal human brain, refer to The Central Nervous System, pages 144- 151. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of depression. What does a healthy brain look like? What is its role in the body?

To understand depression, it is important to know a bit about the healthy brain. The brain is a remarkable organ. Seemingly without effort, it allows us to carry out every element of our daily lives. It manages many body functions, such as breathing, blood circulation, and digestion, without our knowledge or direction. It also directs all the functions we carry out consciously. We can speak, hear, see, move, remember, feel emotions, and make decisions because of the complicated mix of chemical and electrical processes that take place in our brains. The brain is made of nerve cells and several other cell types. Nerve cells also are called neurons. Neurons survive and function with the help and support of glial cells, the other main type of cell in the brain. Glial cells hold neurons in place (think of glial cells like glue!), provide them with nutrients, rid the brain of damaged cells and other cellular debris, and provide insulation to neurons in the brain and spinal cord. In fact, the brain has many more glial cells than neurons—some scientists estimate even 10 times as many. Another essential feature of the brain is its enormous network of blood vessels. Even though the brain is only about 2 percent of the body’s weight, it receives 20 percent of the body’s blood supply. Billions of tiny capillaries carry oxygen, glucose (the brain’s principal source of energy), nutrients, and hormones to brain cells so they can do their work. Capillaries also carry away waste products. The brain has many parts, each of which is responsible for particular functions. The following section describes a few key structures and what they do. For a 3-D view of the brain and its parts, check out: http://www.g2conline.org/ and click on the 3-‐D brain link in the top right hand corner.

11

The main players 1) Two cerebral hemispheres account for 85% of the brain’s weight. The billions of neurons in the two hemispheres are connected by thick bundles of nerve cell fibers called the corpus callosum. Scientists now think that the two hemispheres differ not so much in what they do (the “logical versus artistic” notion), but in how they process information. The left hemisphere appears to focus on details (such as recognizing a particular face in a crowd). The right hemisphere focuses on broad background (such as understanding the relative position of objects in a space). The cerebral hemispheres have an outer layer called the cerebral cortex. This is where the brain processes sensory information received from the outside world, controls voluntary movement, and regulates cognitive functions, such as thinking, learning, speaking, remembering, and making decisions. The hemispheres have four lobes, each of which has different roles:

• The frontal lobe, which is in the front of the brain, controls executive function activities like thinking, organizing, planning, and problem solving, as well as memory, attention and movement.

• The parietal lobe, which sits behind the frontal lobe, deals with the perception and integration of stimuli from the senses.

• The occipital lobe, which is at the back of the brain, is concerned with vision. • The temporal lobe, which runs along the side of the brain under the frontal and

parietal lobes, deals with the senses of smell, taste, and sound, and the formation and storage of memories.

2) The cerebellum sits above the brain stem and beneath the occipital lobe. It takes up a little more than 10 percent of the brain. This part of the brain plays roles in balance and coordination. The cerebellum has two hemispheres, which receive information from the eyes, ears, and muscles and joints about the body’s movements and position. Once the cerebellum processes that information, it sends instructions to the body through the rest of the brain and spinal cord. The cerebellum’s work allows us to move smoothly, maintain our balance, and turn around without even thinking about it. It also is involved with motor learning and remembering how to do things like drive a car or write your name. 3) The brain stem sits at the base of the brain. It connects the spinal cord with the rest of the brain. Even though it is the smallest of the three main players, its functions are crucial to survival. The brain stem controls the functions that happen automatically to keep us alive—our heart rate, blood pressure, and breathing. It also relays information between the brain and the spinal cord, which then sends out messages to the muscles, skin, and other organs. Sleep and dreaming are also controlled by the brain stem. Other crucial parts of the brain Several other essential parts of the brain lie deep inside the cerebral hemispheres in a network of structures called the limbic system. The limbic system links the brain stem with the higher reasoning elements of the cerebral cortex. It plays a key role in developing and carrying out instinctive behaviors and emotions and also is important in perceiving smells and linking them with memory, emotion, and instinctive behaviors. The limbic system includes:

12

• The amygdala, an almond-‐shaped structure involved in processing and remembering strong emotions such as fear. It is located in the temporal lobe just in front of the hippocampus.

• The hippocampus, which is buried in the temporal lobe, is important for learning and short-‐term memory. This part of the brain is thought to be the site where short-‐term memories are converted into long-‐term memories for storage in other brain areas.

• The thalamus, located at the top of the brain stem, receives sensory and limbic information, processes it, and then sends it to the cerebral cortex.

• The hypothalamus, a structure under the thalamus, monitors activities such as body temperature and food intake. It issues instructions to correct any imbalances. The hypothalamus also controls the body’s internal clock.

(b)The Normal Functioning of Neurons

For information on the normal functioning of the central nervous system, please refer to The Brain/ Central Nervous System 3a(ii) (pg.131-140) of your text. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of depression.

13

H. PYLORI You have been assigned Helicobactor pylori (H.pylori) infection for your independent research project. Before you can begin to uncover how H.pylori develops or how it can be treated, you must first understand the normal function of the upper gastrointestinal tract and immune system. A simplified overview of general biology pertinent to this complex disease has been compiled for you so that you may become familiarized with some of the terminology and key aspects of the disease. The information was gathered primarily from the MedPrep, Biology On-‐line, the National Institute for Health and the National Institute for Ageing and reflects a basic level of detail. Be sure to read and understand this information before beginning your research.

The Non-Diseased (Normal) State (b) The Healthy Upper Gastrointestinal (GI)Tract For information on the basics of the healthy digestive system please refer to Chapter 3b (ii), The Digestive System, pages 239- 255. Pay particular attention to pages 239-241 (four basic layers/tissues of the GI tract) and pages 244-248 (the esophagus, stomach, and small intestine). By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of H.pylori. (c) The Healthy Immune System

For information on biological cell defense/immune response, please refer to 3a(v) The Local Support & Defense System (p.182-197) in your text. Pay particular attention to pages 182-186. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of H.pylori infections. (c)The Basics of a Bacterium

Bacteria are unicellular (microscopic) prokaryotes which lack membrane bound organelles like mitochondria, golgi apparatus and endoplasmic reticulum. Bacteria range in size from 0.15 to 4 micrometers. Bacteria are found in soil, in water, and in the air. They are also found on plants, on the surfaces of decayed or decaying matter, and in the digestive and reproductive tracts of humans and other animals.

A bacterial cell consists of a tiny mass of cytoplasm surrounded by three distinct layers: the cytoplasmic membrane, the cell wall, and the capsule (Fig.1).

14

Within the cytoplasm is DNA, material containing genetic information. Unlike that of higher organisms, the DNA of bacteria is not enclosed in a membrane-bound structure, or nucleus. Some strains of bacteria have flagella that enable them to move with a swimming motion, or pili that help them adhere to certain surfaces (Fig.1). Some bacteria contain a special substance that allows them to emit light by a process called bioluminescence.

Figure 1: General bacterium. Courtesy of http://www.singleton-‐associates.org/bacteri2.htm

Bacteria occur in a wide range of environments, but are most abundant in moist and moderate temperature climates. Most bacteria are heterotrophic; that is, they obtain food from other organisms; while others are autotrophic, or manufacture their own food. Heterotrophic bacteria usually feed on dead organic matter, although some species are parasitic. Most autotrophic bacteria use energy from sunlight to manufacture food by photosynthesis. Heterotrophic and autotrophic bacteria can be either aerobic or anaerobic. Aerobic bacteria live in environments in which free (molecular) oxygen is present; anaerobic bacteria live in environments in which free oxygen is absent.

Bacteria generally reproduce by binary fission. Under favorable conditions, an adult organism splits apart to form two new organisms. Bacteria multiply rapidly, often doubling their population every 20 minutes. Some bacteria reproduce by budding, a process in which a small outgrowth from a single parent develops into a new, identical organism. A few bacteria can reproduce sexually (conjugation) under certain conditions. In this case two bacteria unite to form a zygote, which then splits into new cells. Some bacteria form colonies that may become large enough to be seen with the unaided eye.

Based on cell wall composition, bacteria can be separated into two groups; Gram-positive and Gram-negative. These bacteria react to the stain called as the Gram stain. The cell wall of the Gram-positive bacteria is made up of many layers of peptidoglycan and teichoic acids. The gram-negative bacteria have a slightly thinner cell wall made up of a few layers of peptidoglycan. They are

15

surrounded by another layer of lipid membrane containing lipo-polysaccharides and lipoproteins. Most bacteria have the Gram-negative cell wall.

Figure 2: The cell wall composition of Gram-positive and Gram-negative bacteria.

Courtesy of http://silverfalls.k12.or.us/staff/read_shari/mysite/chapter_24_ab.htm

Figure 3: The cell wall composition of Gram-positive and Gram-negative bacteria. Courtesy of ht http://www.websters-online-dictionary.org

Classification of Bacteria Bacteria are generally classified by two methods. The simplest and oldest method is by shape. The three principal categories are bacilli, cocci, and spirilla. Bacilli are rod-‐shaped and the most numerous of all types. They include coccobacilli and streptobacilli. Coci are a spherical bacteria, and are divided into bacteria that occur in pairs (ex. Diplococci), in clusters (ex. Staphylococci), and chains (ex.streptococci). Spirilla are spiral shaped bacteria, and are the least numerous type. The second method of classification is based on other characteristics, such as size, color, and chemical composition, and thus are grouped into Phylum.

16

TYPE 2 DIABETES You have been assigned type 2 diabetes mellitus (T2DM) for your independent research project. Although many of you may be familiar with the disease in a general sense, it is important to start with the basics of a healthy biological system before we can properly understand the onset, development, diagnosis and treatment of T2DM. It is always important to understand healthy biology before we can understand a diseased state! The following information has been compiled from general health websites and reflects a basic level of detail. As well, reference to the course text has been included. Be sure to read and understand this information before beginning your research.

The Non-Diseased (Normal) State of the Pancreas, and Glucose Homeostasis a) The Healthy Pancreas and Liver For information on the normal functioning of hormones, and especially the pancreas, please refer to pages 164-165 (general info), 178-180 (pancreas), 250-251 (liver) of your text. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of T2DM. The healthy pancreas The pancreas is a relatively small organ that is located in the abdomen, posterior to the stomach. It is comprised of millions of islets, called islets of Langerhans (called after the German pathologist who first described them), whose role is to secrete hormones in response to metabolic demands. The pancreas also has a role in the digestive system, as it secretes pancreatic juice, a necessary component to neutralize the acidity of the food as it exits the stomach.

Figure 1: Location and structure of the pancreas.

17

The healthy liver The liver, lying on the top right of the abdomen, just under the diaphragm, is the controller of body in the sense that it has to check-and-balance all the extra, unneeded and hazardous substances that one ingests or produces in the body. Dealing with the toxic and nontoxic (but hazardous if in excess) chemicals, liver serves as a guard for the body, and in a way as an internal line of defense. As a result, any disease that causes a change in the structure or function of the liver can cause significant problems for the entire body. Of interest here, the liver is able to store excess glucose as glycogen during feeding time. This glycogen can later be broken back down to glucose and use as energy fuel for the entire body during fasting or in-between meals. b) The Principles Behind Glucose Homeostasis Why is it important to regulate blood glucose concentrations? Glucose, a simple carbohydrate, is the main source of energy for our body and allows growth, thinking, physical activity, temperature regulation, etc. Every organ (e.g. skeletal muscle, liver, adipose tissue) in our body can use glucose to function, but the brain uses ONLY glucose as an energy source. Therefore, maintaining blood glucose concentrations within a safe range is crucial for health and well-‐being. In healthy individuals, blood glucose concentrations vary between 4-‐7 mmol/L throughout the course of a day. Blood glucose levels falling below this range may be dangerous for cognitive functions and can lead to fainting and coma. Blood glucose levels above this range may lead, in the long-‐term, to renal, visual, and nerve problems. How do hormones (insulin and glucagon) help in regulating blood glucose concentrations? When we ingest carbohydrates, they are broken down into glucose (among others), and absorbed from the small intestine into the blood stream. Glucose is a major source of energy used by the brain, skeletal muscle, liver, etc. However, before glucose can be used as an energy substrate by the cells, it needs to enter the cells. This is one of the main roles of insulin. As we eat, glucose builds up in the circulation, and this sends a signal to the pancreas to release insulin, a hormone. Once insulin is released into the blood, it binds to receptor on the cell surface of many tissues. Here, let’s talk about skeletal muscle, as it is one of the main tissues involved in T2DM (but the same process also occurs in liver and adipose tissue). Insulin binds to its receptor on skeletal muscle the same way a key would fit into a lock. This enables the transport of glucose from the blood into the skeletal muscle cell. The cell can then use the glucose to produce energy, or store it as glycogen for later use.

Between meals, the levels of glucose in the blood stream decreases: this is the signal to the pancreas to secrete glucagon, another hormone. Glucagon’s role is opposite to that of insulin: it sends a message to the cells to release glucose into the circulation. Glucagon mostly ‘speaks’ with the liver, because the liver has the ability to produce glucose. It does so by breaking down glycogen into glucose, and releasing this glucose in the blood. In healthy individuals, the pancreas knows exactly how much insulin and glucagon are required and at what time, depending on the glucose concentrations in the blood. It does not secrete too little or too much, which keeps blood glucose levels within a normal range.

18

What is insulin sensitivity? Insulin sensitivity refers to the ability of organs, namely skeletal muscle and liver, to respond to the insulin in the blood. In other words, in an insulin sensitive individual, when insulin binds to its receptor (i.e. when the key is inserted into the lock), it enables glucose to enter the cell (i.e. the door opens). In some disease states, despite the interaction of insulin with its receptor (i.e. the key in its lock), cells are not responsive to insulin and the glucose is unable to enter the cells (i.e. the door remains closed): this is called insulin resistance. Figure 2: Regulation of blood glucose level by insulin and glucagon.

19

INFLAMMATORY BOWEL DISEASE You have been assigned inflammatory bowel disease (IBD) for your independent research project. Although many of you may be familiar with the disease in a general sense, it is important to start with the basics of a healthy biological system before we can properly understand the onset, development, diagnosis and treatment of IBD. It is always important to understand healthy biology before we can understand a diseased state! The following information has been compiled from general health websites and reflects a basic level of detail. As well, reference to the course text has been included. Be sure to read and understand this information before beginning your research. The Non-Diseased (Normal) State (a) The Healthy Gastrointestinal (GI) Tract For information on the basics of the healthy digestive system please refer to Chapter 3b (ii), The Digestive System, pages 239- 255. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of IBD. (b) The Normal Immune Response

For information on the normal immune system/response, refer to Chapter 3a(v) (pg.188-200): The Local Support & Defense System. Pay particular attention to pages 188-189. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussion of the immune response in IBD. What is a normal immune response? What is its role in the body? In order to understand what is happening when a person has IBD it is necessary to know a little about how the healthy immune system works. The immune system -‐ a complex network of specialized cells and organs -‐ defends the body against attacks by foreign invaders such as bacteria, viruses, fungi, and parasites. It does this by seeking out and destroying the invaders as they enter the body. Substances capable of triggering an immune response are called antigens. Now you might be wondering – how does the immune system know what is foreign and how does it know what is native? Why are we able to recognize bacteria such as e-‐coli as foreign while at the same time allowing millions of bacteria to happily flourish in our gut? Why are we able to tolerate our own lungs, but often transplant patients reject a set of lungs from a donor? The following sections should help to clarify these questions. Amazingly, (but definitely not by magic!), the immune system displays both enormous diversity and extraordinary specificity. It can recognize millions of distinctive foreign molecules and produce its own molecules and cells to match up with and counteract each of them. In order to have room for enough cells to match the millions of possible foreign invaders, the immune system stores just a few cells for each specific antigen. When an antigen appears, those few

20

specifically matched cells are stimulated to multiply into a full-‐scale army. Later, to prevent this army from over-‐expanding, powerful mechanisms to suppress the immune response come into play.

21

OSTEOARTHRITIS You have been assigned osteoarthritis (OA) for your independent research project. Although many of you may be familiar with the disease in a general sense, it is important to start with the basics of a healthy biological system before we can properly understand the onset, development, diagnosis and treatment of OA. It is always important to understand healthy biology before we can understand a diseased state! The following information has been compiled from general health websites and reflects a basic level of detail. As well, reference to the course text has been included. Be sure to read and understand this information before beginning your research. The Non-Diseased (Normal) State (a)Healthy Connective and Muscle Tissue For information on the basics of connective tissue and muscle tissue, please refer to Chapter 1D From Cells to Organs located on pages 56-63. Pay particular attention to pages 57-‐60. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussions of OA. As you likely have come across, a joint is the location where two or more bones come together, such as the hip or knee. The bones of a joint are covered by a smooth and spongy material called cartilage. Cartilage allows the joint to move smoothly, without pain. In addition, the joint is lined by synovium; a thin layer of tissue which produces a slippery fluid called synovial fluid that nourishes the joint and helps reduce friction. Ligaments are strong bands of tissue that connect the bones and stabilize the joint in addition to muscles and tendons to enable movement (Fig.1)

22

Figure 1. The Normal Joint. Courtesy of Arthritis Ireland. Cartilage is composed of chondrocytes and an extracellular matrix of water, collagen, proteoglycans, in addition to other components such as adhesives and lipids. Cartilage is sub-‐divided into several different types: hyaline, elastic, and fibrocartilage. Please refer to your textbook in the assigned reading pages (above) for a description of each of these types of cartilage! Unlike other connective tissues, cartilage does not contain blood vessels. Because of this, it heals very slowly.

Composition of hyaline cartilage

Chondrocytes: Chondrocytes are important in the control of matrix turnover through production of: collagen, proteoglycans, and enzymes for cartilage metabolism.

Matrix: Water distribution varies, making up 65% of wet weight at the deep zone and 80% at the surface. Weight bearing capacity is made possible through regional changes in water content which allow deformation of the cartilage surface in response to stress. The matrix also provides nutrition and lubrication of cartilage.

Proteoglycans: Proteoglycans provide compressive strength and regulate matrix hydration by providing a porous structure to trap and hold water. Proteoglycans are composed of subunits of glycosaminoglycans (GAG’s - disaccharide polymers): chondroitin-4-sulfate (decreases with age), chondroitin-6-sulfate, keratin sulfate (increases with age). GAG’s are bound to a protein core by sugar bonds to form a proteoglycan aggrecan molecule. Aggrecan molecules are further stabilized by link proteins which bind them to hyaluronic acid to form a proteoglycan aggregate (Fig. 2).

23

Figure 2: Proteoglycan aggregate. Courtesy of World Ortho.

Adhesives: Adhesives that mediate the molecular interactions between chondrocytes and collagen fibrils are fibronectin, chondronectin and anchorin CII. Lipids are present in cartilage but their function is unknown.

Collagen: Hyaline cartilage is mainly composed of type II collagen. Collagen forms a cartilaginous framework to provide tensile strength. Collagen molecules and proteoglycans interweave to form cartilage (Fig. 3).

Figure 3: Interweaving of proteoglycans and collagen fibrils. Courtesy of World Ortho.

24

(b) The Normal Immune Response

For information on the normal immune system/response, refer to Chapter 3a(v) The Local Support and Defense System located on pages 182-197. Pay particular attention to pages 186-187. By no means are you expected to memorize everything in the chapter, but you will likely find it to be a great resource for definitions and figures to help orient yourself when reading more complex discussion of the immune response in OA. Evaluation: Homework Assignments: There are 3 take home assignments due as part of the disease seminars, each worth 3% of your final grade. Homework is assigned during seminar #2,3,4 and is due during the first 5 min of the following week’s seminar. During seminar #5, you will have an in class assignment to complete and submit before the end of the seminar period. All homework assignments are graded out of 5 possible marks, as follows: 5 – Outstanding Student has gone above and beyond the basic requirements of the assignment.

Research is detailed, clear, well-‐organized and expands on the students knowledge. All formatting guidelines were properly followed.

4 – Well Done Student has completed all aspects of the assignment correctly as outlined by the TA. Formatting has been followed correctly and an appropriate level of detail was included. 3 - Good

Student completed the homework as assigned, but only with a general level of detail in research or had some errors in formatting/style. More examples or interpretation could be included.

2 – Needs Improvement Student had one or more major errors in the assignment. The level or research or interpretation is lacking for a university level assignment.

25

1 – Incomplete/ Unsatisfactory Homework was submitted, but lacked key components, showed minimal research and/or included major issues with style.

0 – Did not submit/Academic Misconduct Assignment was not submitted within the first 5 minutes of the assigned seminar or included evidence of academic misconduct (plagiarism), whether intentional or not. For all homework assignments, please follow these important formatting/style guidelines, unless otherwise stated by your TA:

1. 1 page maximum 2. Double spaced 3. 12 pt, black font, 1’ margins, Times New Roman font 4. Properly referenced (see writing effectively online workshop)

a. including in text citations and full citations at the end 5. All figures must be cited. 6. 2 copies of your homework are required. 7. All homework is due within the first 5 minutes of your assigned seminar.

-‐ NO exceptions will apply. -‐ Any challenge for illness or compassionate grounds must be sent to the course

coordinator: Nicolette Bradley [email protected] Final Assignment Rubrics Below you will see a rubric that has been developed to evaluate your oral communication, presentation style and the text/research that accompanies your specific disease topic. By referring to this rubric when conducting your research or practicing your portion of the oral presentation, you will be able to see what key features are being evaluated. For example, as part of your oral communication, the TA will be looking for professional body language, eye contact, good volume in your voice, and a relaxed pace. As for the layout of your power point slides, you will be evaluated for your use of figures and text, as well as the organization of information on your slides. Also, they should be visually appealing with large font and appropriate use of colour with little distractions. Finally, you will be asked to hand in a hard copy of your 3 power point slides as well as 3 pages of text, expanding on the information on the slides themselves. This information will be marked for the accuracy and demonstration of comprehension. The information can be gathered from multiple reputable sources but should be focused to the topic of the disease of which you were assigned and must be written in your own words.

26

Detailed Explanation of Disease Tutorial Marking Rubric

CRITERIA Level 4 (1)

Level 3 (0.8)

Level 2 (0.65)

Level 1 (0.5)

Level 0 (0)

Oral Communication Voice

- Volume - Inflection - Articulate

Excellent clear voice, very articulate, appropriate volume and effective enthusiasm. Speaks clearly and distinctly all of the time with no mispronunciations.

Clear, articulate, good volume, enthusiastic. Speaks clearly and distinctly with few mispronunciations.

Less clear or articulate, harder to hear, little enthusiasm. Speaks clearly and distinctly most of the time with some mispronunciations

Not clear or articulate, difficult to hear, monotone, with little or no expression. Often can not be understood or mispronounces many words

The student did not meet the minimum requirements for unapproved reasons.

Speech - Complete

sentences - Vocabulary - Fillers

Excellent use of vocabulary. Sentences are simple, clear and complete. Student does not rely on fillers (um, uh, like).

Vocabulary is appropriate and sentences are complete. Minimal reliance on fillers (um, uh, like).

Vocabulary less appropriate (some use of slang/jargon), sentences are complete. Student often uses fillers (um, uh, like).

Difficulties with appropriate vocabulary and sentences incomplete/halting. Student frequently resorts to fillers (um, uh, like).


Body - Eye Contact - Posture - Body language

Student presents naturally like a planned conversation and maintains effective eye contact. Body language is professional and appropriate throughout entire group presentation.

Student seldom uses notes and makes eye contact most of the time. Body language is professional throughout most of the group presentation.

Reading presentation at least half of the time, makes eye contact a few times. Student is conscious of posture and appears tense. Fidgeting is distracting at times.

Student reads all or most of presentation, minimal direct eye contact. Posture is informal and distracting. Student frequently fidgets.


Organization - Main points - Pace/timing - Flow

Student has obviously rehearsed. Main points are clear and linked. Student speaks at a good pace; pauses where appropriate and is never rushed. Makes excellent use of time allotted.

Student could use an extra rehearsal to polish up. Main points are identified. Student’s speaks at a good pace. Presentation is slightly over or under the allotted 3 min time.

Student could use a few more rehearsals. Main points are difficult to decipher or not clearly linked. Student’s speech is rushed and not planned. Significantly over or under allotted 3 min time.

It is clear that rehearsals were lacking. Student does not seem prepared to present. Main points are not clearly evident. Speech is unorganized and distracted with little concept of allotted time.


Slide Layout - Figures & text - Font - Colour

Slides are clear, logical and effectively enhance the presentation. Graphics used significantly add to the presentation. They are very effective, clear, simple and easy to see. Excellent use of colour and font size with no unnecessary distractions.

Slides are clear and well organized. Graphics are connected to presentation. Graphics are clear and simple, easy to see. Good use of colour and font size with only slight distractions.

Slides are clear but would benefit from more attention. Graphics used loosely support presentation, are busy, overly detailed or difficult to see. Font choice and colour or animations are distracting at times.

Slides are bare or overly busy. Graphics used do not support presentation, are not clear, busy/cluttered and difficult to see. Font is difficult to read and colour distracts from the presentation.


27

Detailed Explanation of Disease Tutorial Marking Rubric

CRITERIA Level 4

(1) Level 3

(0.8) Level 2 (0.65)

Level 1 (0.5)

Level 0 (0)

Background Information & Written Notes Accuracy

Information provided is accurate, up to date and considers the full perspective of the disease. Facts are precise and explicit. Student is able to distinguish essential information for completing the project, while adding interest to enhance the project.

Information provided is accurate and current. Student is able to distinguish essential information for completing the project.

Information provided contains some factual errors or is outdated. Student only identified some of the pertinent information.

Information provided was inaccurate or outdated; the facts in this project are misleading to the audience. Student was unable to select the relevant and essential information to complete the project. Irrelevant data is included.


Mastery of Content

Content is focused and specific to the assigned topic. All key areas were fully addressed. Topic was dealt with in great depth, i.e. points clearly made, enough examples given and shows a thourough understanding of concepts, facts and terms.

Content relates to assigned topic with few tangents. All key points were addressed. Topic was dealt with in depth, but could benefit from more examples or further development in particular areas.

Content attempted to address assigned topic, but was inaccurate or irrelevant at times. Some critical points were missed. Some topic areas were handled on a superficial level. Further development is needed is some areas.

Content did not address the assigned topic. Critical points were incorrect or missing. Assignment was dealt with in a very superficial manner. Evidence of knowledge of the subject under study is lacking.


Understanding

Shows a full understanding of the topic. Student is able to explain relevant information within the context of the disease as a whole.

Shows a good understanding of the topic. Student is able to explain relevant information as it pertains to their specific topic.

Shows a fair understanding of parts of the topic. Student ability to explain relevant information is somewhat limited.

Does not seem to understand the topic well. Information is listed but the student does not explain the relevance of it.


Organization & Style

Relevant and essential information presented in a logical and interesting sequence that enhanced the assignment. Notes are clear, complete and very well written in the student’s own language with no grammatical errors.

Relevant and essential information is organized. Clear links are made between ideas. Notes are well written in the student’s own language with only minor grammatical errors.

Information presented is lacking a clear order at times. Bridges between ideas are evident but weak. Evidence of difficulty with paraphrasing at times. Extra edits could have helped clear up grammatical errors.

Notes are difficult to follow with no obvious structure. Information is scattered and fragmented. Content is not properly paraphrased. Evidence of major grammatical errors.


References

Student used wide variety of resources that enrich project. Referencing is consistent and complete with no errors.

Student used many reputable sources, with only minor referencing errors.

Limited resources were used. Several referencing errors or omissions were made.

Student did little information gathering or used non-reputable sources. Many referencing errors or omissions were made.


28

Peer evaluation Rubric CRITERIA Level 3

(1) Level 2 (0.75)

Level 1 (0.5)

Level 0 (0)

Gather Information

Collects a great deal of information on the topic

Collects some basic information on the topic

Collects very little information on the topic

Does not collect any information on the topic

Participate in Discussion

Enthusiastically participate in discussion to accomplish task

Willing to participate in discussion to accomplish task

Occasionally participate in discussion to accomplish task

Does not take part in discussion to accomplish task

Be sensitive to others’ feelings

Very willing to listen and is sensitive to others’ feelings and learning needs

Shows sensitivity to others’ feelings and willing to listen to others’ opinions

Sometimes needs occasional reminder to be sensitive to others’ feelings

Show no respect to others’ feelings

Cooperate with team members

Takes up any task assigned enthusiastically

S Willing to take up most tasks assigned

Takes up some tasks assigned when urged

Always argues with team members and refuses to do any work

Availability for group work

Attended all seminars and responded rapidly to emails.

Occasionally missed seminar, but was accessible via email.

Frequently missed seminar and did not respond well to email.

Never met with group for work.

Student

#1 Student #2

Student #3

Student #4

Student #5

Student #6

NAME:

Gather Information

Participate in Discussion

Be sensitive to others’ feelings

Cooperate with team members

Availability for group work

TOTAL:

29

Suggested Internet Resources for Seminars Internet (General): Medline (US National Library of Health) www.nlm.nih.gov/medlineplus National Institute for Health www.nih.gov Centers for Disease Control and Prevention www.cdc.gov Health Canada www.hc-‐sc.gc.ca Mayo Clinic www.mayoclinic.com Public Health Agency of Canada www.phac-‐aspc.gc.ca World Health Organization http://www.who.int/en/ Statistics Canada http://www.statcan.gc.ca/start-‐debut-‐eng.html A.D.A.M. Medical Encyclopedia http://www.nlm.nih.gov/medlineplus/encyclopedia.html Internet (Disease Specific): Canadian Cancer Society http://www.cancer.ca Canadian Mental Health Association www.cmha.ca The Arthritis Society www.arthritis.ca National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) www.niddk.nih.gov Canadian Liver Foundation www.liver.ca Crohn’s and Colitis Foundation of Canada

www.ccfc.ca Primary Literature: Pubmed www.ncbi.nlm.nih.gov/pubmed University of Guelph Library Journal Collection – (TUG, other request forms) www.lib.uoguelph.ca

30

Template for Seminar Slides

The following template is meant to be a guide when researching you topic and preparing your presentation. These questions are suggestions to help divide your research into 3 main ideas, which could be helpful when preparing your 3 allotted power point slides. You are not required to follow it exactly. All diseases are different and you may find that certain areas need to be developed further while other areas can be handled more briefly. That is, equal time and equal emphasis does not need to be placed on each of the components within your assigned topic, as long as they are all acknowledged. Part of this seminar exercise is to be able to identify important information and teach it to your classmates in a meaningful way. The primary goal of the seminar activity is to learn about different disease categories using a common template while also being introduced to basic scientific communication in the process. You are not expected to be an excellent public speaker, but you are expected to have a solid understanding of your assigned disease as a whole, and think critically about other diseases based on weekly in-‐class discussions. 1) Anatomy, physiology and pathology – natural course of the disease

• Anatomy: • Which organs/tissues are primarily affected? • What is the normal function of these tissues? • Physiology: • Expand on anatomy – how does the biological system normally work? • Pathology: • What goes wrong in the disease? • Explain the natural course of the disease • This might require 2 slides. • A figure is often helpful here.

2) Individual well being, familial and societal impact

• Individual: • How does the disease affect the individual? • How does daily living change? • Familial: • Does the disease cause a large burden impact on the family? How? • Societal: • What impact does the disease have on society as a whole? • What is the economical cost? Is there a social responsibility to deal with disease? • NB: Depending on the disease, one of these sections may require 2 slides while the other 2

sections may be able to be combined. 3) Risk factors, causes and preventative measures

• Risk Factors: • What factors would put someone at risk of developing this disease? • Consider genetics, lifestyle, environment etc.

• Causes: • What actually causes the disease?

31

• Is it one factor (i.e.: a gene, exposure to a virus) or a combination of several factors?

• Does the disease progress over time or does it just occur at a single time point? • Prevention: • Is there any way to prevent the disease? • Can lifestyle modifications prevent or at least delay development of the disease or

its symptoms? 4) Diagnosis: clinical, and sub-clinical classifications

• Diagnosis: • How is the disease diagnosed? • Is there one test that is classically used? Are several tests used? • How do the tests work? i.e.: explain the physiology behind them • Clinical classification • Are there different stages of the disease? • What key biomarkers are used to distinguish between levels disease? • Are all individuals with the disease actually diagnosed? Can you have the disease

and not know? • Sub-‐clinical classification: • Do sub-‐clinical populations exist? That is, can you have “pre-‐disease x” (eg: pre

diabetes vs. diabetes) • If so, do sub-‐clinical cases always develop into clinical cases? • What is the typical time frame between sub-‐clinical and clinical diagnosis?

5) Physician Prescribed Treatments, Complementary Alternative Medicine and Post-Treatment Management

• Physician Prescribed Treatments: • What treatments exist for the disease? (eg. drugs, surgery…) • If the disease treated with drugs – consider their mechanism of action (ie: what to

they target/why do they work) • Are new cutting edge treatments currently being studied? • Do these treatments cure the disease, or just treat the symptoms? • Complementary Alternative Medicine: • Are alternative therapies common (ie: natural remedies, Chinese medicine etc) • Can the disease be treated by lifestyle interventions? • Are combination therapies most effective? • Do these treatments cure the disease, or just treat the symptoms? • Post-‐treatment management: • How is the disease managed following diagnosis? • Are treatments required on a one-‐time basis or are they continual? • Can the disease be cured, or just managed? • Are continued lifestyle changes required following diagnosis? • NB: you may choose to highlight all the possible treatment strategies on one slide while

expanding on the most common treatment strategy on another slide.

32

Planning Template for BIOL 1080 Disease PowerPoint Presentation Use this template to organize your presentation ideas with your group. Slide 1 Disease Title Page Include -course code -seminar section & TA’s name -date -names of group members

Slide 3 Anatomy • __________

__ • __________

__ • __________

__ • __________

__ • __________

__

Slide 6 Individual • __________

__ • __________

__ • __________

__ • __________

__ • __________

__

Slide 9 Risk Factors • __________

__ • __________

__ • __________

__ • __________

__ • __________

__

Slide 12 Diagnosis • __________

__ • __________

__ • __________

__ • __________

__ • __________

__

Slide 15 Physician Prescribed treatments • ____________ • ____________ • ____________ • ____________ • ____________

Slide 2 Outline -to organize the presentation

Slide 4 Physiology • __________

__ • __________

__ • __________

__ • __________

__ •

Slide 7 Familial • __________

__ • __________

__ • __________

__ • __________

__ •

Slide 10 Causes • __________

__ • __________

__ • __________

__ • __________

__ •

Slide 13 Clinical Classification • __________

__ • __________

__ • __________

__ • __________

__ •

Slide 16 Complementary Alternative Treatment • ____________ • ____________ • ____________ • ____________ •

Slide 18 Conclusion Any questions? And Thank the audience for listening

Slide 5 Pathology • __________

__ • __________

__ • __________

__ • __________

__

Slide 8 Societal • __________

__ • __________

__ • __________

__ • __________

__

Slide 11 Prevention • __________

__ • __________

__ • __________

__ • __________

__

Slide 14 Sub-Clinical Classification • __________

__ • __________

__ • __________

__

Slide 17 Post Treatment Mgmt • ____________ • ____________ • ____________ • ____________

Where possible, let a picture, figure, chart or other graphic tell the story rather than using text.

33

Organizing information

Now that I have all this research done, how do I organize it? How to compile, organize, and create flow

with your information.

A. Compile your information

Step 1: Paraphrase/ brief summary -From your compiled information, write a brief summary of the major points from the information collected on your assigned area of your group’s disease.

B. Create an Outline

To ensure your thoughts are complete and in a logical order, you must organize your thoughts by creating an outline. You will notice that your final writing and presentation goes much more smoothly when you do this! Step 1: Road map

What must you cover? What are the key message you want your audience to take away from your presentation? As an individual? As a Group? -‐Develop a bullet-‐pointed outline of what you want to cover and the approximate order from step 1. Don't go into a lot of detail here...this is just your road map. Make notes on areas that you still need to research a bit more to FULLY UNDERSTAND or on which you need to find additional resources.

Step 2: Condense Part A -‐Take your brief summary and condense it into phrases or short sentences under each section created in your road map. Always remember to create a segue (flow of thought) for your next phrase/sentence. Make sure that sections are given approximately equal attention.

Step 3: Flow Does your information flow logically and smoothly? -‐Once you've completed the outline, it should give you a good sense of whether or not your presentation flows logically and covers the key aspects of your topic. If flow is hampered, return to Step 2 and correct.

Step 4: Proof read -‐ Re-‐read your sections, phrases/short sentences to ensure the most important information is being logically conveyed and that a sense of flow is present.

*Please note that this outline will assist you in preparing your oral presentation but may need to be condensed further for your PowerPoint slides.

34

Power Point Presentation Tips

Presentation Design • Plan the layout of your presentation as a whole group (see template below) • Use an Outline or Table of Contents slide to organize the presentation • Don’t overload your slides with too much text or data • FOCUS. In general, using a few powerful slides is the aim • Where possible, let a picture, figure, or chart tell the story rather than using text • Include an appropriate title for all slides • Proof read everything, including visuals and numbers • Keep “like” topics together • Strive for similar line lengths for text Background Design & Colour • Backgrounds should never distract from the presentation. • Backgrounds that are light coloured with dark text, or vice versa, look good. A dark

background with white font reduces glare. • Colors appear lighter when projected. Pale colors often appear as white. • Consistent backgrounds add to a professional appearance. Text • Font size must be large enough to be easily read.

o Headings = minimum 36 point, text = minimum 18 point, references = 12-‐14 point • Font style must be easy to read. Avoid all capitals. Use no more than 2 similar fonts. • Overuse of text is a common mistake.

o No more than 6 words/line and 5 lines/slide o If possible, make your point with graphics instead of text

Visual Elements • Use clear, simple visuals. Don’t confuse the audience. • Use contrast of text and background (light on dark or dark on light) • Graphics should make a key concept more clear • Place your graphics in a similar location within each screen if possible Charts & Figures • Charts and graphs must be clearly labelled. • Ensure that the text within a chart is large enough to read easily, or highlight key sections to

focus the audience’s attention • Cite your source on the same slide as the chart, figure, graphic.

Excitement • Animation and sound effects can be interesting when used in moderation, but too much

animation is distracting.

35

Oral Communication Tips

Hints for Efficient Practice

Content

• Make a list of key words/concepts for each slide • Read through the list before you begin • Don't attempt to memorize your text; your words will probably be different each time you

practice • Think about the ideas, and your words will follow naturally

Timing

• To end on time, you must PRACTICE! • Talk through your presentation to see how much time you use for each slide • Are you using the right amount of time per slide? Decide which slides or comments need

alteration to make your presentation smoother • When practicing, try to end early. You need to allow time for audience interruptions and

questions.

Hints for the Presentation

Pre-Talk Preparation

• Plan to get there a few minutes early to set up and test the equipment • Dress appropriately for your audience • Turn off your cell phone

Speaking

• Talk at a natural, moderate rate of speech • Project your voice • Speak clearly and distinctly • Repeat critical information • Pause briefly to give your audience time to digest the information on each new slide • Don’t read the slides aloud; your audience can read them far faster than you can talk

Body Language

• Keep your eyes on the audience • Use natural gestures • Don’t turn your back to the audience • Avoid looking at your notes. Only use them as reference points to keep you on track. Talk,

don’t read Questions

• Always leave time for a few questions at the end of the talk • If you allow questions during the talk, the presentation time will be about 25% more than

the practice time

36

• Relax. If you’ve done the research you can easily answer most questions • If you can’t answer a question, say so. Don’t apologize. “I don’t have that information. I’ll

try to find out for you.” Demeanor

• Show some enthusiasm. Nobody wants to listen to a dull presentation. On the other hand, don’t overdo it. Nobody talks and gestures like a maniac in real life

• Involve your audience. Ask questions, make eye contact, use humor. • Don’t get distracted by audience noises or movements • You’ll forget a minor point or two. Everybody does. • If you temporarily lose your train of thought you can gain time to recover by asking if the

audience has any questions Conclusion

• Concisely summarize your key concepts and the main ideas of your presentation • Resist the temptation to add a few last impromptu words • End your talk with the summary statement or question you have prepared. What do you

want them to remember?

Disease Seminar Handbook W12

Documents

Transcript of Disease Seminar Handbook W12