Cardiovascular Disease Chapter 6 PDF

Cardiovascular Disease Chapter 6  Objectives Discuss the incidence, prevalence, and outcomes of cardiovascular disease. Review major types of heart disease, factors that contribute to their development, and the importance of fundamental lifestyle mod...

Cardiovascular Disease Chapter 6  Objectives Discuss the incidence, prevalence, and outcomes of cardiovascular disease. Review major types of heart disease, factors that contribute to their development, and the importance of fundamental lifestyle modifications aimed at prevention. Discuss controllable and uncontrollable risk factors for cardiovascular disease; your own risk profile, and determine the risk factors you can and cannot control. https://www.youtube.com/watch?v=qJq5hA4pnOk  An Epidemiological Overview Cardiovascular disease (CVD) is the leading cause of death in the U.S. In 2005 CVD accounted for approximately 38 percent of all deaths CVD has been the number one killer in the U.S. since 1900 except for 1918 (influenza) More that 2,500 Americans die from CVD each day Among women, 1 in 2.6 deaths from CVD  Prevalence of Cardiovascular Diseases in American Men and Women, Ages 20 and Older Figure 15.2  Death Rates for Cardiovascular Disease, Including CHD and Stroke for Selected Countries Figure 15.3  Heart Function Deoxygenated blood enters the right atrium From the right atrium blood moves to the right ventricle, pumped through the pulmonary artery to the lungs Oxygen blood enters the left atrium Blood from the left atrium is forced into the left ventricle The left ventricle pumps blood through the aorta to various parts of the body  Types Of Cardiovascular Disease Atherosclerosis Coronary heart disease (CHD) Chest pain (angina pectoris) Irregular heartbeat (arrhythmia) Congestive heart failure (CHF) Congenital and rheumatic heart disease Stroke  Percentage Breakdown of Deaths from Cardiovascular Disease in the United States, 2001 Figure 15.5  Artherosclerosis Characterized by deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of the artery Hyperlipidemia – abnormally high blood lipid level Plaque – the buildup of deposits in the arteries  Coronary Heart Disease Myocardium – Muscle tissue around the heart Myocardium infarction (heart attack) – Prolonged blockage of blood to an area of the heart resulting in muscle tissue damage. Symptoms of a heart attack – Pressure in chest, fullness, squeezing pain. – Pain spreading to shoulders, neck, or arms – Lightheadedness, fainting, sweating, nausea  Angina Pectoris Ischemia – reduction of the heart’s blood and oxygen supply. – painful cramp in chest, arm, neck, or back due to brief blockage of oxygenated blood to the heart. – More often during exercise, stress, cold temperature, digesting large fat meal. – Little or no permanent damage The more serious the oxygen deprivation the more severe the pain  Stroke Occurs when the blood supply to the brain is interrupted Thrombus – blood clot Embolus – free flowing clot Aneurysm – bulging or burst blood vessel Transient ischemic attack (TIA) – brief interruptions that cause temporary impairment  Symptoms of a Stroke Sudden – weakness or numbness of the face, arm, or leg (usually on one side of the body) – dimness or loss of vision (usually one eye) – Loss of speech or trouble talking or understanding speech – Unexplained, severe headache – Dizziness, unsteadiness, or sudden fall Common Blood Vessel Disorders Figure 15.6  Heart Disease Risk Factors High blood pressure Family history Cigarette smoking High LDL (low density Lipoprotein) and total cholesterol levels https://www.youtube.com/watch?v=h97hXAUnNzk Physical inactivity Diabetes Obesity Stress  Reducing Your Risk For Cardiovascular Diseases Risks you can control – Avoid tobacco – Cut back on saturated fat and cholesterol – Maintain a healthy weight – Modify dietary habits – Exercise regularly – Control diabetes – Control blood pressure Systolic – upper number Diastolic – lower number – Manage stress  Reducing Your Risk For Cardiovascular Diseases Risks you cannot control – Heredity – Age – Gender – Race  Physiological Reactivity Physiological and cardiovascular reactivity to acute stress (“hot reactors”). – Exaggerated increases in blood pressure, heart rate, catecholamines, corticosteroids High levels of these hormones can damage heart and blood vessels Presence of epinephrine (a catecholamine) increases the formation of clots.  Women And Cardiovascular Disease 2003, CVD deaths – 426,800 men – 483,800 women Estrogen – Once estrogen production stops, risk for CVD death increases Diagnostic and therapeutic differences – Delay in diagnosing possible heart attack – Complexity in interpreting chest pain in women – Less aggressive treatment of female heart attack victims – Smaller coronary arteries in women Gender bias in CVD research – typically CVD research has been conducted on male subjects  New Weapons Against Heart Disease Diagnostic Testing for Heart Disease https://www.youtube.com/watch? v=NC9Lqs1tPpc Techniques for diagnosing heart disease – Electrocardiogram (ECG) – Angiography – Positron emission tomography (PET) – Magnetic resonance imaging (MRI) – Digital cardiac angiography (DSA)  Cardiac Rehabilitation Every year, 1 million people survive heart attacks Cardiac rehabilitation exercise training promotes recovery reduce risk of another attack Heart disease is chronic condition requiring ongoing management.  Rehabilitation Includes: Exercise – Physiological and psychological benefits Weight management Smoking cessation Lipid and BP management include dietary changes to control lipids Reduce excessive alcohol intake Stress management  Rehabilitation Exercise is the key component but: – 50% drop-out rate within first 6 months For those who continue benefits include: – Improved self concept, perceived health, sexual activity, involvement in social activities. Those who stop are more likely to: – Smoke, have poorer cardiac function, have higher body weight, be more sedentary, experience greater anxiety and depression. CHAPTER 7  OBJECTIVES  To differentiate between various types of cancer.  To be able to identify risk factors for cancer.  To understand psychological reactions to cancer.  To recognize early signs of cancer.  To understand the role of psychology in treatment and prevention of cancer.  CANCER  Canceris a disease of cells where cell reproduction is uncontrolled  Caused by a change in cell DNA  Uncontrolled cell reproduction leads to the development of a tumor or neoplasm  Immature cells don’t perform normal function  Tumours are groups of abnormal cells that form lumps or growths. They can start in any one of the trillions of cells in our bodies.  https://www.youtube.com/watch?v=5pP4bMm9y NQ  TUMOR TYPES Malignant Tumor https://encrypted-tbn1.gstatic.com/images?q=tbn:ANd9GcQwuCS3MkQdQqchgX5I1m3kZlfOVVmZPhLuBizNK6xRVYAfonBV  Cells more immature, dysfunctional  More likely to spread to other areas of the body (metastasis)  Metastasis  Spread of cancer cells through blood/ lymphatic system and abdominal cavity (i.e. primary site to secondary sites) Non-Malignant Tumor  Benign cancer  less likely to spread to other areas of the body WHAT CAUSES CANCER? https://www.youtube.com/wat ch?v=S2hD2ESf3Ho  4 BROAD CATEGORIES OF CANCERS 1. Carcinomas  Occur in tissue lining internal/external surfaces of organs (including the skin)  Account for 85-90% of cancers 2. Lymphomas  Occur in lymphatic system (e.g., lymph nodes, lymph vessels, spleen)  4 BROAD CATEGORIES OF CANCERS, CONT. 3. Sarcomas  Arise in connective tissue (e.g., muscle, bone, fat) 4. Leukaemias  Present in blood-forming tissues (e.g., bone marrow)  Essentially involve the production of large numbers of immature white blood cells (leucocytes) of one form or another  MOST COMMON SITES FOR WOMEN Incidence  Breasts, colon/rectum, lung, uterus, ovary, lymphomas Death  Lung, breast, colon/rectum, pancreas, ovary, uterus MOST COMMON SITES FOR MEN Incidence  Prostate, lung, colon/rectum, bladder, lymphomas, oral Death  Lung, prostate, colon/rectum, pancreas, lymphomas, leukaemias  CAUSES OF CANCER It has been suggested that 75 to 80% of cancers are caused by modifiable lifestyle factors! Causes: random mutations and environmental agents  RISK FACTORS Genetics  Some breast cancers are very strongly influenced by genes Viruses  Human Papilloma Virus (disease which leads to suppression of immune function) Radiation  Ultraviolet light (UV)(sun), X-rays, nuclear  LIFESTYLE RISK FACTORS Tar in cigarettes  Accounts for 70-80% of lung cancers and 30% of all cancer deaths Diet  Fat  Carcinogens (natural or additives)  Methods of food preparation (charring, smoking)  Alcohol (heavy drinkers 2x risk) Sexual behavior  Kaposi’s sarcoma, non-Hodgkin’s lymphoma PSYCHOLOGICAL RISK FACTORS Stress  Data not consistent  Stress may impact on the progression of cancer (impaired immune function) Suppression of Emotion  Denial, anger  Greer & Morris (1978) study of psychological factors of women who develop breast cancer PSYCHOLOGICAL RISK FACTORS https://www.youtube.com/watch?v=Et RVoIVogrc https://www.youtube.com/watch?v=9 Dw36ve0Lwc Personality  Type I: Cancer-prone personality  Type II: CHD-prone personality  Type III: Mixed-type (with psychopathic tendencies)  Type IV: Healthy autonomous type  PSYCHOLOGICAL REACTIONS TO CANCER The most common responses are:  Anxiety (symptoms, treatment, prognosis)  Depressive symptoms  Sadness, crying, guilt, hopelessness/helplessness, etc  Most people experience these at some time  Feelings of loss of control  Positive outcomes are not dependent on individual’s behavior  Denial  EARLY WARNING SIGNS OF CANCER? 1. A change in bowel or bladder habits 2. A sore that does not heal 3. Unusual discharge or bleeding from genital, urinary, or digestive tract. 4. A thickening or lump in breast or elsewhere. 5. Indigestion or difficulty swallowing 6. An obvious change in wart or mole 7. A persistent cough or hoarseness TREATMENT FOR CANCER  Physical/medical interventions  Surgery - remove cancer  Radiotherapy / Chemotherapy - shrink, slow cancer, prolong life  Electricity - sarcostic cancers TREATMENT FOR CANCER  Psychological interventions  Aim to improve general functioning and minimize adverse psychological reactions TREATMENT FOR CANCER  The role of psychology  Prevention  Adjunct to medical treatment  Recovery/Relapse The potential role of psychology in cancer PREVENTION OF CANCER Psychological interventions  To modify risk behaviors (eg smoking)  To improve general functioning and minimize adverse psychological reactions  To promote preventative methods  PREVENTION OF CANCER Primary Prevention  Control environmental carcinogens  Remove asbestos from schools  Move all Australian children to Canada … or just introduce hat-wearing policy in schools, Slip Slop Slap!?!  Ban on workplace smoking (bars and cafes)  Anti-pollution laws TREATMENT FOR CANCER Secondary Prevention  Early detection (reduce spread)  Reliable, acceptable, accessible screening  Education (self screening) https://www.youtube.com/watch?v=HfO T8gVfDvk  8 Ways to Reduce Your Coronary Artery Disease Risk https://www.youtube.com/watch? v=mvU3w_tUIrs Chapter 8 Obesity  What is obesity "a condition characterized by the excessive accumulation and storage of fat in the body” – Obesity in Children: At or above the 95% percentile when it comes to BMI (Body Mass Index) In Adults: Overweight is defined as a BMI of 25-29, or being 30% above recommended weight for size  CLPS https://www.youtube.com/watch?v=pNbM6G HcB10 Obesity & Mental Health. 5mins https://www.youtube.com/watch?v=1dw1OR 8hah8 The alarming link between mental health and weight gain. 3MINS  Body mass indix Body mass index With a BMI of: You are considered: (BMI) weight (kg)/ Below 18.5 Underweight height squared (m2). BMI is significantly 18.5 - 24.9 Healthy Weight correlated with total 25.0 - 29.9 Overweight body fat content. 30 or higher Obese  Calculate your BMI https://www.youtube.com/watch?v=NJiw11hI KKM Calculate Your BMI using this simple method  Classes of obesity Obesity is further divided Obesity class BMI (kg/m2) into three separate Class I 30.0- 34.9 classes, with Class III obesity being the most Class II 35.0-39.9 extreme of the three. Class III ≥ 40.0 With a BMI of: You are considered: (Extreme Obesity) Below 18.5 Underweight 18.5 - 24.9 Healthy Weight 25.0 - 29.9 Overweight 30 or higher Obese  Risks Being overweight/obese substantially raises one’s risk of morbidity from: – Hypertension – Gallbladder Disease – Dyslipidemia – Osteoarthritis – Type 2 Diabetes – Sleep apnea – Coronary Heart – Certain cancers (endometrial, Disease breast, prostate, colon) – Stroke Higher body weights are also associated with increases in all-cause mortality.  Risks, Cont. Obesity is also associated with: – High blood cholesterol – Stress incontinence ( urine leakage caused by – Complications of pregnancy weak pelvic-floor muscles) – Menstrual irregularities – Psychological disorders such as depression – Hirsutism (presence of excess body – Increased surgical risk and facial hair)  What causes obesity? Energy imbalance over a long period of time. Energy in > Energy out. Excess calories and lack of physical activity. Energy balance is like a scale. When calories consumed are greater than calories used, weight gain is the result. Negative attitudes toward Obese Individuals Negative attitudes affecting interactions Stereotypes leading to: – Stigma – Rejection – Prejudice – Discrimination Verbal, physical and relational forms Subtle and overt expressions – Peer teasing – Teacher bias How do people respond to weight bias? Poor self-esteem, depression Avoidance of medical care Overeating / Binge eating Physical inactivity Watch and write one page analysis https://www.youtube.com/watch?v=K60xHx8 36T0 Winning The Mental Battle of Physical Fitness and Obesity | Ogie Shaw. 18mins Assignment What are the important lessons you have learned from this clip?  Binge eating disorder Abnormal for circumstances? Marked distress?  Binge eating disorder (BED) Recurrent episodes of binge eating, an episode being characterized by both of the following: − Eating, in a discrete (separate) amount of time (e.g., within a 2-hour time period), an amount of food that is definitely larger than most people would eat during a similar period of time in similar circumstances − A sense of lack of control during the episodes, for example, a feeling that one can’t stop eating or control what or how much one is eating  Binge eating disorder (BED), Cont. Marked distress about binge eating Frequency of 2 days per week for 6 months Does not occur only during the course of bulimia nervosa or anorexia nervosa  Strategies to prevent obesity Assessing Your Behavior and Environment Adopting Healthy Habits Other Behaviors that will help you prevent obesity.  Assessing your behavior and environment Knowing the amount and type of food you eat Knowing your physical activity habits If you live in a environment dominated by speed and convenience you will need to set time aside for exercise Avoid high calorie foods if possible  Assessing your behavior and environment examples Keep a daily food diary and activity diary – This allows you to see how much food you intake and how much physical activity you endure throughout the day. Shopping Guide – Knowing healthy food before going to the store can save time and improve eating habits  Adopting healthy habits Physical Activity – An increase in physical activity is an important part of weight management – Exercise can reduce risks of cardiovascular disease and diabetes which can be caused by obesity – All adults should have at least 30 minutes of physical activity a day Healthy Diet – Most weight loss occurs because of decreased caloric intake – Fat Free does not mean calorie free check to see calorie per serving  Other Behaviors that will help you prevent obesity. Set the Right Goals – Effective goals are 1) specific 2) attainable and 3) forgiving Example: Walk 30 minutes five days each week. Balance your food – Make sure to include all food groups during your day – Keep track of the caloric intake Knowing when you are full – It takes 15 minutes for your body to know its full – Slowing the rate of eating allows fullness to set in – Eating a lot of vegetables can make you feel fuller  Chapter 8 Living with Chronic Illness  clip https://www.youtube.com/watch?v=RBki71pV 8Ag  What is the difference between acute and chronic illness? Acute Chronic Onset Abrupt Usually graduated Duration Limited Lengthy indefinite Cause Single Multiple changes Diagnosis Usually accurate Often uncertain Prognosis Usually accurate Often uncertain Intervention Usually effective Often indecisive Outcome Cure No cure Uncertainty Minimal Pervasive Knowledge Professionals complementary  The context of chronic illness With chronic disease, the patient’s life is irreversibly changed. Neither disease nor its consequences are static. They interact to created illness patterns requiring continuous and complex management. Variations in patterns of illness and treatments with uncertain outcomes creates uncertainty about prognosis. The goal is not cure but maintenance of pleasurable and independent live  Chronic Illness as a Crisis Serious chronic illness is a crisis – Disruption and change (identity, location, role, social support, future goals) – Increased demands (ongoing response to illness) – Uncertain outcomes – No cure, requires ongoing management  Initial reactions to chronic illness Shock Denial Loss and grief Anxiety and depression – 20-25% experience psychological symptoms If these reactions last too long, they can have an unhelpful effect on the illness  Chronic Illness as a Crisis Illness can be considered a crisis because it represents a turning point in an individual’s life. Disruption to established patterns of personal and social functioning produces a state of psychological, social, and physical disequilibrium Adaptation = finding new ways of coping with drastically altered circumstances.  Crisis Theory (Moos, 1982) A model describing the factors that affect people’s adjustment to having serious illness. Coping process (3 stages) is influenced by 3 factors – Illness-Related Factors – Background and personal Factors – Physical and Social Environment Factors Coping process influences outcome of crisis The Coping Process  Contributing Factors Illness-Related Factors – Degree to which an illness is hidden – Degree to which illness intrudes on lifestyle Background and Personal Factors – Age, gender, social class, philosophical or religious commitments, self-esteem Physical and Social Environment Factors – Social support  The Coping Process Cognitive appraisal – Meaning or significance of the illness – Meaning of Illness Questionnaire Adaptive tasks – Formulation of tasks to help cope with illness Illness-related General psychosocial functioning Coping skills – Denial, information seeking, goal setting, recruiting support  Outcome of Crisis Adaptation and Adjustment – Physical, vocational, self-concept, social, emotional, compliance Quality of Life – Degree of excellence people appraise their lives to contain – Excellence usually = fulfillment or purpose – Health-related quality of life (physical status and functioning, psychological status, social functioning, disease or treatment-related symptomatology)  Psychosocial Interventions Education and support services – Most common intervention to help people adjust – Majority choose not to attend such groups – Current trend to examine other ways of offering support (workbooks, telephone linkups, websites) Psychotherapy, CBT, family therapy, etc – Costly, not always necessary  clips https://www.youtube.com/watch?v=RBki71pV 8Ag Living with a chronic illness | Season 6 | The House of Wellness https://www.youtube.com/watch?v=MKPn0d QJZmc My Life with Chronic Illness | Venus Williams Chapter 10 HIV/AIDS  Objectives Define and understand the difference between HIV infection and AIDS Know Causes of HIV/AIDS Describe the progression of HIV from initial infection to disease Understand the modes of transmission of HIV Understand and describe role of psychology in prevention and treatment of HIV infection  What is HIV? HIV- The acronym for Human Immunodeficiency Virus. This virus causes HIV infection and AIDS The HIV infected person may, or may not have AIDS. AIDS- Acquired Immune Deficiency Syndrome Infectious disease (unlike cancer, CVD) Immune system destroyed by HIV Characteristic set of illnesses as a result  How does HIV cause AIDS? Human Immunodeficiency Virus (HIV) HIV causes AIDS by attacking helper T cells Course of the HIV infection Stage 1 - brief flu like illness (1 week after infection) Stage 2 - latent period (asymptomatic) Stage 3 - AIDS-related complex (cluster of symptoms) Stage 4 - AIDS (T-lymphocyte count below 200)  How is the virus transmitted? 3 bodily fluids (rich in white blood cells) Blood (needle sharing, blood transfusion, mother to fetus) Semen (unprotected sex) Vaginal fluids (unprotected sex)  Signs/ symptoms of HIV Infection Usually – none Early warning signs might include fever, skin rash, diarrhea, swollen glands, night sweats, fatigue, cough, oral problems, repeated vaginal infections, and/or weight loss. (Remember, other illnesses can cause similar symptoms.)  How is the virus transmitted? 5 factors increase the likelihood of infection Infection dose Concentration of virus in infectious fluids Semen more dangerous than vaginal fluids Co-factors (e.g., genital ulcers) Immune status of the recipient Clinical status of the carrier most infectious at early stages  Psychological Aspects of HIV Infection HIV infection has a major psychological impact on: The infected person The infected person’s family The infected person’s friends The economic status of affected persons  Examples of Psycho-Social Issues associated with HIV Isolation Denial Guilt Bereavement Anger Fear Confusion  Treatment of HIV/AIDS … there is still no cure! Antiretroviral agents Inhibit HIV replication Increased helper T cell count Many opportunistic diseases can be treated with medication (antibiotics)  Role of Psychology Primary Prevention Condom Use Health Belief Model Theory of Reasoned Action/Planned Behavior Needle sharing Drug laws (Glascow vs. Edinburgh) CBT (relapse prevention)  Role of Psychology Helping people with HIV Psychological impact of HIV unclear Compliance with medical regimes Palliative care (relieving without curing)  Role of Psychology Secondary Prevention Testing Test positive (own reaction, others’ reaction) Test negative Not tested  https://www.youtube.com/watch?v=a6lP4cxs_mI Using Mindfulness for Stress Management in Chronic Disease | Linda Manning. 19mins https://www.youtube.com/watch?v=Gg6j2K8OAp0 Guided Questions: Practicing Body Gratitude 8mins  Role of Psychology Kubler-Ross - Stages of Adjusting to Dying Bereavement Grief (feeling) and mourning (expression of feeling) AIDS unique Gay men receive less social support when partner dies Numerous AIDS deaths (demoralization) Urging to “get on with life” unproductive  Role of Psychology Kubler-Ross - Stages of Adjusting to Dying Bereavement Grief (feeling) and mourning (expression of feeling) AIDS unique Gay men receive less social support when partner dies Numerous AIDS deaths (demoralization) Urging to “get on with life” unproductive https://www.youtube.com/watch? v=oFqSGZpLCts https://www.youtube.com/watch?