1. Coronary (or ischemia) heart disease (heart attack)

2. Cerebrovascular disease (stroke)

3. Hypertension (high blood pressure)

4. Heart Failure

5. Rheumatic Heart Disease

Why is there a rise in CVDs? Significant change in:

(7 different options)

1. Diet habits (high consumption of saturated fats, salt and refined CHO, as well as low consumption of fruit and veggies)

2. Physical activity levels

3. Tobacco consumption worldwide

4. Industrialization

5.Urbanization

6. Economic development

7. Food market globalization

Risk factors for CVDs that we can control (MODIFIABLE):

(9 possible)

-overweight/obesity

-waist circumference

-physical activity

-high blood glucose level

-high blood pressure

-lipoprotein level

-tobacco use

-stress

-high alcohol consumption

-35' for women

-40' for men

Risk factors for CVDs that we cannot control (BIOLOGICAL):

(4 possible)

-Heredity (family history)

-Age (75% of all heart attacks occur in people 65 and older)

-Gender (men are at greater risks than females, but post-hormonal women may be at greater risk than men)

-Race (e.g. black are at 45% greater risk for hypertension than white)

Effective Strategies in Preventing CVD

(8 possible)

-Substitute non hydrogenated unsaturated fat (especially polyunsaturated fat) for saturated and trans-fats (saturated come for animal sources while unsaturated come from plant source)

-Increase consumption of Omega-3 fatty acids from fish oil or plant source

-Consume a diet high in fruits, veggies, nuts, and whole grains and low in refined grains

-Avoid excessive salty or sugary foods

-At least 30 minutes of regular physical activity daily

-Avoid smoking

-Maintain a healthy weight

-Stress Management

Examples for Best Practice for CVDs:

(3 examples)

1. In the USA, a decrease in saturated fat intake in the late 1960s began the large decline in coronary heart disease death seen in the last few decades

2. In Japan, gov't led health campaign has greatly reduced salt intake which lead to reduced hypertension and stroke rate, which fell by more than 70%

3. In Mauritius, cholesterol reduction was achieved largely by a gov't-led effort to switch the main source of cooking oil from palm to soya bean oil

-Pancreas makes little or no insulin.

-Patients need a daily injection of insulin

Common causes of Type 2 diabetes:

(4 things)

-obesity and physical inactivity

-hypertension

-abnormal cholesterol

-high triglycerides

Complications with diabetes:

(5 possible)

-Blindness

-Kidney disease

-Nerve disease

-Limb amputation

-Cardiovascular diseases

-Changing eating habits

-Weight control and exercise program

-Anti hyperglycemic agents

Disparities in cancer are:

(7 possible)

-Income (poverty)

-Race/ethnicity

-Culture

-Geography (urban/rural)

-Age

-Sexual Orientation

-Literacy

-Smoking, obesity, and organic viruses

OR

-External (chemicals, radiation, viruses, and lifestyle)

-Internal (hormonal, immune conditions, and inherited mutation)

Primary Preventions of Cancer:

(7 things)

1. Tobacco control

2. Diet

3. Control of alcohol consumption

4. Occupation and environment

5. Infections (viruses and parasites)

6. Reducing sunlight exposure

7. Sexual and reproductive factors

I. Education (ex. promote peer to peer programs for adolescents)

II. Legislation (ex. taxation of tobacco products)

III. National Leadership (ex. encourage organizations to cooperate and engage in anti-tobacco advocacy)

Factors contributing to being overweight:

(many factors)

-Greater consumption of fast foods

-More meals eaten outside home

-Increased portion sizes

-Increased consumption of soft drinks and convenience foods

-More time spent in activities such as playing video games, surfing the web, watching TV

-Fewer gym classes for children

-Lack of comprehensive health education in schools

-Lack of nutritious school lunches

-Fewer short trips on foot or bicycles and more by automobile

-Greater labor-saving devices for household chores

Best indicators of weight-related health risks:

(3 indicators)

-Body Mass Index (BMI)

-Waist circumference (WC)

-Waist-to-hip ratio (WHR)

Below 18.5: Underweight

18.5 - 24.9: Healthy weight

25.0 - 29.9: Overweight

30 or higher: Obese

Class 1 obesity - BMI between 30.0 and 34.9

Class 2 obesity - BMI between 35.0 and 39.9

Class 3 (severe obesity) - BMI of 40.0 and higher

- Obese people have overall mortality rate almost twice that of non obese people

- Associated with unhealthy cholesterol levels and impaired heart functioning as well as death from cardiovascular disease

-Other health risks: hypertension, some kinds of cancer, impaired immune function

- Gallbladder and kidney diseases, skin problems, sleep disorders, arthritis, bone and joint disorders

-  Diabetes

-Psychological wellness such as depression, self esteem (at failing to lose weight), stigma

-Discrimination from others and separation

1600 calories: many sedentary women & some older adults

2200 calories: most children, teen girls, active women, sedentary men

2800 calories: teen boys, many active men, some very active women

1. Aerobic training

2. Strength training

-Viruses (e.g. Influenza viruses, Herpes viruses, Hepatitis viruses, Retroviruses)

- Bacteria(pathogenic e.g. diphtheria and nonpathogenic Escherichia coli)

-Fungi (e.g. athlete's foot infection)

-Protozoa (e.g. malaria)

-Helminthes (parasitic worms) (e.g. Schistosomiasis)

Major means of transmitting diseases:

(4 ways)

-Animals or insects called a vector or carrier of the microorganisms which cause the disease (e.g. Malaria, Rabies)

-People: if the infectious organism passed from person to person, the disease is called a communicable disease (e.g. colds, measles, chicken pox, AIDS, gonorrhea)

-Food

-Water

How the Body Protects Itself:

-Skin & mucous membranes

-Cilia (microscopic hairs)

-Blood and the immune system

-Tears, wax, coughing, spitting, sneezing

generalists - macrophages which are large to engulf and digest foreign cells and particles

specialists - B cells and T cells which respond to specific invaders

any substance the white blood cells recognize as foreign

(B cells create antibodies which are proteins that bind to antigens and mark them for destruction by other white blood cells)

Internal - age, sex, immunological competence, previous infections, hormonal status, presence of other diseases, nutritional status, emotional stress level, heredity

External - infection in the community, season, hygiene and sanitation, drugs and medication, and environmental pollutants or toxins

-colds do not result in long-term illness or death compared to the flu, which is more serious

-flu has killed millions over the past century

-vaccines available for the flu, but have to determine which flu virus will manifest each year, and vaccines have to be developed for specific viruses

-common in young adults

-caused by Epstein-Barr virus (EBV) infection

-Once infected, it stays in the body for life

-Once you have it, you're immune to subsequent infections with EBV

-Can be highly contagious when infected people shed virus through secretions in nose and mouth

-Fatigue, fever, swollen lymph glands in adults

-treatment is rest for 1-2 weeks

You're given a vaccine that contains specific proteins from inactivated viruses, bacteria, or toxins

-viral diseases that have been eliminated/reduced with immunizations: whooping cough, measles, mumps, hepatitis

- In 2005, meningitis vaccine was approved in the U.S. new vaccine called Menactra, is recommended for adolescents aged 11 to 18, the group that is most at risk. Had to get before coming to college

- In 2006, vaccine against several strains of Human Papillomavirus (HPA) was approved in order to protect women from developing cervical cancer ages 9 to 26

-In 2007, a vaccine against herpes zoster was approved for use in adults older than 60 years old (a viral infection that causes chicken pox in children, in adults it causes shingles, an extremely painful outbreak of sores on the trunk of the body)

- In 2009, the H1N1 flu vaccine which is recommended for children and adults

1. Immunizations (keep track of the ones you've received and the dates)

2. Good health habits (maintain a healthy life style, boost your defense through healthy nutrition and sleep)

3. Prompt treatment

4. Risk elimination - minimize exposure to people with contagious diseases

2009 Influenza Pandemic (H1N1)

-  H1N1 flu contains genetic material from swine, bird, and human flu virus

-Spreads from Mexico to U.S. within a month

-  Most cases were mild, and the infections respond to antiviral drugs oseltamivir phosphate (Tamiflu) and zabamivir (relenza)

- H1N1 flu vaccine is produced and effective in protecting people

1. Accidents

2. Suicide

1. Physical (slapping, shoving, beating, rape, homicide)

2. Emotional

3. Verbal

4. Threats of physical harm

-females between 19-29 yrs old

-family with income below poverty level

-women who were abused as children

-alcohol/drug use by perpetrator

-being stalked by current or former partner

1. Tension: minor battering incident may occur (slapping, kicking, pushing)

2. Explosion: Physical injuries may occur during this phase and the batterer may be stopped by a third party (police, friend, family)

3. Contrition (honeymoon phase): The batterer may be kind, loving, and promise to seek counseling help

1. Alcohol

2. Marital dissatisfaction

3. Personality disorder

1. Fatal outcome: suicide/homicide

2. Non-fatal outcome:                    

   -Physical - injuries, STDs, unwanted pregnancy, gastrointestinal and genitourinary complaints

-Mental - depression, anxiety, sexual dysfunction, personality disorder, confusion, and withdrawal

-Fear, haplessesness and lack of knowledge regarding resources

-Children

-Financial reasons

-Hope that the situation will change

-Cultural/religious reasons

-Love

 any unwanted or unwelcomed behavior of sexual nature

-       78% of teen rape victims do not tell their parents

-       71% tell at least 1 friend

- At least 50% of college rapes involve alcohol

-75% of men had been drinking

-55% of women had been drinking

-Regretted sex occurs for 90% of sexually active persons

1. GHB -

-Made at home

  -Effects: dizziness, nausea, amnesia, coma, slow heart and breathing rates

Rohyponal -

- also known as roofies, Mexican valium, date rape drug

-sedates, induces sleep, major effect on memory

- Freshman: alone for first time, more independence in decision making, feelings on insecurity, need to belong, more intense dating

- Miscommunications: verbal and nonverbal

-Increased exposure to alcohol and date rape drugs

-  Don’t understand what date rape is

-Females believe they are responsible

-Males don’t see their actions as rape

- 2/3 of males in college admitted they would commit rape if they thought they could get away with it.

  any person who in the course of their work come into contact with children and have reasonable cause to suspect on the basis of their professional training that a child is being abused

Who suggested improvements of sanitation of soldiers in the 19^th century which reduced mortality and morbidity?

Primary: the consumption (alcohol/drugs) behavior

Secondary: the behaviors resulting form the consumption of the substance

Long Term: Abuse, addiction, physical dependence (addiction is a disease of "theft"

Short Term: "any given night" dosing

-central nervous system depressant

-3 brain levels (thinking, emotional, "hind")

-synaptic activity

-"back up in the body" raises B.A.C.

Under .10: outer brain, "thinking brain"

.15 to .20: emotional brain

.20: "overdose"

.30 and higher: medical emergency, hitting "hind" brain areas

1. Heroin- smack, skag, junk

2. Cocaine- snow, coke, blow

3.  Barbiturates- yellow jackets, red, blues, amy’s, rainbows

4. Street methadone

5.  Alcohol

  6. Ketamine- powerful hallucinogen, special

  7. Benzodiazepines- family of sedative drugs

8. Amphetamines- greenies among baseball players

9. Tobacco

10. Buprenorphine- bupe or subbies

11. Cannabis: includes marijuana

12. Solvents: volatile substances that can be inhaled such as glue, nail polish remover, paints, hair spray and lighter fuel

13. 4-MTA- a derivative of amphetamine and has similar effects to ecstasy

14. LSD

15. Methylphenidate: central nervous system stimulant, commonly sold as Ritalin

16. Anabolic steroids

17. GHB: short for gamma hydroxybutyrate, a powerful nervous system depressant, date rape drug

18. Ecstasy

19. Alkyl nitrates: poppers

20.Khat: an amphetamine- like stimulant

1. Pride (fears of humiliation/bullying)

2. Personal convictions: morals, values, belief systems

3. Essential needs (Maslow's Hierarchy of needs)

4. Entitlements and/or wants

1. Motivated to get control back

2. "Self Talk" to convince selves they have right to be in control

3. "Scan" options of ways to react (thinking)

4. ACT

rights consistently violated

maintain rights of both parties

constantly violates rights of others

-Revenge/punishment: eye for an eye thinking

-Civil disobedience/social justice

-Mental illness

-Impaired judgment/alcohol and/or drugs related; desperation

-Social modeling; thinking its funny

-Protective reactions: pre-emptive to protect

-Gets me what I want

-Group think; diffusion of personal responsibility (both direct and passive aggression: bystander relating with the aggressor)

-Fear/uncontrolled anger; lack of knowledge of other options available

-social and economic conditions

-unsafe roads and automobile

-unsafe home and work site

-personal factors: poor judgment, lapse in attention, recklessness, loss of emotional control, and mental states imbalanced by drugs/alcohol or using cell phones

1. Motor Vehicle Accidents

2. Falls

3. Poisoning by solids/liquids

4. Fires/burns

5. Drowning

Abnormal Energy Transfer

-mechanical energy (moving objects) (31% motor vehicle, 22% firearm, 22% falls)

-thermal

-electric

-chemical

-radiation

Phase 1: Pre-event phase (lack of skills/knowledge, alcohol)

Phase 2: Event phase

Phase 3: Post-event phase

-Human (host): age, gender, experience, alcohol, fatigue

-Vehicle (agent): failure, speed, design

-Environment: road conditions, traffic, weather

1. Environment

2. Host

3. Agent

1. Visual - taking your eyes off the road

2. Manual - taking your hands off the wheel

3. Cognitive - taking your mind off what you're doing

-texting is the most alarming, because it involves all three types of distraction

-Reduce firearm related injuries

-Reduce deaths by poisonings

-Reduce student health service emergency clinical visits caused by injuries

-Reduce deaths and non fatal injuries caused by MVA

-Reduce pedestrian deaths & injuries on public roads

-In 2006, traffic accidents injured 70,000 pedestrians and killed 6,000 pedestrians

-The majority of pedestrian deaths involve children age 5 to 9 years old

-Young children are unable to judge the speed and distance of approaching motor vehicles

-Elderly persons are also at risk because of failing eyesight, hearing, and mobility

-The single most important factor in reducing bicycle deaths is the use of protective helmets

-A total of 55,000 bicyclists were injured and 1100 were killed in collisions with motor vehicles in 2006.

-Most often cause of accidents was the cyclists failure to yield the right of way

-Bicycle riders are required to follow the same rules of the road as automobile drivers

-Wearing bright, reflective clothing and equip your bike with reflectors and lights

 falls, fires, suffocating, poisonings, and drowning

any chemical substance that causes illness, injury or death.

1. Unintentional

2. Intentional

3. Undetermined

Comes from a head injury involving a temporary loss of consciousness and a period of amnesia upon waking

Grade 1 - feeling dazed or confused for less than 15 minutes

Grade 2 - mental confusion persists for longer than 15 minutes

Grade 3 - involves any loss of consciousness

1. Inhalation

2. Ingestion

3. Contact (skin)

-Air pollution (indoor and outdoor)

-Water pollution and fresh water shortage

-Exposure to toxic industrial and agricultural chemicals

-Electromagnetic and microwave radiation

-Nuclear, chemical and biological terrorism and welfare

-Extinction of species from deforestation overhunting and fishing

-Global warming

Human Activities: (main problem)

-Urbanization – people leaving rural areas, changing environments

-Industrialization – CO₂ and other contaminants, oil refineries, cars, electric power plants

-Population growth – population keeps growing

Natural Factors:

-  Physical (e.g. volcanic activity)

-  Severe weather

-  Biological (e.g. epidemic diseases)

21% Oxygen

78% Nitrogen

1% of other gases

1. Ground- level Ozone (O3) – at O₂, it’s good.  At O₃, it’s terrible for you.  It’s close to the surface of the air.  It blankets over the Earth.

2. Carbon Monoxide (CO) – brings O₂ level in blood down

3. Sulfur Dioxide (SO4) – Acid Rain

4. Nitrogen Oxides (NO and NO2) – Nitric Acid/Acid Rain

5. Smog – Photochemical smog

6. Particulate matter (PM) – Dry cleaning, paint chips

7. Volatile Organic Compound (VOC) – We inhale result of burning wood, gas, and oil

    contains a large amount of sulfuric dioxide and nitrogen oxide that have been released in the atmosphere. When combined with water they produce sulfuric acid and nitric acid

-       a secondary air pollutant created when primary pollutants react with sunlight and atmospheric oxygen

-Denver, Los Angeles, Phoenix and Salt lake city all experience it

-Cigarette smoke and secondhand smoke

-Radon: radioactive gas that is produced in the ground in areas that contain uranium ore.  Long-term exposure increases the risk of lung cancer.

-Lead: a heavy metal that causes a serious threat to the health of millions of Americans, especially children.  Lead poisoning causes loss of appetite, weakness, anemia, brain damage, and learning disability among children.

-Methyl mercury is a worldwide environmental pollutant found in freshwater, land and ocean. Coal-fired power plans are responsible for 40% of all mercury poisoning. 

1. Don't eat shark, swordfish, king mackerel, or tilefish

2. Limit consumption of commercial fish to 12 ounces per week (2 meals)

3. Fish with the lowest levels of mercury are: shrimp, canned light tuna, wild salmon, Pollock, and catfish)

·      “No body exists without a mind; no mind exists without a body”

·      Nervous, endocrine and immune system interaction

·      Psychoneuroimmunology

·      Harmony/Disharmony

·      Biofeedback

·      1^st Sign – Anxiety Symptoms

·      Autonomic nervous system

·      “Fight or flight”

o   Elevated heart rate

o   Elevated BP

o   Constricted blood vessels

o   Dilated pupils

o   Alert, aroused state

o   Release of glucose and fatty acids for quick energy

-Harm and loss

-Threat

-Challenge

Eustress = positive stress

Distress = negative stress

1. Alarm

2. Resistance

3. Exhaustion

Prolonged stress --> activates GAS -->physiological changes

-GI

-Respiratory

-Skin

-Eating

-Depression

-Sleep

-Ms

-Metabolic

-Cardiovascular

-Menstrual

-Cancer

-Accident prone-ness

-T cells and B cells function suppression

-Decreased interferon synthesis

-Decreased macrophage function

-Increased susceptibility to infection

o   Problem focused – things to do to limit stress, change perception, change/alter goals

o   Emotion focused – focusing that it’s not too big to overcome, changing your attitude

    o   Denial/giving up – recognizing that maybe the stressor isn’t going to change or go away

time management, plan ahead, keep a to-do list, clarify intentions, don’t “just do it”, sleep, schedule downtime, don’t sweat the small stuff, prioritize tasks

-Humor - psychoneuroimmunology

-Placebos

-Faith, spirituality, and healing