HLTH 312 Exam 3 (Ch 16-24)

improving air quality

-About 78 million tons of air pollution were emitted into the atmosphere in the United States in 2016. •Represents a 67% reduction in total emissions of the major air pollutants since 1980 -About 60% of air pollution is caused by emissions from cars, trucks, buses, aircraft, and ships. •The elimination of lead gasoline in the United States has markedly reduced the blood levels of lead of U.S. citizens. -Environmental Protection Agency (EPA) •Established in 1970 •Tends to lock horns with industry when Congress and the presidential administration are pro-environment -Industry resists changes in the design and manufacture of products intended to provide a clean environment on the ground that the costs of doing so will weaken the U.S. economy.

homeopathy medicine

-Alternative medicine that administers very dilute substances that mimic the patient's symptoms -Most widely used alternative medicine in the United States •Used by a variety of practitioners including physicians, nurse practitioners, dentists, naturopathic doctors, chiropractors, and veterinarians Also widely used in Europe and India -Only about 200 years old •Founded by Samuel Hahnemann in Germany •Primarily a self-healing system assisted by very small doses of medicines or remedies •Believed that tiny doses of a substance that evoked symptoms similar to the disease symptoms could, in some way, stimulate the body's natural defenses and promote healing -Based on four principles •Substances that produce the same symptoms that the disease does will cure the disease. •Substances are tested by giving them to healthy subjects and observing the symptoms. •Smaller doses are more potent than undiluted solutions. •Vital forces must be released in the patient to reestablish body harmony, or homeostasis. -Began to be practiced extensively around 1830 •Fell out of favor when homeopaths chose to remain outside mainstream medicine in the early 20th century •Reemerged in the United States in the 1970s as part of the general resurgence of alternative medicine -Treatments •Used to treat acute and chronic conditions •Does not generally treat structural diseases or those stemming from long-term organic damage •Sources of remedies -Plants -Animals -Microbial sources -Minerals

osteopathy medicine

-Alternative medicine that uses manipulation and medicines for healing -Osteopaths •Receive training comparable to that of physicians •Can prescribe drugs •Primarily rely on physical manipulation and exercises for patients' conditions

chiropractic medicine

-Alternative medicine that uses manipulation of the spine and joints for healing -Founded by Daniel David Palmer •Had no scientific or medical training •Concluded that virtually all diseases are caused by subluxed (misaligned) vertebrae •His son, B.J. Palmer, turned the practice into a multimillion dollar business. -Two schools •Straights -Adhere to the original idea that almost all diseases are caused by subluxation (misalignment of the vertebrae) •Mixers -Believe that other factors are involved in disease processes -Include nutrition, relaxation, exercise, and other techniques, along with spinal manipulation, in their practices -90% of patients seeking chiropractic help do so because of back pain, neck pain, or headaches. -Subluxation can be caused by genetic disorders, falls, injuries, improper sleeping habits, poor posture, obesity, stress, or occupational hazards. -Research has concluded that chiropractic: •Offers both short-term and long-term benefits for chronic, disabling back pain •Is cheaper and more effective in treating back pain and musculoskeletal disorders than conventional medicine

naturopathy

-Alternative medicine that uses nutrition, herbs, massage, and other techniques to promote healing -Emphasizes the prevention of disease and the individual's responsibility for a healthy lifestyle -Draws on all available alternative medicines, as well as aspects of conventional medicine, but rejects the use of surgery and drugs -Eight basic principles •A human body can heal itself. •Treat underlying causes of illness. •Educate patients. •"Do no harm." •Focus mainly on prevention of illness. •Good nutrition is essential. •Treatment involves the whole person. •Ultimate goal is optimal health. -Naturopathic doctors receive training that is as complete as a medical school that awards the M.D. degree. •It is the approach to healing that distinguishes the N.D. from the M.D. •Naturopaths do not treat acute illness or conditions that require emergency care.

acupuncture

-Ancient Chinese alternative medicine that uses thin needles inserted into specific points on the body to produce healing energy -Qi •Vital life force that circulates throughout the body -Meridians •Channels along the body where energy flows and where acupuncture points are located -Meridians (continued) •There are 12 major meridians that connect all of the major organs, along with a network of minor meridians. •The meridians intersect with the surface of the body at many positions. -These are the acupuncture points that are "needled" to restore balance to the qi to cure illness or relieve pain. -Acupuncture points •Very thin metal needles are inserted just under the skin at specific acupuncture points. •There are about 365 points located along 14 meridians in the body. •Usually no more than a dozen or so needles are inserted and left in place for about a half hour. -Can be effective in treating: •Postoperative dental pain •Nausea from surgery, chemotherapy, or pregnancy •Drug and smoking addiction •Lower back pain •Stroke rehabilitation •Menstrual cramps •Tennis elbow •Carpal tunnel syndrome -Also used to treat: •Neurological disorders •Gastrointestinal disorders •Respiratory disorders •Arthritic conditions •Migraine and chronic tension headaches

ayurveda medicine

-Ayurvedic medicine •Traditional form of preventive medicine and healing, involving mind, body, and spirit, practiced in India for thousands of years •Spreading to Western countries -The word Ayurveda comes from the Sanskrit words for life and knowledge. •Health is knowledge of life. -Sees nature and people as being made of five elements or properties: earth, water, fire, air, and space •Each element consists of both matter and energy. •Harmony among the five elements produces health. •Disharmony in any of the elements produces disease. -Doshas •Mediate the functions of the body tissues and waste products •Produce physical, emotional, and spiritual health when in balance •The goal of Ayurvedic medicine is to restore the balances of the doshas that is correct for each person. -Pulse diagnosis •Method used by Ayurvedic physicians to diagnose a patient's disease •Highly developed skill in taking a pulse -Other methods of diagnosis involve examining the tongue, urine, and aspects of the body such as the condition of the nails, skin, and lips. -Remedies involve nutrition and exercise. •Six "tastes" are recognized -Salty -Sweet -Sour -Pungent -Bitter -Astringent •Each taste is associated with a physiological function. •Exercises may include yoga, t'ai chi, and jogging. -Other techniques •Massage •Meditation •Herbal remedies -Use caution when making purchases. •Medicines are often made in Southeast Asia without regulation and may contain potentially harmful levels of heavy metals.

worldwide environmental problems

-Global warming -Land degradation -Fresh water shortages -Air pollution -Exposure to toxic chemicals -Extinction of species -Nuclear, chemical, and biological problems

herbal medicine

-Materials derived from plants and other organisms that are made into teas, powders, and salves to treat diseases and injuries -Often contain a mixture of herbs -Many are used for a variety of ailments and conditions -Can have the same potential for side effects and harm as prescription drugs -St. John's Wort •Can be effective in reducing depression •Reduces the effectiveness of many prescription drugs, including birth control, other antidepressants, AIDS drugs, and anticoagulants -Kava Kava •Used as a relaxant or for stress reduction •Can cause liver damage and possibly death when extracts from the bark and root are used -Ephedra (ma huang) •Added to dietary supplements as a stimulant to help people lose weight and is used by athletes to enhance performance •Contains the drug ephedrine -Responsible for desired effects, but also unpleasant and dangerous side effects including increased blood pressure and heart rate, psychiatric symptoms, and gastrointestinal problems •Can cause heart palpitations FDA banned ephedrine in weight loss supplements •Herbal Medicine -Manufacturers are not required to carry out tests that establish the safety and efficacy of herbal supplements before selling them. •Actual amounts of active chemicals in most are not known or are misrepresented on the label -Many herbs are added to foods to increase marketability and sales. •Do not consume any herb in food "just because it might help me feel better."

violence

-Physical or verbal behavior in which the intent is to harm, injure, or destroy someone or something -Used by some as a means of gaining power -Power and violence manifest in society as rape, domestic violence, child abuse, elder abuse, homicide, suicide, terrorist attacks, gang fights, and wars between nations -Only solution is prevention

intimate partner violence (IPV)

-Physical, sexual, or psychological harm by a current or former intimate partner or spouse -Categories include: •Physical violence •Sexual violence •Threats of physical or sexual violence •Psychological or emotional violence •Stalking •It is estimated that fewer than half of all cases of family violence are reported. •In addition to medical problems, partners who experience battering or rape may suffer from: -Anxiety -Depression -Chronic pelvic pain -Gastrointestinal upset -Substance abuse -Obesity Headaches •Assaulted individuals may also develop symptoms of PTSD, such as: -Reexperiencing the traumatic event -Intense reactions to things that symbolize the traumatic experience -Nausea and difficulties with sexual relations -Denial or dissociation about the trauma -Manipulation of others and the environment -Persistent arousal symptoms •Causes of Domestic Violence -High level of conflict and stress in the family -Male dominance -Cultural norms that permit family violence -Displays of violence on TV and in other media -Being raised in a violent family -Alcohol and drug abuse -Victim-blaming ("people get what they deserve") -Denying the existence of a problem -Women at the greatest risk for serious injury from domestic violence include those with male partners who: •Abuse alcohol or drugs •Are unemployed or intermittently employed •Have less than a high school education •Are former husbands or boyfriends of the women -Ways to prevent domestic violence include: •Provide shelters, safe houses, and other protective environments for abused women and their children •Reduce contributing social and economic factors •Hold the abusers accountable for their actions •Train law enforcement and health care professionals to recognize and intervene in cases of domestic violence •Conflict resolution Reduce the amount of violent imagery •Domestic violence also affects children -Conflicts between parents can affect the long-term health of children. -Children who grow up in physically or sexually abusive environments are much more likely to find themselves in abusive relationships themselves.

therapeutic massage

-Promotes relaxation and healing by massage of the skin and muscles -Effects •Improves blood circulation •Benefits digestion and elimination •Hastens wound healing •Eases muscle pain caused by strain or injury •May stimulate the release of endorphins and enkephalins -Contraindicated conditions •Recent bone fractures or severe sprains •Herniated disk in the spine •Excessive blood pressure •Areas of the body in which hemorrhage has occurred •Acute inflammation of the skin or joints •Blood conditions such as phlebitis and thrombosis •Severe varicose veins Certain kinds of cancer -Basic types of manipulation •Gliding stroke that warms the skin and relaxes muscle tension •Kneading motion that relieves soreness and improves circulation •Friction manipulation for joints and thick muscles •Circular movements that help break up adhesions •Chopping or tapping that stimulates the skin •Vibrating motions that stimulate nerves and circulation -Types •Swedish massage -Uses long strokes, kneading of muscles, and friction techniques on the outer layers of the body and active and passive movements of joints •Shiatsu and acupressure massage -Use pressure on specific points of the body to treat pain and improve body functions •Lomi lomi massage -Ancient Hawaiian healing art that is a form of spiritual massage used to restore mind-body harmony •Rolfing (structural integration) -Realigns the body through deep massage of underlying myofacial tissues •Rosen massage -Uses gentle touch and verbal communication to relieve suppressed emotions locked into musculature from past traumatic accidents •Trigger point massage -Uses finger pressure on "trigger points" in painful or inflamed areas of muscle to break the cycles of spasm and pain

quackery

-Promotion and sale of unapproved and worthless products, especially for medical problems and health enhancement -Legally difficult to separate quackery and fraud -Dealt a serious blow in 1906 with the passage of the Pure Food and Drug Act Made sales of worthless medicines illegal -Most prevalent fraudulent products include: •Fraudulent arthritis products •Fake cancer clinics and bogus AIDS cures •Penis enlargement pills and devices •Instant weight-loss and false nutritional schemes •Fraudulent sex aids •Useless baldness remedies •Useless muscle stimulators Candidiasis hypersensitivity cures

aromatherapy

-Use of fragrant extracts of plants to promote healing -Popular oil extracts are derived from: •Leaves of eucalyptus and peppermint •Fruits and blossoms of oranges and lemons •Flowers of lavender and roses •Woods such as camphor and sandalwood •Cinnamon bark, lemongrass, fennel, and rosemary •Dried spices such as cloves and garlic -Essential oils •Very concentrated •Contain hundreds of chemicals that can act as drugs •Only minute amounts are used •Can be administered through: -Inhalation -Direct application to the skin as part of a massage -Addition to a hot bath -Used to treat: •Infections •Pain •Arthritis •Skin disorders •Headaches •Digestive disorders •Other conditions -No evidence that it cures any disease

biomagnetic therapy

-Use of magnetic fields to treat pain, ailments, and diseases -Has not been substantiated by scientific studies •Some success in treating severe depression, bone healing, and pain relief •May produce benefits by virtue of the placebo effect

carbon dioxide, global warming and climate change

Carbon Dioxide (CO2) -Natural component of Earth's atmosphere -Relatively steady level of 290 parts per million (ppm) prior to the Industrial Revolution •Reached about 400 ppm in 2014 •Increases about 2 ppm per year -Absorbs infrared radiation, trapping heat in the atmosphere •Known as the greenhouse effect •Earth's temperature is increasing. -Not due to natural fluctuations in global climate -Caused principally by increased levels of human-generated carbon dioxide -Amount of methane is also increasing •Contributes to global warming -Predicted that the temperature of Earth will increase 5 to 10 degrees Fahrenheit sometime in this century •Predicted effects of global warming -Rise in sea level -Massive change in the Earth's climate -Spread of disease to new regions -Increased number of intense storms •In 2007, China surpassed the United States as the world's largest emitter of carbon dioxide. •Reducing Your Carbon Footprint -Carbon footprint •Measure of how your lifestyle adds to CO2 emissions and global warming. -Strategies •Drive less and walk or ride a bicycle more often •Buy a car with high fuel efficiency •Update to fluorescent and LED light bulbs •Reduce electrical power use whenever possible •Change your diet and where you buy food •The Ozone Layer -Consists of ozone molecules that form a layer in the outermost region of the earth's atmosphere -Absorbs much of the dangerous ultraviolet (UV) light that is radiated from the sun -Protects us from skin cancer and cataracts in the lens of the eye •The Ozone Layer -Chlorofluorocarbons (CFCs) •Widely used as refrigerant and propellant gases in cans during the 20th century •Escape into the atmosphere, rise to the ozone layer, and destroy ozone molecules •31 industrialized countries have agreed to phase out CFC use •Evaluating the Risks of Air Pollution -Emission •Amount of a substance released into the atmosphere from an automobile or other source of air pollution -Exposure •Amount of the substance to which people are exposed -It is important to identify both the sources of greatest emission and the sources of greatest exposure.

alcohol use disorder

•About 9.8 million men and 5.3 million women in the United States have an Alcohol Use Disorder (AUD). -Pattern of uncontrollable alcohol use that is socially and personally harmful -Characterized by alcohol-related impairment or distress and/or neurobiological dependence (addiction) on alcohol •Alcoholism, the most severe form of AUD, is characterized by: -An intense craving for alcohol -Compulsive drinking behavior -An inability to control one's drinking -Physical dependence on alcohol •Withdrawal symptoms -Anxiety and stress -Delirium tremens (DTs) •Characterized by hallucinations and uncontrollable shaking •AUD can cause numerous negative consequences. -It can impair job and school performance. -It can destroy family relationships and friendships. -Drunk driving can cause financial problems, injuries, legal problems, and fatalities. -Excessive drinkers may have vitamin deficiency syndromes that result in mental confusion and loss of muscular coordination. •Causes of AUD -Complex and the subject of considerable scientific research -Was once thought to be a manifestation of immorality and irreligiousness -Many healthcare professionals interpret alcohol abuse as a biologically based behavioral disorder or medical disease involving the alteration of genes and physiological systems. •The Stages of Alcoholism -Stage 1 •Psychological attachment to alcohol •Develops a tolerance and experiences withdrawal -Stage 2 •Tolerance and preoccupation with drinking increase •May deny that he or she is drinking excessively •May experience blackouts -Stage 3 •Characterized by loss of control over how much alcohol is consumed •May rationalized drinking behavior •May still carry out responsibilities •May blame the problem on a particular drink or usual place of drinking and switch to a different drink or drink in a new location -Stage 4 •Dependency •Drinking behavior consumes all aspects of life •May miss school or work occasionally •Health consequences may intensify •Bender may take place •Alcohol Use Disorder and the Family -Close relatives of a problem drinker may: •Try to cope by assuming responsibility for the problem •Be designated as scapegoats and blamed for the drinker's problem with alcohol •Withdraw in silence •Try to maintain their sense of humor •Deny the problem •Try to rationalize the problem •Isolate themselves -Al-Anon •Organization that helps spouses, families, and friends of alcoholics •Alateen is a similar organization that helps children of alcoholics. -Family therapy may help a family find ways to cope with the problem and regain harmony. •Children of Alcoholics -Often experience: •Neglect •Emotional deprivation •Abuse •Unstable family environment •Violence -May develop thought, emotion, and behavior patterns that impair their personal lives and relationships in adulthood -Many experience denial. •Refusal to admit a drinking problem exists -Many have a negative self-image. •Believe themselves to be the cause of their parents' erratic violent behavior •Tend to believe they are responsible for everyone else's emotions and develop codependency -Relationship pattern in which the nonaddicted family members identify with the alcoholic -May tend to try to control situations and other people because they believe that their interpersonal environment is likely at any moment to become emotionally painful, violent, or disruptive •Tend to be constantly anxious and hypervigilant •Tend to be compliant and agreeable •Try to be totally self-reliant and in control of their lives -These "survival" mechanisms limit the opportunity to grow and experience healthy relationships. •Treatment Options for AUD -Requires strong motivation -Alcoholics Anonymous (AA) •Worldwide, nonprofit, self-help organization that assists people on the road back to wellness and healthy lives •Aims for total sobriety and anonymity, and offers a step-by-step program of recovery •Emphasizes that sobriety is a state of mind, which means that becoming sober changes personal values, attitudes, and lifestyles -Problem drinkers can also receive help from individual and group psychotherapy. -Certain medications may help. •Disulfuram (Antabuse) causes uncomfortable physical and mental feelings when alcohol is ingested. •Naltrexone can help reduce the craving for alcohol. •Acamprosate reduces withdrawal symptoms.

thinking about aging

•Acceptance of change is crucial to "successful" aging. •Health and aging are lifelong processes, not goals that can be set and achieved with concentrated effort. •You can take steps at any age to improve your health now and later in life.

the effects of alcohol on behavior

•Acts as a central nervous system depressant •At moderate amounts, may affect the parts of the brain that control judgment and inhibitions •Behavior effects depend on BAC. -"Loosening-up" effects manifest at a BAC of 0.02 -Depressant effects become pronounced at a BAC of 0.10 •Even 1 or 2 drinks can impair a person's motor skills, judgment, and reaction times. -About 32% of nearly 34,000 annual highway fatalities involve people who are intoxicated. -Each year, there are more than 120 million self-reported episodes of alcohol-impaired driving in the United States. -Rates of alcohol-impaired driving are higher among males than females. •Alcohol and violence -Alcohol •Blunts self-control and other brain functions •Enables impulsive outbursts of anger and violence toward others and oneself •Can cause inattention to potentially violent social situations •Sexual Behavior -Sexual behavior changes vary from person to person and depend on the BAC. -Small amounts of alcohol may make individuals lose their sexual inhibitions. -Larger amounts of alcohol may cause: •Erectile and ejaculation difficulties in males •Inadequate vaginal lubrication and difficulty reaching orgasm in females •Alcohol can: -Irritate the organs of the gastrointestinal tract •Can cause upset or irritation, nausea, vomiting, or diarrhea -Dilate arteries and cause bloodshot eyes •Can cause a drop in blood pressure and decrease body heat •Alcohol should not be ingested simultaneously with other central nervous system depressants. •Long-Term Effects -Long-term heavy drinking can: •Affect immune, endocrine, and reproductive functions •Cause neurological problems •Contribute to various cancers •Increase the risk of: -Chronic gastritis -Hepatitis -Hypertension -Cirrhosis of the liver Coronary heart disease -Chronic alcoholic men may develop: •Breast enlargement •Female body hair patterns -Chronic alcoholic women may experience: •Menstrual disturbances •Loss of secondary sex characteristics •Infertility More gynecological problems •Fetal Alcohol Syndrome -Birth defects and mental disabilities caused by ingestion of alcohol by the mother during pregnancy -Harmful effects are believed to occur during the first few weeks of prenatal development. •Women should refrain from drinking if they are trying to become pregnant. •Health Benefits of Alcohol -Consuming about a drink per day can lower one's risk of heart disease and stroke. -Alcohol consumption may also reduce the risk of: •Blood clots •Gallstones •Type 2 diabetes -No benefit is associated with heavy drinking.

america's aging population

•Aging -Normal changes in body functions that begin after sexual maturity and continue until death •Maximum life span -Theoretical maximum number of years that individuals of a species can live -About 120 years for human beings •Average life span -Age at which half the members of a population have died •Life expectancy -Average number of years a person can expect to live -Has increased by 30 years since 1900 in the United States •Genes -Not the primary cause of aging -Account for much less than half of the difference in life span among individuals •Average life expectancy cannot be increased significantly by curing the major causes of death. -Slowing the aging process can allow most people to live almost 60 years beyond age 50. •Because of disease, accidents, and other factors, actual populations do not survive according to the idealized situation. •The dramatic increase in the average U.S. life span over the last century has led to a rapid increase in the number of older Americans. •Graying of America -Expected to strain all areas of society •The federal government must address how to sustain Social Security payments in the future. •Many older Americans require ongoing medical care, and some need expensive long-term care.

water pollution

•Agriculture, cities, and industry are enormous consumers of water. •Water is continually recycled in the environment by evaporation and rain. •As more water becomes polluted, less clean water is available for human consumption and agriculture. -Worldwide it is estimated that 1.2 billion people are without safe, unpolluted drinking water. •Drinking Water -Safe Drinking Water Act •Passed in 1974 and renewed in 1996 •Establishes federal drinking water safety standards -Arsenic •Poisonous chemical that occurs naturally in soil and water •Low doses increase the risk for cancer. •Higher doses cause skin eruptions, vomiting, diarrhea, pain, and death. •Drinking Water -Americans generally take their supply of safe, clean water for granted. •More than a billion people in the world do not have access to safe, clean water. •Water is becoming increasingly scarce worldwide. •The average American uses 100 or more gallons of water a day. •Water for drinking, agriculture, manufacturing, and other needs is going to become more difficult to obtain.

defining alternative medicine

•Alternative medicine can be divided into four broad categories -Spiritual, psychic, or mental approaches -Nutritional therapies -Therapies using herbs or other substances derived from natural sources -Physical therapies

the medicating of americans

•Americans consume huge amounts of drugs every year, both prescription and nonprescription. -4.5 billion drug prescriptions per year -$34 billion in over-the-counter drug sales -Millions use herbal extracts, teas, and vitamins to treat or cure disease. •Psychoactive drugs -Primarily alter mood, perception, and other brain functions -Include tranquilizers, sleeping pills, and mood modifiers -Examples include alcohol, tobacco, caffeine, and illegal drugs •Older persons -Tend to take the most drugs, often prescribed by different physicians at different times -Risk of drug interactions causing additional problems

understanding aging and dying

•Average life expectancy -At an all-time high in the United States •White men: 76.3 years •White women: 81.3 years •African American men: 72.2 years •African American women: 78.5 years -To attain the average or better-than-average life expectancy, it is vital to adopt healthy behaviors and lifestyles while young.

being a wise healthcare consumer

•Behaviors that help protect you from health fraud and unnecessary medical procedures: -Being well informed and knowing how to make healthy decisions. -Seeking reliable sources of information. -Being skeptical about health information appearing in the news media or in advertising. -Avoiding unlicensed practitioners. •Behaviors that help protect you: -Selecting practitioners with great care and asking questions about fees, diagnoses, treatments, and alternative treatments. -Reporting healthcare fraud to the appropriate authorities. •Three principles of being a wise consumer -Working in partnership with your healthcare provider -Sharing in healthcare decision making -Becoming skilled at obtaining health care •Partnering with your healthcare provider -Physicians are required to discuss benefits, risks, and costs of appropriate treatments and alternatives. -Manage minor health problems, and observe and record symptoms to share with your doctor. •Sharing in healthcare decision making -Let your doctor know what you want. -Do your own research. -Ask why a test or treatment is recommended. -Ask about alternatives. -Consider watchful waiting. -State your healthcare preferences. -Accept responsibility for the course of treatment. •Becoming skilled at obtaining health care -Exercise self-care and self-responsibility. -Seek health care from a primary care physician. -Reduce unnecessary medical tests. -Reduce drug use. -Use specialists only when necessary. -Use emergency services only for emergencies. -Use hospitals only when recommended by a physician.

theories of aging

•Biological Clocks Regulate Aging -Evidence comes from measuring specific metabolic rate •Amount of energy per gram of body weight consumed per day •The slower the metabolic rate, the longer the life span •Humans have the slowest metabolic rate and the longest life span. -Longevity has also been associated with the number of heartbeats. •Limited to about 1.5 billion before the heart wears out -Cells grow and divide for a fixed number of generations and then die. •Cancer cells seem to be able to grow and divide infinitely as long as fresh nutrients are provided. • •Environmental Factors Affect Aging -Exposure to radiation and chemicals: •Damage DNA in cells, leading to cell death over time •Can cause the loss of cellular repair enzymes, leading to widespread cell death -Known as error catastrophe theory •Produces free radicals that damage mitochondria in cells -Known as mitochondrial error theory -Immune system functions also become less efficient with age.

how human population growth affects us

•By 2050, the world's population is expected to increase to 9.6 billion. •Nearly all of the population increase in the next 40 years is expected to take place in underdeveloped nations. •All of the world's environmental problems stem, in one way or another, from human activities and human overpopulation.

endocrine disruptors

•Chemical substances in the environment that interfere with the actions of one or more of the body's hormones -Some mimic the effects of a hormone, while others block the action of normal hormones. •Types -Pesticides -Industrial chemicals and by-products •EPA Endocrine Disruptor Screening Program -Focuses on possible effects of environmental chemicals on estrogen, androgen, and thyroid hormones •Endocrine-disrupting chemicals have been found in high levels in many types of animals. -Evidence suggests they also occur in humans. •Pesticides must be approved by the EPA for manufacture and sale. -Registrants must generate scientific data necessary to address concerns pertaining to the identity, composition, potential adverse effects, and environmental fate of each pesticide.

pesticides

•Chemicals that kill unwanted plants and animals -Insecticides kill insects. -Fungicides kill molds and fungi. -Herbicides kill weeds. -Rodenticides kill rats and mice. •Contribute to agricultural productivity, but create health problems for people and animals -Many have been banned by the EPA. •Atrazine -Used to control weeds -Carried by runoff into lakes and streams -Causes sexual deformities and sterility in fish and amphibians -May be associated with human birth defects -Now found in significant amounts in drinking water around the country Banned in some countries •Most pesticides that accumulate in the bodies of young children come from the food they eat. -Changing to an organic diet greatly lowers the concentration of agricultural pesticides in their bodies. -Within a few days of a person switching to organic fruits, vegetables, and grains, pesticides cannot be detected in urine samples. -It seems that the effects of pesticides on people and animals are subtle.

maltreatment of children

•Child abuse -Physical or mental injury, sexual abuse or exploitation, maltreatment, or neglect of a child by a person who is responsible for the child's welfare -Over three million documented cases each year in the United States -Has short-term and long-term physical and emotional effects -Directly or indirectly affects everyone •Shaken-baby syndrome (SBS) -Form of child abuse in which an infant is violently shaken by an adult -Affects as many as 1,400 infants each year -Can be identified by physicians and trained personnel by a collection of symptoms that result from violent shaking -Any kind of shaking of an infant is a crime. •Physical abuse -Intentional force of any kind that results in injury •Emotional abuse -Psychological abuse can cause severe emotional distress and can produce illness and violent behavior. •Sexual abuse -Sexual contact between adults and children is forbidden by cultural taboos and criminal law. •Neglect -Includes failure to provide a child with: •Adequate nourishment •Proper clothing •Prescribed medications •Oversight of proper hygiene -Most common form of maltreatment of children -Many neglected children engage in self-destructive behaviors. •Social Aspects of Child Maltreatment -Men tend to abuse children more than women do. -Boys are abused more frequently than girls are. -Boys tend to blame themselves for the abuse more than girls. -Two-thirds of all abused children are between the ages of 5 and 17 years. -Children who have a physical or mental disability are more likely to be abused. •Social Aspects of Child Maltreatment -Men tend to abuse children more than women do. -Boys are abused more frequently than girls are. -Boys tend to blame themselves for the abuse more than girls. -Two-thirds of all abused children are between the ages of 5 and 17 years. -Children who have a physical or mental disability are more likely to be abused. •Social Aspects of Child Maltreatment -Mothers who have a low level of education tend to express more abusive behavior toward children than mothers with a high education level do. -If the family lives in an unsafe neighborhood, family members may feel afraid to venture out to seek help for their problems. •Social Aspects of Child Maltreatment -Other reasons for child abuse •Social isolation •Lack of friends •Dangerous neighborhoods •Lack of access to transportation •Child Maltreatment Prevention -Stress management programs are particularly important in communities where unemployment rates are high. -Conflict resolution and anger mediation programs can also help prevent child abuse. -Training in life and social skills for all individuals involved with child abuse is recommended.

nicotine delivery systems

•Cigars -Compared with nonsmokers, cigar smokers face 3 times the risk of dying of lung cancer if they do not inhale, and 11 times the risk if they do inhale. -Cigar smokers have a greater risk of death from cancer of the lip, tongue, mouth, throat, esophagus, larynx, pancreas, and bladder. -Cigars give off greater amount of secondhand smoke than cigarettes. •Hookahs -Water pipes used to smoke flavored tobacco -Also known as narhile, argileh, shisha, hubble-bubble, and goza -Generally part of a group activity -Hookah smokers inhale: •Large amounts of nicotine •Many of the same chemicals found in cigarette smoke •Tar, metal, and various other chemicals -The volume of smoke inhaled during a typical hookah session is about 90,000 milliliters, compared with 500 to 600 milliliters inhaled when smoking a cigarette. -Hookahs also produce secondhand smoke. -Hookah smoking can lead to nicotine addiction and the negative health effects of nicotine consumption. •Bidis and Kreteks -Bidis •Small, thin, hand-rolled cigarettes imported to the United States, primarily from India and other Southeast Asian countries •Comprise tobacco wrapped in a tendu or temburni leaf and may be secured with a colorful string •Can be flavored or unflavored -Kreteks (clove cigarettes) •Imported from Indonesia •Typically contain a mixture of tobacco, cloves, and other additives -Bidis and kreteks are not harmless. •Bidi smoke contains 3 to 5 times the amount of nicotine as a regular cigarette. •Kretek smoking increases the risk of lung damage that can lead to abnormal lung function. •E-Cigarettes -Deliver nicotine to the body, along with flavorings and chemicals, via an inhaled vapor -Effect of the vapor on the lungs is unknown -Do not deliver the hazardous chemicals released in burning tobacco, but still contain nicotine -No conclusive scientific evidence that they promote successful long-term smoking cessation -As long as manufacturers do not claim that e-cigarettes have any therapeutic value, they are unregulated by the FDA. -Many states have no restrictions on sale to minors. -Concerns about increasing use among adolescents •Potential to become addicted to nicotine and eventually become tobacco smokers •Potential to cause acute nicotine toxicity •Long-term effects of nicotine exposure •Smokeless Tobacco -Chewing tobacco •Shredded smokeless tobacco that is chewed or placed in the mouth between the lower lip and gum •Processed into three forms -Loose leaf -Firm/moist plug -Twist/rope -Snuff •Made from powdered or finely cut leaves •Available in dry and most forms •Can be: -Inhaled through the nose—method in many European countries -Placed in the mouth and held in place between the cheek and gum (snuff dipping)—more popular in the United States •Dipping snuff is highly addictive. •Moist snuff is the most hazardous form of smokeless tobacco because of the methods used in processing it. -Creates dependence on nicotine -Leads to cancer of the mouth, lip, and gum -Causes other diseases of the mouth, including leukoplakia and gingivitis Also associated with tooth decay, receding gums, halitosis, and loss of taste and sme -Social consequences •Yellow and brown stains on teeth, clothing, and automobile •Tobacco clinging to teeth, lips, tongue, and clothing •Disgusting others by spitting tobacco juice -Comprehensive Smokeless Tobacco Health Education Act •Banned all smokeless tobacco ads on TV and radio •Mandated the inclusion of health warnings on packages

land pollution

•Communities are beginning to run out of space to dump what they want to get rid of. -The average American generates more than twice as much garbage as citizens of other industrialized countries. •Many abandoned solid waste disposal sites are dangerous to health because they contain hazardous materials. •Superfund Act -Passed in 1980, it provides for the cleanup of the most dangerous waste sites. •394 sites have been cleaned up, but 1,342 sites remain. •Many items can be recycled with a little effort. •Think of the environment when you consume and when you discard.

how alcohol affects the body

•Composition of Alcoholic Beverages -Contain ethyl alcohol (ethanol) -Label lists alcoholic content •Usually as the percentage of total volume -Hard liquors list alcohol content in terms of proof. •Represents twice the percentage of alcohol in the product Most standard portions of alcoholic drinks contain about the same amount of alcohol •How Alcohol is Absorbed, Excreted, and Metabolized -Absorbed into gastrointestinal tract and carried through the bloodstream to all tissues and organs -Contains 7 calories per gram •Almost twice as many calories per gram as sugar •Regular serving of beer, wine, or a mixed drink contains100-150 calories •How Alcohol is Absorbed, Excreted, and Metabolized -Factors that slow the absorption of alcohol: •Food in the stomach •Nonalcoholic substances in alcoholic beverages -Factors that increase the absorption of alcohol: •Presence of carbon dioxide in beverages •Higher alcohol content •How Alcohol is Absorbed, Excreted, and Metabolized -Blood alcohol content (BAC) •Concentration of alcohol in the blood •To calculate BAS, assume that one standard drink per hour, which has about 0.5 ounces of ethyl alcohol, produces a BAC of 0.02 in a 150-pound male. •How Alcohol is Absorbed, Excreted, and Metabolized -Women tend to have a higher BAC than men who have had the same amount to drink because: •They generally weigh less. •They have proportionately more body fat. •Their sex hormones increase the rate of absorption and decrease its elimination. •They tend to absorb more alcohol from the stomach. •How Alcohol is Absorbed, Excreted, and Metabolized -Elimination •10% is excreted through sweat, urine, or breath. •90% is broken down (metabolized) primarily by the liver at a rate of about one-half ounce per hour. -Ultimately winds up as carbon dioxide and water •Sobering-up remedies do not accelerate the rate at which the liver removes alcohol from the body. •The Hangover -Unpleasant physical sensations resulting from excessive alcohol consumption -Possible reasons for hangovers include: •Liver functions slowing down to metabolize alcohol •Alcohol inhibiting REM sleep •Congeners, chemicals in alcoholic beverages •Acetaldehyde, a toxic substance produced when the liver breaks down alcohol -Best way to deal with a hangover is to: •Sleep •Drink juice to replace lost body fluid and blood sugar •Take an analgesic (for a headache) -Ingesting more alcohol will only prolong the hangover symptoms.

osteoporosis

•Condition in older people, particularly women, in which bones lose density and become porous and brittle •Contributing environmental factors: -Poor diet -Smoking -Corticosteroid use -Excess alcohol consumption -Lack of exercise •Loss of bone material -Osteoporosis occurs because the rate of bone breakdown exceeds the rate of bone renewal. -Estrogen loss in older women contributes to loss of bone material. -Aging results in bone loss and increases the risk of fracture in both older women and men. •Hormone replacement therapy (HRT) -Administration of estrogen to menopausal and postmenopausal women to help prevent symptoms of menopause, osteoporosis, and heart disease -Slightly increases the risks of heart attack, stroke, and breast cancer -Very low doses of estrogen may help prevent osteoporosis while avoiding the risks of standard HRT. •Prevention -Best way to avoid osteoporosis is to build up as much bone mass as possible while young through: •Maintaining a healthy diet •Getting sufficient calcium and vitamin D •Exercise -Milk contains large amounts of calcium and is fortified with vitamin D to facilitate calcium absorption. •Treatment -Two approaches •Slowing the breakdown of bone -Bisphosphonates •Accelerating the synthesis of new bone -Fragment of the parathyroid hormone -Both can be treated with drugs, but only one or the other is effective, not both.

hospital emergency room (ER)

•Contact emergency services (call 911) if you or someone with you thinks you are experiencing a medical emergency. •If transport to a hospital ER is required, that facility is bound by law to: -Accept the patient -Diagnose the problem -Initiate treatment if required, regardless of the patient's ability to pay

end-of-life decisions

•Death is the greatest of human fears. -Can lead to anxiety and stress that may hasten the aging process -Fears associated with aging •Cancer •Poverty •Being victimized •Being disabled •Memory loss •Sexual inadequacy •Stages of Dying -Not all people experience all of the following stages, but most experience some: •Denial and isolation •Anger •Bargaining •Depression •Acceptance •Advance Directives -Legal documents that express your desires regarding treatments should you be unable to communicate -Living will •Expresses your wishes regarding treatment -Healthcare power of attorney •Designates someone to make healthcare decisions •Medical Aid in Dying -Physician assistance in helping a patient who no longer desires to live because of pain or an incurable illness to die -Terminally ill patient must: •Be mentally competent •Express a desire to die on a number of occasions -Second physician must be consulted •Medical Aid in Dying -Both physicians must agree that the patient: •Is mentally competent (not clinically depressed) •Has an incurable, painful disease -One physician supplies the patient with the drugs for ending life. -Permitted in only a few states •Most states have laws explicitly criminalizing any form of assisted suicide •Medical Aid in Dying -Two national healthcare organizations have proposed that every physician attending to a dying patient should make the following six promises: •You will have the best of medical treatment. •Your care will be continuous, comprehensive, and coordinated. You and your family will be prepared for everything that is likely to happen in the course of your illness •Medical Aid in Dying -Physician promises to dying patients (continued): •Your wishes will be sought and respected, and they will be followed whenever possible. •We will help you consider your personal and financial resources and we will respect your choices about their use. •We will do all we can to see that you and your family will have the opportunity to make the best of every day. •Palliative Care -World Health Organization (WHO) definition •Affirms life and regards dying as a normal process •Neither hastens nor postpones death •Provides relief from pain and other distressing symptoms •Integrates the psychological and spiritual aspects of patient care •Offers a support system to help patients live as actively as possible until death •Offers a support system to help families cope with the patient's illness and death •Palliative Care -Emphasis of treatment shifts from prolonging life to: •Enhancing the quality of life that remains •Preserving a person's dignity •Relieving suffering -Now seen as a reimbursable form of therapy by many health insurance programs The Hospice -Place for terminally ill patients to spend the time before death in an environment that: •Attends to their physical, emotional, and spiritual needs •Does not administer any further treatments -Can be given in a patient's home -Philosophy is that dying is part of living and should not be resisted with every weapon in the modern medical arsenal •The Hospice -Offers counseling and social services -Encourages close family members to participate in daily activities -Medicare Hospice Benefit Act •Passed in 1982 •Ensures that Medicare will pay hospice costs for any terminally ill patient whose projected life expectancy is 6 months or less

what is a drug?

•Drug -Single chemical substance that alters the structure or function of the body's biological processes •Medicine -Drug or combination of drugs intended to: •Prevent illness (vaccine) •Cure diseases (antibiotics) •Aid healing (heartburn medications) •Suppress symptoms (pain relievers) •Drugs are usually classified according to the particular biological process they affect rather than by their chemical properties. -All substances that increase urine production are called diuretics. -All those that reduce pain are called analgesics. -Those that produce nervous system excitation are called stimulants. •Drug Laws -Categories of drugs •Prescription drugs •Nonprescription or over-the-counter drugs •Dietary supplements •Tobacco and alcohol •Illegal or illicit drugs -Regardless of its legal category, no drug is entirely safe. •How Drugs Work -Receptor •Protein on the surface or inside of a cell to which a drug or natural substance can bind and thereby affect cell function. •Similar to a key (drug) fitting into a lock (receptor) -Many drugs chemically resemble natural body components. •Bind to the receptor in place of the natural substance and thereby alter physiology •Pharmacogenetics -Tailoring drugs to a particular individual to match his or her biology -Genetic variations determine: •How the body responds to a certain drug •How it is eliminated from the body -Goal is to someday be able to tailor drugs to a person's specific biology to produce optimum benefit with minimum risk •Unintended Harmful Effects of Medicines -Side effects •Unintended and often harmful actions of a medication •Occur when a drug binds to a variety of receptors in or on different cells •Can be minor or severe •Common side effects -Allergic reactions -Harm to developing embryos -Physical dependence •Unintended Harmful Effects of Medicines -Contraindication •Any medical reason for not taking a particular medication -Adverse drug reactions (ADRs) •Unintended, unpleasant, and/or harmful reactions to a medicinal product •Incidence is 5-10% of patients •Unintended Harmful Effects of Medicines -Rebound effect •Reemergence of symptoms for which a drug is administered after the drug is suddenly stopped or the dose lessened •Symptoms are often more severe than the original symptoms. •Tapering reduction of the drug may allow the body to adjust to lower doses. •Unintended Harmful Effects of Medicines -Consumers of medications should: •Remember that all drugs and medicines have the potential for harm •Learn as much as they can about the intended use and side effects of their drugs •Ask their medical providers to explain the rationale for the medications prescribed •Effectiveness of Drugs -Effectiveness of a dose of a drug is influenced by: •Person's body size •How rapidly the drug breaks down and is eliminated •The presence of other drugs or food in the body •Person's mental state •Person's expectations of the drug's efficacy -Most drugs have a narrow range of effectiveness. -Many drugs are toxic when taken in excess. •Effectiveness of Drugs -Double-blind placebo controlled study •Drug study in which neither the person receiving the drug nor the person administering the drug knows whether patients receive a placebo or the drug •Placebos are often almost as effective as the drugs.

drug misuse, abuse and addiction

•Drug abuse -Persistent or excessive use of a drug without medical or health reasons -Characteristics •Failure to fulfill major obligations •Recurrent substance use in situations in which it is physically hazardous •Recurrent substance-related legal problems •Continued use despite persistent problems caused or exacerbated by the effects of the substance •Drug abuse -Refers to whether the person taking the drug is personally or socially impaired -Most commonly abused drugs are psychoactive substances that change consciousness. •Particularly dangerous because the cognitive, emotional, and behavioral processes that the drugs alter are required for harmonious adaptation to one's environment. •Addiction -Physical and psychological dependence on a drug, substance, or behavior -Characterized by: •Compulsion •Loss of control •Continued drug use despite adverse consequences Distortions in normal thinking •Addiction -Many people who are addicted to drugs have coexisting mental health issues such as: •Depression •Bipolar disorder •Panic disorder •Generalized anxiety disorder •Antisocial and dependent personality -Addiction is chronic and progressive. •It tends to get worse over time. •Physical Dependence -Physiological state that depends on the continuous presence of a legal or illegal drug -Absence of the drug may cause: •Discomfort •Nervousness •Headaches •Sweating •Sometimes death •Tolerance -Condition in which increased amounts of a drug or increased exposure to an addictive behavior is required to produce desired effects •Withdrawal -Consequence of physical dependence that occurs when the body adapts to the absence of a drug on which it has become physically dependent -Also known as abstinence syndrome •Withdrawal symptoms -Uncomfortable and sometimes dangerous reactions that occur after a person stops taking a physically addicting drug -Withdrawal from depressants causes hyperexcitedness, anxiousness, irritability, and susceptibility to seizures. -Withdrawal from stimulants causes sleepiness, depression, and loss of consciousness. •Psychological Dependence -Dependence that results because a drug produces pleasant mental effects -Also known as habituation -Causes compulsive drug-seeking behavior -Common with physically addicting drugs such as heroin, alcohol, and nicotine

Phencyclidine (PCP)

•Drug that, depending on the route of administration and dose, can be a stimulant, depressant, or hallucinogen •Originally developed as an animal anesthetic •Also known as angel dust, hog, crystal, and killer weed •Intended effects -Heightened sensitivity to external stimuli -Mood elevation -Relaxation -Sense of omnipotence •Unintended effects -Paranoia -Confusion and disorientation -Restlessness -Feelings of depersonalization -Violent or bizarre behavior •Can cause coma, interruption of breathing, and psychosis in high doses •Does not induce tolerance or physical dependence •Eliminated slowly from the body -Chronic users may experience effects for an extended period of time. •Effects are unpredictable and frequently unpleasant.

depressants

•Effects -Reduced level of arousal, motor activity, and awareness of the environment -Increased drowsiness and sedation •Types -Alcohol -Drugs that affect sleep Sedatives, hypnotics, and opiates •Low doses -Create mild state of euphoria -Reduce inhibitions -Induce feelings of relaxation •High doses -May impair mood, speech, and motor coordination •Carry the potential for: -Physical and psychological dependence -Tolerance -Withdrawal symptoms -Toxicity from continual use or overuse •Synergistic effect -Two or more taken together can produce a much stronger effect than the sum of both drugs. •Sedative and Hypnotic Drugs -Sedative •Central nervous system depressant used to relieve anxiety, fear, and apprehension -Hypnotic •Central nervous system depressant used to relieve anxiety, fear, and apprehension -Both are highly regulated and are available only by prescription. -Tranquilizers (benzodiazepines) •Used medically to: -Relieve anxiety -Promote relaxation and induce sleep -Alleviate muscle spasm and lower back pain -Treat convulsive disorders -Lessen the discomfort of alcohol and opiate withdrawal •Long-term use increases the risk of dependence and reduces the likelihood of overcoming the original issue for which they were prescribed. -Barbiturates •Sedative-hypnotic drugs that include: -Amobarbital (Amytal) -Pentobarbital (Nembutal) -Phenobarbital (Luminal) -Secobarbital (Seconal) -Tuinal (50% amobarbital plus 50% secobarbital) •Tend not to be prescribed for medical conditions that call for sedative-hypnotic drug therapy •Opiates -Central nervous system depressants derived from the opium poppy -Include morphine, codeine, Demerol, Duragesic, Oxycontin, Percodan, and Vicodin -Cause physical dependence, habituation, and tolerance Produce serious withdrawal symptoms -Used medially for pain relief, cough suppression, and treatment of diarrhea -Can be taken by mouth, injection, snorting, and smoking -Morphine •Evenly excreted in urine, saliva, sweat, and breast milk •Crosses the placenta and may cause a developing fetus to become addicted -Regular use can produce: •Tolerance to psychological effects •Constipation •Loss of appetite •Depression •Loss of interest in sex •Constriction of the pupil •Disruption of the menstrual cycle •Drowsiness

electromagnetic and microwave radiation

•Electromagnetic fields (EMFs) -Form of radiation produced by electrical power lines and appliances -May increase the risk of cancers such as childhood leukemia and brain tumors -We are all exposed to EMFs every day. •People who live near high-voltage transmission lines may have significant exposure. -Evidence about its effects is conflicting. •Cellular Phones -Any possible health consequences from long-term cell phone use are as yet unknown. -People should use a headset to keep the phone away from the head. -For now, it is considered a small danger compared to the risks of chemical pollutants in air, soil, water, and food.

the FDA and you

•FDA drug approval process -Step 1: Someone discovers or invents a chemical that, in laboratory animals, shows promise as a medicine. -Step 2: Based on laboratory studies, a drug company decides that a chemical has promise as a human medicine and applies for FDA approval to conduct tests on people. -Trial phases •Phase 1 trial: The test drug is given to 50-100 healthy volunteers to determine its safety. •Phase 2 trial: The test drug is given to several hundred people with the disease or condition to test its effectiveness. •Phase 3 trial: The test drug is given to as many as 3,000-5,000 people with the disease or condition to determine the drug's overall efficacy. •FDA drug approval process -Step 3: If the test drug passes all three trials, the pharmaceutical company can apply for approval to manufacture and market the drug. -Step 4: After a drug is approved and made available to consumers, its safety and efficacy are monitored.

choosing a healthcare provider

•First decide what kind of healthcare provider you need for your particular problem. -Western medicine is based on scientific principles. -Traditional medicine is based on observation and theories of the universe and of human biology that differ from modern science. •People choose healthcare providers for many different reasons. •Healthcare Providers -Physicians are the primary source of medical advice and care. -Other healthcare providers: •Physicians assistants (PAs) •Nurses •Emergency medical technicians (EMTs) •Physical and occupational therapists (PTs and OTs) •Physicians Assistants (PAs) -Trained in many aspects of patient care -Work independently and with the supervision of physicians -Can spend more time with a patient -Usually can answer most of a patient's questions regarding medications or operations •Nurses -Registered nurses (RNs) •Trained to promote health, advise patients on how to prevent disease, and assist in the care of patients •May specialize in such areas as surgical, cancer, maternity, or emergency room care -Nurse practitioners •RNs with additional training and skills that enable them to provide many primary care services •Emergency Medical Technicians (EMTs) -Deliver emergency medical care at homes and accident sites -Work in hospitals and with police and fire departments -Paramedics •Have more advanced training that enables them to perform a variety of emergency procedures for sick or injured people •Physical and Occupational Therapists (PTs and OTs) -PTs are trained to restore function, improve mobility, and relieve pain of patients suffering from injury or disease. -OTs help people in the workplace perform their daily tasks even if they have a disability or injury -These two often work closely together to help workers recover from illness or injury. •Sports Medicine -Involves the coordinated efforts of many different kinds of healthcare providers and specialists -Specialties include: •Cardiology •Orthopedic surgery •Biomechanics •Traumatology •Nutrition, drug, and psychological counselors •Sports Medicine -If you experience any of the following symptoms after a sports injury, you may need to consult a sports medicine specialist. •Comparative weakness •Muscle cramps •Numbness •Reduced range of motion •Sprains

outdoor air pollution

•Fresh clean air consists of about 21% oxygen, 78% nitrogen, and trace amounts of seven other gases. •If oxygen content drops below 16%, body and brain functions are affected. •Smog -Air polluted by chemicals, smoke, particles, and dust -Can cause breathing problems, coughs, bronchitis, asthma, and even death -Photochemical smog •Consists of ground-level ozone, carbon monoxide, sulfur dioxide, nitrogen oxides, particulates, and volatile organic compounds -Ground-Level Ozone (O3) •Consists of three atoms of oxygen •Not emitted directly into the air from polluting vehicles or industry •Formed when sunlight acts on two other pollutants (volatile organic compounds and oxides of nitrogen) •Can damage lung tissue, reduce lung function, and sensitize the lungs to other irritants -Carbon Monoxide (CO) •Colorless, odorless, poisonous gas produced by incomplete burning of carbon-containing fuels •Primary source is motor vehicle exhaust •At high levels, causes impairment of visual perception, manual dexterity, learning ability, and performance of complex tasks •At 80 parts per million (ppm), reduces the body's oxygen supply by 15% -Sulfur Dioxide (SO2) •Produced when gasoline, diesel fuel, coal, or oil, all of which contain sulfur, are burned in cars, trucks, power plants, and industrial and home heating systems •Makes breathing difficult and aggravates existing respiratory and cardiovascular diseases •Can combine with water to form acid rain -Nitrogen Oxides (NO and NO2) •Come from transportation, electric power plants, and industrial boilers •Can irritate the lungs, opening the way for bronchitis, pneumonia, and other respiratory infections •Contribute to ground-level ozone and acid rain •May alter terrestrial and aquatic ecosystems -Particulate Matter (PM) •Microscopic particles that arise principally from the burning of diesel fuel and coal •Causes haze associated with photochemical smog and damages soil and structures •Damages the respiratory system, impairs breathing, and aggravates existing respiratory and cardiovascular diseases •Causes over 3 million premature deaths every year -Particulate Matter (continued) •EPA monitors two sizes -2.5 micrometers (PM 2.5) -10 micrometers (PM 10) •Size of particulates is directly related to their potential for causing health problems •Those under 10 micrometers pose the greatest problems because they can get deep into the lungs, and a percentage of those enter the bloodstream and travel to other parts of the body. -Volatile Organic Compounds (VOCs) •Chemical substances that exist in the air as gases •50% from industrial and commercial processes such as oil refining, printing, painting, and dry cleaning •40% from motor vehicle exhaust •5% from power generation Some are harmful to human health. -Volatile Organic Compounds (continued) •VOCs cause: -Eye, nose, and throat irritation -Headaches -Loss of coordination -Nausea -Damage to liver, kidney and central nervous system •Some are suspected to or known to cause cancer. -Children and Air Pollution •Children who live in regions of high air pollution, such as Los Angeles and Mexico, suffer a 10% to 15% decline in lung function. •Early exposure increases the risk of respiratory disease in adult life. •Children are much more likely than adults to develop pollution-related lung damage.

how long can human beings live?

•Gerontology -Science that studies the causes and mechanisms of aging Many gerontologists believe that populations in many countries are approaching the current maximum average life span of 85 to 90 years •In the United States, there are significant differences in life expectancy between the sexes and races due to: -Biology -Socioeconomic factors -Education -Access to health care •Studies suggest that socioeconomic factors are the strongest predictor.

responsible drinking

•Guidelines -Make sure alcohol does not harm or destroy your social interactions. -Drink slowly and avoid mixing alcohol with drugs. -Be sure that using alcohol does not make either you or others feel disgusted with your actions. -When you plan to drink, designate someone who will not drink to be the driver.

age-related hearing loss

•Hearing loss with advancing age as cells of the inner ear die or become less functional •Some may be caused by exposure to loud noise earlier in life -Known as noise-induced hearing loss -Protecting your hearing while young is essential to preserving as much hearing as possible when you become old.

age-related vision loss

•Loss of vision as a result of death of cells in a region of the eye called the macula -Contains specialized cells that give the eye the capacity to see fine detail •Progresses slowly over several years •Affects 2% of people between 65 and 74 years old and14% of people over age 75 Estimated to increase markedly by 2020 •Two forms of macular degeneration -Age-related dry macular degeneration •Most common •No approved treatments •Progression can be slowed by antioxidant supplements -Age-related wet macular degeneration •Caused by proliferation of blood vessels in the macula •Most serious form because vision loss is rapid •Can be treated with laser surgery and the drug ranibizumab (Lucentis)

choosing an alternative medicine

•Many people are satisfied with the medical care they receive, but some wish to explore alternative medicines to complement conventional treatments. •It is often wise to begin with the least invasive form of treatment before undergoing surgery or taking drugs.

why people smoke

•Many smokers begin their habit in their teen years to: -Emulate friends, parents, or celebrities -Attain acceptance in their peer group •Despite the adverse effects and known risks, some people continue to smoke because of an unusually high susceptibility to nicotine addiction. •Other factors that contribute to the development and maintenance of regular smoking: -Stimulation -Handling -Pleasurable relaxation -Reducing negative feelings (crutch) -Craving Habit

physiological effects of tobacco

•Most are attributable to the pharmacological effects of nicotine. •The most prominent effects include: -Increased heart rate -Increased release of adrenaline -Direct stimulatory effect on the brain -Lower skin temperature Reduced blood flow in the legs and feet

healthy aging depends on a healthy lifestyle

•Most of the disability and long-term medical care in elderly persons results from major chronic diseases already present in midlife. •Significant predictors of a healthy old age -Low blood pressure and low serum glucose levels -Not being obese -Not smoking cigarettes while young •People who live to the oldest ages without disabilities are those who: -Have practiced good nutrition -Were physically and mentally active -Did not use tobacco or drink alcohol excessively •Every age of life provides opportunities for growth and satisfaction. -The way we choose to live when we are young will greatly affect our health later.

parkinson's disease

•Neurodegenerative disease in which brain functions that control movements of the body are gradually lost •Defining symptoms -Tremor -Rigidity -Bradykinesia -Postural instability •Treatment -Most effective drug is L-dopa •Delays the onset of symptoms -Carbidopa (Lodosyn) •Reduces the dose of L-dopa needed and increases its effectiveness -Effectiveness of L-dopa therapy diminishes as the disease progresses •Causes -Genetic factors •Several genes are linked to rare, familial forms of PD. •Other genes impact the development of sporadic PD. -Environmental factors •Exposure to pesticides and other chemicals •Cognitive Impairment and the Right to Vote -Individuals with cognitive impairment may no longer be competent to make informed choices. •Family members or caregivers may fill out ballots based on their own choices and ask the person to sign, or may forge their signature. •Close elections can be decided by relatively few votes. •To protect the legitimacy of elections, it may be necessary to no longer allow those with neurodegenerative diseases the right to vote

firearm violence

•Nonmilitary violence committed with the use of a gun with or without criminal intent •Criminal gun violence -Intentional homicide (except if ruled justifiable) -Assault with a deadly weapon •Noncriminal gun violence -Accidental or unintentional injury or death •In response to mass killings in recent years, many people: -Believe that gun violence is a very big problem in the United States -Support strengthening gun control laws -Agree that a major cause of gun violence is the ease with which people can obtain guns •Hate Crimes -Any unlawful act committed against a person, group, or place that is motivated by hate or bias -Additional penalties are added if a person is convicted of a hate crime -Differs from freedom of speech •Biased views and verbal attacks cannot be prosecuted as hate crimes. Worldwide phenomenon •Bullying -Unwanted, aggressive behavior among school-aged children that involves a real or perceived power imbalance -Includes: •Making threats •Spreading rumors •Attacking someone physically or verbally Excluding someone from a group on purpose •Bullying -Illegal types include harassment, hazing, and assault. -Many students subjected to bullying suffer from mental and physical problems and may be forced to leave school. -Many school districts have instituted "no bullying" policies at school and on school buses. •Most occurs outside of the school's jurisdiction. •Bullying -Cyberbullying •Bullying on the Internet •Can produce enormous stress and emotional harm •Some instances have led students to commit suicide.

reducing drug use

•People are overmedicated and overly dependent on drugs. •The healthiest approach is to be as free of drugs as possible. •Wellness is not achieved by taking drugs. •All drugs can be dangerous, and illegal recreational drugs are especially dangerous.

drug company advertising

•Pharmaceutical industry -Largest sale of profits come from sale of prescription medications -Invest considerable resources in: •Educating and persuading physicians to prescribe their products •Direct-to-consumer advertising to encourage consumers to request their products •Direct-to-consumer advertising (DTCA) -Designed to encourage consumers to demand advertised drugs from their doctors in the belief that the drugs they see advertised are superior even when other equally effective, and sometimes less expensive, medications are available -Generally overstates or overemphasizes the benefits of a drug

elder abuse

•Physical, sexual, or emotional maltreatment or financial exploitation of an adult aged 60 or older •May be by a spouse, child, relative, friend, or professional caregiver •More than 1 million victims each year in the United States •Common methods -Screaming and yelling -Physical restraint -Forced feeding or medicating -Blows and slaps -Threats to send the person to a nursing home •A disabled or immobilized elder person may try to control caregivers by using abusive methods such as: -Screaming and yelling -Pouting and withdrawing -Refusing food and medication -Crying or becoming emotional -Throwing objects -Threatening to call the police •Often remains hidden or undocumented because the victim may: -Be concerned about the family's privacy and fear public exposure and embarrassment -Feel shame at having raised a child who has now become abusive -Fear that the child will be arrested and sent to jail -Feel that the abusive situation is preferable to being sent to a nursing home

toxic plastics

•Plastics are derived from petroleum. -One or more individual components of some plastics can be harmful to health. •Leaching -Occurs when plastic degrades and releases toxic chemical components into the environment -Can occur when a plastic is heated, is exposed to microwave radiation, or comes into contact with liquids, fats, oils, and detergents •Phthalates -Chemicals used in the manufacture of various plastics -Significant levels in nearly 100% of humans -Effects •May cause abnormal genital development in males and premature breast development in girls •Increases the risk of allergy and asthma •Impacts brain development •Bisphenol-A (BPA) -Used to manufacture polycarbonate plastics -Linked to miscarriages, birth defects, and abnormal brain development in fetuses -Leach out as plastics age, are heated, or are exposed to strong detergents -Significant amounts found in 92% of Americans -Should be avoided by pregnant women and nursing mothers •Monitoring Environmental Chemicals -The CDC has been measuring the chemical load in a cross section of Americans every 2 years since the late 1990s. -Biomonitoring •Measurement of environmental chemicals present in the body that may harm health -The most recent reports indicate lead and cotinine have declined significantly, but organophosphate pesticides and phthalates are increasing.

club drugs

•Psychoactive chemicals used at parties, dances, festivals, and raves to enhance social experiences and increase sensory stimulation •Examples -Ecstasy -GHB -Ketamine Rohypnol •Characteristics -Give a sense of emotional closeness and euphoria -Carry little or no risk for addiction -Ingested orally -Can be especially dangerous when taken with alcohol or other drugs •Ecstasy -Club drug with both stimulant and pleasurable effects -Also called "Adam," "XTC," "Clarity," "Essence," and MDMA -Most often taken orally in tablet form •Also available as a powder that may be snorted or smoked Rarely injected -Effects •Increases levels of the neurotransmitter serotonin in the brain •Produces a high that lasts from several minutes to an hour •Stimulant effects include enhanced sense of pleasure and self-confidence and increased energy •Psychedelic effects include feelings of peacefulness, acceptance, and empathy -Risks •Confusion, depression, sleep problems, drug craving, and severe anxiety and paranoia •Muscle tension, involuntary teeth clenching, nausea, blurred vision, rapid eye movement, faintness, and chills or sweating •Increases heart rate and blood pressure •Long-term damage to serotonin-producing nerve cells Liver damage with long-term use. •GHB (Gamma-hydroxybutyrate) -Street names include "Georgia home boy," "liquid ecstasy," and "grievous bodily harm." -Ingested as a white powder or clear, bitter tasting liquid (often mixed with alcohol) -Effects begin about 30 minutes after ingestion and can last several hours. -Low doses •Produces light sedation, increased sexual interest, relaxation, and short-term amnesia •Many users experience unconsciousness, vomiting, and profuse sweating. -Moderate doses •Causes lethargy -Large doses •Users can become comatose and stop breathing. •Ketamine -Anesthetic used as a club drug -Also called "K," "special K," "vitamin K," and "black hole" -Generally ingested orally as a white powder or intranasally with an inhaler •Can also be injected -Effects begin after about 30 minutes, and can last up to 3 hours. -Causes an out-of-body dissociative state and hallucinations at very low doses -Produces muscular rigidity, bizarre behavior, psychosis, and social withdrawal at high doses •Rohypnol -Powerful tranquilizer -Reduces anxiety, inhibition, and muscular tension -Can cause unconsciousness at higher doses -Effects dangerously compounded when taken with alcohol or other sedating drugs -Can cause dependence and withdrawal symptoms with chronic use

marijuana

•Psychoactive substance present in the dried leaves, stems, flowers, and seeds of plants of the genus Cannabis •Effects -Euphoria, sense of relaxation, and mood elevation -Altered perceptions of time and space -Heightened sensory awareness -Increased hunger -Dry mouth •Can be smoked or ingested as food prepared with it as an ingredient •Types -Hashish -Ganja -Bhang (ditch weed) -Sinsemilla •May evoke: -Confusion -Anxiety -Panic -Hallucinations -Paranoia •Can also impair speech, perception, motor coordination, and reaction time •Health dangers of long-term use -Risk of bronchitis -Increased heart rate and blood pressure -Slight depression of the immune system •Heavy, extended use is associated with: -Impaired short-term memory and attention -Loss of internal control -Reduced learning

hallucinogens

•Psychoactive substances that alter sensory processing in the brain, producing visual or auditory sensations that are not real •Typically cause enjoyable visual hallucinations •Most often ingested orally •Takes effect in 45 to 60 minutes and can last from 1 to 24 hours •First effects are physical -Sweating, nausea, increased body temperature, and pupil dilation •Psychological effects manifest in 1-2 hours. •LSD (acid) -Powerful hallucinogen -Alters brain chemistry and produces a variety of hallucinogenic and behavioral effects

rape and sexual assault

•Rape -Nonconsensual sexual behavior, generally penile penetration of a bodily orifice •Sexual assault -Combination of nonconsensual sexual penetration (rape) and nonsexual violence, such as battery, the threat of harm, or homicide -Not for sexual gratification, but to control, harm, humiliate, and dehumanize the victim •Penetration -Generally means by penis, but may also include objects or other body parts •Nonconsensual -Victim is incapable of giving legal consent due to: •Mental development •Physical disability •Being intoxicated •Being unconscious •Types of rape -Date or acquaintance rape -Marital rape -Stranger-rape -Gang-rape -Statutory rape •Approximately 300,000 adult American women and 90,000 adult American men report being raped each year. -These data are thought to represent only 40% of actual rape incidents because rape is largely an underreported crime. •It is theorized that gender role attitudes and expectations facilitate the occurrence of many rapes. •Motivation for rape -Anger-motivated assaults •About 20% of rapes •Generally motivated by an intense hatred of women •Tend to be committed by a strange -Power-motivated assaults •About 80% of rapes •Tend to be committed by someone the victim knows who wants to control the victim •Facts about sexual violence -Sexual violence is not motivated by sexual attraction, passion, or sexual deprivation. -Most incidents of sexual violence are not reported to friends, family, or the authorities. -Most incidents occur in the victim's immediate environment and are premeditated and planned. •Facts about sexual violence -The victim often knows the perpetrator. -Sexual violence is perpetrated by people from all backgrounds. -Victims do not secretly want to be sexually violated. •Acquaintance Rape -Sexual assault occurring when the victim and the rapist are known to each other and may have previously interacted in some socially appropriate manner; also known as date rape -Half of all rapes occur on dates, at parties, or in other social situations. -Women of high school and college age are the most vulnerable to acquaintance rape •Acquaintance Rape -Cultural views on sexual relationships between men and women play a significant role. •Many young women who are victims of attacks do not know that what happened to them was sexual assault. •A significant proportion of men whose actions meet the legal definition of sexual assault believe they have not committed sexual assault. •Consequences of Acquaintance Rape -Victims of acquaintance rape •Often suffer serious, long-term psychological effects •Tend to blame themselves for what happened •Often have difficulty trusting people in later relationships •May take longer to recover •Less likely to seek crisis services, tell someone, report the incident to police, or seek counseling •May not get the same support as victims of stranger rape -Having sex with a woman who is unconscious or semiconscious is defined as an act of rape. -People who commit rape on drugged victims are sentenced to long terms in prison if convicted. -Being raped: •Exposes victims to pregnancy and acquiring a sexually transmitted disease •Creates in victims a sense of having been personally violated •May cause victims to experience chronic pelvic pain, gastrointestinal disorders, migraines, back pain, and facial pain for months or years •May make victims susceptible to alcohol and drug abuse •Consequences of Sexual Assault -Rape trauma syndrome •Immediate and long-term psychological difficulties, including PTSD, from having been raped -Three possible responses following an assault •Frequent crying and appearing agitated, hysterical, and anxious •Appearing calm and emotionally in control •Shock and disbelief, disorientation, confusion, and inability to carry out normal tasks •Consequences of Sexual Assault -Recovering from sexual assault requires patience and support. •Survivors are encouraged to seek psychological counseling. •Joining a support group of other assaulted individuals can be helpful in releasing the shame and horror associated with the assault. •Support and understanding from family, friends, intimate partners, and the community are also valuable. •Sexual Violence at American Colleges and Universities -Each year about 3% of American college women and 1% of American college men experience attempted or completed sexual assault against their will. •Sexual Violence at American Colleges and Universities -Approximately 90% of sexual assaults on college campuses are acquaintance rape. •Sometimes this is interpreted as a result of miscommunication among those involved. •Men are socialized to believe that women prefer to be overcome sexually. •Alcohol use among victims, offenders, or both is associated with most rapes among college students. •Sexual Violence at American Colleges and Universities -College acquaintance rape victims suffer the same psychological harms as other rape victims. •May leave school for fear of facing their attacker -Many in the campus community often do not interpret forced sex by a victim's dating partner or intimate partner as criminal assault. •Consider forced sex by an acquaintance something other than rape •What to Do After a Sexual Assault -Contact a rape crisis hotline. -Do not take a shower, bathe, douche, change or destroy clothing, or straighten up the area where the sexual assault occurred (if indoors). •Could destroy important evidence -Go to the nearest hospital emergency room. -Notify the police. Seek professional counseling.

exploring alternative medicines

•Reasons for using alternative medicine -Coming from a culture that used herbal remedies -Believing that Western medicine has failed to provide relief or a cure •As many as half of patients with serious medical problems use some form of alternative medicine along with conventional treatments •Complementary medicine -Alternative therapy used along with conventional medicine -Usually some scientific evidence for its effectiveness and safety •Integrative medicine -Combination of the practice of scientific, Western medicine with alternative medicines that are safe and effective for patients •A significant number of adult Americans use some form of alternative medicine. -More than two-thirds of American medical schools offer education and training in complementary and integrative health. -National Center for Complementary and Integrative Health (NCCIH) •Tests nontraditional therapies that have a plausible scientific basis and that can help patients' unmet needs

alzheimers disease and senile dementia

•Senile Dementia -Loss of cognitive functions in elderly people -Symptoms: •Loss of memory that increases over time •Feeling confused •Loss of problem-solving skills •Suffering from delusions and agitated behavior •Becoming lost in familiar settings Loss of interest in daily activities •Senile Dementia -Medical conditions that cause dementia •Small strokes that gradually destroy cognitive functions •Neurodegenerative diseases -Parkinson's disease, Huntington's disease, and Alzheimer's disease •Viral and bacterial infections -HIV/AIDS, syphilis, tuberculosis, and meningitis •Alzheimer's Disease (AD) -Causes more than half of all cases of dementia -Caused by damage to neurons in the brain -Causes loss of cognitive functions, memory, mobility, and eventually death -Frequency increases rapidly with age -By mid-century, AD will be diagnosed in: •14 million Americans 106 million people worldwide •Alzheimer's Disease (AD) -Diagnostic criteria include the presence of: •Bundles of tangled nerve fibrils called tau tangles •Plaques made of amyloid protein localized in certain areas and blood vessels of the brain -Forms of AD: •Familial AD (early-onset AD) -Rare form that develops by age 50 •Sporadic AD -May be caused by undetermined environmental factors •Alzheimer's Disease (AD) -Medications •Cholinesterase inhibitors -Donepezil (Aricept), rivastigmine (Exelon), and Galantamine (Razadyne) •Mermantine (Namenda) -Blocks the attachment of a specific neurotransmitter to cells •Antipsychotic drugs -Prescribed when AD progresses and behaviors become more agitated •Alzheimer's Disease (AD) -Amyvid test •Brain scan test that can confirm the amount of amyloid plaques in the brain of someone suspected of having AD •Only recommended for patients who already exhibit loss of memory and cognitive function -College graduates are less likely to develop AD. •Key is to use the brain throughout life •Exercising the brain helps maintain mental fitness

drinking on campus

•Several college students die from alcohol poisoning each year. •80% of North American college students drink alcohol at least once in a while. •Most drinking takes place when partying. -About 50% of male college students and 35% of female college students consume five or more drinks while partying. •Excessive alcohol consumption impairs one's judgment, increasing the risks for: -Being involved in a motor vehicle crash -Unintended pregnancy -Acquiring a sexual infection -Being a perpetrator or victim of sexual assault •College students who regularly drink to excess are more likely to: -Miss class -Get behind in schoolwork -Have sex without protection -Engage in unplanned sexual activity -Get into trouble with campus police -Damage property -Get injured -Engage in dangerous driving behaviors -Disturb, insult, quarrel with, or assault others -Require care from others while being sick from drunkenness •Secondhand binge effects -Being interrupted while studying -Being awakened at night -Having to take care of a drunken fellow student -Being insulted or humiliated by a drunken student -Being pushed, hit, or assaulted by a drunken student -Being the victim of sexual assault •25% of college students abuse alcohol to a degree that it adversely affects their academic progress, personal relationships, and health. •20% of college students meet the criteria for alcohol dependence. •Students with the most enthusiastic attitudes toward drinking are typically the heaviest drinkers. •College campuses are working to change the campus culture regarding alcohol use. -Irresponsible drinking is not viewed as: •A rite of membership in campus organizations •An acceptable way to lessen social anxiety in party or other social situations •The definition of partying •An acceptable means to deal with academic stress •A rite of passage into adulthood and independence

eliminating tobacco use

•Smoking -Kills more people than AIDS, car accidents, alcohol use, homicides, illegal drugs, suicides, and fires combined -Contributes substantially to deaths from: •Cancer •Cardiovascular disease •Lung disease •Burns •Problems in infancy caused by low birth weight •Smoking -Costs the United States more than $300 billion in healthcare costs and lost productivity annually •Only 17% of those costs are covered by smokers themselves. •The remaining smoking-related costs are borne by nonsmokers. •On average, each pack of cigarettes sold costs American society about $4.00 in smoking-related health expenses.

noise pollution

•Sound activates the nervous system thereby affecting functions of the endocrine, cardiovascular, and reproductive systems. •Sound levels are measured in decibels. -Danger zone for hearing loss begins around 85 dB •Many daily activities expose us to sound levels that can permanently damage hearing. •Tinnitus -Persistent ringing in the ears, often caused by repeated or sudden exposure to loud noises •Hearing loss can be caused by: -Listening to loud music -Noise in urban environments -Noise levels at sporting events and rallies

stimulants

•Substances that increase the activity of the central nervous system •Include cocaine, amphetamine, amphetamine-like drugs, and caffeine •Increase mental arousal and physical energy •Produce a state of euphoria •Can also cause restlessness, talkativeness, and difficulty sleeping •Cocaine -Obtained from coca shrub -Commonly taken by: •Sniffing •Injecting directly into the bloodstream •Smoking "free base" or "crack" cocaine -Rapidly produces: •Euphoria •Sense of power and clarity of thought •Increased physical vigor -Effects last from minutes to an hour -Causes a "crash" after the initial high -Continued use can result in: •Appetite and weight loss and malnutrition •Sleep disturbance •Altered thought and mood patterns •Inflamed nasal passages and permanent damage to the nasal septum -Overdose can cause seizures or death. -Pregnant women who ingest cocaine risk giving birth to cocaine-addicted babies. -Produces: •Tolerance •Physical dependence •Withdrawal -Strong potential for psychological dependence •Some people develop such a strong craving that their lives are consumed by their cocaine habit. •Amphetamines -Synthetic drugs that stimulate the central nervous system and sometimes produce hallucinogenic states -Most common are: •Dextroamphetamine •Methamphetamine •Dextromethamphetamine Amphetamine -Used medically to treat narcolepsy and ADHD -Principally used (illegally) to produce feelings of: •Euphoria, increased energy, and greater self-confidence •Increased ability to concentrate • Increased motor and speech activity •Perception of improved physical performance •Appetite suppression Frequently used by people who fight sleep -Excessive use can cause: •Headaches •Irritability •Dizziness •Insomnia •Panic and confusion •Delirium -Users often experience a "crash" when the stimulants wear off. -Prolonged use can lead to: •Tolerance •Mild physical dependence •Psychological dependence -Chronic use can cause amphetamine psychosis. •Auditory and visual hallucinations, delusions, and mood swings -Types •Ice is a smoked form of pure amphetamine hydrochloride. •Some college students use the prescription medications Adderall and Ritalin for studying purposes. •Caffeine -Psychological dependence can result from chronic use, and tolerance can gradually develop. -Mild withdrawal symptoms can occur when caffeine use is ceased, including: •Headache •Irritability •Restlessness Lethargy

cosmetic surgery

•Surgery performed not for any medical condition, but solely to enhance appearance or correct visible effects of aging •Health insurers are now offering cosmetic surgery to their members for a fee. •Dermatologists and plastic surgeons perform the majority of these surgeries. Most are safe, but complications can occur.

anabolic steroids

•Synthetic derivatives of the male hormone testosterone •Promote growth of skeletal muscle •Increase lean body mass •Used to enhance athletic performance and to change physical appearance •Taken orally or injected in cycles of weeks or months •Stacking -Using several different types of steroids to maximize their effectiveness •Side effects -Liver tumors and jaundice -Fluid retention -High blood pressure -Severe acne -Trembling •Side effects in males -Shrinking of the testicles, reduced sperm count, infertility, baldness, and development of breasts •Side effects in females -Growth of facial hair, changes or cessation of menstrual cycle, enlargement of the clitoris, and deepened voice

health insurance

•System intended to pay some or all of the costs of a person's medical, surgical, and hospital care -Basic principle is that individuals contribute money regularly to a fund from which contributors can withdraw money to pay for medical expenses •The medical insurance system in the United States is a combination of public and private funding. •Large employers pay for health insurance for employees and their dependents. •The U.S. government supplies health insurance for federal employees, veterans, members of the armed services, and their dependents. •Federal, state, and local governments provide health insurance for the elderly and people with disabilities. •Categories of private health insurance plans: -Fee-for-service plans (indemnity plans) -Some form of managed care plan •Health maintenance organizations (HMOs) •Preferred provider organizations (PPOs) •Point-of-service (POS) plans One of the primary goals of all managed care plans is to control health care costs •Fee-for-Service Plans -Allow a person complete freedom in choosing a physician or hospital -Pay some fraction of the patient's medical costs (usually 80%) for a fixed monthly fee -Restrict the kinds of services they will pay for •Most do not pay for routine physical exams, immunizations, drug abuse programs, and mental health services •Health Maintenance Organizations -Nonprofit or for-profit organizations of physicians, hospitals, and support staff that provides medical services to members -Prepaid health insurance plans that are an alternative to private insurance •Health Maintenance Organizations -Characterized by four principles •Organized system that accepts responsibility to provide health care •Agreed-upon set of comprehensive health maintenance and treatment services •Voluntarily enrolled group of people in a specific geographic region •Reimbursement through a prenegotiated and fixed payment schedule on behalf of enrollees •Health Maintenance Organizations -Physicians may: •Be prohibited from recommending certain expensive procedures that are not covered by the HMO •Receive bonuses for not recommending referrals or for other services •Be prohibited from disclosing the conditions of their contracts (gag rule) •Preferred Provider Organizations -Physicians who belong to the organization provide medical care at reduced costs that are negotiated by the organization. -Participants must use one of the "preferred" providers if they want their medical bills paid. •If a participant opts for care from a nonprovider, he or she will be charged a substantial fee. •Point-of-Service Plans -Allow a patient to be referred to a physician who is not a member and still receive coverage •Patient is responsible for all or part of the costs if he or she chooses to go to an outside physician without a referral

precision medicine

•Tailoring treatments to the genetic makeup of individual patients •Possible because thousands of specific mutations have been identified that are causally involved with specific diseases •A patient's DNA can be examined for disease-causing changes and medicine can be offered for that specific situation, particularly cancers.

stress, telomeres, and aging

•Telomeres -Short segments of DNA at the end of chromosomes in all body cells -Retain the functional integrity of the DNA during cell division by protecting the ends of chromosomes -Long in early life, but shorten over time -Eventually cannot protect chromosomes and cells malfunction and die •Telomeres -Shortening of telomeres can: •Compromise mental health •Accelerate brain and body illness -An unhealthy state of mind can accelerate aging and accompanying illness. -Telomere length can be measured by clinical tests.

public, government provided health insurance

•The U.S. government provides health insurance for about 37% of Americans through three programs: -Veterans Administration -Medicare -Medicaid •Medicare -Federal insurance program for: •Americans over age 65 •Certain disabled Americans under age 65 •People of any age with permanent kidney failure -All eligible Medicare beneficiaries are automatically enrolled in Medicare, Part A when they reach age 65. •Enrollment in Part B is voluntary. •Medicare -The number of people covered is expected to jump to 80 million by 2030. -Because of the projected rising costs of Medicare, the federal government is seeking ways to reduce costs. •Benefits may be curtailed or eliminated. •Payments to physicians and hospitals may be lowered. •Medicaid -Provides health insurance for people who are economically disadvantaged and cannot pay for medical care •To be eligible, an individual must be on welfare, have dependent children, or receive supplementary Social Security income for persons who are aged, blind, or disabled. -Covers nursing home care for many elderly Americans -Joint federal and state program that, together with the Children's Health Insurance Program, provides health coverage to 75 million mostly low-income Americans -Single largest source of health insurance coverage in the United States Eligibility varies widely among the states •Affordable Care Act (ACA) -Passed in 2010 and mandated that every person in the country have health insurance -Extended to the states the option to provide Medicaid coverage to all individuals with income less than 138 percent of the federal poverty level •This is called Medicaid Expansion. -Responsible for providing health insurance for over 28.1 million people

violence in america

•The United States has a larger percentage of homicides, suicides, rapes, other forms of interpersonal violence, and people in prisons, than any other industrialized country. •Approximately 1 out of every 100 U.S. citizens is behind bars. •The Innocence Project -Investigates wrongful convictions -Have succeeded in getting over 350 prisoners released •Convictions were overturned largely based on analysis of DNA evidence recovered from the crime scene and preserved along with other evidence. •Almost 40% of those convicted had confessed to their crimes even though they knew they were innocent. •Solitary confinement -Thousands of inmates are placed into solitary confinement every year. •Some spend years there with virtually no contact with other people. •Long-term isolation has been associated with the development of brain abnormalities. •Violence and its consequences are profoundly unhealthy to individuals and to society.

seeing the doctor

•The majority of people who go to the doctor: -Have minor complaints -Have come for a routine checkup -May need some kind of reassurance •Patients generally fall into three categories -Those who think they are sick and are -Those who think they are well, but are sick -The "worried well" who are not sick but seek reassurance that they are not sick •Frequent medical exams for people who are basically healthy are unnecessary. •How often you see a physician depends on your personal needs. •Often people are asking more from their doctors than just medicine. •The quality of health care depends to a great degree on the interaction between the physician and the patient. You can increase the chance of a successful encounter with your healthcare provider if you have a clear understanding of what you want to accomplish during your office visit •Two important choices in any illness -Admitting you are sick and finding out what is wrong •Diagnosis -Cause of a disease or illness as determined by a physician Deciding the best course of treatment

indoor air pollution

•The most serious indoor air pollutant is cigarette smoke. -Since smoking has been banned in most workplaces, office buildings, airplanes, and restaurants in some areas, the air quality for many Americans has been improved. -In other countries, this is a problem because of cooking with indoor fires fueled by inorganic matter. •Radon -Radioactive gas found in some homes that can increase the risk of cancer -Naturally produced in the ground in some areas -Can also be emitted from building materials containing radioactive minerals -Slowly released into the house over many years Increases the risk of lung cancer •Heavy Metal Pollution -Lead •Heavy metal that contaminates air, land, water, and houses that still contain lead-based paints •Plumbism (lead poisoning) -Causes loss of appetite, weakness, and anemia, and can -Can lead to brain damage and learning and behavior problems -Associated with criminal activity and arrest later in life •CDC acceptable level of lead in people's blood has dropped from 60 µg/dl in 1960 to 10 µg/dl today -Lead (continued) •Poor children are at the highest risk for having elevated blood lead levels. -Associated with inhaling dust containing lead from lead-based paints and very young children eating paint flakes •Neurological damage from lead poisoning cannot be reversed by detoxification. •It is still an uphill battle to further reduce the amount of lead released into the environment because of lead's importance to many industries. •Heavy Metal Pollution - Mercury •High levels of mercury in any form, but especially methylmercury, cause a variety of severe neurological problems. •Methylmercury is a worldwide environmental pollutant found in fresh water, land, and oceans. -Contamination of both freshwater fish and ocean fish is now common. -Mercury (continued) •Nursing mothers and women who plan to become pregnant should: -Avoid eating shark, swordfish, king mackerel, tilefish, marlin, and bigeye tuna. -Limit consumption of commercial fish to 12 ounces per week. •Fish with the lowest levels of mercury include shrimp, canned light tuna, wild salmon, pollock, and catfish. -Mercury (continued) •Coal-fired power plants are responsible for 40% of all mercury pollution. -Mercury released into the air is washed into lakes, rivers, and oceans when it rains., and bacteria transforms it into methylmercury. -The EPA allows the worst polluters not to reduce mercury pollution if cleaner coal-fired power plants offset the mercury the worst plants would produce. -People living near "dirty" plants are at risk for neurological damage.

tobacco use in the united states

•The prevalence of adult American smokers has declined in the past 35 years, but it is offset by increased use of other tobacco products. •A large majority of American and Canadian college students refrain from using nicotine delivery systems. •Smoking among Americans younger than age 18 increased during the 1990s, but has declined since then.

quitting smoking

•The smoking habit is: -Part biological •Addiction to nicotine -Part psychological •Smoking alters mood and provides pleasure. -Part social •Smokers smoke with other smokers. •Quitting smoking requires: -Examining how smoking is integrated into one's life -Planning and adopting alternative experiences that meet the biological, psychological, and social needs that smoking satisfies •Stopping smoking is a process, not an event. -People often think about stopping for a period of time before they even consider trying. -Sometimes people go through one or more cycles of stopping and starting up against before they quit permanently. •Successful smoking cessation plans center on a predetermined quit date. -Day that the smoker stops smoking completely •Prior to the quit date, the smoker can: -Cut back in the number of cigarettes smoked -Identify which cigarettes will be hardest to give up -Prepare to do without the benefits of smoking -Ask friends and family to offer support -Seek professional smoking cessation counseling -Stay away from smoking stimuli -Consider using nicotine replacement therapy •People stop smoking for a variety of reasons -To reduce the risk of early death -To enjoy the unpolluted taste of food -To please nonsmoking loved ones -To eliminate ashes and the smell of cigarette smoke from their homes and cars -To fulfill a commitment to be healthy

what is tobacco?

•Tobacco -Processed from leaves of Nicotiana tabacum -Introduced to European societies by the Spanish returning from voyages to the Americas and quickly spread -Cigarette smoking became the predominant form of tobacco use worldwide in the 1880s with the invention of the cigarette-making machine. •Tobacco smoke -When burned, tobacco releases approximately 4,000 substances, including acetone, acrolein, carbon monoxide, methanol, ammonia, nitrous dioxide, hydrogen sulfide, traces of various mineral and radioactive elements, acids, insecticides, and other substances. -Nicotine is responsible for tobacco addiction.

reducing tobacco's damage to society

•Tobacco is the only legal consumer product that causes disability and death when used as intended. •Health groups try to persuade people not to smoke, while the tobacco industry encourages them to smoke. •Family Smoking Prevention and Tobacco Control Act -Requires tobacco-product manufacturers to list ingredients and additives put into tobacco products -Bans cigarettes with fruit, spice, and other flavorings (except for menthol) -Gives the FDA the authority to regulate the use of certain terms in promotional materials -Requires larger, more prominent warning labels •The tobacco industry spends billions of dollars a year to promote its products and recruit new smokers through: -Print advertising -Sponsoring concerts, sporting events, and travel excursions -Supporting health research and smoking cessation programs -Price discounts to retailers •Master Settlement Agreement -Settled states' lawsuits to recover tobacco-related healthcare costs -Cigarette companies agreed to: •Pay $206 billion to the states over 25 years •Pay $5.15 billion over 12 years into a trust fund to compensate tobacco farmers and others for anticipated financial losses •Master Settlement Agreement -Includes bans on: •The use of cartoons in tobacco advertisements •Targeting youth in advertising, promotions, or marketing, including free sampling •The use of most outdoor advertisements •The distribution of apparel and merchandise with brand-name logos •Payments to promote tobacco products in films, TV, and theater productions •Master Settlement Agreement -Also bans: •Distributing free samples of cigarettes any place where underage persons may be present •Tobacco company lobbying against any proposed laws that limit youth access to tobacco •Tobacco industry attempts to limit or suppress research on the health effects of smoking •Other strategies -Raise taxes on cigarettes and other tobacco products -Create more smoke-free public places Provide comprehensive smoking cessation programs for all smokers who want to qu •"Tips from Former Smokers" (Tips) -Antismoking ads produced by the CDC -Encourage people to quit smoking by showing the toll that smoking-related illnesses take on smokers and their loved ones -Placed in or on television, radio, print, out-of-home, theater, and online -Produced in English and Spanish Focus on reaching low socioeconomic groups •Real Costs -Educational program for youth aged 12-17 -Distributed on TV, radio, the Internet, and in magazines and movie theaters -Themes include: •Harmful effects of smoking on skin •That tobacco addiction is about losing control of your life to a drug habit rather than independence •The many toxic chemicals in tobacco smoke

hospitals

•Upon admission to a hospital, a patient is required to sign an informed consent form. -Delegates decisions regarding health care to the hospital and physicians •The Patient Care Partnership -Published by the American Hospital Association -Describes the situations and questions most often encountered by hospital patients •Except in the case of a life-threatening emergency that demands immediate action, you have the right to be fully informed of all medical procedures and the reasons for them. -As a patient, you have the responsibility for deciding what you want done. -Once you have made that decision, you should understand how to cooperate fully with the healthcare team to gain the most benefit.

inhalants

•Vaporous substances that, when inhaled, produce alcohol-like intoxication •Depressants of the central nervous system •Intended effects -Loss of inhibition and a sense of euphoria •Unintended effects -Dizziness, amnesia, inability to concentrate, confusion, impaired judgment, hallucinations, and acute psychosis •Types used for recreational purposes: -Commercial chemicals •Model airplane glue, nail polish remover, shoe polish, paint thinner, gasoline, and other substances -Aerosols •Found in aerosol spray products -Anesthetics •Amyl nitrate, nitrous oxide, diethyl ether, and chloroform •Enter the body rapidly -Effects often felt within minutes •Do not produce tolerance, withdrawal, or physical dependence •Damage the kidneys, liver, and lungs •Can upset normal heartbeat

sexual violence

•Violent actions that include: -Rape -Incest -Attempted rape -Unwanted sexual touching •All types involve victims who do not consent, who are unable to consent, or who are unable to refuse to allow the act.

alcohol use in the US

•Volstead Act (1919) -Constitutional amendment that prohibited the sale and consumption of alcoholic beverages -Repealed in 1933 by another amendment •Statistics -70% of adults have at least one drink per year. -56% have at least one drink per month. -20% are lifetime abstainers. About 9% drink excessively. •About 120 million Americans admit to alcohol-impaired driving each year. -1 million are arrested for driving while intoxicated -11,000 die from alcohol-related traffic collisions •Alcohol abuse is also linked to: -Divorce and family violence -Crimes -School and job absenteeism -Medical problems

healthcare costs

•Why Healthcare Costs Continue to Rise -Factors that contribute to the high cost of health care in the United States •Physician salaries and fees •Cost of prescription drugs •Malpractice insurance •Cost of hospital rooms and emergency services •Cost of health insurance •Aggressive marketing of medical technology, new drugs, and tests •Magnetic Resonance Imaging (MRI) -Use of a strong magnetic field to produce images of internal parts of the body -Important diagnostic tool, but expensive •Requires frequent use to pay for it •Most hospitals must have one to remain competitive •Waste -The Institute of Medicine estimates that 31% of health care dollars is wasted. -About half of the wasted money goes for overcharging, administrative costs, and fraud. -The greatest waste comes from unnecessary health care services. •Other factors contributing to rising health care costs include: -Unhealthy lifestyles •Obesity •Smoking •Excessive alcohol use -Aging population •Associated with an increased need for medical attention, costly drugs, and surgery •Medical Tourism -Traveling to another country for lower-cost medical or dental procedures -Many countries aggressively advertise for medical tourists. -Joint Commission International •U.S. nonprofit agency that accredits hospitals overseas -Many surgeons working overseas have been board certified. •Healthcare Costs in Other Countries -Other industrial nations spend half as much on health care as the United States does, and they manage to provide insurance for all citizens. -Although it is said that the United States has the best health care, it has lower life expectancy and higher infant mortality rates than many other industrialized nations. -Some advocate adopting Canada's model to provide universal health care for all citizens. •Would provide everyone with basic health care •Would increase wait times for diagnostic testing and treatment and surgery for conditions that are not life-threatening -Researchers from Johns Hopkins University found that the United Kingdom ranked first in providing quality healthcare outcomes. •The United States spends more per capita on health care, but ranked last in the 11 developed countries studied. •Healthcare Disparities -Health disparity •Higher burden of illness, injury, disability, or mortality experienced by one population group relative to another group -Healthcare disparity •Differences between groups in health coverage, access to care, and quality of care -Factors impacting health disparities •Racial or ethnic group •Religion •Socioeconomic status •Education •Gender •Age •Mental health -Factors impacting health disparities (continued) •Cognitive, sensory, or physical disability •Sexual orientation or gender identity •Geographic location •Other characteristics historically linked to discrimination or exclusion -Other factors impacting health disparities include availability and access to: •High-quality education •Nutritious food •Decent and safe housing •Affordable and reliable public transportation •Culturally sensitive health care providers •Clean water and nonpolluted air Affordable quality health care -The effects of race and sex on how long someone lives is an example of a health disparity. •Organ Transplants -Most major organs can be transplanted. •Can be transplanted from cadavers or living donors -More than 71,000 people in the United States have donated an organ to another person. •Kidney donations are the most frequent. -No federal guidelines or laws regulate who can donate and who can receive an organ. •Each hospital makes its own rules. •Medicalization of Human Behaviors and Traits -Medicalization •Medical treatment of conditions, behaviors, or traits that generally were not regarded as illnesses or medical problems -Once medicalized: •Conditions are deemed to require treatment •Payment by health insurers is permissible -Examples of medicalized conditions •Homosexuality •Smoking •Excessive alcohol use •Idiopathic short stature •Male aging problems •Attention deficit hyperactivity disorder (ADHD) •Obesity

smoking and disease

•Years of research have established that smoking is a risk factor for: -Coronary artery disease -Lung cancer -Bronchitis -Emphysema -Multiple types of cancer -Duodenal ulcer Allergies •Lung Cancer -Smoking is responsible for almost 90% of lung cancers among men and more than 70% among women. -In recent years, incidence and death rates for men have declined, while those for women have increased. -The increase in lung cancer deaths is the principal reason that the overall cancer death rate continues to rise. •Heart Disease -Smoking can: •Increase tension in the heart muscle walls •Speed up the rate of muscular contraction •Increase the heart rate •Reduce the amount of high-density lipoprotein (HDL) cholesterol (the "good" cholesterol), facilitating plaque formation and abnormal blood clotting •Bronchitis and Emphysema -Bronchitis, emphysema, and asthma are sometimes classified as chronic obstructive pulmonary diseases (COPD). •Each of these diseases is associated with breathing difficulty caused by obstruction or destruction of some part of the respiratory system. •Persons often suffer from more than one of these conditions at the same time. -Bronchitis •Inflammatory condition of the upper part of the respiratory tract, principally the trachea •Characterized by excessive production of mucus in the airways due to irritation from cigarette smoke •Causes continual cough, production of large amounts of sputum, and shortness of breath •Can be almost completely reversed by quitting smoking, reducing exposure to polluted air, or both -Emphysema •Results from destruction of the tiny air sacs, called alveoli, deep in the lungs. •Irreversible, disabling condition in which the walls of the air sacs in the lungs lose their elasticity and are gradually destroyed •Impairs lungs' ability to obtain oxygen and remove carbon dioxide •Causes the heart to work harder, resulting in it becoming enlarged •Tobacco Smoke's Effect on Nonsmokers -Environmental tobacco smoke (ETS) •Creates a health risk for nonsmokers •Comprises about two-thirds of the smoke from a burning cigarette •Contains more than 4,000 chemicals, but in a higher concentration because it is unfiltered •Increases the severity of asthma in children •Is responsible for thousands of cases of bronchitis and pneumonia in children younger than 18 months •Effects of Parental Smoking on Children -Smoking is a risk factor for: •Spontaneous abortion •Newborn death •Sudden infant death syndrome (SIDS) •Giving birth to a low-birth-weight infant -Children exposed to environmental tobacco smoke have a higher risk of bronchitis, pneumonia, other respiratory tract infections, asthma, and ear infections.