Kin 170

Postpartum

3 months after delivering a baby, vaginal delivery- 1-3 days leave, c-section 3-5 days, contractions after, 6-8 weeks for reproductive organs to go back to normal, lochia, postpartum depression: stamina is lowered, 5-9% get depression- emotional low, rest and support

adapting to physical changes

anticipate and accommodate these changes, hearing loss- slowly (prebycusis), protect, vision changes- glaucoma, AMD, prebyopia (inability to focus sharply on nearby objects, loss of elasticity, cataracts, arthritis- joint inflammation= chronic pain., swelling, loss of mobility, 100 different types, OA- cartilage wears away, weight-bearing joints- weight management, exercise, avoid excessive muscle use, treatment, changes, benefits, practice safer sex, osteoporsis- W occur in first 5-10 years after menopause, build and maintain bone- food and exercise

Drug

any chemical other than food intended to affect the structure of function of the body- abuse and addiction, psychoactive drugs- alter consciousness or experience- cause intoxication (state of being mentally affected by a chemical, literally a state of being poisoned)

Managing stress

identify stressors, social support (critical counterbalance), communication- assertive and respectful to maintain healthy relationships, exercise- maintain healthy body and mind, stimulates birth of new brain cells- not completing energy circle if no exercise- expend the nervous energy (avoid overdoing it), nutrition- energy bank, limit/avoid caffeine, excess stress can affect eating habits, sleep-physical benefits, improves mood, fosters feelings of competence and self worth, enhances mental functioning, supports emotional functioning- REM (dreaming), non-REM (deep sleep, 4 stages)= decreased BP, HR, RR, temp, growth hormone is released, slow and even brain waves, stress hormone levels change throughout the day- low during non-REM, increase during REM, sleep deprivation (lack of sleep over time)- mental and physical processes deteriorate- headaches, irritability, lack of concentration, forgetfulness, hallucinations, insomnia (inability to fall asleep or stay asleep)- insomnia syndrome(insomnia for at least 3 nights/ wk for one month with associated impairment or distress), sleep apnea (breathing is interrupted), time management- set priorities, schedule tasks for peak efficiency, set realistic goals and write them down, budget your time, break up long term goals into short term ones, visualize the achievement of you goals, keep track of the tasks you have put off, consider doing your least favorite tasks first, consolidate tasks when possible, identify quick transitional tasks, delegate responsibility, say no when necessary, give yourself a break, avoid personal time sinks, stop thinking/talking about it and do it, confiding in yourself through writing, cognitive techniques- think and act constructively, take control, problem solve, modify expectations, stay positive (talk to yourself as you would talk to a child you love), cultivate sense of humor, focus on what's important, relaxation techniques- response (physiological state characterized by a feeling of warmth and quiet mental alertness), decrease HR, RR, metabolism, counter-act stress- progressive relaxation (tense and relax muscles), visualization (creating/recreating vivid mental pictures of a place or experience), meditation (quiet the mind by focusing on a particular word, object, or process), mindfulness meditation, deep breathing (chest to stomach), yoga, tai chi, music, biofeedback (monitoring devices help a person become consious of unconscious body processes (temp, BP) to exert some control over them) Counterproductive coping- tobacco use, use of alcohol/other drugs (caffeine, marijuana, opioids), unhealthy eating habits Creating a Personal plan- identity stressors, design plan (stress reduction techniques, rewards), getting help

Immune system- stress

increased vulnerability to cold/ infections, asthma and allergy attacks, susceptibility to cancer, flare ups of chronic diseases-- digestive problems, tension headaches/migraines, insomnia/fatigue, injuries, menstrual irregularities, loss of interest in previously enjoyed activities

Infections

invasion of the body by microorganisms, don't notice until you become sick

Making a personal healthy eating plan

making informed choices about food- reading food labels: serving size, amount of fat (sat, trans, chol), Na, total carb, fibre, sugars, proteins, not packaged= no label,- natural health products: V/M, herbal, homeopathic, traditional medicine, probiotics- tablets, capsules, liquids, powders, need CT to determine safety, effectiveness, side effects, risks, possible interactions, appropriate dosages,- protect against food borne illness- raw/ undercooked animal products, contaminated F/V, diarrhea, vomiting, fever, weakness- from pathogens (microoganisms that cause disease), improper handling/storage, compylorbacter jejuni, salmonella, shigella, e. coli, listeria monocytogenes, stapholococcus aureus, clostridium botulinum, norovirsues, colostridium perfringes, vibrio vulnificus, yershia, enterocolitica, Hep A, trinonienella spiralis, anisakis, giardia camblia, cyclospora cayetanensis, tapeworms, moulds, bovine spongiform encephalopathy, destroy during cooking, safe handling and cooking instructions, warnings, drink lots of clear fluids, wash hands, Dr, - environmental contaminants and organic foods- minerals, antibiotics, hormones, pesticides, PCB (polychlorinated biphenyls- industrial chemical used as an insultator in electrical transformers and naturally occurring substances), organic (grown and produced with strict guidelines limiting the use of pesticides, inorganic ingredients, hormones, antibiotics, irradiation, genetic engineering- least possible amounts of residues at the lowest possible levels, can come into contact with pesticides during transport, better for environment, local food and slow food- supports local agriculture and support economy, fish consumtipns- mercury in predator fish, additives in food- maintain and improve nutritional quality, maintain freshness, help in processing/preparation, alter taste/apperance- sugar, salt, corn syrup , citric acid, baking soda, vegetable colours, mustard, pepper (> 1% of our food, those make up 98% of food additives), nitrates./ nitrites, BHA/ BHT, sulphites, monosodium glutamate, food irradiation- treatment of foods with gamma rays, x-rays, or high voltage electron to kill potentially harmful pathogens and increase shelf life, reduces spoilage- only onions, potatoes, wheat, flour, whole wheat flour, whole/ground spices and dehydrated seasoning, not radioactive, GMOs- alter characteristics by adding, rearranging or replacing genes in its DNA, improves yield and increase disease resistance/ nutritional content, lower prices, less pesticide use- animal cloning- somatic cell nuclear transfer has food concerns, labeling GM foods- no special labeling unless composition/ nutritional profile changes significantly or allergen is added, food allergies and intolerances- annoying-life threatening, allergy (an adverse reaction to food/ food ingredient in which the immune system perceives a particular substance as foreign and tries to destroy it), minutes of ingesting- skin, GI tract, reps tract, mouth- anaphylaxis, 90% of allergies are cow milk, eggs, peanuts, tree nuts, soy, wheat, fish, shellfish, intolerance (adverse reaction to food/ ingredient that doesn't involve the immune system) -problems with metabolism can't digest bc of chemical deficiency/ reaction- lactose, gluten, suphite, localized and not life threatening reactions,may have small amounts of food

Coping with death

no right way to live/die, suffering comes from feelings of overwhelming loss, emotional havoc and medical care, loss of income, hospitalization and physical pain, spirituality, awareness: living-dying experience, hope and honesty- middle knowledge/ a state of knowing when a person both acknowledges the reality of a threatening situation and maintains hope for a positive outcome, 5 stages of grief (denial, anger, bargaining, depression, acceptance) go back and forth, 4 dimensions- physical: body needs and decrease physical distress, psychological; maximizing a sense of security, self worth, autonomy, and richness in living, social: sustaining significant relationships and addressing the social implications of dying, spiritual: identifying, developing, or reaffirming sources of meaning and fostering hope- pay attention to life story, fighting spirit-illness as a threat and challenge, positive, be present during final stage-sitting quietly and listening carefully, physical touch, trying to cheer up can be frustrating, speak simply and from the heart, level of alertness fluctuates, hearing and touch are last senses to go, trajectory of dying- duration and nature of a person's experience in approaching death as influenced by the underlying cause of death, forewarning- steady and fairly predictable, when death is in the future or imminent- affect pts and caregivers and influence their actions, unexpected deaths may cause extreme difficulties- cannot say goodbye/ emotionally prepare, support can make situation tolerable, may experience SOB, irregular breathing, decreased appetite and third, n/v, incontinence, restlessness and agitation, disorientation and confusion, decrease consciousness, treat pain aggressively, death rattle, cold extremities, blue, urination becomes less frequent, ability to communicate may be lost, mottling, reposition pt, cover, dim room's lighting, hold hands, may die as soon as members are out of the room

Attachment

emotional tie between baby and adult- helps child develop and function well socially, emotionally, and mentally, adjustment requires effort and energy

Anatomy

gonads- primary reproductive organs that produce germ cells (sperm and ova), and sex hormones-ovum- germ cells produced by females, combines with sperm to make fetus, sperm- germ cell produced by a male

Self care

manage own health care-gather info and learn skills from a variety of resources, solicit opinions and advice, make decisions and take action, be a good observer of own body and assess symptoms- when to seek professional advice and when to deal with it on your own, self-assessment- symptoms are often an expression of the body's attempt to heal itself-help decrease anxiety, note when symptom began, how often/when it occurs, what makes it better/worse, any associated symptoms, monitor VS, health literacy and EBP- process document and online info, most vulnerable-seniors, immigrants and unemployed- lack of access to trustworthy information/inability to understand and use that info, EBP- people's values and beliefs are a vital part of the process, understanding different kinds of evidence- learn how to interpret the nature and level of evidence, gold standard= experimental/scientific method, subjects, intervention group/control group, placebo, double-bind, statistical conclusions (significance), peer-reviewed journals, cohort studies, case control, case studies, expert opinions, Cochrane consumer network, plain language, self-medication- OTC highly effective in relieving symptoms and sometimes curing illnesses, used to be prescription drugs, brand or generic name- same in terms of quality, purity, effectiveness, safety, advertising, risks, side effects, guidelines- always read labels and follow direction carefully, DIN, do not exceed recommended dosage or length or treatment unless you discuss this change with your physician, use caution if you are taking other medications/supplements b/c of drug interactions, try to select medications with one active ingredient rather than combination products, try to use generic drugs (cheaper), never take/give a drug from unlabelled container or in the dark when you can't read what the label says, if you are pregnant/nursing/chronic condition consult with HCP before self-medicating, expiration date is the estimate of how long the medication is likely to be safe and effective, store medications and home medical kit in a cool, dry, out of children's reach place, use special caution with aspirin,

Wellness

optimal health and vitality, living life to it's fullest

Bacteria

single, celled, 100 species can cause disease- when they feed on live matter, bacilli (rod), cocci (spherical), spirochete (spiral), vibrious (comma), we have harmful and helpful bacteria on skin, GI/ repro tract, pathogenic in food/drink can invade cells/ produce damaging toxins, human body is usually aseptic- pneumonia: inflammation of the lungs- fever, chills, SOB, increase mucus production and cough, vaccine, mycoplasms-sore throats, ear infections, pneumonia, menigitis- infection of meninges (membranes covering brain and spinal cord), viral goes away but bacterial can be life threatening- fever, severe headache, stiff neck, sensitivity to light, confusion, vaccine is not effective against all strains fo bacteria, strep throat- streptococcus, skin infections, strep throat, rheumatic fever, pneumonia, scarlet fever, spherical, grows in chains, close contact- flesh-eating strep, TSS and staphylococcus- clustered, found on skin in nasal passages- enter body and cause infection, skin infections- blood infections and pneumonia, MRSA, TB- chronic, affect lungs, myobacterium tuberculosis, coughing, fatigue, night sweats, weight loss, fever, tick borne infections- Lyme disease, borrelia burgdorferi, treatable at all stages, Rocky Mountain spotted fever-sudden onset of fever, headache, muscle pain, spotted rash, ulcers-then NSAIDs, other- tetanus- muscular stiffness and spasms, vaccine, C.diff- diarrhea- life threatening colitis, NAP1 produces multiple toxins, generates further, AR, pertussis- toxin from bordetella pertusus, rapid coughing, long inhale, high pitched whoops, 1-3 die, UTI- bladder and urethra infection- most common in sexually active women, antibiotics, urintate b/a intercourse- immune system can fight off most but antibiotics- sythethic/naturally occuring substances used as drugs to kill bacteria-interupt production of new bacteria by damaging some part of reproductive cycle, penicllin inhibits formation of cell wall, others invade production of certain proteins, resistance- genetic mutation, grow and flourish with exposure to antibodies- very difficult to treat, happens if bacteria encounter antibodies too often, or inappropraitely taking- don't take one every time you get sick, use as directed, never take without presciption

Getting started and staying on track with exercises

improve at fastest rate, have fun, minimize risks of injury- selecting instructors, equipment and facilities- finding help and advice about exercise- class, personal trainer- program/training, expert articles, selecting equipment- best that you can afford, appropriate safety equipment, investigate before you buy, space, footwear, choosing a fitness center- right programs, and equipment, comfortable, clean and well maintained, staff should be well trained, certified, and helpful, get trial first-- eating and drinking- well balanced diet contains all energy and nutrients, if less calories are intook than expenditure= fat loss, drink enough water before and after- at least 1/2 L 2h before exercise, at least 250 mL for every 20-30min, weight- any loss is fluid and needs to be replaced, 60-90 min-cool water, longer- sports drinks- water, lytes, carbs-- managing fitness program- start slowly, and gradually, beginners progress and maintenance phase, exercsie consistently- training journal, don't increase volume by more than 5-10%/ wk, assessing your fitness- depends on your goals, program, and natural ability, assessment from sports medicine lab, prevening and managing athletic injuries- not serious/permanent unless not cared for- medical attention, stop bleeding and clean, RICE, gradually reintroduce exercise- full ROM, normal strength and balance, no injury- compensation movements, no pain, stay in condition, warm up , use proper body mechanics, don't exercise if ill or overtrained, use proper equipment, return once healed, stayign with your program- exercise regularly and consistently, adapt to chagnes in environment/schedule, meaningful goal, vary program (cross training- participating in two or more activites to develop a particular component of fitness)- prevent boredom and injuries, HIIT, set goals, select activities, make a commitment, begin and maintain program, record and assess program

Stats for exercise, health and fitness

inactivity is one of the top 5 global risk factors for mortality, 1998- 2/3 of Canadians were inactive, less than half of population is active enough to trigger health gains, 95% of children (5-17) do not get recommended amount of pa every day, 15% of adults get enough active minutes per week, 24% of children t get to school with active modes, 62% with only inactive, and 13% by both, physically active adults live 2-4 1/2 years longer, only 13% of 60-79 get enough activity, 85% of can, adults are not active enough for health benefits , more than half of can are overweight/obese, can. who are obese get half as many mins of pa as their non-obese counterparts, inactivity increases risk for CVD by 50-240%, only 22% of Canadian schools provided daily PE, 90% of probaseballers use steroids, 2-6% of high school athletes use steroids, 50% of uni students thought people did but only 1 % actually used

CVD- stress

increase BP= atherosclerosis= heart attack and stroke, cardiomyopathy (mimics MI but no damage), situations with anger and hostility, increase cholesterol, inflammation= increased homocytsteins and c-reactive protein

Health risks of excess body fat

increased mortality rate, decrease life by 10-20 years, 50-100% increased risk of early death, unhealthy cholesterol and triglyceride levels, impaired heart function- death from CVD, HTN, cancer, impaired immune function, gallbladder and kidney diseases, skin problems, impotence, sleep and breathing disorders, back pain, arthritis/ other B and J disorders, pregnancy complications, menstrual irregularities, urine leakage, increased surgical risk, psychological disorders and problems, DM (more than 3x as likely to develop in obese pts), occur in ppl who are twice the desired body weight

SDOH

influence the health of individuals and groups

Minerals

inorganic compounds needed in relatively small amounts for regulation, growth, and maintenance of body tissues and functions, help release energy, 17 essential, exceed 100 mg- calcium, phosphorus, mg, sodium,k, chloride, essential trace- copper, fluoride, iodide, iron, selenium, zinc, symptoms if too much/ little, anemia (deficiency in 02- carrying material in RBC,) osteoporosis- bones are extremely thin and brittle and break easily

Possible risk factors CVD

insulin resistance and metabolic syndrome- weight gain = muscles, fat and liver becomes less sensitive to insulin, pancreas secretes more to keep glucose level in normal range, homocysteine- damages lining of blood vessels= inflammation and development of fatty deposits, cognitive impairment, infectious agents- chlamydia pneumoniae, lipoprotein a- promotes clots and deliver chol to site of vascular injury, genetics, lifestyle, LDL particle size- A= buoyant and large, B= small and dense, C= mixture, blood viscosity and iron, uric acid- increase inflammation and platelet aggression, time of day/year- 6:00 am- noon: natural increase in adrenaline and cortisol levels, increase SNS, BP is highest in the morning, more fatal

CAM

integrative medicine, implies along with rather than instead of, need to be evaluated for effectiveness, harm, side-effects, utility, focuses on integration of mind, body, spirit to restore whole person to harmony, based on healing traditions and accumulated experience, seen as quackery, work in partnership, anecdotal testimonials, 5 domains- alternative medical systems, mind-body interventions, biological- based therapies, manipulate and body based methods and energy therapies

Nutrition

know what nutrients you need and in what amounts- put into diet of foods you like, the science of food and how the body uses it in health and disease- proteins, fats, carbohydrates, vitamins, minerals and water- 50 essential nutrients(substances the body must get from foods b/c it cannot manufacture them at all or fast enough to meet its needs), macronutrients- essential nutrients required by the body in relatively large amounts- protein, fat, carbs), micronutrients- vitamins, minerals, essential nutrients required by the body in minute amounts, digestion- the process of breaking down foods in the GI tract into compounds the body can absorb, various nutrients provide energy, help build and maintain body tissues and help regulate body functions

Choosing wellness

knowledge, self-awareness, motivation, effort, factors that influence- behaviour (health habits- poor habits take hold before adulthood, can be harmful or beneficial) family health hx (genome- complete set of genetic material, genes- control production of proteins for structure and regulation, errors can create diseases), environment (air and water, substances and conditions in home, workplace, and community), access to health care (adequate- improve quality and quantity of life through preventive care and treatment of the disease, behaviour can make a difference)

Breastfeeding

lactation-production of milk, 3 days after a birth, colostrum- yellowish fluid by mammory glands around the time of childbirth until milk comes in- antibodies and proteins, 6 months then combo until 2 years of age, for as long as mother and baby desire, benefits for both, some things can transfer in breastmilk, prevent menstruation for 6 months

Surgery for weight loss

last resort, BMI>40, conditions improve after, need lifestyle changes, gastric bypass- Roux-en-Y gastric bypass: stomach is separated into 2 pouches, Y segment attaches intestine to small pouch, restricts food intake and food absorption, vertical banded gastroplasty- small pouch in stomach made by applying a double row of staples that elongates the esophagus, controls emptying of food and volume of food eaten, behaviours don't change, liposuction- removal of localized fat deposits, cosmetic,

Tobacco

leading cause of preventable death, 37 000 can die prematurely- affects everyone, earlier person stops-greater health benefits, ETS, rates vary depending on gender, age, ethnicity, and education level, current smokers, occasional- less likely to try and quit, young people- 1.6 billion cigarettes are consumed by minors, other drugs- frequently used together- 70% alcoholics and 90% of heroin addicts, 2-4x more prevalent in mental health problems, leaves of a plant prepared for smoking/chewing- addicted to nicotine: poisonous, addictive substance, responsible for many of tobacco's effects, highly addictive, reaches brain via bloodstream, releases norepi, epi, and dop- modulate everyday emotions, low doses= stimulant, increase BP, HR, alertness, concentration, rapid info processing, memory, learning (not in teens), may be mild sedative- relieves withdrawal symptoms, increase glucocorticoids and endorphins- milder mood variation- meets criteria for substance dependence, loss of control, need gratification, about 40 mins without nicotine, plan activities around, debt, withdrawal- tolerance, several hours after- severe cravings, insomnia, confusion, tremors, difficulty concentrating, fatigue, muscle pains, headache, nausea, irritability, anger and depression, changes in brain waves, HR and BP, poor performance on tasks requiring attention

Physical activity

levels remain low, males more active than females (except age 35-54), boosts concentration, memory and learning, 10% increase in children who only use inactive transportation to school, white and Aboriginal are more likely to be moderately active- black, west/south Asia are Arab are least likely, effects DOW, any body movement carried out by the skeletal muscles requiring energy, continuum, exercise- subset, planned, structured, repetitive movement to improve or maintain fitness-genetics and behavior, strength training at least 2 days/wk, mod (150 cal)- vig intensity most days/wk ,at least 10 min (150 min/wk or 30/day), limit sedentary activities- tv time, time indoors, motorized transport, increase duration and intensity of pa, more vig activity, amounts of activity depends on the individuals health status and goals- long and intensely enough to improve body's capacity for exercise (improve physical fitness), set personal goals, choose to be active when you can- start slowly and gradually increase

Behaviour change

lifestyle management process that involves cultivating healthy behaviors and working to overcome unhealthy ones- examine current health habits, target behaviour- learn about, find help, ppl may not change b/c they feel healthy- evaluate pros and cons- feeling better, looking better, doing better in school, improving in a sport, reducing stress, increasing self esteem, boost self efficacy- the belief in your ability to take action and perform a specific task-- locus of control: figurative place a person designates as the source of responsibility for the events in his or her life- internal vs external. Visualization and self talk: imagine being successful. Role Models and other supportive individuals- social support, gain strength from others experience. Identify and Overcome barriers to change: don't let past failures discourage you

Fats

lipids, stored= usable energy, insulate body, support and cushion organs, absorb fat- soluable vitamins, add important flavour and texture- linoleic acid and slpha linoleic acid to regulate body functions, molecule of gylcerol and 3 fatty acid chains (triglyceride)- unsaturated far, monounsaturated, polyunsaturated, saturated, large amounts of saturated- solid at room temp, naturally in animal products- red meats, homogenized milk, cheese, hotdogs, lunch meats, mono/poly unsat- plant sources are liquid at room temp- olive, canola, safflower, peanut, and soybean, corn, cottonseed oils, hydrogenation (process by which hydrogens are added to unsat fats, increase degree of saturation and turning liquid oils into solid fats, produces a mixture of sat fatty acids and standard trans forms of unsat fatty acids), increase stability of an oil, trans fatty acid- a type of unsat fatty acid produced by hydrogenation, atypical shape that affects their chemical activity- in processed foods, 8.4 g of trans fatty acid conusmed/day cholesterol- waxy substance found in the blood and cells and needed for synthesis of cell membranes, vit D and hormones- LDL- blood fat that transports cholesterol to organs and tissues- excess= accumulation of deposits on artery wall, sat and trans raise, HDL- blood fat that helps transport cholesterol out of the arteries- protecting against heart disease- mono can increase, choose unsat over sat and trans- raise LDL, decrease HDL and produce inflammation, trans- "partially hydrogenate oil/ vegetable shortening", monunsat- avocados, nuts, olive/ canola/peanut/ safflower oils- improve cholesterol levels, omega 3 fatty acids (polyunsat found in fish oils that are beneficial for CV health)- contain alpah-linoleic acid, decrease tendency of blood to clot, inhibit inflammation, and abnormal heart rthyms, decrease BP and risk of heart attack/stroke, Omega-6 had linoleic acid, high fat= increased risk for cancer, weight management challenges, men 17 g of linoleic acid and 1.6 of alpha, women- 12 g of linoleic acid, 1.1 g of alpha, 30-45 mL of unsat, 20-33% of total calories

Immediate effects

low concentrations of alcohol (BAC 0.03-0.05%)- light headedness, relaxation, release of inhibitions, euphoria, sociable, higher concentrations of alcohol- interference with motor coordination, verbal performance, intellectual functions, irritable, angry, crying, 0.1%- most sensory and motor functioning is reduced-sleepy, 0.2%- unable to function, coma at 0.35%, fatal if higher, small doses may improve sexual functioning but high doses decrease testosterone levels and impairment of sperm production, blood vessels dilate- body temp may decrease, disturb sleep patterns, hangover: headache, shakiness, nausea, diarrhea, fatigue, impaired mental functioning, from toxic products of alcohol breakdown, dehydration, and hormonal effects-prevention, driving ability is impaired, alcohol poisoning- large amounts in short time- CNS/resp depression or by inhaling fluid/vomit into lungs, using alcohol with other drugs- CNS depression, increase effects of both, life-threatening overdoses, related injuries and violence- impaired judgement, weakened sensory perception, decrease inhibitions, impaired motor coordination, increase aggressiveness and hostility, alcohol and aggression: more aggressive behaviour, antisocial personality disorder, havoc on home life, alcohol and sexual decision making- impaired, multiple sex partners, high risk behaviors, risk for rape

Sources of stress

major life changes, daily hassles, post secondary stressors- academic stress, interpersonal stress, time pressures, financial concerns, worries about the future, job-related stressors- burnout (state of physical, mental and emotional exhaustion), social stressors- support, prejudice, discrimination, virtual social networks, environmental stressors- severe (accidents, violence, disasters), can avoid if mere inconveniences, internal stressors- pressure, goals, physical and emotional states

Mind-Body interventions

make use of connection b/w mind and body, effect each can have- meditation, yoga, visualization, taijiquan and biofeedback, psychotherapy, support groups, prayer, music, art and dance therapy, placebo effect, hypnosis (includes a state of deep relaxation in which an individuals is more suggestible, used for pain, phobia, and addiction)

Alternative medical systems

may have practiced for a long time, used alongside western medicine, concepts in common, think disease is a disturbance/imbalance, focuses on energies within the body, mind, spirit, larger environment, treatment is comprehensive, Traditional Chinese medicine (TCM)- based on techniques and methods, individualized diagnosis, treatment and prevention, no identical diseases, qi, ying/yang- qi is blocked/disturbed=illness- restore balance and flow, increase energy, prevent disease and support the immune system, diagnosis- I listening, /smelling, inquiry, palp, herbal remedies and acupunture (insertion of thin needles into the skin at points around 12-15 meridians- pathways through which qi flows, rarely draws blood, 2000 points- left in for 20-40 mins), use of single medicinal botanical is rare, heat, acupressure, friction, suction, laser or electronic stimulation, points are individualized, named but not for anatomical spot, help relieve n/v, pain, few negative side effects, homeopathy- treats illness by giving very small doses of drugs that in larger doses would produce symptoms like those of the illness, like cures like, remedies are more effective with greater dilution, based on individual, >1000 different substances (animal/plant parts, minerals, chemicals)-talk- assess physical and psychological and emotional health, controversial

Psychological health

mental health, defined either negatively as the absence of illness or positively as the presence of wellness, our capacity to feel and behave, can be supported or sabotaged, good= positive sense of emotional and spiritual well being that values fairness, culture, dignity, and interpersonal connections, NOT psychological normality (psychological characteristics attributed to the majority of people in a population at a given time, "normal"), psychological diversity is a valuable asset to society- cannot judge psychological health by the way ppl look

Substance use disorder

mild- 2-3 symptoms, mod/severe- 4-5, 6-11 1. Developing tolerance 2. Experiencing withdrawal 3. Taking the substance in larger amounts or longer period 4. craving 5. making unsuccessful efforts to stop. 6. spending time obtaining the substance 7. giving up/reducing important activities 8. continuing to use 9. using the substance repeatedly-failure to fulfill obligations 10. using the substance repeatedly- resulting in dangerous situations 11. continuing to use the substance despite social/interpersonal problems

Ovarian cancer

more rare than U/E, but causes more deaths, no warning signs, increase abd size and bloating, urinary urgency and pelvic pain, cannot be detected by simple screening methods- diagnosed late, RF- increase age, no pregnancy, fhx of breast/ovarian cancer, obesity, specific genetic mutations, high # of ovulations- decrease by pregnancy, breastfeeding, OC, F/V, pelvic exams at regular intervals- US, surgery to remove both ovaries, FT and uterus, chemo/R

Skin cancer

most common, highly curable, melanoma- malignant from pigmented cells-mole, from excessive UV radiation- A and B - sun, tanning beds, burns and tans can lead to skin cancer, M are more likely to develop and die from it, earlier in childhood- burned= increased risk for developing it later on, having many moles, spending time at high altitudes, fhx, exposure to coal tar, pitch, creosote, arsenic and radioactive materials, basal cell carcinoma- deepest layers of the skin, squamous cell carcinoma- surface layers of the skin- 93% of diagnosed cases, found in chronically sun-exposed areas- face, hands, arms, neck, pale, wax like, pearly nodules/ red, scaly, sharply outlined patches, painless but may bleed, crust of form an open sore, melanoma spreads rapidly, occurs anywhere- back, chest, abd, legs, from preexisiting moles- ABCDE, prevent overexposure to sunlight (blistering and peeling sunburns) examine skin regularly- ABCDE, dermatologist if fhx, biopsy, surgery

Prescription drugs for weight loss

must reduce energy consumption, increase energy expenditure, or interfere with energy absorption, most often appetite suppression, have potential side effects, most are only approved for short term use + behavioral modification, only recommended for certain people

Phytochemicals

naturally occurring substance found in plant food that may help/prevent/ treat chronic diseases, cruciferous veggies- cabbage family- cabbage, brocoli, brussel sprouts, cauliflower, kale, flower petals look like cross)-may render some carcinogenic compounds harmelss, allyl sulphides- boost immunity of cancer fighting cells

Physical responses of stress

nervous system- ANS (controls basic body processes- SNS (reacts to danger effect, also called noradrenaline) and PNS- moderates excitation, norepinephrine - increase function of tissues during increased activity, causes arousal. Endocrine system- glands, tissues, and cells release hormones to influence metabolism and other body processes- both systems make the assumption of a threat- cortisol and epinephrine are released= increased HR and RR, hearing and vision become more acute, live releases extra sugar into bloodstream to boost energy, increased perspiration, brain releases endorphins (pain-inhibiting effects)= fight or flight reaction (prepares an individual for conflict/ escape by triggering hormonal, cardiovascular, metabolic and other changes- PNS restores homeostasis- everything goes back to normal, many stressors we face now do not require a physical response

Immediate effects of smoking

nicotine poisoning-faintness, dizziness, rapid pulse, cold, clammy skin, n/v, diarrhea, effect depends on dose and tolerance, excite/tranquilize NS, stimulates cerebral cortex (outer layer of the brain, controls behaviors and mental activity), adrenaline is released, inhibits formation of urine, constricts blood vessels, increase HR and BP, decrease hunger contractions, dulls taste buds

Weight loss programs

noncommercial- provide group support, no diet, seek out professional advice for creating plan, free, TOPs, OA, commercial- provide group support, nutrition education, pa recommendations, and behavior modification advice, WW, Nutri- System, Jenny Craig, LA weight loss, should have safe and balanced diet (DRI and all food groups), pa and exercise should be strongly encouraged, promote slow, steady weight loss, physical eval and monitoring should be recommended, include plans for weight management (maintenance), provide info about fees and costs, online- self help and support with chat rooms, bulletin boards, and e-newsletters, self-assessment, many are free, clinical- hospital

Health

overall condition of a person's body/ mind to the presence or absence of illness or injury, resource NOT objective to living

Measures of weight

overweight- body weight that falls above the recommended range for good health, obesity- condition of having an excess of non-essential body fat, BMI >30, >25% BF M, 33% W-- height-weight charts, BMI (measure of relative body weight that takes height into account, correlated to more direct measures of body fat, weight in kg over height in meters squared), body composition analysis- hydrostatic (underwater) weighing and bod pod: % BF can be calculated from bone density, muscle has higher density than fat, bod pod uses air- how much is displaced, skinfold measurements- thickness of fat under skin and formulas, circumference measures- waist, waist to hip, electrical impedence analysis : electric current through body-fat free tissues are favoured, scanning procedures: CT, MRI, dual energy X-ray absorptiometry, dual-photon absorptiometry, infared reactance, total body electrical conductivity

Chain of infection

pathogen: microorganism that causes disease, produce toxins (poisonous substances) that harm human tissue, reservoir: natural environment in which a pathogen typically lives- person, animal, environmental component, ill or asymptomatic, portal of exit: saliva, mucus membranes, blood, feces, and nose/throat discharges, means of transmission: direct (passed from one person to another w/o an intermediary, fairly close), or indirectly (vectors- insects, rodents, or other microorganisms that carry and transmit a pathogen from one host to another), portal of entry: direct contact with/ penetration of the skin, inhalation through the mouth or nose, ingestion of contaminated food/water, local/systemic infection, the new host: depends on immunity, conditions need to be right for pathogen to multiply and produce disease, break the chain with public health measures and individual action

Phases of immune responses

phase 1: dendritic cells goes to injured site, consume foreign cells, display antigens on surface and helper T cells come, phase 2: HTC multiply rapidly and trigger production of KTC and BC, cytokines help regulate and coordinate the immune response, phase 3: KTC strike foreign and invaded cells, identifying with antigen, sacrifice body cells to destroy foreign organism within cell-mediated immune response, BC produce large quantities of antibody molecules- Y- antibody mediated immune response work OUTSIDE the cells, phase 4: slow down of activity, lymphocyte proliferation (death), dead cells are scavenged by WBC, filtered by spleen, liver, kidneys and excreted out- immunity, acquired-mobilize cellular memory of an attack, incubation- active multiplication of bacteria and viruses, no symptoms- appear in prodromal period, from immune response

Skill related fitness

physical abilities that contribute to performance in a sport/activity including speed (ability to perform a movement in a short time), power (exert force rapidly, based on a combo of strength and speed), agility (change body's position quickly and accurately), balance (maintain equilibrium either while moving or stationary), coordination (perform motor tasks accurately and smoothly by using body movements and the senses), reaction time (respond quickly to a stimulus), developed through practice

Health related fitness

physical capabilities that contribute to health- cardio respiratory endurance, muscular strength, muscular endurance, flexibility, and body composition, withstand physical challenges and protection from diseases

Risk factors for addiction

physical, psychological and social factors- difficulty controlling impulses, strong need for excitement, stimulation and immediate gratification, blot emotional pain, raised in a family with abuse, HCP, poverty, mental illness, common co-occurrence- drug abuse may bring about symptoms of another mental illness, mental disorders can lead to substance abuse, overlapping genetic vulnerabilities, environmental triggers, involvement of similar brain regions, developmental disorders, other risks- intoxication: injury, unsafe sex, incidents of aggression and violence, unexpected side effects, unknown drug constituents-composition, dosage, toxicity of street drugs is highly variable, IDU- share/reuse equipment- HIV/ HCV, infections, endocarditis, TB, tetanus-exchange programs, legal consequences

Maslow's hierarchy

physiological, safety, love, maintaining self- esteem, self actualization- realsim, acceptance (self concept/ self esteem), autonomy- physical, social, emotional, and intellectual independence, inner directed not outer directed, authenticity- not afraid to be themselves, genuineness, capacity for intimacy, creativity

Cancer

prevented through simple lifestyle changes, abnormal, uncontrolled cellular manipulation- tumor (neoplasm)- a mass of tissue that serves no physiological purpose, benign/malignant( can spread)- invade blood vessels, lymphatic system (network of vessels that returns proteins, lipids and other substances form fluid in the tissues to the circulatory system), and nerves, no regard for normal control mechanisms- produces sign/symptoms- X-ray, biopsy- metastasis: spread of cancer cells form one part of the body to another, cancer cells do not stick together as strongly as normal cells- recruit and modify cells- remove ALL cancer cells- stages: classifies the process or extent of a cancer in a person, types: can retain some of the properties of normal cells for a time, carcinomas- epithelial, sarcomas- CT and fibrous tissue, lymphoma- lymph nodes, leukemia- blood forming cells, bone marrow, vary in how they are detected and how they respond to treatment, oncologist, hematologist

Aging stats

primary cause of injury is falls, 20-30%, 85% of hospitalization from falls, falls -95% of hip #, 20% die within a year, 20% decrease in falls could result in 7500 fewer hospitizations, >65- 19%-20% self reported obesity, alcohol abuse affects 6-10%, 66%> 65 have > prescriptions, 13% of older adults are participating in the work force, 80% participate >1 social activity, 36% volunteer, low income decrease from 21.4%-5.2%, glaucoma- 1/100 >40, AMD is third leading cause of blindness, 80% >50 from OP, 1/5 expected by 2036, 1/3 W, 1/5 M experience a fracture, 1/4W, 1/8 have, W have 10-25% less bone in their skeleton, 15% have some degree of OP, 10% tied to gene mutations (Alzheimer's), 5:1 W/M >100, lifespan is only 3% heritable, older adults 16% of total pop in 2014, increase to 24-28% by 2063, 2012- 4% >80, 92% >65 live in private households, 7% live in collective dwellings, >85- 30% live in special care facilities, divorced 12%, 3/4 cases, family takes care, CPP/QPP- replace 25% of earnings, low-income 21%-5%, 42% believe in life after death, 56% do not have a signed will, 70% deaths occur in hospitals, 13% >15 have provided EOL care, 1/3 chose not to use lethal injections, 3/4 from deceased, (increased 5% in 5 years, 17% in 10), 90% support organ donation, <25% have made plans, 66% cremation 2013 can

Immunization

process of conferring immunity to a pathogen by administering a vaccine-preparation of killed/ weakened microorganisms, inactivated toxins, components of microorganisms that is administered to stimulate immune response and future protection against pathogen, attenuates (weakened) dead- active immunity (produces own antibodies) passive immunity (gets antibodies from someone else), few adverse reactions

Health Promotion

process of enabling people to increase control over and improve their health

Acceptance and change with weight loss

professional help: weight may be related to how we feel about ourselves, have experience with weight management, body image issues, eating disorders, addictions and abuse, severe body image problems- diet restrictively, eat compulsively, extreme= body dysmorphic disoder- overly concerned with physical appearance- focus on slight flaws, r/t OCD- depression, social phobia, suicide, may bear little resemblance to fact, muscle dysmorphia, acceptance and change: heredity, lifestyle changes, learning when limits have been reached and accepting them, W measure self-worth with appearance, positive and realistic atmosphere

Dietary supplements and diet aids

promoted everywhere, there is no quick easy way to lose weight- formula drinks and food bars- difficult to use for long periods of time= muscle loss and health problems, weight is regained, herbal supplements- little info available, labels mat not list ingredients- toxic?, other- fibre acts on intestines, vitamins

Designing Exercise Program

promotes health, and is fun for you to do, CRE, strength, flexibility, and neuromuscular training, medial clearance- PAR-Q (self-screening), get complete physical and ECG id cardio risk, basic principles- specificity- exercise for each component, progressive overload- amount of stress placed on the body - gradual increase in amount causes adaptations that improve fitness, depends on current fitness levels- FITT (frequency, intensity, time, type of activity)- rest and recuperation- overtraining leads to injury, illness, and excessive fatigue- reversibility- fitness improvements are lost when demands on the body are lowered- individual differences- genes, men (increased testosterone), selecting activities: slowly and gradually increase amount of mod pa, what make sense to you? training in specific skills- get help

Body composition

proportion of fat and fat-free mass (muscle, bone, water) in the body, excessive abd fat is more likely to experience heart disease, increased BP, stroke, joint problems, diabetes, gallbladder disease, cancer, back pain

Giving the gift of life

pros and cons of organ donation- high demand, living donors- kidney, parts of liver, lungs, intestine and pancreas, blood, bone marrow, deceased donors- hearts, whole lungs, or other parts that cannot be from living donor- eyes, bone, tendons, skin, heart valves, matched, immunosuppressants, anyone can register, saving a life is always first priority, does not change body for funeral, religion may inhibit

Prions

protenaceous- no DNA/RNA, infectious particles thought to be responsible for a class of neurodegenerative diseases known as transmissible spongiform encephalopathies- spongelike holes in the brain- loss of coordination, weakness, dementia, death, creutzfeldt Jakob disease, mad cow disease, scrapie in sheep, from genetic mutations/ eating infected material, resistant to heat, radiation and chemicals, long incubation period

Absorption/metabolism of alcohol

rate is affected by many factors-carbonation, artificial sweetness, food, metabolism and excretion- rapidly distributed throughout body tissues, liver, small amount in stomach, converted to acetalehyde-acetate- burned for energy/converted to fat, what is not metabolized in liver- lungs, kidneys, sweat glands, readily enters human brain (affects neurotransmitters)- different brain regions are disrupted

Characteristics of addiction

reinforcement, compulsion/craving, loss of control, escalation, negative consequences , addiction starts when a person does something to bring pleasure/ avoid pain-repeat- tolerance- deterioration of other effects, withdrawal (symptoms including anxiety, pain, irritability, sweating, tremors, vomiting and insomnia- depends on personality, lifestyle, heredity, social and physical environment, nature of substance/behaviour, used to cope

Planning for social changes

retirement, reestablish important relationships, developing satisfying interests, saving income, changing roles and relationships: empty nest syndrome, more time spent as a couple, increased leisure time- freedom form deadlines, competition and stress, many do not know how to spend their free time, volunteering, economics of retirement- may have severely restricted budget/ financial disaster

Breast Cancer

risk increases with age, genetics (3 fold risk), early menstruation, late onset of menopause, no children, first child after 30, HT, obesity, alcohol use, estrogen!, low fat, vegetable rich diet, exercise regularly, limit alcohol intake, maintain healthy body weight, mammogram q2 yr> 50, MRI, very low levels of cancer from mamm, US, clinical breast exam, breast awareness (BSE), lump, swelling, thickening skin, irritation, dimpling, nipple pain, scaliness, retraction, lumpectomy, mastectomy, armpit lymph node, chemo/R, selective estrogen receptor modulators- tamoxifen, genetic test

Planning a funeral/ memorial service

rites of passage that commemorate a person's life and acknowledge their passing, survivors can show support for one another, disposition of the body- disposed of for sanitary reasons- surrounded by social, cultural, religious, psychological and interpersonal considerations, burial, cremation- if body will be viewed- embalming- removing blood and other fluids and replacing them with chemicals to disinfect and temporarily slow deterioration of a corpse, good death- pain and symptom management, clear decision making, preparation for death, completion, contribution to others, affirmation of the whole person, arranging a service: casket at funeral, not memorial service, both may be done, able to express grief through ceremony- healing, share memories and support, held anywhere, clergy, family member/close friend, photos, food, terminal illness may plan own, religious and culture views

Protozoa

single-celled, product recurrent, cyclical attacks, malaria- plasmodium, flu-like symptoms and maybe anemia, giardiasis-intestinal disease from giardia lambia, n/v, bloating, abd cramps, water- borne- food, rarely serious, treated with medication, trichomoniasis (trich)- common vaginal infection, increase risk of HIV transmission, trypanosomiasis- from infected tsetse fly-fatigue, fever, rash, severe headache, CNS damage and death, amoebic dysentery- intestines from entamoeba histolytica- bloody diarrhea, stomach pain, fever

Fungi

single/multi celled, absorbs food from living/ dead organic matter, moulds, mushrooms, yeast, only 50 cause diseases in humans- skin, mucus membranes and lungs, spores, candida albicans, can go systemic- histoplasmosis

Stress management

social support, participating in and contributing to family and community, setting higher expectations with clear boundaries and fair, consistent expectations, build life skills, avoid the urge to control the outcome, know limits, trust others

General Adaptation Syndrome (GAS)

stress can increase vulnerability to many ailments, universal and predictable response, stress is triggered by a pleasant stressor (eustress), stress brought on by an unpleasant stressor (distress)- alarm: fight or flight reaction, more susceptible to disease/ injury- headaches, indigestion, anxiety, disrupted sleep/ eating patterns, - resistance: continued stress- body develops new level of homeostasis, -exhaustion: stressor persists, life threatening physiological state, long term negative impact of the stress response on the body (wear and tear): allostatic load- depends on genetics, life experiences, emotional and behavioral responses to stressors, if allostatic load exceeds your ability to cope, you are going to get sick

Exercise program for CRE

stress on large portion of body's muscle mass for a prolonged period of time- walking, jogging, running, swimming, bicycling, aerobic dancing, F- 3- 5x/wk, I- increase maximal oxygen consumption (V02 max)- max ability of cells to use oxygen, measure HR- benefits occur at target heart rate range (may improve quickly as body adapts-more fit= more hard you will have to work to improve), T-20-60 min, low-mod intensity- 45-60 min, high- 20 min, warm up/ cool down- enhances performance, and decreases chance of injury, spread synovial fluid (to protect joint surfaces), low intensity similar to movements of exercise, stretch after, cool down to restore body's circulation

Psychoneuroimmunology

study of interactions among the nervous, endocrine, and immune systems through nervous and endocrine system actions- impairment of immune system- flexible, and capable of change w/o compromising health, increased cortisol= decreased lymphocytes, neuropeptides, acute stress- WBC move into skin to enhance immune response, no significant immune changes, chronic- prolonged secretion of cortisol and may accelerate the course of diseases that involve inflammation, optimism, successful coping, positive problem solving= positive effect on immunity

Carbs

sugar, starches, dietary fibre, supply energy for body cells- brain (NS), blood and muscles during high intensity, if not enough- body synthesizes carbs from proteins- own organs and tissues, simple- sucrose, fructose, maltose and lactose, provide sweetness, complex- starches and dietary fibre- grains, legumes, tubers, during digestion body breaks down carbs into simple sugars (glucose-basic fuel), release of insulin, glycogen (stored in liver and muscles)- refined (processed), unrefined (whole grain- entire edible portion of a grain- germ, endosperm, bran)- most times just the endosperm is left- lower in fibre, vitamins and minerals- added sugar (no more than 10% of total calories), unrefined take longer to chew and digest and enter bloodstream more slowly, insulin and glucose levels rise and fall during a meal- can be quick and dramatic or more moderate (glycemic index- a measure of how the indigestion of a particular food affects blood glucose levels), more acidic and high fat= lower, hard to base foods off of, 45- 65% of total calories, added sugar 5-25% of daily calories

Effects of chronic abuse

the digestive system- alters functioning of liver, fatty liver- inflammation- alcoholic hepatitis- cells are damaged and destroyed-cirrhosis-depends on susceptibility, jaundice, edema-50% 5YSR, inflame the pancreas-n/v, abnormal digestion, severe pain, GI bleed, EV, CV system- depend on amount consumed, moderate doses may reduce risk of HD/HA, increase BP (higher risks for stroke and ha), cardiac myopathy (weakening of heart muscle), holiday heart (abnormal heart rhythms), cancer- breast, colon, rectum, esophagus, larynxm liver, mouth, pharynx, 5-6 daily drinks increase risk by 50 or more, brain damage- tempered by physiology and genetics, brain shrinkage with loss of grey and white matter, decrease blood flow, slowed metabolic rate, cognitive impairments-memory loss, dementia, compromised problem solving and reasoning abilities, mortality- average life expectancy is 15 years less, during pregnancy: damage to fetus- depends on amount consumed and stage of pregnancy, early= miscarriage- FAD-facial deformities, heart defects, and physical and mental disabilities, permanent, incurable, 3x as many have alcohol related neurodevelopment disorder (ARND)- cognitive and behavioural problems as adults- more likely to develop substance abuse/criminal records, no amount is safe, avoid if trying to conceive/ sexually active w/o contraception, enters breast milk

Body image

the mental representation a person holds about her or his body at any given moment in time, consisting of perceptions, images, thoughts, attitudes, and emotions about the body

Physical fitness

the more you ask of your body, the stronger and fitter it becomes- left unchallenged, bones lose their density, joints stiffen, muscles become weak and cellular energy begins to degenerate, the body's ability to respond/adapt to the demands of stress and physical effort,perform vigorous levels of physical activity without becoming tired

Aging

the process of becoming older, genetically determined but affected by environment, occurs throughout life, attitude toward life and attention to health influences the satisfactions you get from life- biological: normal, progressive, irreversible changes to the body that begin at birth and end at death-psychological: more abrupt changes in circumstance and emotion- doesn't happen to everyone, time varies, may have to adjust, requires preparation- good health habits in teens/twenties, many characteristics associated with aging are from neglect and abuse of our bodies and minds- biochemical processes, damage- needs to be extensive before function decreases

Atherosclerosis

thickening and hardening of the arteries= narrowing, plaques- deposits of fatty substances on the inner wall of arteries- if heart, brain/organs are affected (deprived of blood and 02)- fatal- coronary heart disease (CAD), blockage of coronary artery= heart attack, cerebral artery= stroke, artery in limb= peripheral arterial disease

Major risk factors for CVD

tobacco use- damages lining of the arteries, decreases HDL, increases triglycerides and LDL, increase BP and HR, CO displaces oxygen, platelets stick together, speeds development of fatty deposits, HTN- risk for heart attacks and stroke, too much force on artery walls., chronic is bad, 120/80- HTN= 140/90, DM < 130/80, from increased output or resistance (atherosclerosis), scars and hardens arteries, silent killer, damages vital organs, essential/primary, test BP q 2 years, lifestyle changes- increase F/V, decrease NA (no more than 1500 mg), medication, increased cholesterol- needed for proper functioning of the body but too much clogs arteries, lipoproteins: protein and lipid substances in the blood that carry fats and cholesterol- classified according to size, density, and chemical composition, HDL and LDL, LDL below 3.4, HDL above 1.6, total less than 5.2, may reverse deposits, increase fibre, unsat for sat and trans, PA- exercise, decrease BP, resting HR, increase HDL, maintain desirable weight, improve condition of blood vessels, prevent/control DM, obesity- weight increase = increased risk for CVD, endothelial cells- cells lining the inside of arteries, regulate blood flow and prevent platelets from sticking- dysfunctional- limit blood flow (obesity already has to work harder)= hypertrophy= HF, DM- increase blood glucose because insufficient supply/ inadequate action of insulin, increase risk for CVD by 2-4 %, accelerated atherosclerosis

Manipulative and body-based methods

touch and body manipulation- correct misalignment to bring optimal health, massage, acupressure, Feldrenerias, Rolfing, chiropractic- MSK problmes, manipulation of spine and other joints

Learning about death

understanding/attitudes change we grow/mature, young-interruption, absence, do not understand it is final, irreversible, 6-9-understand that death is final, universal and inevitable- mature understanding of death- understands that it involves the cessation of all physiological munitioning and there are biological reasons for its occurrence, further refined in adolescents and young adults- formal understanding: universality- all living things eventually die, irreversibly- cannot be made alive again, non-functionality- cessation of all physiological functioning, causality- biological reasons, can hold empirical ideas too- non-corporeal continuity- the notion that human beings survive in some form after the death of the physical body, many people seek to avoid any thought/mention of death, few are present at the death of a loved ones, fictitious deaths show reversibility, fear- death is "creepy", avoid denial, hospice

Canada health act

universally available to permanent residents, comprehensive in the services it covers, accessible w/o income barriers, portable within and outside the country, publicly administered, must prove coverage for all medically necessary hospital and physician services, medical doctors- independent practitioners who hold a doctor of medicine degree from an accredited medical school, doctors of osteopathic medicine- incorporates the theories and practices of scientific medicine but focuses on MSK problems and manipulate therapy, whole person approach, podiatrists- specialize in the medical and surgical care of the feet, optometrist- trained to examine the eyes, detect eye diseases and prescribe corrective lens, dentists- specialize in the prevention, and treatment of diseases and injuries of the teeth, mouth, jaw, allied HCP- typically provide services under supervision/control of independent practitioners

Emotional responses to pregnancy

unpredictable, extra support and reassurance- exhilarated and euphoric, worry, happy, stress, depression, happy excitement and anticipation

CVD

various diseases of the heart and blood vessels, 1.3 million can from unhealthy diet, OW, sedentary, smoking, ineffective ways of managing stress, increased BP and cholesterol, heart disease and stroke claim 1 life every 8 minutes

Female anatomy

vulva- external female genitals/sex organs, mons pubis, labia majora and minora, opening of urethra, opening of vagina, clitoris- highly sensitive female genital structure, prepuce- foreskin of clitoris/penis, urethra-duct that carries urine from bladder to outside of body, hymen- membrane that partially covers the vaginal opening, vagina- passage leading from the female genitals to the internal reproductive organ; the birth canal, cervix- end of the uterus opening toward the vagina-uterus- hollow, thick-walled muscular organ in which the fertilized egg develops; the womb, Fallopian tubes- a duct that guides a mature ovum from the ovary to the uterus (oviduct), ovary- reproductive glands that produce ova and sex hormones

Exercise Program for Muscular strength and endurance

weights, calisthenics, condition and tone whole body-choose exercises that target major muscles of shoulders, chest, back, arms, abd, legs, resistance exercise (activities that force muscles to contract against increased resistance, strength training), isometric (static)-application of force w/o movement, 6 sec for 5-10 reps, useful for recovery from injury, don't hold breath, isotonic (dynamic)- application of force with movement, equipment- weight machines, free weights, exercises- work all major muscle groups- neck , upper back, shoulder, arms, chest, abd, lower back, calves, thighs, buttocks, 8-10 exercises, F- at least 2 nonconsecutive days/wk, I/T- weight= intensity in CRE, # of reps= time, enough to temporarily fatigue the muscles- heavier= fewer reps (1-5), strength, light weight= high reps (20-25) for endurance, 8-12 reps of each exercise for both- add weight once you can do more than 12, 1-3 sets, supplements- dangerous, expensive

Anxiety disorders

when fear is out of proportion to real danger (problem), feeling of fear that is not directed toward any definite threat. Simple phobia- fear of something definite, persistent and excessive fear of a specific object, activity, or situation Social phobia- fear humiliation or embarassment while being observed by others- speaking in public Panic Disorders- sudden, unexpected surges in anxiety + rapid heartbeat, SOB, loss of physical equilibrium, feeling of losing mental control- agorophobia: fear of being alone, away from help, avoidance of many different places and situations, fear of leaving home Generalized Anxiety Disorder (GAD)- excessive, uncontrollable worry about all kinds of things and situations, thinking in circles Obsessive Compulsive Disorder (OCD)- uncontrollable, recurring thoughts and the performing of irrational rituals, obsessions are recurrent, unwanted thoughts/impulses, compulsions are repetitive, difficult to resist actions, associated with obsessions, feel anxious, out of control and embarrassed Behavioural Addictions- experience intense urges to engage in the behaviour- anxiety intensifies until behaviour is completed- relief and elation, maladaptive and persistent despite negative consequences Post Traumatic Stress Disorder (PTSD)- reaction to severely traumatic events- reliving through dreams, flashbacks, and hallucinations, re experiencing the trauma, numbing of feelings, hyperarousal, sleep disturbances, months- years Treatment- psychological interventions focusing on thoughts and behaviours and drug treatments

Problems with very low levels of body fat

,8-12 % W, 3-5 % M, reproductive, circulatory, immune system disorders, muscle wasting, fatigue, dangerous eating disorders, female athlete triad- abnormal eating patterns, excessive exercising, loss of menstrual periods (amenorrhea) and decreased bone density- right weight is based on lifestyle

Uterine/Endometrial Cancer

. >55 yrs, RF- prolonged exposure to estrogen, early menstruation, late menopause, no pregnancy, obesity, T2DM, OC provide protection, pelvic exam, surgery- hysterectomy, R/chemo/ HT

Tobacco stats

1/5 deaths, 1/2 die from related illness, 20.3% (<12) use products, uni-25% until 2005- rates decrease by 4.9%, 2012- 23% W, 17.5% F, 80% believe tobacco will shorten life, 43% relapse, approx, 3.2 attempts to stop, before 30- avoids 90% of lung cancer mortality, 72% Inuit, 52% adults (about double gen pop), 60% aboriginal (1/5 deaths are tobacco related), 55% from retail, 1/3 from social, grade 6-9- 15.5% tried, 2.2% current (4.3% in Quebec and SK), 8.1%- cig, 7.56%-cigars, 70% tried to quit, 11.8% 15-19 current, m-13.0%, W- 10.56%, 16 >15 use smokeless,half want to quit, programs are successful if 15% can quit, 60% relapse in 3 mon, 75% in 6 mon, DRD2- 3x as likely to become regular, >half teens progress to daily use, 1/2 goes to dependence, 70% wish they never started, 75% smoking 7-9 years about HS/uni, 73% smoke in movies, 82% pg 13, 3x as likely if seen movie, nose filters 75% of foreign matter- bypassed, 10% of weight, 44% 12-17 have tried, 31% >18, inhale 8x as much tar, less likely to quit, increase plaque formation by 50% if smoker, 25% for ex-smokers, 20% regular exposure to ETS, death rate is 70% higher than non-smoker, <40- 5x as likely to have ha, 21% less blood supply in smokers, >2 packs/day- LC increase by 12-25x, 85% LC deaths are from smoking , after 1 year of not smoking- risk decreases, after 10 years risk is 50% less than continuing smokers, 4th leading cause of death , 18 x more likely to die form emphysema and chronic bronchitis, 4% of pop, 80-90% cause is smoking, half as likely to live until 75, more sick days, 17% F more sick days than F non-smokers, 1/20 has CP- 90% from smoking, 17% have used spit

Body's defense system

1st line: physical and chemical barriers- immune system (collective physical and chemical defenses against foreign organisms and pathogens)- physical and chemical barriers- skin, mucus membranes (cell designed to prevent passage of unwanted organisms and particles, body openings and fluids are rich in antibodies and destructive enzymes, resp tract has cilia, immune system- defenders, neutrophils (engulf foreign organism and infected, damaged or aged cells, during inflammatory response), macrophages (phagocytic, devour foreign particles), NK (destroys virus infected and cancer cells), dendritic cells (activate T and B), lymphocytes (works in bloodstream and lymphatic system), lymph nodes, T- arises in bm, matures in thymus, B- bone marrow, antibodies, helper T cells- lymphocytes that help activate other T and B cells produce antibodies, killer T cells- lymphocytes that kill body cells that have been invaded by foreign organisms, suppressor T cells- lymphocytes that inhibit the growth of other lymphocytes (regulatory), antibodies- specialized proteins produced by WBC that neutralize specific microbes, memory- lymphocytes generated during an initial infection that circulate the body for years, remembering specific antigens that caused the infection and quickly destroying them if they appear again, autoimmune disease, markers- self and nonself- trigger immune response- antigens- makers on the surface of a foreign substance that immune system cells recognize as nonself and trigger immune response, lock and key with antibodies- response- inflammation, histamine and other substance dilate blood vessels and fluid to flow from capillaries to injured tissue, increased heat, swelling, and redness- pus, immune response- innate and adaptive (acquired)

Fetal Development

1st trimester: 30 hours after fertilization- cell divides- different kinds but only certain cells respond it, 4th day- 32-128 cells- blastocyst (days 6-14, before the cell cluster becomes the embryo and placenta), implants and draws nutrients from endometrium- embryo (b/w blastocyst and fetus, wk 2-8)- inner cells separate into 3 layers- inner body parts, digestive and respiratory system, middle layers- muscles, bone, blood, kidneys and sex glands, 3rd layer- skin, hair, NS, chorionic villi (network of blood vessels that forms placenta)- exchange of nutrients and waste, placenta is expelled through uterus, umbilical cord- connects placenta and fetus, through which nutrients pass, amniotic sac- membranous pouch enclosing and protecting the fetus, holds amniotic fluid, wk 2-9 has rapid differentiation and change- all major structures are formed and function- heart and liver- vulnerable to environmental damage, quite active, 2.5 cm long, weighs <30g, 2nd: 35 cm, 680g, large amounts of food, oxygen and water, all body systems are operating and fetal heartbeat can be heard, fetal movements- 3rd: gains most of birth weight, needs calcium, iron and nitrogen, needs fat, time for organs to develop, immunity

Alcohol stats

20% is rapidly absorbed from stomach to bloodstream, 75% absorbed in upper part of intestine, 2-10% is not metabolized by the liver,11% of 18-24s have CAB, uni 23-75% CAB drinkers, 3x binge drink, 2x sexual advantage, 1/3 suicides involve alcohol, more than triples the chance of fatal injuries- 1/2 of fatal falls/burns, 50% of murders, assaults and rapes, verbal abuse 8.9%, emotionally hurt/neglected 7.1%, feel threatened 6.3%, physically hurt- 2.2%, binge drinkers 5x more likely to engage in unplanned sexual decisions, 5.5x to be unprotected, >0.14-480x, BAC-0.14, 40X more likely to be in a crash, 42% of MVAs, 2010- 16-25 year olds only 13.6 of gen pop but 33.4% of alcohol related traffic deaths, 17.4% can, 68% are concerned, mortality- 6%, 8% of can deaths aged 0-64, 1/2 are from chronic conditions, 14% increase of alcohol consumption, 76% >15, 60% 15-19, 83% 20-24, heavy 1/2, 21% exceeded 1st guideline, 15% second, 29% and 23% of y of exceeded both, 20 and 14% a exceeded, homeless- less than 5%, tolerance- 50% more, withdrawal- severe 5%, mortality rate- 15%, twins twice the risk if one is addicted, 4x gen pop if identical, 50-60% determined by genetics , 1/3 can stop on their own, treatment is successful for 1/2, 73-77% W use alcohol

Addiction stats

3% of can adults are affected by gambling disorder, >60% of youth have done it at least once in the past year, 2% have gambling problem, increase in young men, 2% of youth are affected, up to 10% of users may experience internet addiction, 2004-2011- cannabis rates increased in 15-24 year olds, 3x for cannabis, 5x for illicit drugs, 15.2% (2x higher) M, 7.7% W uni- 17.5% use weed, 3.5% use illicit drugs, increase from 2004, 5.6% use hallucinogenic, 5% opioids, 2.5% ectasy, 2.1% cocaine, 2.6% amphetamines, 1/3 ppl with a mental illness have sa problems, 2011- IVD made up 14% of new HIV/AIDs cases, legal consequences- 310/ 100 000

Cancer stats

33% of cases can be prevented, 5ySR- 63%, 46% M, 41% W develop at some point, Lung cancer makes up 14%, tobacco smoke- 30% of all cancer deaths, 85% of lung cancer deaths, ETS- increases risk by 20-30%, LC- 16% are detected before spread, 5ySR is 17%, SCLC-15%, prevent 76-90% of cases of colorectal, but only 1/2 are up to date on screening, breast- only 15% occur with family hx, 1/2 deaths as lung but most common, 1/9 get it, 1/29 die, <1% <30, 80% >50, mammogram- 85-90% of cancer is identified, biopsy-90% harmless bulbs, > 5 yrs- 98% if no lymph node involvement, 88% 5yrs, 82% for 10 yrs, prostate- 3rd leading cause of death, 89% >60yrs, genetics- 5-20%, 5YSR- 96%, cervical- 70% develop >1 HPV infection, 1/3 are malignant, uterine/endometrial- 5YSR- 85%, ovarian- 5ySR- 45%, skin- 5ySR- 90%, oral - twice as great in M, >40, 5ySR- 63%, Testicular- 1.1% but more prevalent be 15-49, 5rSR-97%, pancreatic- 20-30% is linked to smoking, stomachh- 5ySR- 25%, Bladder- 3x in M than w, kidney- 5ySR- 68%, brain- 20% from smoking, smoking- 85% LC, and 30% of all cancer deaths

Physical activity among FN ppl off reserve, metis, inuit

37-39% vs 30% inuit inactive- 31%- aboriginal ppl off reserve may be more active than non-aboriginals- 1/5 of FN ppl living on reserves engaged in at least 30 min of mod-vig actvity 4 or more x/wk, males more active, support social environment-more exercise, active (4 more kilocalories/kg of body weight/day), mod active (less than 3-1.5), inactive (less than 1.5), sociodemographic factors, each group was more likely than non-aboriginal people to report general and mental health as good/fair/ poor rather than excellent/ very good, higher prevalence of chronic conditions off reserve (71%) and Metis (74%) than NA (64%), A have more dependent children and are younger than NA- rural, single, low annual income, less than secondary graduation, less employed, leisure time- age, gender, and education- higher- male, more education, 12-17- higher for NA, married, child, 35 or older, employed, lower income= less activity , a ppl tend to report poorer health- obesity, chronic complications (DM), tradition may be associated with health

Nutrition stats

45% of childhood deaths, 11% of diseases are from undernutrition, in can- 25% of M/ 23% of F >19 have fat intake > 25-35%, 80% of ppl>50 have fractures from oteoporosis- 19% W, 3% M >50, genes influence 50-90% of bone mass- environment for the rest, 2011-2012 8.3 % had food insecurity- 5.8% mod, 2.5% severe, 47% of F, 34.6 M have > 5 servings of F/V/ day, more than half are consuming more than double Na DRI, most take in more than they need, underestimate caloric intake >30%, 4% of can are vegetarian, 73% of can use natural health products, 2 % of children 5-9 have peanut allergies, 80% is lifelong

Weight management stats

54% report being overweight, 18% identify as being obese,(34% OW, 26% O) # of adults with obesity tripled between 2985-2010, by 2021- 70% M and 50% W will either be overweight or obese, Diabetes- 6th leading cause of death, 80% of OW W increased risk of CAD, 34% FN OW, 35% O1, 5% in O2, childhood obesity from 2-9% (tripled) in 1 gen, 7% of children and youth are meeting national guidelines, 60% of OW can be linked to excessive tv viewing, 580 min/ day sedentary, > 20% of daily cal from foods not in 4 groups, 2002- > 50% of ads for weight loss made false claims, 26% have BMI > 30, 4% fall into class 3 obesity, (2/3 are W), 40-70% of total weight loss is associated with surgery, students with bdd- 2-13.1% compared to 0.7-2.4% in general population, 1.1% of W have eating disorders, 90% begin during adolescence, 1% self-starvation, (95% are W), 1/10 ppl die from self-starvation, 90% W binge, 15-20% of W have symptoms of ED

Sexuality and pregnancy stats

9% in canada, 30% are worldwide, HIV decrease by 60%, genes- both are carriers, child has 25%, 14% w have slight bleeding, nausea 2/3, circulatory system increases by 50%, 60% of weight gain directly r/t baby, skin darkens 90%, 85% consumed calcium, iron, and nitrogen goes to fetus, 3% are born with a birth defect, false positive 2-4%, lungs are 40% more efficient, 10.5% smoke during pregnancy, 25% W carry gene for strep, 31% have complications, 2% gen pop, 4% of deaths in can (FT pregnancies), miscarriage- 50% before 12th wk, 15-20% miscarry- 60% are due to chromosomal abnormalities- 70-90% become pregnant again, 1% suffer 3 or more, 5% have preeclampsia, 2.6% in can- 0.5% to eclampsia, 1/250 live births, 20% of bleeding in third trimester, 30% of bleeding in 3rd trimester, 4% have gestational diabetes, 30-50% of preterm labor resolve itself, 6% LBW, 8% premature, 51% exclusive breastfeeding for 4 months, breastfeeding-89%, 26% did exclusively for 6 months, 50-80% experience baby blues

CV system stats

90% can have >1 risk factor, 1/7, 15% deaths from tobacco use, 30% uni smoke, twice the risk of MI, increase risk of death by 30% by ETS, 90-95% of cause is unknown (HTN)- 20% can adults have, only 60% is controlled, 20% have preHTN, 17% do not know, 40% have high cholesterol, decreased risk of MI by 2% for every 1% that total blood chol levels are decreased, obesity- death is 2-3x more likely, every 5 unit increment of BMI, risk for death by CVD increases by 30%, increase weight 1 kg= increase risk of DM by 9%, 3.5 yrs after MI- 1/3 of ppl will develop DM, FN DM 4x as likely to heart disease, M with anger- 2-3x increased MI risk, high hostility- 2X as likely, CVD 7x more deaths than breast cancer, 85% >65 and after 55 risk doubles each decade, statins decrease risk by 50%, 50% more MI in winter, heart disease kills > 49 000, CAD- 65- 80% of deaths among young ppl with DM, vfib- 1 q 12 min, MI chest pain- 1/3 M, 42% W don't, 30% higher survival if CPR is given immediately, > 80% occur at home, intracerebral stroke- 10%, subarachnoid- 3%, hypertrophic cardiomyopathy- 1/500, most common cause of sudden deaths in athletes <35, mitral valve prolapse- 27%, stroke survivor- 20% of another within 2 years, 1/4 deaths

Conventional medicine

A system of medicine based on the application of the scientific method, diseases are thought to be caused by identifiable physical factors and characterized by a representative set of symptoms, biomedicine/standard western medicine, identifies causes of disease as pathogens, genetic factors and unhealthy lifestyles taht have molecular and cellular changes, physical cause of illness, symptoms are similar for everyone, biological disturbances, destroy/remove pathogens - public health measures, pharmaceuticals, relies heavily on surgery and on advanced medical technology to discover, correct, remove/destroy cause, EHRs, empirical (based on evidence of the sense and observation, carried out under careful conditions, verified by others), rational (follow rules of logic, consistent with known facts), testable (verifiable through direct observation or lead to predictions about what should occur), parsimonious (explain phenomenon by using the fewest # of causes), general (broad explanatory power), rigorously evaluated (for consistency with evidence and known principles, for parsimony and generality), tentative (entertain possibility that explanations are faculty based on new evidence), drugs are developed and tested in lab and with humans, publication often leads to further research

Addictive behaviours

Any habit that becomes out of control, resulting in a negative effect on a person's health, addiction: chronic disease that disrupts the brain's system of motivation, reward and memory, compulsive desire and increasing need for a substance/behavior and by harm to the individual and society, craving, inability to recognize risk- body urges changes, tolerance: physical state in which the body adapts to a drug so that the initial dose no longer produces the original physical, psychological effects, some activities release the same amount of chemicals in the brain

Completing an Advance directive

Any statement made by a competent person about choices for medical treatment should he or she become unable to make such a decisions or communicate them in the future- instructional directive: allows individuals to provide instructions about the kind of medical care they want to receive if the become unable to participate in treatment decisions and proxy directive: allows an individual to appoint another person as an agent in making health care decisions if they are unable- durable POA for health care, substitute decision making- the agent appointed by a person to act on his/her behalf by means of a proxy directive, may have more than one, means different things at different life stages

Pathogens

Bacteria, viruses, fungi, protoza, parasitic worms and prions, infections can occur anywhere in the body

Energy therapies

CAM that uses energy fields originating either within the body (biofields) or from outside sources (electromagnetic) to promote health and healing, biofields influenced by movement, touch, pressure, placement of hands, qigong- TCM- combines movement, meditation and regulation of breathing to enhance flow of qi, improve blood circulation and enhance immune funtion, therapeutic touch-healers can identify and correct energy imbalances by placing hands over pt body, Reiki-correct disturbances in the flow of energy and enhance the body's healing powers through the use of 13 hand positions on the patient, bioelectromagnetics- EEG, ECG, MRI, based therapy- electromagnetic fields can be used to promote healing and manage pain, would healing, nerve stimulation, immune system stimulation, modulation of neuroendocrine system

biological based therapies

CAM therapies that include natural and biologically based interventions and products, examples include herbal remedies and dietary supplements, extracts from animal tissues, botanicals, holistic nutrition, herbal remedy may not technically be herbs, pharamacopoeia (a collection of descriptions and formulas for drugs and medicinal preparations), botanicals sold as tablets, pills, capsules, liquid extracts, tea, labels

Fibre

Can need 21-38 g of fibre, but average is 14 g, nondigestable carbs from plants, facilitates elimination- dietary (nondigestable carbs and lingnin that are intact in plants), functional (nd carb either isolated from natural soruces or synthesized, may be added), total- sum of both, soluable (viscous) fibers- dissolve in water/ is broken down by bacteria= increase fecal bulk and prevents constipation and hemorrhoids, all plant foods have some dietary, fruits, legumes, oats, barley and wheat, psyllium, 38g M, 25 g W, 30 g if older than 51 (on average consume half of this)

Dimensions of wellness

Constant, dynamic, change and growth, physical- not just body's overall condition and absence of disease but also fitness level and ability to care for yourself, make choice to avoid illnesses and injury. Emotional- ability to understand and deal with your feelings, attending to own thoughts and feelings, monitoring reactions, identifying obstacles- finding solutions. Intellectual- Challenge the mind- detects problems, finds solutions and directs behavior, try to learn new things. Interpersonal- ability to develop and maintain satisfying and supportive relationships, participate in/ contribute to community and society. Spiritual- possess a set of guiding beliefs, principles or values that give meaning and purpose to your life, spirituality as an attitude for negative feelings, find meaning and purpose in own lives, Environmental- livability of your surroundings (safety-food supply), physical either supports or diminishes, protect yourself from hazards. *Occupational- level of happiness and fulfillment you gain through work, enjoy their work, comfortable with financial situation

DNA basics and issues with cancer

DNA, 23 pairs of chromosomes- instructions for building, operating and repairing your body- controls production of proteins- build cells and make them work, divide into two, mutations- change in the makeup of the gene, inherited, mutagens (environmental factors such as radiation, certain viruses, chemical substances in the air)- carcinogen, when both copies of a gene is damaged or cell needs two normal copies- cell will not behave normally-oncogenes (turn normal cell into cancer cell), tumor suppressor genes- restrain cellular growth- rapid and uncontrolled cell division, p53 gene, hereditary- BRCA1, mostly occurs after birth, lifestyle decisions are still important, testing and ID, promoters- don't directly produce DNA mutations- accelerate the growth w/o damaging or altering DNA, less time for cell to repair DNA damage

Viruses

DNA/RNA with protein coat, lack independent metabolism and need host cell to reproduce- lack enzymes- parasites-organisms that live on/in host- benefits parasite, harms host, from contagious disease, common cold- from any of 200 viruses, hand-to-hand contact, wash hands, OTC help with symptoms, influenza- infection of resp tract, highly infectious and adaptable, new strains, cold and fever and fatigue, vaccine, measels, mumps, rubella- rash, fever, measels may affect liver/brain/lungs (infection-pneumonia), rubellla can be transmitted to a fetus, mumps-swelling of salivary glands, chicken pox, coldsores and herpes-frequently causes latent infections-never free of virus, varicella-zoster virus- chicken pox, shingles (follows nerve pathways, herpes simplex virus types 1 and 2- cold sores and STI herpes, transmitted even w/o cold sores, epstein-barr virus- mono, can reactivated but no symptoms, cytomegalovirus- infects lungs, brains, colon, eyes, HHV- Kaposi's sacroma, viral encephalitis- inflammation of the brain- fever, headache, nausea, lethargy, memory loss, seizures, brain damage, death, viral hepatitis- inflammation of the liver, HAV- food or water contaminated sewage/infected person, mild, HBV-passed to child, sexually, HCV- blood contact, vaccines for A and B-fatigue, jaudice, abd pain, loss of appetite, nausea, diarrhea, may be asymptomatic or crippling- paralysis and death, rabies- rhabdovirus, CNS from animal bite, vaccinate animals, rare in can, traced to bats, HPV-100 different types cause cause a variety of warts- OTC or cyrotherapy/survey, chronic, vaccine, treating: antiviral drugs interfere with virus life cycle

Guidelines for healthy eating

DRI= estimated average requirements (EAR), AI, RDA, Tolerable upper intake level(UL), Dietary Reference Intakes, role of nutrients in promoting health and preventing chronic diseases, intakes-recommended- max= UL, not set for all nutrients, daily values (simplified version of RDAs used on food labels), Guidelines for Eating Healthy- variety, emphasize cereals, breads, grain products, F/V, choose lower fat dairy products, leaner meats, achieve and maintain healthy weight, limit salt, alcohol and caffeine, adequate nutrients within caloric needs, weight (wiser choices, less calories), fat- 20-30% of daily cal, sat > 7%, trans >2 %, chol > 300 mg, Na/K- decrease we only need small amounts, > 2300 mg- 1 tsp, in processed foods, increase K, alcoholic beverages have calories but few nutrients, Eating Well with Canada's food guide - guiding food selection to promote health- Mediterranean diet- variety, serving size/ quantities, make each serving count, advise for different ages and stages, promotion of pa- grains- 6-8 servings, F/V- vareity, > 1 dark green and 1 orange veg per day, whole f/V over juice, milk and alternatives, meat and alternatives, assumes nutrient dense- low in fat, sodium and sugar, then small amount of additional calories can be consumed (discretionary calorie allowance)- can loose weight if not incorporated

Death

Death promotes variety through evolution of species, long enough to reproduce, brief enough for new genetic combinations, senescence is the biological process of aging- genetics, challenges emotional and intellectual security, what happens after-religion and philosophy- offers solace and meaning, challenging and painful, difficult to define, cessation of flow of vital body fluids, heart and breathing stop- CPR, ventilators, artificial heart pumps, life support systems-medical technologies that allow vital body functions to be artificially sustained, brain death- a medical determination of death as the cessation of brain activity indicated by various diagnostic criteria , including a flat EEG reading- lack of receptivity/response to external stimuli, absence of spontaneous muscular movement and breathing, absence of observable reflexes, absence of brain activity, second set of tests, clinical death- determination of death made according to accepted medical criteria, cellular death- breakdown of metabolic processes at the level of the body's cells, gradual, has legal and social consequences, organ transplantation

Erikson's stages of development

Developing an Adult Identity- unified sense of self, characterized by attitudes, beliefs and ways of acting- know who you are, and what you're capable of, what roles you place, place among peers, assess own strength's and weaknesses- relationships with others but also a strong sense of self, different models (parents, peers, rock stars, etc.), w/o a personal identity, we begin to feel confused about who we are (identity crisis) Developing Intimacy- sharing, open communication, long- term commitment, love, those who lack a firm sense of self may have difficulty establishing relationships b/c they feel overwhelmed by closeness and the needs of another person Developing values and purpose in your life- values: criteria for judging what is good and bad, underlie moral decisions and behaviour- consider options carefully, chose w/o succumbing to outside pressure, make a choice and act on it Developing a positive self concept- develop in childhood (love), integration (made for yourself)- personality characteristics and mannerisms of your parents, stability- integration of self and freedom from contradictions (extremes) Spiritual wellness- social support, healthy habits, positive attitude, moments of relaxation

Cognitive Model

Emphasizes the effect of ideas on behavior and feeling, behavior results from complicated attitudes, expectations and motives rather than reinforcements, tires to expose and identify false ideas that produce negative feelings, substitute more realistic thoughts

Behavioural model

Focus on what ppl do, psychological problems as maladaptive behaviours or bad habits, discover what reinforcements keep an undesirable behavior going and then alter those reinforcements, stimulus- anything that causes a response, response- a reaction to a stimulus, reinforcement- increasing the future probability of a response by following it with a reward- practice exposure (learns to come into direct contact with a feared situation) until the fear goes away, can be through imagination or virtual reality

Health issues for diverse populations

Infectious diseases, life expectancy has increased, chronic diseases- life style choices: conscious behaviors that can increase or decrease a person's risk of injury/disease such as eating a healthy diet, smoking, exercises, etc., danger of stereotyping and overgeneralizing- accepted dimensions are gender (sex- biological and physiological characteristics that define men and women, r/t chromosomes and effect on reproductive organs, gender- roles, behaviors, activities, attributes that are shaped by experience and environment), ethnicity (health disparities from genetic variations, environmental factors, and health behaviors), income and education (highest poverty and lowest education have the worst health status, exposed to more daily stressors), disability(activity limitations, need assistance, perceive themselves as having a disability, inactive, overweight, depression), geographic location (rural has higher death rates, physically inactive, do not use seatbelts, and do not use screening tools, less likely to finish high school, have less access to emergency services, higher rates of diabetes and injuries, but less likely to have cancer, are less stressed, strong sense of community) and sexual orientation (emotional wellness and personal safety are affected by factors r/t personal, family, and social acceptance- may engage in risky behaviours)

body fat distrubution

M and PMW store fat in upper regions of body- abd (apple), pre M W store fat in the hips, buttocks, thighs (pear), abd fat= increased risk of high BP, type 2 DM, heart disease, stroke, cancer, mortality, measure waist circumference (<102 cm M, <88cm W)

Biological Model

Mind's activity depends entirely on an organic structure (brain), neuronal activity and chemical reactions- pharmacological therapy- prescription, more effective than placebo- antidepressants (SSRIs, tricyclics, MAOIs, et.c), mood stabilizers- prevent mood swings, antipsychotics- reduce hallucinations and disordered thinking, calming effect on agitated patients, anxiolytics (antianxiety) and hypnotics (sleeping pills, benzodiazepines), stimulants- ADHD, anti-dementia drugs, issues- decrease stigma, provide relief

CAM stats

NA consumes 80% of world's opioids, OTC- 60%, 6 mon-2/3 use one or more, 70% are not effective. 71% take NHP, 15% increase of generic meds, 2008- 453 million prescriptions, >65 take 40% meds given 80% of the time, 35-50% of HAI are preventable, adding pharmacist- decreases risk by 66%, com 70%, 2-10% of $ is to fraud, 54% have tried CAM, F more than M, 30-40% given placebo show improvement, 70% effective, chiro- 15% in 2009, 15% out of pocket, 12% private, 73% paid by government

Other types of cancer (oral, testicular, pancreatic, stomach, bladder, kidney, brain, leukemia, lymphoma, multiple myeloma)

Oral- lip, tongue, mouth and throat from cigarette, cigar or pipe smoking, spit tobacco, excessive consumption of alcohol, easy to detect but hard to cure, surgery/ R, testicular- risk- genetics (family hx), undescended testicles, DES in mothers, self-exam, surgery/chemo, pancreatic- well advanced before symptoms, M, obese, sedentary, >65, inheriting a disorder, DM, diet high in fat and meat and low in vegetables, seldom cured, stomach- >50, twice as commin in M, H. pylori infection, ulcers, diet high in smoked, salted or pickled fish/meat, no screening, recognized once it has spread, bladder- smoking is key risk factor (2.2x more likely), exposure to chemicals in dye, rubber, and leather, no screening test- blood in urine or increased frequency of urination, 90% are curable with early detection, kidney- >50 but anyone, few controllable risk factors- smoking, obesity, fhx, s=fatigue, pain in the side, blood in the urine, brain - develop for no apparent reason, ionizing radiation- headaches, fatigue, behavioral changes, seizures, may by curable by surgery/r/chemo but most are not, depends on type- 1-8 yr survival rate, Leukemia- WBC, bone marrow- lymph nodes, spleen, liver, organs, CNS, different types and subtypes, radiation and certain chemicals and infections-symptoms b/c cells crowd out production of normal blood cells- fatigue, anemia, weight loss, increase infection, lymphoma- lymph nodes and spreads to almost any part of the body- Hodgkins and NHL- compromised immune systems, multiple myeloma- malignant plasma cells may produce tumors in bone marrow, grow in multiple sites- anemia, excessive bleeding, decreased resistance to infection, age, obestiy

Psychological problems and stress

PKC is activated- influences the brain's prefrontal cortex- negative affect on focusing, judgment, ability to think clearly, anxiety/ depression producing

Male anatomy

Penis- male genital structure consisting of spongy tissue that becomes engorged with blood during sexual excitement, scrotum- loose sac of skin and muscle fibers that contains the testes- keeps sperm 3 degrees below the rest of body (34 degrees)- regulates, 1/2 male gonads, site of sperm production-- sperm life cycle: produced in tiny, tightly packed tubules within the testes- epididymis- storage duct for maturing sperm, on the surface of each testis- vas deferences- tube that carries sperm from the epididymis through the prostate gland to the seminal vesicles, carries to abd cavity- prostate gland (organ, produces some of the fluid in semen, help transport and nourish sperm- vas deferentia merge into seminal vesicles- tube leading from the vas deferens to the ejaculatory duct, provides nutrients- ejaculatory ducts- tube that carriers mature sperm to the urethra so they can exit the body on ejaculation, couper's glands- small organ that produces pre-ejaculatory fluid- clear, mucus-like, at tip of penis, helps lubricate the urethra- glans-rounded head of penis/ clitoris, circumcision- surgical removal of the foreskin- may do for cultural, religious and hygienic reasons, decrease risk for infections(UTI, STI), not routinely performed

Transtheoretical (Stages of Change Model)

Precontemplation: do not think they have a problem and do not intend on changing their behaviour, unaware of risks, may have tried unsuccessfully in the past, blame external factors. Contemplation: know they have a problem and intend to take action within 6 months, aware of benefits and costs, wonder about courses of action but do not know how to proceed. Preparation: plan to take action within a month/ already made small changes in behaviour but not regularly, worried about failing. Action: Outwardly modify behaviour and environment, commitment of time and energy. Maintenance: New lifestyle for at least 6 months, lapses may have occurred but they reestablish desired behaviour, few months-years. Termination: no longer tempted to relapse- dealing with relapse: not linear- spiral, don't give up- not the same as failure- forgive yourself, give yourself credit for the progress you have already made, move on- developing skills: Creating a personalized plan- monitor your behaviour and gather data (record what the activity was, when and where it happened, what you were doing, how you felt at that time), analyze the data and identify patterns (note connections b/w feelings and external cues), be SMART about setting goals (set goals you can live with, may need to focus on something other than outcome goal ), devise a plan of action (get what you need ASAP, modify environment, control related habits, reward yourself, involve the people around you, plan for challenges), make a personal contract (prevent procrastination and remind, statement of goal, start date, steps to measure progress, strategies you plan to use to promote change, end date, witness)- putting plan into action: commitment, resolve to stick with it, remember why- staying with it: obstacles are inevitable, social influences (gather support, focus on yourself), level of motivation and commitment (inner drive), choice of techniques and level of effort, stress barrier (wait for it to pass of find healthy ways to manage it), procrastinating, rationalizing, blaming

Cervical cancer

STI- HPV: multiple sex partners, rare in W w/o heterosexual intercourse, regular use of condoms, circumcision, +smoking and infection with genital herpes, Pap test-scraping of cells from the cervix for exam under a microscope, cervical dysplasia- abnormal but not cancer, surgery, cyroscopic probe, localized laser treatment- w/o treatment- invades walls and spreads to adjacent lymph nodes and uterus, chemo, R, vaccine (HPV)

Other things that cause cancer (tobacco use, diet, inactivity, carcinogens)

Tobacco use- lung, bronchial, larynx, mouth, pharynx, esophagus, stomach, pancreas, kidneys, bladder, cervix, dietary factors- can support or detract abilities to protect against cancer, EWCFG-limit consumption of processed and red meats(high fat and meat = colon, stomach, prostate), positive relationship between the consumption of sugary foods and drinks- increased risk for endometrial, colorectal, pancreatic, obesity, alcohol- oral, colon, fried foods- high levels of the chemical acrylamide, fibre, F/V- prevent carcinogens from forming, block them from reaching target cells, boost detoxifying enzymes, slow development, cut off cell blood supply- anticarcinogens- vit C, E, selenium, carotenoids= antioxidants, phytochemicals, eat variety, don't rely on supplements, inactivity and obesity, carcinogens in the environment- microbes (viruses, bacteria, parasites)- ingested chemicals-preservatives and additives, nitrates and nitrites are dangerous-environmental/ industrial pollution, fossil fuels- radiation, medical x-rays, radioactive substances, UV rays, try to reduce risk in clinical setting

Diagnosing Fetal Abnormalities

US- creates a visual image of fetus (sonogram)- show position, size and gestational age, presence of anatomical problems, sex, aminocentege- amniotic fluid is removed and analyzed to detect birth defects , integrated prenatal screen- combination of US and two blood tests, to assess risk of fetal abnormalities, fetal programming- fetal programming theory- conditions in womb influence risk of adult diseases- hormones, growth factors, environmental conditions, prenatal care- essential for mother and fetus, checkups until delivery- asked about health hx, diet info, BP, weight gain, urine, size and position of fetus, blood tests- blood type, anemia, Rh incompatibilities, diseases, prenatal nutrition- avoid drugs and other environmental hazards, 1st- vulnerable to teratogens (cause physical defects in a developing fetus)- congenital malformations physical defects existing at time of birth-inherited or caused during gestation, alcohol- FAD, tobacco, cafeine- raises epinephrine= stress, decrease blood supply to uterus, drugs- medical supervision, baby has withdrawal symptoms, STIs and other infections- Group B strep: STIs infect fetus, exercise and activity- contributes to wellness, need more sleep and rest, moderately active, kegels, preparing-classes, relaxation and details

Emerging infectious diseases

West Nile Virus- birds and mosquito, few-no symptoms, permanent brain damage/death, vaccines, protect against mosquito bites, SARS- pneumonia, rotavirus, causes gastroenteritis, kills almost every child from poor hygiene and sanitation practices , E.coli 0157: H7- - bloody diarrhea and kidney damage, hantavirus- rodents, urine, droppings or saliva- dangerous build-up of fluid in the lungs, Ebola- infected blood/body secretions

Eating disorders

a serious disturbance in eating patterns or eating-related behavior, characterized by a negative body image and concerns about body weight or body fat, dissatisfaction with body image and weight- distorted thinking- dysfunctional attitudes about eating, heredity, turning points can trigger, anorexia nervosa- characterized by refusal to maintain body weight at a minimally healthy level, intense fear of gaining weight/ becoming fat, self-starvation, even emaciated think they are fat, compulsive rituals- behaviours that help keep them from eating, binge and purge (vomit, laxatives, excessive exercise, restrictive dieting, enemas, diuretics, diet pills to compensate for food that was eaten), ofen hide/hoard food, introverted, emotionally reserved and socially insecure, rarely complain, want approval, F- stop menstruating, become intolerant of cold, develop decreased BP and HR, dry skin with fine hair, hands and feet may swell and turn blue- CV, GI, endocrine, skeletal problems- body turns to own organs for proteins, bulimia nervosa- recurrent episodes of binge eating and purging- overeating and using compensatory behaviours to prevent weight gain, usually concealed and normal weight, binge- rapid consumption of thousands of calories- lose control and cannot stop, uncomfortable around food, occur in secret, feelings are blocked- emotionally and physically drained, life changes, deal with feelings, puts strain on the body- erodes tooth enamel, damage to liver and kidneys, cardiac arrhythmia, chronic hoarseness, esophageal tearing, stomach rupture, menstrual problems, increased depression, excessive preoccupation, binge-eating disorder- binge eating and lack of control over eating behaviour in general, feelings of guilt and shame, eating more rapidly, until uncomfortably full, when not hungry, preferring to eat alone, no planned mealtimes, rarely eat because of hunger- coping mechanisms, almost always obese, borderline disordered eating- anywhere from healthy to seriously disordered, depends on life stresses, illnesses and many other factors, some may have symptoms but do not meet full diagnostic criteria, excessive dieting, occasionally bingeing/purging, problem- if thoughts of food and weight dominate your life, if you think your worth is based on how you look, feelings of guilt, treating- address problematic eating behaviours and misuse of food to manage stress and emotions, restore body weight and then psychological aspects, stabilize eating patterns- change and develop coping skills, psychotherapy and medical management

Cardiorespiratory endurance

ability of the body to perform prolonged, lar-muscle dynamic exercise at moderate to high levels of intensity, lung's ability to deliver oxygen, heart's capacity to pump blood, ability of nervous system and blood vessels to regulate blood flow, body's ability to use oxygen, when this is low the heart has to work hard during normal activities- heart disease, colon cancer, stroke, depression and anxiety-- endurance training- exercise intended specifically to improve CRE with prolonged, larges muscle, dynamic exercise-heart pumps more blood, decrease resting HR and BP, blood volume increases, blood supply to tissues improves, Body can cool itself better, improve body chemical systems-walking, jogging, cycling and aerobic dancing

Flexibility

ability to move joints through full ROM, depends on joint structure, length and elasticity of CT and nervous system activity, stiffness can cause unnatural body postures that stress joints and muscles,

Muscle Endurance

ability to resist fatigue, and for muscles/groups of muscles to remain contracted or to contract repeatedly for a long time, depends on the size of the muscle cells, the ability of the muscles to store fuel and blood supply to muscles- good posture and injury prevention, helps cope with physical demands of everyday life, degree of strength/endurance depends on the type and amount of stress

Meeting challenges to self-esteem

adjust your goals to your abilities, do not become demoralized, notice patterns of thinking, avoid focusing on the negative- all or nothing thinking (cognitive distortions: patterns of negative thinking that make events seem worse than they are), develop realistic self- talk- defense mechanisms- rearranging thoughts and feelings to cope, be optimistic, honest communication with others- fear denial of the request, assertiveness (expression that is confident and direct but not hostile), be clear, right balance of being alone and being with others- examine patterns of thinkning, deal with anger appropriately, balance b/w not expressing it and intermittent explosive disorder- reframe and distract yourself, do not react to angry ppl with anger

Colorectal cancer

age >70, heredity, polyps (small, usually harmless, masses of tissue that project from the inner surface of a mucus membrane)- from inherited gene mutations, chronic bowel inflammation and T2DM, excessive alcohol use and smoking, obesity, diet rich in red and processed meats increase risk, oral contraceptives and NSAIDs, pa, F/V, whole grain, folic acid, vit D, magnesium, calcium decrease risk, removed if caught early, bleeding from the rectum and change in bowel habits, regular screening >50, sigmoidoscopy/ colonoscopy, surgery- radiation and chemo to shrink before, monoclonal antibodies

Exercise Program for Flexibility

all major muscle groups and joints, statically, ballistatic stretching is dangerous and counterproductive, active- under person's own power by contracting opposing muscles, passive- outside force/resistance from you, partner, gravity or weight- greater ROM and more intense stretch, F-2-3 days/wk (ideally 5-7 days), I/T- stretch to point of tightness and hold for 15-30 sec, rest, and go further, breathe and relax, 2-4 reps, 20-30 min

Psychodyamic Model

also emphasizes thoughts but cannot be changed by others ideas and impulses, symptoms are result of complex set of desires and emotions hidden by active defense mechanisms, patients speak freely and try to understand the basis of feelings, focus on present- self help: what you can do on your own, become more aware of self-defeating actions and ideas- journal, share with others, professional help

BAC

amount of alcohol in the blood, expressed as percentage of alcohol in decilitre of blood, measure of intoxication- affected by body weight, %BF, sex (enzyme is 4x more active in men), balance of absorption and metabolism- cannot be influenced by exercising, breathing deeply, eating, drinking coffee

musclar strength

amount of force a muscle can produce with a single maximum effort-size of muscle cells, ability of nerves to activate its muscle cells, strong muscles keep the skeleton in proper alignment (good posture), greater muscle mass= higher metabolism and faster energy use, older ppl lose muscle cells (sarcopenia) and muscles become unattached from nervous system, strength training helps maintain muscle mass, function and balance, weights or bodyweight (callisthenic)

Proteins

an essential nutrient, compound made of amino acids that contains carbon, hydrogen, oxygen and nitrogen, forms muscles and bones and elements of blood, enzymes, some hormones and cell membranes, amino acids (building blocks)- 20 in food, 9 are essential- histidine, isoleucine, leucine, methronine, phenylalanine, threonine, tryptophan, valine, complete- supply all essential amino acids in adequate amounts (meat, fish, poultry, eggs, milk, cheese , soy), incomplete if not- legumes (veggies such as peas and beans that are high in fibre and important sources of protein) and nuts, combos of veg proteins, vegetarians need to get adequate levels of protein- hemp, chia seeds, quinoa, 0.8 g/kg of body weight/day- extra may be synthesized into fat, high protein can strain kidneys , 17% of daily caloric intake

Stress

an uncomfortable response to a negative event (more nervous tension), stress can be associated with positive experiences (personal challenges and achievement of goals), situations that trigger physical and emotional reactions and the reactions, general physiological and emotional state that accompanies the stress response (the physical and emotional changes associated with stress), stressor- any physical or psychological event/ condition that produces stress)

Hormones

androgens- M sex hormones produced by the testes in M and adrenal glands in both sexes- testosterone, F- produced by ovaries- estrogen- bring sexual maturation at puberty and maintain reproductive functions, progestins- sustain reproductive functions- progesterone, adrenal glands- regulated by hormones of the pituitary gland- base of brain, FSH and LH from hypothalamus- controls secretions of the pituitary, nervous control of sexual functions- sex chromosomes X and Y, determine biological sex, F-XX, M-XY, determines if testes or ovaries are produced, Y= testosterone

Addiction

any substance /activity that becomes the focus of a person's life at the expense of other needs/interests can be damaging to health, neglect other areas of life- gambling disorder: financial problems, risk for suicide, characteristic behaviour- preoccupation with gambling, unsuccessful efforts to quit, gambling when feeling distressed, lying, compulsive exercising: harmful, with severe psychiatric disorders, excessive preoccupation/dissatisfaction with body image, use of laxatives/vomiting to lose weight, development of other OCD symptoms, work addiction: intense work schedule, inability to limit one's own work schedule, inability to relax, failed attempts at curtailing the intensity of work, risk for CVD, type A, sex and love: extreme occupation with sex, compulsion to have sex repeatedly in a given period of time, spending great deal of time/energy looking for partners or engaging in sex, using sex as a means of relieving painful feelings, suffering negative emotional and professional consequences- online can be passively or interactively, compulsive buying/shopping: buys more than is needed or can afford, internet: skip important school, social, or recreational activities to spend time online, drugs: prescription-antibiotics, antidepressants, OTC, alcohol, tobacco, caffeine, illegal- LSD, heroin, pharmacy (art of compounding drugs from various substances

PAD

atherosclerosis in arteries in legs/arms that can impede blood flow and lead to pain, infection, and loss of affected limb, risk is significant in smokers and people with diabetes, claudication- pain with exertion, resolved by rest, rest pain

Energy balance

balance of calories consumed and expended, focus on permanent changes, positive energy balance= take in more than what is burned= weight gain, negative- take in less than what is burned

Supporting immune system

balanced diet and healthy weight, get enough sleep, exercise, don't smoke, alcohol in moderation, sufficient vit D, wash hands frequently, avoid contact with sick ppl, drink clean water, avoid contact with carriers, practice safer sex, vaccinations, avoid injectable drugs

Characteristics of trying drugs

being male, troubled adolescent, being a thrill seeker, dysfunctional family, peer group that accepts drug use, poor, dating young--- NOT RISKS: believe drugs are risky, disapprove, positive self-esteem/concept, assertive, independent thinkers, optimism, academic achievement, regular church attendance, strong family with clear drug policy- may be curious, rebellious/vulnerable to peer pressure, alter mood, spiritual experience, escape negative feelings

Benefits of exercise

bring out long term changes and improvements in the body's functioning, CR system has to work harder-improve function of the heart and ability to carry blood and oxygen to tissues, keeps arteries from stiffening or clogging, improves sexual functioning and general vitality, improves metabolism, generate energy, use carbs and fat for energy, and regulate hormones, protects cells from damage of free radicals and inflammation, activation of antioxidant enzymes, healthy body comp- excess calories are stored as fat, increase daily cal expenditure, increase metabolic rate, increase muscle mass, decreased risk of premature death, lowers risk for chronic, disabling diseases, CVD- sedentary lifestyle is risk + smoking, abnormal blood fats, increase BP, diabetes and obesity- metabolic syndrome (insulin resistance, increased BP, abnormal blood fats, abd fat deposits, type 2 DM, blood clotting abnormalities, blood vessel inflammation), exercise has positive effect on balance of lipids (cholesterol), endurance exercise decreases BP, CAD- exercise interferes with disease process and regulates blood flow-stroke risk is reduced with exercises , cancer- may have increased pa and decreased risk- speed movement through the GI tract, lower blood insulin levels, enhance immune function, reduce blood fats, osteoporosis- build bone density, strength and impact training, balanced diet, too much exercise can depress levels of estrogen, type 2 DM- exercise prevents development-burns excess sugar and makes cells more sensitive to insulin and healthy body fat levels, social. psychological and emotional benefits- decrease stress, decrease anxiety and depression- increase self-image, increase learning and memory, enjoyment, improved immune function, prevention of injuries and lower back pain- good posture and body mechanics, improved wellness for life- longer and healthier life- special health concerns- consults Dr. before starting exercise

Professional care

broad network of professions, different settings, complementary/alternative medicine (CAM)- therapies or practices that are not part of conventional/mainstream health care and medical practice as taught in most Canadian medical schools and available at most Canadian health-care facilities (acupuncture, herbal remedies, relaxation techniques, massage, chiropractic), use in addition to conventional medical treatment but do not tell physicians- want to know, may boost immune system, lower chol levels, losing weight, quitting smoking, enhance memory, chronic may try, controversial be aware of safety issue, vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines, probiotics, other (amino acid and essential fatty acid)- must be safe, no prescriptions

Prostate cancer

can block flow of urine, most common, increased risk- diet high in calories, dairy products, animal fats and low in plant foods, obesity, inactivity, hx of STD, T2DM/insulin resistance, no symptoms- early- changes in urinary frequency, weak/interrupted urine flow, painful urination, blood in urine, DRE, PSA blood test- may be normal, measure free floating in the blood, most are not deadly, US, needle biopsy, treatments vary based on stage and age- radical prostatecomy- incontinence, ED, radioactive seed implantation, external R, hormones to shrink tumors, cyrotherapy, chemo

Vitamins

carbon-containing substances needed in small amounts to help promote and regulate chemical reactions and processes in the body, need 13- 4 are fat soluable (ADEK), 9 are water soluble (C, 8 complex B- thiamine, riboflavin, niacin, vit B6, folate, vit B12, biotin, and pantothenic acid)- solubility affects how it is absorbed, transported, stored- water-absorbed directly into bloodstream and travel freely- excess removed in kidneys, fat- carried by special proteins, stored in liver and fat tissues, help unleash the energy in carbs, proteins, fats, produce RBCs and maintain nervous, skeletal and immune systems- antioxidants (substances that can lessen the breakdown of food or body constituents by free radicals-electron seeking compound that reacts with facts, proteins, DNA, damaging cell membranes and mutating genes in its search for electrons, produced through chemical reactions and exposure to environmental factors, protect against them by- prevent/reduce formation, removing them from the body, repair the damage, black berries, walnuts, strawberries, artichokes, brewed coffee, raspberries, pecans, blueberries, cloves, grape juice, unsweetened chocolate, sour cherries, red wine, brussel sprouts, kale, cauliflower, pomegranates- bind to 02, donating electrons to free radicals and repairing damage to molecules and preserve healthy cells- vit E, C, A precursor to beta-carotene, get form foods, F/V, grains, may develop a deficiency- scurvvy (Vit C), rickets (vit D), blindess (vit A), seizures (vitB), most often in developing countries, excess can be dangerous- fat soluble is stored, consume veggies as soon as possible after purchasing, store in fridge/ freezer and cover, minimize amount of water use and cooking time

Parasitic worms

cause intestinal and other infectious tapeworm, 7m long, hookworm- mild infections, pinworm- most common, flukes can be deadly, from contaminated food/drink, control hygiene

Life enhancing measures

challenge your mind- reading, doing puzzles, learning language, studying, music, develop physical fitness- enhances psychological and physical health, decrease BP and healthier chol levels, better production/survival with ha, increased lung capacity, maintenance of strength, flexibility and balance, weight control, improved sleep, longer life capacity, protection against osteoporosis, T2DM, increase effectiveness of immune system, maintenance of mental agility and flexibility, response time, memory, hand-eye coordination- prevents loss of fluid intelligence (ability to develop a solution when confronted with a new problem), less susceptible to depression and dementia, fends off sacropenia, >65 at least 150 min of mod-vig/wk, in increments of 10 mins, strength training- 2x, balance, active, eat wisely- EWCFG, take vit D supplements, ensure adequate calcium, limit sodium intake, increase K, eat foods rich in dietary fibre and drink plenty of water, pay special attention to food safety, maintain a healthy weight, control drinking and over dependence on medication- 13-14 years fewer, schedule physical exams to detect treatable diseases , recognize and reduce stress- cut down, get enough sleep, do not use substance abuse, focus on breathing

Changes in brain chemistry

characteristic, molecules carried in bloodstream, injected/inhaled enter brain more rapidly than digesting, faster= more addiction, acts on neurotransmitters- transmit nerve impulses-synapse, 5 min-12 hr depends on how long it takes to be excreted

Dietary challenges for special populations

children and teens- need to be encouraged to eat, select healthy options, variety, uni students- convenient may not be healthy, cost, older adults- less active= less calories- more nutrient dense foods, athletes- increase energy requirements and drinking enough fluids, may increase carbs, avoid unhealthy patterns, low income families- not enough income to support a healthy diet, may need emergency food support, FN/I/M- challenges with traditional food prep and eating practices, at risk for chronic diseases, mental health challenges, and addictions- EWCFG- FN/I/M, special health concerns

Pregnancy and childbirth

choose whether and when to have a child- consider suitability and readiness- health and age- high risk over 35, emotional preparedness, financial circumstance, relationships, future plans, attitude and aptitude, fetus: 9th wk after consumption, birth, pre-conception care- health care in preparation for pregnancy- pre-existing conditions, medications, prior pregnancies, age, tobacco, alcohol and caffeine use, infections, HIV, diet, multiple births, genetic diseases, dominant if only one gene- sickle cell anemia- hemochromatosis, tay-sachs disease, cystic fibrosis, thalassemia, lactose intolerance, conception- fertilization, initiation of biological reproduction, union of nucleus of an egg cell with nucleus of sperm, egg is released, fertilized egg- after penetration by a sperm, zygote, many sperm do not survive acidic environment- only one reaches egg- enzymes soften layer, tail drops off head, impenetrable by others- emotional response, pregnancy- trimesters, 1/3, 3 months periods of pregnancy- 1st: few physical changes, 2nd: gains weight, looks noticeably pregnant, 3rd: breathe, digest, excrete and circulate blood for herself and growing fetus- hardest, pregnancy tests- human chorionic gonadotropin- produced by fertilized eggs that can be detected in the urine or blood of the mother within a few weeks of contraception

CV system

circulates blood through the body, heart and vessels, R- pulmonary circulation: circulation of blood between the heart and lungs, L- system circulation: circulation of blood between heart and rest of the body- oxygen poor blood travels through venae cavae into RA-fills and contracts- RV-fills and contracts- pulmonary artery to lungs-picks up oxygen and discards carbon dioxide-pulmonary veins - LA- fills and contracts-LV- fills- aorta, period of contraction= systole, period of relaxation+ diastole- BP= force exerted on the walls of the blood vessels from pumping >S than D, HR determined by nerve impulses (sinoatrial node/ pacemaker), blood vessels- veins, arteries(thick, elastic walls), capillaries deliver 02 and nutrients and pick up 02 poor blood, venules (small veins), heart has own a/v/c- coronary arteries, 68 kg person= 5 L of blood, circulates in 1 min

Emotional and Behaviour responses to stress

cognitive appraisal of a potential stressor strongly influences how you view it- successful prediction and perception of control, 5ws are generally evaluated fairly but evaluation of person outcome varies, common responses are anxiety, depression, and fear- from inborn personality/ temperament, behavioral- somatic NS (manages conscious actions, governs motor functions, and sensory info)- talking, laughing, exercising, meditating, learning time- management skills, becoming more assertive- promote wellness, personality (sum of behavioural, cognitive, and emotional tendencies) affects how ppl perceive and react to stressors- Type A: ultracompetitive, controlling, impatient, aggressive, hostile, higher perceived level of stress and more problems coping with it, react explosively, - Type B: relaxed and contemplative, less frustrated by daily events and more tolerable of behaviours of others, -Type C: anger-suppression, difficulty expressing emotions, feelings of hopelessness and despair, exaggerated response to minor stressors, may impair immune functions, -Type D: distressed, joint tendency to feel (not express) negative emotions and avoid social contact with others, gloomy, socially inept, anxious worries- expressing emotions is beneficial, not expressing is problematic, but habitually expressing exaggerated response is unhealthy, hardness (view stressors as challenges, and opportunities for growth and learning, commitment, control), resilience (set goals face adversity through individual effort- non reactive, homeostatic, positive growth, can't change personality but can change behaviors and patterns of thinking, cultural background, gender role, experience)

Alcohol use disorder

combines previously distinct categories of alcohol abuse and dependence, mild, mod, severe, in 12 month period, mild 2-3, mod- 4-5, severe >6- consuming alcohol in larger amounts/over longer period, having persistent desire/unsuccessful efforts to cut down, spending a great deal of time or activities necessary to obtain alcohol, recurrent use in a failure to fulfill major role obligations, cravings, continued use despite problems, giving up/ reducing important activities, recurrent use in situations in which it physically hazardous, continued use despite recurrent physical/psychological problems, developing tolerance, experiencing withdrawal, patterns and prevalence- all groups/levels, exacerbation and remissions, health effects- tolerance , withdrawal- severe, seizures, confusion, hallucinations, delirium, tremors, severe disorientation, confusion, epileptic-like-seizures, hallucinations of vermin/small animals, nutritional deficiencies, memory gaps, social and psychological effects: 3-4 people are affected, trouble in families, mental disorders, causes: genetics, certain personality disorders, violent/troubled household, imitating use of peers/adults, drinking excessively in teens, denial, rationalization, social factors, treatment: may not need professional help, rock bottom, treatment program- AA, 12 steps, powerless over alcohol, seek help from higher power, sponsor, counselling, medical care, rational recovery/ women for sobriety-avoid emphasis on higher power, mod, manage- limit intake/ abstaining, Al-Anon- for families and peers, employee assistance programs, school based programs, in pt hospital rehab- disulfiram - inhibits metabolic breakdown of acetaldehyde, flush, feel ill when drinking, naltrexone- decrease cravings, and pleasant effects,- IV, acamprosate- maintain abstinence, CT, antidepressants, antianxiety, diazepam

Alcohol

common, used in cultural/social situations- can lead to addiction, intoxicating ingredient in fermented/distilled beverages, colourless, pungent liquid, beer-3.6%, ales/malt 6.8%, wine-fermentation- 9-14%, fortified- 20%, hard liquor 35-50%, alcoholic beverages- 1.1% or more of alcohol by volume, one drink- 13 g of alcohol, standard drink- multiple servings, 7 cal/g, 100-120 cal, add extra calories to diet=weight gain

Water

composed of 60%, can live only a few days w/o it, distributed all over body, used in digestion, absorption of food, medium for chemical reactions, regulate body temp, M 3.7 L, F 2.7 L + more if exercise, hot climate

Other CV system issues

congenital heart defects- malformation of the heart/major blood vessels at birth, holes in the wall that divide chambers, corarctation of the aorta, hypertrophic cardiomyopathy- inherited- enlargement of the heart muscle, especially between two ventricles, murmur- turbulent blood flow, rheumatic heart disease- rheumatic fever- fever, inflammation and pain in joints, damages heart valves and muscles, heart valve disorders- valves fail to open/close properly, treatment depends on location and severity, mitral valve prolapses- billows out during ventricular contraction, blood may leak from LV- LA

Evaluating CAM

consumers need to take active role, decision analysis, consider effectiveness, potential harm, unintended side effects, utility of any one therapy, work with physician- safety, effectiveness, timing, cost, questioning CAM practitioner- ask about education, training, licensing, certification, why is it beneficial, describe conventional treatments, ask how long, ask about expected costs, do own research- library, online, talk to others, cost of equipment/technology, insurance

Tobacco smoke

contains hundreds of damaging chemical substances-acetone, ammonia, hexamine, toluene, 5 billion particles/ cubic millimetre- cigarette tar (brown, sticky mess created when the chemical particles in tobacco smoke condense), carcinogens, cocarcinogens- works with a cargcinogen to cause cancer, damage lining of resp tract, poisonous substances (arsenic and hydrogen cyanide), fatal in high doses, CO (400x the same limit), breathlessness, additives to manipulate taste and effect- sugars, humectants, enhance addictive properties, sugars cause people to inhale more, and more nicotine gets into the bloodstream, ammonia decreases the acidity of tobacco smoke- releases nicotine as a base, sidestream smoke (uninhlaed smoke) less obvious and objectionable, all smokers absorb some gas, tar and nicotine- kept in bodies if inhaled, as cigarettes burn down, there is less filter, no such thing as a safe cigarette-low nicotine- make smoke more, inhale more deeply, take longer/ more frequent puffs, block ventilation holes, menthol-bronchodilator, inhale more deeply and hold smoke in their lungs longer

Heart disease/ Attack

damage to/death of heart muscle, resulting from failure of the coronary arteries to deliver enough blood to heart, symptoms, angina- pain in chest, L arm and shoulder, when heart does not receive enough blood, tightness, pressure, arrhythmias and sudden cardiac death- sinus node, if electrical conduction system is disrupted= change in normal pattern of the heartbeat, and a non-traumatic unexpected death from sudden cardiac arrest, from v fib helping a person- die within 1-2 hr of symptoms- get help ASAP, aspirin, CPR, detecting and treating disease- stress/exercise test, electron beam CT, echo, multi-slice CT, MRI, radiotracers, PET- angiogram-balloon angioplastly (PCI), CABG

Long term effects

deadly and disabling diseases- total amount of tobacco smoke inhaled is a key factor- CVD- CHD from atherosclerosis, angina- MI interfere with electrical activity, decrease HDL, creates lesions in arterial walls, increase tension in heart muscle walls, CO displaces 02, lung/other cancer- benzo(a)pyrene causes genetic mutations in lung cells, exceeds breast cancer deaths, stroke, aortic aneurysm, pulmonary heart disease, COPD, emphysema- loss of lung tissue elasticity, and breakup of the air sacs, impairing the lungs ability's to obtain oxygen and remove carbon dioxide, breathless, constantly gasping for air, feeling of drowning, heart has to pump harder, chronic bronchitis- recurrent, persistent inflammation of the bronchial tubes, secrets excess mucus- cough- breathing is difficult, decrease production of cilia- slows then stops action , macrophages work less effectively- SOB, smoker's cough, worsening of allergy and asthma symptoms , increase susceptibility to cold, damage may not be permanent, health and economic concerns, ulcers, impotence, reproductive health problems, dental diseases, diminished physical senses, injuries, cosmetic concerns, costs, osetoporosis, QOL, disabled at young ages, more M than F but rapidly getting closer, W- increase risk for clots, cancer- 1.2-1.7% in F, menstrual problems, reproduction problems, F more likely to join support group but less successful, other forms- spit (smokeless), cigars, cigarillos, pipes, clove cigarettes, bidis

Benefits of alcohol

decrease CHD rates-raise HDL levels, thin the blood, decrease inflammation and risk of dangerous blood clots, less likely to develop/manage DM, HTN, strokes, PAD, cognitive decline, BPE

Canada's low risk alcohol drinking guidelines

decrease long terms risk of diseases/conditions- W no >10/wk, >2/day, M no >15/wk, >3/day, plan non-drinking days, decrease short term risk of injury/harm/illness, W no >3 M no >4 on a single occasion- youth (before 18 and 19)- delay until late teens, no >1-2 at a time/wk, young adults (18/19-24), older can >65, alcohol is processed more slowly, greater % of M than F exceed guidelines-traditional gender roles, more likely to engage in risky behaviour, more likely to drive recklessly, impact on W will be different and greater

detecting, diagnosing and treating and preventing cancer

detecting- CAUTION, routine check ups, self exams, diagnosing- physical exam, imaging studies, exploratory surgery, biopsy, MRI, CT, US, treating- surgery- partially or completely removed, less effective when cells of immune system are affected, or with metastasis- chemo- interfere with DNA synthesis and replication- n/v, diarrhea, hair loss, induction chemo- used before surgery, radiation- kills tumor cells with x-rays or gamma rays, radioactive seeds, less toxic- new and experimenting techniques: gene therapy- manipulation of gene expression, turns off genes responsible fro causing cells to divide rapidly and become malignant, bone marrow and stem cell transplant- healthy cells from a compatible donor, stem cells- unspecialized that can develop and produce special cells- identified, purified and grown outside of body, biological therapies- enhance immune system's reaction, vaccines, genetic modification, genetically engineered cytokines, proteasome inhibitors- help control cell cycle- halt cell division and killing the cells, anti-angesis drugs- keep tumors from growing and spreading, enzyme activators/ blockers- activate caspase or reactive telomerase, living with cancer- psychological support, prevention- avoid tobacco, control diet and weight, exercise, protect your skin, avoid environmental and occupational carcinogens

Diet and eating habits

diet- daily food choices, enjoy and enables you to have healthy body composition, total calories: equal to maintain weight, lose weight- decrease intake or increase calories burned, combo of both is best, portion sizes: packaged food and foods at restaurants have increased in size, easier to track than calories, energy (calorie) density- # of cal/g- certain weight leads to feelings of fullness, fresh F/V are low- so are whole grain foods, limit serving seizes of energy dense foods, eating habits: several small meals (4-5/day), skipping meals leads to excessive hunger, feelings of deprivation, and increased vulnerability to binge eating or snacking, consume cal during day not evening, eat in moderation, don't try to lose weight faster than 1 kg/wk, 8-10% of body weight over 6 months, maintaining is harder than losing- lifelong project, fad diets- may not meet a person's nutrient and calorie requirements

Sexuality

dimension of personality shaped by biological, psycho social and culturally forces and concerning all aspects of sexual behaviour, biological, sex, gender, sexual anatomy and physiology, sexual functioning and practices, social and sexual interactions with others, intense feelings- cultural and societal norms

Schizophrenia

disturbance in thinking and in perceiving reality, severe and debilitating, quite mild- cannot see anything is wrong, genes and environmental factor, disorganized thoughts, inappropriate emotions, delusions, auditory hallucinations, deteriorating social and work functioning- regular medication

Factors contributing to disease

drug resistance, poverty, breakdown of public health measures, travel and commerce, mass food production and distribution, human behaviors, bioterrorism

Protecting yourself from CV issues

eat heart healthy, decrease fat and chol intake, high fibre, decrease NA, increase K, avoid excessive alcohol consumption, omega 3 fatty acids, plant stanoles and sterolds, folic acid, vit B6 and 12, calcium, soy protein, healhy carbs, total cal- exercise regularly, avoid tobacco, know and manage BP, chol levels, develop effective ways to handle stress and anger

Complications and loss with pregnancy

ectopic- embryo develops outside of the uterus, in FT, occur because FT is blocked, spontaneous abortion- miscarriage before 20th week, may happen before pregnancy is known , stillbirth- delivery of fetus that shows no signs of life , preeclampsia- characterized by increased BP and protein in the urine- headache, RUQ pain, vision changes, swelling, weight gain- untreated: seizures, eclampsia, placenta prella- placenta covers cervical opening, preventing the mother from delivering the baby vaginally, placental abruption: normally implanted placenta prematurely separates from uterine wall, gestational diabetes, preterm labor- before 37th week, labor induction- not delivery 7-14 days past their due date, low birth weight weighing <2.5 kg at birth- premature, before 37th week, small for date/gestational age, not sufficiently developed, infant mortality <1 year old, SIDS- during sleep, put on back, coping with loss- deep grief, intense feelings, physical symptoms, get help

Mood disorders

emotional disturbance that is intense and persistent enough to affect normal function- depression and bipolar Depression- loss of interest, sadness, hoplessness, loss of appetite, disturbed sleep, restlessness/ fatigue, thoughts of worthlessness and guilt, trouble concentrating/ making decisions, thoughts of death/suicide- expression of the wish to be dead, revealing contemplated methods, increased social withdrawal and isolation, sudden, inexplicable lightening of mood, hx of past attempts, suicide by family/friend, readily available means, hx of substance abuse/ eating disorders, serious medical problems, self injury, ask direct questions and help them (get yourself) professional help, treatment- drug therapy and psychotherapy, hospitalization, electroconvulsive therapy, seasonal affective disorder- usually in winter with less daylight- light therapy Mania and Bipolar Disorder- mania- restless, have a lot of energy, need little sleep, talk non-stop, excessive elation, irritability, talkativeness, inflated self esteem and expansiveness- swing b/w mania and depressive episodes (bipolar)

Calories

energy in food- kilocalorie (1= amount of heat needed to raise the temp of 1 L of water by 1 deg C)= needs about 2000/ day, fat- 9 calories/g, protein- 4 calories/g, carb- 4 calories/g, alcohol- 7 calories/g, excess calories turn into fat

Planning for death

ensure that it is not more difficult for survivors, making a will, unnecessary hardships, will- legal instrument expressing a person's intentions and wishes for the disposition of property after death, estate- the money, property and other possessions belonging to a person, testate- person who makes the will- can be changed, replaced or revoked, intestate- situation in which a person dies w/o having made a legal will- distributed by rules of territory/province, testamentary letter- information about personal affairs, considering EOL care- home care: in familiar setting with family and friends, care is typically 24hr at the end- need skills, medical knowledge and physical strength, institutional care may be more appropriate, hospital-based palliative care- controls pain and relieves suffering by caring for all needs, QOL, hospice palliative care- program of care for dying patients and their families, arrange to receive services, team-oriented approach, relieve pain and emotional/spiritual support, choose where they die, difficult decisions- stop doing tests/ treatments , medical interventions can cause discomfort and decease QOL, persistent vegetative state- a condition of profound unconsciousness in which a person lacks normal reflexes and is unresponsive to external stimuli lasting for an extended period of time with no reasonable hope of improvement, withholding/withdrawing treatment- constitutionally protected even when pt is unable to communicate, PAD- the practice of a physician intentionally providing, at the patient's request, lethal drugs or other means for a patient to hasten death with the understanding that the pt plans to use them to end his/her life, only specific cases, active euthanasia- a deliberate act intended to end another person's life; voluntary ae involves the practice of a physician administering- at the request of a patient- medication. some other intervention that causes death, must orally request at least 15 days apart, written, signed by 2 witness, 2 physicians need to confirm diagnosis and prognosis, whether person is capable of making decision, whether patient had mental illness, must be informed about alternative (Dying with Dignity Act), personal autonomy, double effect: a situation in which a harmful effect occurs as an unintended side effect of a beneficial action- pain, not PAD if intent is to relieve suffering, AE- involuntary: w/o pt consent, non-voluntary- surrogate decision maker asks physician, voluntary- pt request by someone other that the pt, unlawful in NA, adequate pain control can be difficult to achieve-palliative sedation: practice of using a sedative medication to keep a pt in an unconscious/semi-conscious state until pain is brought under control or the pt dies as a result of the underlying disease, last resort

Allergy

exaggerated response to foreign chemicals and proteins (hypersensitivity), allergens trigger, inhaled, swallowed, come into contact with skin, pollen, animal dander, dust mites and cockroaches, moulds and mildew, food, insect stings, medication, IgE- binds to mast cells, release histamine- anaphylaxis(trouble breathing, decrease BP, heart arrythmias, seizure), avoidance, medication, immunotherapy, 2.3 million adults, 1/2 million youth, have asthma, infectious disease- death 25%

Family and community resources for older adults

family involvement in caregiving- W rewarding and hard work, give special considerations to needs, other living and care options, community resources- senior centres/adult daycare centres, homemaker services, visiting nurses, household services, friendly visitor/daily telephone reassurance service, home food delivery, adult day hospital care, low-cost legal aid, transportation services, case management, transportation- drive with more caution, crashes are more likely to be fatal, decision to stop driving can be a difficult one, government aid-pensions, learn to judge productivity rather than age

Fat and fat free mass

fat-free mass- bone, water, muscle, CT, organ tissues, teeth, subcutaneous fat: just beneath the skin, critical for normal body functioning, visceral: inside abd wall and around the internal organs- excess= risk for heart disease, insulin resistance, and metabolic syndrome, 10-20% M, 5-8% W, ectopic: on/within organs (liver, brain, heart), 1 kg of body fat= 7000 calories, percent body fat- % of total bodyweight that is composed of fat- overfat

Infection stats

fatal in 11% of cases, 20% of reactions have permanent hearing loss/ serious effects to meningitis, TB- 5-10% of latent become active, 7% monoresistant, 1% MDR, 30% ppl carry staph bacteria in blood, 85% MRSA causes from health care facilities, Lyme disease (95%), 70-80% bulleyes shaped rash, 10-20% impaired coordination partial facial paralysis, heart rhythm abnormalities, 1/2 chronic/recurring arthritis, 90% of ulcers from H.pylori- fatal in 10-20%, c. diff- increase 10 % annually, 2005-2010- 26.7% decrease, >2% die, adults- 28% of cases, UTI- E.coli 80% of cases, 21% Can do not know if they have HCV, chronic-HBV- 5-10%, HCV- 85-90%, developing countries- 10% of child deaths from malaria- 130/day, 1/min, SARS is fatal in 4% of cases, 80% W have lupus, hantavirus- 38% are fatal, Ebola- 25-90% fatality rate

CHF

fluid backs up when heart cannot maintain regular pumping rate and force, pulmonary edema, decrease workload of heart, modify salt intake, drugs to remove excess fluid

Vegetarian Alternative

foods of animal origin are eliminated/ restricted- vegans: no animal products at all, only plant foods, lacto-vegetarian- include milk and cheese into diet, lacto-ovo-vegetarian- no meat, poultry, fishbut eat eggs and milk products, partial/semi/ pesco- eggs, dairy products and small amounts of poultry and seafood in the diet, have more potassium, fibre, antioxidant-rich nutrients, modify focus on nonmeat choices

Lung cancer

from tobacco smoke, asbestos particles, pollutants, ETS, difficult to detect at early stage and hard to cure early, symptoms do not show up until invasive stage- persistent cough, chest pain, recurring bronchitis, spiral CT, chest x-ray, sputum sample, fibre-optic bronchoscopy, radiation, chemo (selective destroying), remission- no symptoms or other evidence of disease

Factors contributing to excess body fat

genetic: nutrigenomics ( how nutrients and genes interact), 600 genes associated with obesity-influence body size and shape, body fat distribution, and metabolic rate, ease in which weight is gained (80% of being obese if parents are) + environmental factors, tendency is genetic, physiological: metabolism- sum of all the vital processes by which food energy, and nutrients are made available to and be used by the body, resting metabolic rate (energy required to maintain vital body functions- RR, HR, temp, BP while the body is at rest), heredity and behavior- muscles are more metabolically active than fat, higher RMR- burn more calories at rest, weight loss (gain)- RMR and energy to perform physical tasks decreases, exercise increases RMR, hormones- changes contribute to the amount and location of fat accumulation, leptin- lets brain know big or small the body's fat stores are- regulate appetite and metabolic rate, fat cells- function of # and size , may increase ability to store fat, visceral- contains inflammatory chemicals and growth factors= insulin resistance, pear= gynoid, apple= android, lifestyle factors: eating- calorie dense foods, habits, more high fat, sugar, and cal foods, eating out (ppl underestimate cal by 30%), extra cal from cabs, decreased pa, pa- declining, cut pe classes and recess, conveniences, burn cal and keep metabolism geared to using food, may suppress appetite, increase QOL an obesogenic environment- promotes over consumption of calories while discouraging pa, choices, influenced by socioeconomic factors, religion, culture, geographic location, endocrine disrupting chemicals, psychosocial factors- food to cope, binge eating, socioeconomic status, part of social celebrations, thinkning and emotions- way you think of youself and your world influences (both ways) how you feel, act, self- talk, coping strategies- find new healthy ones

Choosing a primary care physician

get to know you, coordinates medical care, refers to specialists, look for one before you get sick, make a choice of possible choices, ask for recommendations-call to find out info, schedule a visit, F more likely than M

Getting the most out of medical care

good communication, physician-patient partnership, physician is consultant, patient had active involvement, your appointment-prepare ahead of time, bring list of medications, records, test results, be open, make sure you understand, diagnostic process, med hx, past hx, social hx, physical exam- VS, specific physical, diagnostic testing, x-rays, biopsies, blood/urine tests, scans, endoscopies-false positives/negatives, med/surg treatments- prescription medications- adverse drug effects from medication errors, off label drug use, online pharmacies, costs, pts have responsibilities too, web/internet health information- skepticism, surgery-outpatient

Handling psychological and mental changes

good health- mentally alert and can fully learn and remember, dementia- deterioration of mental functioning (memory, concentration, judgement) resulting from a brain disorder, accompanied by emotional disturbances and personality changes, early symptoms- slight disturbances in a person's ability to grasp the situation, memory failure, >30 causes are treatable- Alzheimer's disease- progressive loss of mental functioning, caused by a degeneration of brain cells, heredity, 8yrSr after onset of symptoms, Lewy body and multi-infract are irreversible- unpredictable levels of cognitive ability/ attention/ alertness, changes in walking/movement, REM sleep behaviour disorder, MI series of small strokes, distortion, sniffling, incontinence, inappropriate emotions, difficulty with instructions, problems with money, grief- increase loss, loneliest and most intense times, unresolved can have consequences -hostility toward people connected to the death, talking about the death as though it occurred yesterday, unrealistic or harmful behaviour, M>65 have highest suicide rates, depression- consult a professional, listen carefully when older people talk about being down/depressed varies among ethnic groups, few cases of people dying young, lifespan- a theoretically projected length of life based on the maximum potential of the human body in the best environment (100-120 yrs), healthspan (period of life when a person is generally healthy and free from chronic/serious diseases), behaviour changes can't extend maximum human lifespan, complex- life in an aging canafa- new policies and changes in attitudes, factors contributing low fertility rates, long life expectancy, effects of baby boom generation, old age security (CAS) pension- monthly benefit for >65 living in Canada for at least 10 years, living costs are substantial, gerontologist- a person who studies the biological, psychological and social phenomena associated with aging and old age, gertiatricians- a physician specializing in the disease, disabilities and care of older adults

Coping with loss

grief: a person's reaction to loss as manifested physically, emotionally, mentally and behaviorally- disbelief, confusion, anxiety, disorganization, depression, relief, sorrow/sadness, anger, self-pity, crying, searching for deceased, talking incessantly about the deceased and the circumstance of death, sighing, insomnia, loss of appetite, bereavement- objective event of loss, mourning- the process whereby a person actively copes with grief in adjusting to a loss and integrating it into his or her life, based on cultural and gender norms- tasks: accept the reality of the loss, work through the pain of grief, adjust to a changed environment w/o deceased, emotionally relocating the deceased and moving on, grief is individual- shock, numbness, disbelief, denial, cause/mode influences physical and emotional stressor, difficulty sleeping, eating, taking medications, confused, difficulty concentrating- anxiety, pining, despair, influences on grieving: urge to look back, cry and search for what is lost, urge to look forward, explore the world that emerges out of loss and discover what can be carried forward from the past into the future, social and cultural pressures that influence the first two urges are inhibited/expressed, may avoid/ confront grief- balance to come to terms- loss oriented, and restoration oriented mourning, eventually pain subsides and reintegration into social world, sadness goes to background- need social support- groups- initially want physical comfort then listening- avoid speaking too much, refrain from making judgment, professional help, helplessness or taking charge, find out what they want to do, losing a close friend unexpectedly is traumatic, may feel left out and unsupported, blame yourself, children cope in a healthier way if included in family's experience of grief and mourning- help them understand, keep explanation simple, denying death results in denying life

Social and psychological factors to smoking

habit while doing something else-secondary reinforces- stimuli that are not necessarily pleasurable in themselves but that are associated with other stimuli that are pleasurable, genetics: initiation and dependence- CYP2A6-influences how nicotine is metabolized- longer= more neg effects (nausea. dizzy), DRD2, 85% start before 18, experiment at younger ages, depends if parents/siblings use tobacco, peers use it, child comes from blue-collar family, comes from low income home, headed by a single parent, poor performance in school, drops out of school, positive attitudes toward use-emulate fav athletes, lose weight/ stay thin , peers- minimize and deny health risks and pain, stress, trauma, diseases, sense of invincibility, smoking in the movies- rating

Risk factors that cannot be changed CVD

heredity- multiple genes, modifiable by lifestyle factors, screening only for few conditions, aging, being male- no estrogen, ethnicity- south asian, african, aboriginal have higher rates, inflammation and C-reactive protein- statins

CVD contributing factors

high triglyceride levels- blood fat, unhealthy lifestyle, psychological and social factors- stress can strain heart, hostility and anger- Type A personality, suppressing psychological distress- Type D, depression- each symptom increase risk in a linear way, common in ppl with CVD, anxiety- 3 fold increase in risk, social isolation, low socioeconomic status, alcohol/drugs- increase BP, no stimulants

Drinking and driving

highest rate occurs at age 19, dose-response function: relationship between amount of alcohol/drug consumed and type/intensity of resulting effects,legal consequences, legal limit of 0.08%- fines, loss of license, confiscation of vehicle, jail time, zero-tolerance laws, DD, signals- wide, abrupt/illegal turns, straddling centre line/lane marker, driving against traffic/on the shoulder, weaving, swerving and nearly striking an object or another vehicle, following too closely, driving w/o headlights/with windows down in cold weather

Changes in a women's body during pregnancy

hormonal changes, early signs and symptoms- missed menstrual period, slight bleeding, nausea, from increased hormones, "morning sickness" but can be all day, breast tenderness, increased urination, sleepiness, fatigue, emotional upset, Hegar's sign- softening of the uterus just above cervix, labia minora and cervix may be purple, uterus enlarges to about 3x the size, 4th month-showing, 7th-8th month- uterus pushes up into rib cage, breasts enlarge and are sensitive, area around areola darkens and broadens, muscles and ligaments attached to bones to begin to soften and stretch, circulatory system becomes more efficient, lungs are more efficient kidneys are highly effective, gain about 12.5 kg (28 lbs), stretch marks, back acne, retains more fluid, Braxten-Hicks contractions- short, irregular, painless, lightening- uterus sinks down because the baby's head settles into the mother's pelvic area

Stroke

impeded blood supply to some part of the brain resulting in the destruction of brain cells, CVA, 2 million brain cells die/min, brain ages 3.5 years/1 hr- ischemic: blockage, thrombotic, embolic, hemorrhagic- cells are deprived of blood and cannot function, intracerebral: blood vessel ruptures within the brain, subarachnoid: vessel on brain's surface ruptures and bleeds into space between brain and skull, aneurysm- sac formed by distension/ dilation of artery wall- prevents nerve cells from functioning, depends on part of brain, early treatment- ASAP, silent strokes, TIA- interruption of blood supply- numbness and difficulty with speech , CT, MRI, US, careful diagnosis!