CHLH 100 Final Exam
Weight Control
2 Factors in Weight Control: Caloric intake Energy expenditure 3,500 calories in 1 lb To lose 1 lb. need to have 500 calories less per day for a week From eating less cals and/or burning more cals
Asthma Treatments
2 main treatment types: Controller Medication Taken daily to help prevent symptoms Has to be taken daily to help control symptoms Rescue Medication Taken when needed for asthma attack/flare-up Fast-acting
Types of Carbohydrates
2 types of carbohydrates Complex carbohydrates Starch, dietary fiber Simple carbohydrates Sugar
Medicaid
46+ million people covered by Medicaid Health insurance program for low-income, no age requirement Although additional requirements can be (and are) made by states Eligibility determined by each state Very costly budget item for states, but get lots of federal $ too Noncontributory program (no payroll tax)
Hospitals (inpatient)
5,795 registered hospitals in the U.S Many different types of specialties Ex: Cardiac, Behavioral Health, Children's VA operates 153 hospitals in U.S.
Fad Diet: Macrobiotic Diets
A "flexitarian" diet- mainly vegetarian with the option for some meat and fish Goal achieving balance Foods should be consumed in their most natural state Excluded foods: processed foods, fatty meats, most dairy, sugars, coffee, caffeinated tea, stimulating beverages, alcohol, chocolate, refined flour, very hot spices, chemicals and preservatives Founder of diet claimed it enabled individuals to overcome all illness No scientific proof of this
Asthma
A chronic lung disease where airways narrow and swell and produce extra mucus Makes breathing difficult, can include wheezing, shortness of breath, coughing
Variables affecting health insurace cost
Age: Premiums can be up to 3 times higher for older people than for younger ones. Location: Where you live has a big effect on your premiums. Differences in competition, state and local rules, and cost of living account for this. Tobacco use: Insurers can charge tobacco users up to 50% more than those who don't use tobacco. Individual vs. family enrollment: Insurers can charge more for a plan that also covers a spouse and/or dependents.
Health Maintenance Organization (HMO)
All care from HMO network providers Must designate a Primary Care Provider (PCP) Care originates/is coordinate through a PCP PCP provides referral to see specialist Emphasis on preventive care
Other Home Safety Methods
Childproof house Lock away chemicals, cleaning products, tools, guns, medications Fall prevention Stairwells, balconies, window Also helpful for older adults Have a fire extinguisher And know how to use it! Training information online and also through local fire depts. Test for radon levels Varies by region Prepare everyone to deal with emergencies First aid kit Shelter-in-place plans and materials Emergency contact information
Children's Health Insurance Program (CHIP)
Children whose families make too much money for Medicaid but still too low-income to be able to afford insurance on their own
Key Behaviors Tied to Health
Cigarette smoking Leading cause of preventable death and major cause of heart disease, cancer, and other diseases Environmental tobacco smoke: Increases risk of disease too Second-hand smoke and third-hand smoke Poor diet and physical inactivity Cause about as many deaths as smoking Overweight and obesity Contribute to numerous diseases
Fad Diet Characteristics
Claim of big weight loss Promoting specific products you have to buy Often promoted by celebrities Rarely scientifically studied, rarely work Sometimes there is a connection to something that works Ex: in Grapefruit diet, the grapefruit doesn't make a difference But eating many fewer calories does Ex: promises 5 lbs loss in first week Could happen just through loss of water weight
Genetics influencing obesity development
Clear genetic contribution to obesity development Genes involved in energy intake and energy expenditure E.g., defect in leptin gene -hormone that suppresses appetite and increases energy expenditure Interaction between genetic predisposition and environment Genetics alone do not explain obesity epidemic
Types of Proteins
Complete- high quality and supply all amino acids Incomplete- low quality
Medicare
Covers more than 46.5 million people Federal health insurance program for those: 65+, certain disabilities/severe illnesses Contributory program through FICA tax Meaning, all working people pay for part of Medicare
Dental disease
Dental caries (cavities) Periodontal (Gum) Disease Effected by: systemic factors: HIV, diabetes, leukemia medication: ie. anticonvulsants malnutrition specific bacteria, virus or fungus
Fad Diet: Lemon Detox Diet
Dieters replace food with a lemon juice concoction Key is really starvation- very low calorie consumption Will look like weight loss at first Really just loss of water weight Then... body naturally holds on to calories in face of starvation
You & Preventing Cancer
Don't smoke smoke/quit smoking & avoid ETS Healthy diet Be physically active Do regular screenings Pap smear Monthly TSE & BSE Testicular Self-Exams: Breast Self-Exams: Talk to your doctor about HPV vaccine
Primary Prevention for Cancer
Don't use tobacco Don't smoke, quit smoking, avoid second and third-hand smoke, don't use other tobacco Healthy diet Eat fruits, veggies, whole grains, lean proteins Avoid high fat, excessive alcohol Be active Guidelines recommend 150 mins/week of moderate intensity PA Be sun smart Wear sun screen, avoid peak exposure, don't use tanning beds HPV vaccine Avoid radiation and chemical exposure Use protective gear if work-related exposure
Inpatient vs. Outpatient
Outpatient- recover at home Inpatient- recover in hospital; admitted
Reading a Nutrition Facts Label
Serving Size: standardized reference amount of how much of the food you should be eating and other amounts based on this Calories Per Serving: having the number of calories and number of calories from fat next to each other makes it easy to see if a food is high in fat % Daily Values: Percentages based on the values given below in the footnote for a 2000-claorie diet Daily Values Footnote: Daily Values are shown for two claoric intake levels to emphasize the important of evaluating your own diet to apply the info on the label Caloric Conversion Information: Handy reference values help you check the math on your own calculations
NIH Guidelines for Weight Loss Programs
Should be safe and include all RDAs of food groups, vitamins/minerals Should be directed to slow, steady weight loss Doctor evaluation if weight goal is over 20 lbs. Include plans for weight maintenance Should know all fees and costs of program Weight Watchers follows these guidelines!
Cancer Treatment (cont.)
Some techniques are used to enhance effectiveness of current treatments Light therapy to kill cancer cells Heat to kill cancer cells Marrow transplants used to repopulate blood cells Treatments to help immune system to less side effects Clinical Trials Trials of potential new treatments Before trials occur in people have been threw many other tests Only try legitimate trials- usually through teaching hospitals or national research centers
Origin of Health Insurance
Started in World War II Wages frozen, companies developed new strategies to recruit/keep workers
Weight Loss
Steady weight loss of 1-2 pounds per week recommended Caloric intake not to fall below 1200 calories Supplements are not usually necessary Exercise plays a key role 95% who lose weight regain within 1 year Behavior modification to establish a permanent change in habits is needed
Bariatric Surgery
Surgery to produce weight loss by restricting size of stomach or bypassing a portion of intestine Limits the amount of food that can be eaten High complications Used in cases of severe obesity or overweight Done only after trying many other options Done with medical supervision
Treatment for Cancer
Surgery- Primary treatment for most early stage cancers Removes tumor and nearby tissue Radiation- Attacks cancers with radiation with external or internal material and also destroys normal cells Cancerous cells absorb radiation more/faster than regular cells, but regular cells do too It's a race/battle to kill more cancer cells than regular cells Chemotherapy- Treatment with anticancer drugs that usually circulate to all parts of the body Very often a combination of treatments
Added Sugars
Syrups Words ending in ose Ingredients with the word sugar Juices Crystals
Dental biofilm
is colonized oral bacteria accumulates every 24-30 hours releases waste products [toxins] toxins are pathogenic
Copayment
a set amount you pay for certain services Ex: $20 for a physician visit
malignant tumor
cancerous- can invade & damage nearby tissues and organs
Snacks Good for your Teeth
cheese fresh fruit & vegetables, nuts or nut butters, whole grain crackers yogurt that is low in sugar.
Co-insurance
the amount you pay of a service you use Ex: For any inpatient care you pay 20% & insurer pays 80%
Policy
your contract with the insurer Lists covered services
Premium
your regular payment to the insurance plan for coverage (whether you use it or not)
Pre-existing condition
condition diagnosed/treated before coverage starts
Energy Balance
energy intake vs. energy expenditure In Balance- this means we are consuming the same amount of calories and we are burning. When you are in balance you don't lose weight or gain weight. You maintain the weight you are at. Positive Balance- this means we are taking in more calories than we burn out, so we would be gaining weight. Negative Balance- this means we are taking in fewer calories than we burn out, so we would be losing weight.
Obesity Trends
About 70% of US adults are overweight (including obese) 33+% of US adults are obese Obesity rates have tripled in the last 3 decades
Nonprescription Products for Weight Loss
Alli/Orlistat- Blocks enzymes and reduce fat absorption Some significant risks Talk with your medical provider first When used correctly, the person follows a low-fat diet, and Alli can help with some additional weight loss. This only works if the person is following a low-fat diet. Otherwise what happens is the person consumes fat, the body can't digest, and the person's body has challenges getting rid of the fat. can lead to fat/grease leakage in your poop and some other very unpleasant things. Diet Teas Claim can help people lose weight No tea has been proven for weight loss Some contained laxatives that only caused side effects (cramps, diarrhea)
Whole Grains
Amaranth Barley Brown rice Buckwheat Bulgur (cracked wheat) Lentils Millet Popcorn* Quinoa Wild rice Wheat berries Whole-grain barley Whole-grain corn Whole oats/oatmeal Whole rye Whole wheat Pop corn is * because it is often served with lots of unhealthy things on it
BMI & Weight Status
Below 18.5 Underweight 18.5 - 24.9 Normal 25.0 - 29.9 Overweight 30.0 and Above Obese
How healthcare was spent/paid for
Biggest spender- hospital care Biggest payer- private health insurance
Dubious Products
Body wrapping- Claim to trim inches off body Cellulite removers- Creams or electric stimulation claim to remove fat No product can remove fat from an area
Secondary Prevention for Cancer (Get Screened!)
Breast cancer- breast self-exam, clinician exam, mammogram Prostate cancer- prostate-specific atigen test, clinician exam Colon cancer- sigmoidoscopy, colonoscopy Cervical cancer- pap smear Testicular cancer- TSE
Dental Self-Care
Brushing your teeth 2x daily Flossing Mouth rinse Chewing xylitol gum
Smoking Cessation Products
Burpropion Nicotine Gum Nicotine Inhaler Nicotine Lozenge Nicotine Nasal spray Nicotine Patch
Types of Home Safety Alarms
CO detector Smoke Alarms
Dangers of Caffeinated Alcoholic Beverages
Caffeine masks the depressant effects of alcohol Caffeine thought to help liver metabolize alcohol... Has no effect on the metabolism of alcohol by the liver Does not reduce blood alcohol concentrations or reduce the risk of alcohol-related dangers Drinkers of CABs are 3 times more likely to binge drink* Twice as likely to report being taken advantage of sexually* Twice as likely to report riding with a driver who was under the influence of alcohol
Major Components of Food
Carbohydrates Lipids Protein Vitamins Minerals Water Carbs, lipids, and proteins are macronutrients which are energy yielding nutrients
Fad Diet: Grapefruit Diet
Eat half a grapefruit or drink grapefruit juice after each low-carb, low-cal meal Grapefruit thought to lower insulin levels and promote weight loss No science behind this
Health Risks of Obesity
High blood pressure Increase risk of sickness and death from type 2 diabetes Liver, kidney, heart disease Osteoarthritis, blood vessel disease Sleep apnea And more...
Health Expenditures for US/Other Countries
General- spend a lot more than other countries Spend a lot more on private expenditures vs. public Other countries spend majority on public Not a new phenomenon- healthcare costs have been rising since 1960
Key Provisions to the ACA
Goal: To expand coverage and increase access to health care Key Provisions: Coverage required for 10 Essential Health Benefit Categories Consumers required to get health insurance Large employers required to offer health insurance Small employers encouraged to offer health insurance Health Insurance Exchanges/Marketplaces created to help individuals, families, and small business get better access and rates on health insurance Got rid of pre-existing condition exclusions
Cancer Prognosis
Grading- Classifies cancer cells based on how abnormal they look under a microscope and how quickly the tumor is likely to grow and spread Staging- Estimates how far the disease has advanced- based on size of tumor, involvement of lymph nodes Grading and staging are used to select treatment and estimate prognosis
dental Calculus
Hardened plaque biofilm Forms within 72 hours
Allergy Treatment
Have confirmed by physician in order to guide treatment Skin and blood test can identify allergies May need to consult an allergy specialist Best way to control allergies ...is to avoid them (when possible) Variety of medications- pills, creams, antihistamines, inhalers, injections Available OTC and with Rx Severe allergies need to have proper medication with them at all times Ex: Epi pen
Health and Natural Foods
Health foods are claimed to be special foods that can benefit people's health The term is usually a gimmick to sell foods All foods can be healthy if eaten in the right amounts And healthy foods can be unhealthy if eaten in excess Natural foods are claimed to be produced with minimal processing and no additives Not much regulation on these claims Usually cost more
Safe Transit Practices
Helmets- bike, scooter, motorcycle, snowboard, skateboarding Lights Driving cars with effective safety devices Working headlights and taillights Working seatbelts, airbags, brakes Child safety seats Appropriate seat in appropriate location
Outpatient Medical Facilities (cont.)
Hospital Outpatient Clinics Some offer fees based on ability to pay Receive support from Hill-Burton Act that covers some care Community Clinics Run by health department or non-profit agency Ex: CUPHD clinic, Frances Nelson FQHC Urgent Care Centers Walk in care for minor medical emergencies Often located in shopping centers or within neighborhoods New model- hybrid urgent care/primary care and tied to hospital Ex: Take Care Clinic, Carle Clinic Urgent Care- offer evening/weekend hours Ambulatory Surgery Centers Outpatient surgery is performed after medically evaluated elsewhere
Healthcare Providers working to lower costs
Hospitals merge with other hospitals Profit making organizations are buying hospitals Physicians form independent practice organizations Use physician assistants or nurse practitioners- less expensive for services Electronic records allow for more efficient and safer care
Sugar Sweetened Beverages/Oral Health
Increased consumption of sweetened beverages, soda, Gatorade, and energy drinks (Red Bull, Starbucks) causes an increase in dental cavities by the sugar and acids eating away at the enamel
Gingivitus
Inflammation Red, swollen, bleeding gums Reversible
Periodontal Disease/Other Health Problems
Inflammation associated with Periodontal Disease linked to: Cardiovascular disease Diabetes Adverse pregnancy outcomes other
Common Allergens
Inhaled substances: pollen, dust, feathers, animal skin, smoke Foods: peanuts, nuts, wheat, soy, shellfish, eggs, milk Substances on skin: plastic, lotion, metal, cosmetics Medications: aspirin, penicillin
Periodontitis
Irreversible Affects the bone that holds your teeth in
Trans Fats
Manufactured by adding hydrogen to vegetable oil (hydrogenation) to turn liquid oils into solid fats Only small amounts are found naturally Increases the shelf life and flavor stability of foods Sources: vegetable shortenings, some margarines, crackers, cookies, snack foods, and foods made with or fried in partially hydrogenated oils. Raises the LDL cholesterol that increases your risk for CHD Nov 2013- FDA proposed a ban on trans fats
Other Factors Influencing Obesity Development
Lifestyle Behavior Physical activity Dietary patterns Psychosocial Factors Regulating emotions Environment Culture Socioeconomic Status The neighborhoodwe live in- not safe to walk outside only fast food nearby- can't make healthy choices
Fad Diet: Raw Foods Diet
Lifestyle that promotes consumption of uncooked, unprocessed and often organic foods as most of diet Believe it is a great health benefit Include raw fruits, vegetables, nuts, seeds, eggs, raw milk, raw cheese Claim cooking foods produces harmful toxins Myth, and in fact, can be opposite
Top 3 Cancer Deaths (Both Sexes)
Males: Lung/bronchus Prostate Colon/rectum Females: Lung/bronchus Breast Colon/rectum
Top 3 Cancers (Both Sexes)
Males: Prostate Lung/bronchus Colon/rectum Females: Breast Lung/bronchus Colon/rectum
metastisis
Malignant tumors break away and start new cancers elsewhere
Prescription Drugs for Weight Loss
No drug can ensure permanent weight loss Amphetamines- once widely used to suppress appetite but have side effects Thyroid hormones- help control metabolism, should only be used for hormone deficiency Diuretics- cause water loss but is only temporary
Low-Calorie Products
Per FDA- low calorie foods can not contain more than 40 calories per serving Reduced calorie- must be at least 25 % lower in calorie content then similar food Low calorie or reduced calorie- have nutrition information on label
Healthcare improvements/good parts
Preventative care- bad Tertiary care- good
Four Levels of Prevention
Primary- Strategies to prevent the development of disease Examples: vaccines, nutrition, physical activity, washing hands Secondary- Strategies to detect and treat an existing disease in early stages Examples: Diabetes screening, mammograms Tertiary- Strategies to reduce the negative impact of established disease; reducing complication Examples: medication, surgery Quaternary- strategies to reduce or avoid consequences of unnecessary interventions
Outpatient Medical Facilities
Private medical offices Have scheduled hours and operate by appointment University student health services Services vary from school to school Most are covered by university fees HC fee often wrapped into tuition Hospital Emergency Departments Most are open 24 hours/365 days and supervised by physicians Costs more than doctor's office visit For patients & healthcare providers Can have long wait times ER vs. ED
Oragnic Foods
Promoters suggest they are safer and more nutritious Grown without artificial fertilizers or pesticides Animals have not been treated with hormones or antibiotics Less likely to contain pesticides, but only in minimal amounts Run-off/neighboring farms can complicate this Usually cost more than "traditional" foods No nutrient difference
Fad Diet: Aitkens Diet
Promotes avoiding carbs Promotes eat all the protein and fat you want Can lead to very high consumption of protein and fat, under-consumption of fruits and veggies Whole brand of Atkins products They sell you their specific foods and they make $$$$
Fad Diet: Paleo diet
Promotes eat like caveman Keys to diet are meats, non-starchy vegetables Some also include fruits, nuts, and berries Avoid processed foods Research questions the logic/science on this Many ancients ate grains, dairy, legumes Focus on proteins can lead to overconsumption, higher fat intake
Fad Diet: The Fork It! Diet
Promotes eating what you want for breakfast and lunch Promotes in evening only eating foods that can be eaten only with a fork (no spoon no knife) Potentially could force evening eating to be healthier White meat, fish, lentils, veggies
Preferred Provider Organization (PPO)
Providers give discount to managed care organization, these become in-network providers Patients can see in-network or out-of-network providers Patients who see an in-network provider receive better benefits (ex: 20% less cost)
Accreditation
Public recognition that it meets standards set by a recognized accrediting agency Joint Commission on Accreditation of Hospitals Develops standards and evaluates their implementation (& impact) Goal to improve safety and quality of care Accreditation is voluntary but needed by hospitals to have a residency program
Insurance Providers working to lower costs
Raise deductibles and co-payments Limit what they pay for each service Limit certain services Ex: not cover certain drugs Limit maximum benefits Require pre-authorization Use financial incentives to encourage cost-conscious decisions or pay a bonus to physician
Flouride
Remineralizes tooth surfaces Shown to prevent tooth decay Sometimes can even reverse tooth decay
U.S. Weight Loss Marketplace
Reported in U.S.- 65% women and 42% men were trying to lose weight 2010 sales of weight loss products was $60.9 billion
Fee for Service
See a dr. for a certain service that has a fee Pay the dr. that fee for that service
Tertiary Prevention for Cancer
Treatment Getting treated early is key Early treatment tied to survival rate
Negative Side Effects/Cancer
Treatment kill cancer cells but also healthy cells in process
Differences between Type 1 and Type 2 Diabetes
Type 1 Autoimmune disease that destroys the cells that produce insulin No known way to prevent Treatment: insulin Type 2 Body is producing enough insulin, but cells are less sensitive (less responsive) to it Lifestyle and pharmacological management Can be prevented with healthy diet/exercise
Unsaturated Fats
Typically liquid at room temperature Monounsaturated Help reduce LDLs and maintain HDLs (the "good" cholesterol) Sources: canola oil, olive oil Polyunsaturated Reduce both LDLs and HDLs Sources: corn oil, soybean oil, fish oils
Saturated Fats
Typically solid at room temperature. Examples: butter, visible fat on meat Primarily come from animal sources Contribute to increased blood cholesterol, especially LDLs (the "bad" cholesterol)
Tips for Calorie Reduction
Use alternatives to food as rewards Find nonfood outlets for release of stress Resist temptation of clean your plate Eat moderate portions of favorite foods Do not eat while doing anything else
Body Mass Index (BMI)
Used as an indicator of overweight/obesity Correlates with the amount of body fat Correlates with risk of disease and death Simple, quick and inexpensive to calculate Calculation: Body weight (kg) /height (m)2
Importance of Vaccines
Vaccinations protects others in community that can't get vaccinated Young infants, people with immune conditions Not getting vaccinated means you are relying on herd immunity You're relying on others to do their part- you skimp out but benefit This doesn't last long- if people stop vaccinating the herd principle can't work
Out-of-pocket limit
after patient pays this much, insurance covers 100% of costs Re-starts each policy period
Deductible
amount you must pay before insurance will kick in Some plans have low deductibles ($250), some have higher deductibles, ($2000) Many plans provide preventive services before you've met your deductible.
Benign Tumor
non-cancerous, doesn't spread