Health and Wellness Final Review PDF

Health and Wellness Final Review Week 1: Intro to Health and Wellness Major health problems in Canada today 1. Obesity 2. Diabetes 3. Heart Disease 4. Cancers - These are also the leading killers in Canada Causes of death for young people today - Suicide/mental heal...

Health and Wellness Final Review Week 1: Intro to Health and Wellness Major health problems in Canada today 1. Obesity 2. Diabetes 3. Heart Disease 4. Cancers - These are also the leading killers in Canada Causes of death for young people today - Suicide/mental health - Drug and Alcohol Addiction - Accidents - Cancer Six Dimensions of Wellness - The concept of wellness includes vitality in six interrelated dimensions, all of which contribute to overall wellness 1. Physical 2. Emotional 3. Intellectual 4. Interpersonal 5. Spiritual 6. Environmental - Interpersonal: relating to relationships or communication between people Social Determinants of Health - Income/ income distribution - Education - Unemployment/job security - Employment and working conditions - Early childhood development - Food insecurity - Housing  - Social exclusion - Social safety net and network - Health services - Gender - Race - Disability - A complex problem has multiple causes and multiple solutions - Health Literacy is the ability to read, write, understand information pertaining to your health Evidence- Informed Decision Making Model (EIDM) Steps: 1. Define 2. Search 3. Appraise 4. Synthesize 5. Adapt 6. Implement 7. Evaluate - Dave Sees All Small Animals In the Evening Hierarchy of Evidence Pyramid 1. Systematic Reviews Scholarly synthesis of evidence research that identify, define and assess research on a topic 2. Randomized Controlled Trials Scientific experiment used to control factors not under direct experimental control 3. Cohort Studies Observational studies that follow a group of participants overtime to examine how certain factors affect health outcomes 4. Case- Control Studies An experiment which an independent variable is systematically manipulated and dependant variable (effect) is measured All factors are held constant except for the independent variable  Comparison (controlled) groups are used 5. Case Series, Case Reports Articles that describe and interpret an individual case often written in the form of a detailed story-used to document unique cases that cannot be explained by known diseases or syndromes 6. Editorials, expert opinions Articles written that present opinions of people, publishers, magazines, etc. - Study Results Can Create Clear Evidence Week 2: Mental Health and Psychological Disorders Psychological Health is… - Important to every dimension of wellness - Our capacity to think, feel, and behave in ways that contribute to our ability to enjoy life and manage challenges - Not merely the presence of wellness or the absence of sickness Psychological health is influenced by a variety of factors (e.g., diet, sleep patterns, relationship issues) Achieving Healthy Self-Esteem - Begins in childhood by feeling loved, feeling one can give love, and having a sense that one can accomplish goals - Integration, or feeling that one has created their own self-concept rather than adopting an image that others have created, is essential to a positive self-concept - Stability depends on the integration of the self and its freedom from contradictions Meeting Life's Challenges - Everyone must learn to cope with life's large and small challenges - Throughout our lives, we will continue to grow psychologically, developing new and more sophisticated coping mechanisms Resilience - Adapting well in face of adversity, trauma, tragedy, stress - “Bouncing back” from difficult experiences - It is not a personality trait, Resilience is a set of behaviors, actions, thoughts that people use to get through these stressful and traumatic life events Factors are associated with resilience - Having caring and supportive relationships - Capacity to carry out realistic plans - Positive view of self and self-confidence in abilities - Communication and problem-solving skills - Being able to manage feelings and impulses The Mental Health Continuum Connection between mental and physical health - Associations between mental and physical health include: 1. Poor mental health is a risk factor for chronic physical conditions 2. People with serious mental health conditions are at high risk of experiencing chronic physical conditions 3. People with chronic physical conditions are at risk of developing poor mental health - Social determinants of health impact chronic physical conditions and mental health Psychological Disorders - Generally the result of many factors and can include genetics, learning and life events, exposure to trauma, and parental/peer influence s Anxiety Disorders  - Anxiety is another word for fear, especially a feeling of fear that is not in response to any definite - Threat - When fear is disproportionate to the actual danger, it can be considered a problem - Anxiety disorders are the most common psychological disorders among Canadians Psychological Disorders : Anxiety Disorders - Simple, or specific phobia Fear of something definite (e.g, snakes, heights) - Social phobia Fear of humiliation or embarrassment while being observed by others - Panic Disorders Sudden unexpected surges in anxiety Rapid and strong heart beat Shortness of breath Loss of physical equilibrium Feeling of losing mental control Agoraphobia - Generalized Anxiety Disorder (GAD) Excessive, uncontrollable worry about a variety of things Anxiety in many situations - Obsessive-Compulsive Disorder (OCD) Obsessions-recurrent unwanted thoughts Compulsions- repetitive, unwanted actions - Behavioural Addictions Urges to engage in behaviour creates anxiety; Engaging in the behaviour brings relief - Post-Traumatic stress disorder (PTSD) Reaction to a severely traumatic event by reliving it through dreams, flashbacks, hallucinations Treating Anxiety Disorders - Medication (e.g. anti-anxiety meds) - Psychological interventions (ex. Cognitive- behavioral therapy) - Alternative therapy (ex. Meditation and yoga) Psychological Disorders: Mood Disorders - Depression affects about 11% of Canadians at some point during their lifetime - Women have depression rates that are 2 x higher than men - Depression takes different forms but usually involves demoralization and can include: A feeling of sadness and hopelessness  Loss of pleasure in doing usual activities Poor appetite/weight loss insomnia / disturbed sleep Restlessness or fatigue Thoughts of worthlessness and guilt Trouble concentrating or making decisions Thoughts of death or suicide - Dysthymic disorder may be diagnosed in those who experience persistent symptoms of mild or moderate depression for two years or longer - Suicide is one of the principal dangers od severe depression - Although a suicide attempt can occur unpredictably and unaccompanied by depression, the chances are greater if symptoms are numerous and severe Recognizing the warning signs of suicide - Expressing the wish to be dead - Increasing social withdrawal/isolation - Sudden inexplicable lightening of mood - History of previous attempts - Suicide by a family member or friend - Readily available means of committing suicide - History of substance abuse or eating disorders - Serious medical problems Helping yourself or a friend - Expert help is essential - Dont be afraid to discuss suicide - Do not leave a person alone if you feel the danger of suicide is immediate - Talk with expert Treating Depression - 80% of Canadians respond well to treatment, however only 10% of Canadians with depression will seek treatment - Treatment can be drug therapy, psychotherapy, or combination - Severe depression may be treated with electroconvulsive therapy (ECT) - Seasonal affective disorder (SAD) is typically treated with light therapy Nerve Cell Communication Psychological Disorders: Mood Disorders - Mania and Bipolar disorder Gender differences Equal numbers of men and women suffer - Schizophrenia Disorganized thoughts Inappropriate emotions Delusions Auditory hallucinations Deteriorating social and work function Uncertain about what causes it Positive Psychology - Study of the strengths that enable individuals and communities to thrive - Founded on belief that people want to lead meaningful lives, cultivate what is best within themselves, and enhance their experiences of love, work and play Week 3: Drugs, Opioids, and Marijuana Addiction - Use despite consequences - Craving - Loss of control - Compulsion to use Habit - No compulsion - No need to increase dose Characteristics of addicts - Reinforcement - Loss of control - Escalation - Negative consequences Risk and Protective Factors for Drug Abuse and Addiction Risk Factors Protective Factors Aggressive behaviour in childhood Good self control Lack of parental supervision Parental monitoring and support Poor social skills Positive relationships Drug experimentation Academic competence Availability of drugs at school School anti-drug policies Community poverty Neighborhood pride - Community is a group of people who have something in common Neurophysiology of addiction - Frontal lobe competes with the Amygdala to decide your actions  - Amygdala is the irrational, emotional part of the brain - Frontal lobe is the rational part of the brain responsible for reason and logic 1) Limbic system (controls emotions) 2) Reward system Reward pathway of the brain: - Ventral tegmental area (VTA) Neurons contain dopamine Dopamine released in nucleus accumbens and prefrontal cortex - Nucleus accumbens - Prefrontal cortex Effects of drugs on our bodies 1. Brain chemistry- neurotransmitters and receptors 2. Drug factors Dose-factors Time-action Tolerance Method of administration 3. Individual factors Harm Reduction - Helping people learn safer ways to use substance - Helping people learn how to recognize the signs of an overdose - Providing clean needles and other injection equipment (“works”) for injection drug use (to reduce transmission of infections such as HIV/AIDS and hepatitis C through needle sharing - Substituting a safer drug for the one a person is using (e.g., substituting methadone for heroin) Marijuana Acute neurophysiology effects 1. Marijuana 2. Meth 3. Ecstasy 4. LSD (hallucinogen) - Amygdala- involved in emotional learning, generation of fear - Hippocampus-memory Chronic health effects: marijuana - Carcinogenic  Oral cancers, esophagus, leukemia, testicular - Impair immunity, decrease resistance ot infection - Chromic bronchitis - Possibility lowers testosterone and sperm production, disrupts ovulation Week 4: Alcohol and Tobacco What is binge drinking - In 2 hours…. 4 drinks for women 5 drinks for men Alcohol use and Canada’s low-risk alcohol drinking guidelines - Reduce long-term risk of diseases and conditions caused by several years of alcohol consumption - Reduce short-term risk of injury, harm, and/or acute illness - Population specific guidelines: Delay youth drinking until their late teens Young adults should not excessively drink and have non-drinking days Older adults should be aware of prescriptions and follow guidelines for limited alcohol intake Binge Drinking - Approx. 5 drinks for men or 4 drinks for women consumed within about 2 hours - Frequent binge drinkers: 3-7x more likely to engage in unplanned or unprotected sex, to drive after drinking, and to get hurt or injured Alcohol intake and blood alcohol concentration - Blood alcohol concentration (BAC) is a measure of intoxication: Amount of alcohol consumed in a given amount of time Influenced by body weight, percentage body fat, sex, rate of alcohol metabolism due to genetic factors and drinking behavior - Food can slow the rate of alcohol absorption - Metabolic rate cannot be influenced by exercising , breathing deeply, eating, drinking coffee, or taking other drugs Absorption - Rate of absorption is affected by many factors Carbonation Food in stomach  Alcohol concentration Factors affecting absorption 1. Women have proportionally more body fat than men- alcohol is not very fat soluble= enters the bloodstream faster 2. Women's bodies have proportionately less water than men's bodies= alcohol does not become as diluted as in men 3. Alcohol dehydrogenase (in stomach) is more active in men 4. Smaller body size 5. Alcohol is more quickly absorbed during the premenstrual phase of a woman's cycle. Women using birth control pills absorb alcohol faster than usual Slow down rate of alcohol elimination Metabolism and Excretion - The main site=liver Gender, Setting and Population Differences - Men more than women report drinking patterns that exceed Canada's low-risk drinking guidelines for both chronic and acute effects - Women tend to become addicted to alcohol later in life than men and have fewer years of heavy drinking - Alcohol abuse is widespread and severe health problem in First Nations Communities What causes a hangover - Dehydration - Inflammatory response from your immune system - Glucose metabolism - Sleep deprivation Immediate Effects of Alcohol on Health - Alcohol- related injuries and violence are a result of impaired judgment, weakened sensory perception, reduced inhibitions, impaired motor coordination, and increased aggressiveness and hostility - Alcohol is associated with more acts of aggression and violence than any other legal or illegal drug - Alcohol seriously affects your ability ro make wise decisions about sex Drinking and driving - In Canada, drinking and driving remains the single largest criminal cause of death - The highest rate of impaired driving deaths occurs at age 19 - Dose-response function Driving with a BAC of 0.14% is more than 40 times more likely to be involved in a crash. When BAC is greater than 0.14%, the risk of fatal crash is estimated to be 380 times higher Chronic health effects - Alcohol metabolism-induced oxidative stress Alcohol-induced fatty liver disease affects 80% of heavy drinkers (80g alcohol per day over time) Standard drink= 10g - Steatohepatitis: liver inflammation, type of fatty liver disease - Cirrhosis: late stage of scarring (fibrosis) of the liver Nicotine Addiction Acute health effects - As cigarette burns.. 1. Tar released 2. Carbon monoxide (CO) Most harmful component of tobacco smoke CO attaches to hemoglobin in the blood- forms carboxyhemoglobin- unable to transport oxygen to the tissues and cells 3. Heat Hot gases and vapours damage/weaken tissues and contribute to cancers Chronic health effects - Smoking contributes to 12%-14% of all stroke deaths - Smoking increases stroke risk: Acutely: effects on thrombus formation Chronically: increased burden of atherosclerotic disease Other forms of tobacco: Pipes and Cigars - Becoming more popular among youth and women - pipe/cigar smokers have the same rate of cancer frequency as cigarette smokers with mouth , larynx, throat, esophagus - Most cigars have as much nicotine as several cigarettes - Cigarettes contain an average of about 8 milligrams of nicotine but only driver about 1 to 2 mg of nicotine to the smoker - Many popular brands of larger cigars contain between 100-400 mg of nicotine Smokeless tobacco - A.k.a “Dip”/”Chew” - Contains more nicotine than cigarettes - Major risk is leukoplakia - Impairs sense of taste, receding gums, tooth decay, damage to teeth, jawbone - Presence of fiberglass-create cuts in mouth to increase uptake of nicotine Tobacco Control - Pricing /regulation - Advertising bans - Smoking bans - Smoke-free campuses - Smoke-free housing Quitting - “Cold turkey” - Apps - Counselling - Motivational interviewing - “Run to quit” - Medication such as Champix, NRT Week 9 Immune System The chain of infection 1. Pathogen: the microorganism causing the disease 2. Reservoir: where the pathogen lives and multiplies (ex. person/animal or place) 3. Portal Exit: How the pathogen leaves the reservoir 4. Means of Transmission: Direct (i.e, hand to hand) or indirect (use vectors) 5. Portal Entry: Where the pathogen enters (i.e, inhalation, ingestion) 6. New Host Ways to Break the Chain of Infection Ways to get rid of Pathogens: - Pasteurization of milk - Chlorination of drinking water - Disinfectants Ways To Break Chain Through Reservoir: - Medical treatment and testing - Insect and rodent eradication - Quarantine Ways To Break Chain Through Portal Of Exit - Condoms - Masks - Covering mouth while coughing Ways To Break Chain Through Means Of Transmission - Hand Washing - Avoid infected individuals - Sexual abstinence or safer sex - Sanitary practises Ways To Break Chain Through Portal of Entry - Condoms - Masks - Insect Repellant Ways To Break Chain Through New Host - Immunization - Health Promotion - Medical Treatment The Immune System - Antibodies are specialized proteins produced by white blood cells that can recognize and neutralize specific microbes - Autoimmune disease is a disease in which the immune system attacks the person’s own body - Antigens are markers on the surface of a foreign substance that immune system cells recognize as non-self and that trigger the immune response Viruses - Are very small infectious agents composed of nucleic acid surrounded by a protein coat - Lack all enzymes essential to energy production and protein synthesis in normal animal cells - Cannot grow or reproduce themselves - Take what they need for growth and reproduction from the cells they invade (parasites) - Cause illnesses known as contagious diseases  - Thrive in cold environments - The common cold: ★ May be caused any of more than 200 different viruses that attack lining of nasal passages - Influenza: ★ The flu, an infection of the respiratory tract - Measles, mumps, rubella: ★ Childhood illnesses that have waned in Canada due to vaccines - Chicken pox, cold sores, herpesvirus infections: ★ Once infected, you are never free of the virus - Viral encephalitis: ★ Inflammation of brain tissue - Viral hepatitis: ★ Inflammation of the liver - Poliomyelitis: ★ Affects the nervous system causing irreversible paralysis and death - Rabies: ★ Infection of the central nervous system - Human papillomavirus: ★ A variety of types HPV cause warts - When you take medicine in the short term it helps but in the long term the sickness lasts longer - In between 36-39 degrees you are not supposed to take medicine - A pathogen creates a virus and is foreign Natural Killer and Dendritic Cells - Natural killer cells ★ Can induce apoptosis of cells that are infected with pathogens or are cancerous - Dendritic Cells ★ Reside in tissues ★ Consume pathogens and stimulate lymphocytes Immunization - Immunization is the process of conferring (granting) immunity to a pathogen by administering a vaccine - A vaccine is a preparation of killed or weakened microorganisms, inactivated toxins, or components of microorganisms that is administered to stimulate an immune response; a vaccine protects against future infection by the pathogen - Types of Vaccines: ★ Made in a variety of ways ★ May confer active or passive immunity - Vaccine Safety: ★ Soreness at injection site ★ There is no research to suggest that vaccination leads to autism Treating Viral Illnesses - Antiviral drugs work by interfering with some part of the viral life cycle  - Antivirals are currently available to fight infections caused by HIV, influenza, herpes simplex, varicella-zoster, HBV, and HVC Emerging Infectious Diseases - Infections whose incidence in humans has increased or threatens to increase in the near future - West nile virus - Severe acute respiratory syndrome (SARS) - Rotavirus - Escherichia Coli o157:H7 - Hantavirus - Ebola Factors Contributing to Emerging Infections - Drug resistance - Poverty - Breakdown of public health measures - Travel and commerce - Mass food production and distribution - Human behaviours - Bioterrorism Supporting Your Immune System - Eat a balanced diet - Get enough sleep - Dont smoke - Moderate alcohol use - Vitamin D - Wash your hands - Avoid contact with contagious people - Drink water from clean sources - Avoid contact w disease carriers - Practise safe sex - Do not use injectable drugs of any kind - Receive all recommended vaccinations Week 10 Physiological Changes With Aging Senescence - All post maturational changes and the increasing vulnerability individuals face as a result of these changes - The group of effects that lead to a decreasing expectation of life with increasing age - Differs from other biological processes: ★ Changes come from within the individual ★ Associated processes occur gradually ★ Changes have a deleterious effect of the individual Age-Related Physiological Changes - All people age but not at the same rate At age 75, The Average Person Compared To Age 30: - 92% of brain weight - 84% of basal metabolism - 70% kidney filtration rate - 43% of maximal breathing capacity Skin Wrinkling: - Loss of subcutaneous fat ★ Lower vulnerability to pressure sores ★ Less insulation of body to cold (also affected by diminished blood flow to skin and extremities) and heat Skin and Nails - Atrophic changes in sweat glands - Thickened fingernails and toenails - Generalized loss of body hair and head hair - Decrease in number of functioning pigment-producing cells which leads to graying ★ Some remaining pigment cells enlarge known as “age spots” ★ Skin changes increase along with the vulnerability to infections/disorders Skeletomuscular System Changes - Arthritis and allied bone and muscular conditions are among the most common of all disorders affecting people 65 years of age and over - Arthritis: A generic term that refers to an inflammation or degenerative change in a joint ★ Occurs world wide and is one of the oldest known diseases - Osteopenia to Osteoporosis:  ★ Gradual loss of bone that reduces skeletal mass without disrupting the proportions of minerals ★ For many, its asymptomatic ★ Bones most critically involved: vertebra, wrist, hip - Sarcopenia: ★ Loss of muscle mass that occurs with aging ★ Cause not completely understood ★ preventable/reversible with regular physical activity Arthritis - Osteoarthritis: ★ Cause not known ★ Also referred to as degenerative joint disease ★ A gradual wearing away of joint cartilage that results in the exposure of rough underlying bone ends ★ Can do damage to internal ligaments ★ Most commonly associated w/ weight bearing joints - Rheumatoid Arthritis: ★ A chronic, systemic, inflammatory disease of connective tissue ★ 2-3 times more common among women than men ★ Currently viewed as an autoimmune disease ★ May occur at any age but the most common onset is between 20 and 50 Gastrointestinal System - Atrophy of secretion mechanisms - Decreasing motility of the gut - Loss of strength/tone of muscular tissue and supporting structures - Changes in neurosensory feedback ★ Enzyme and hormone release ★ Innervation of the tract ★ Diminished response to pain and internal sensations - The phenomenon of referral is common in the GI. Ie, signs and symptoms often associated with one part of the tract may actually be associated with another part of the tract. “Discomfort perceived as originated in the stomach ma actually be coming from the lower GI tract.” - The GI symptoms often have their origins in psychosocial factors Cardiopulmonary System - In the absence of disease, the heart tends to maintain its size - Heart valves tend to increase in thickness with age - BP tends to go up with age ★ Systolic stabilizes at about age 75 ★ Diastolic stabilizes at about 65 then may gradually decline Atherosclerosis VS Arteriosclerosis - Atherosclerosis: ★ Developed by an overwhelming number of people in industrialized nations ★ A narrowing of arterial passageways as a result of the development of plaques on their interior walls ★ Reduces the size of the passageways even to the point of closing it off. A cause of ischemic heart tissue ) tissue deprived of adequate blood supply) - Arteriosclerosis: ★ A generic term referring to the loss of elasticity of arterial walls ★ Often referred to as “hardening of the arteries” ★ Considered a general aging phenomenon Respiratory Changes - Airways and tissues become less elastic and more rigid with age - Osteoporosis may alter the size/shape of the chest cavity - Power of respiratory and abdominal muscles becomes reduced and hinders diaphragmatic movement Urinary System - “The bladder of an elderly person ahs a capacity of less than half (250ml) that of a young adult (600ml) and often contains as much as 100 ml of residual urine” - Micturition reflex is delayed and usually activated when bladder is half full; in OAs not until bladder is nearly at capacity Genital System Changes  - “The genital system is characterized by a number of age-related changes in physiology and anatomy. On a whole, very few age-specific disorders are associated with this body system. With the exception of declining levels of testosterone, most of the problems of sexuality and aging are sociogenic or psychogenic” Female Genital Tract - External genitalia ★ Folds become less pronounced ★ Skin becomes thinner ★ Vascularity and elasticity decrease ★ Becomes more susceptible to tissue trauma and itching ★ Number of glands decrease, as does the level of secretion - Internal reproductive organs ★ Uterus decreases in size and becomes more fibrous ★ Uterus has fewer endometrial glands ★ Cervix reduced in size ★ Uterine tubes become thinner ★ Ovaries take on an irregular shape ★ Ovulation stops and becomes menopause (50% between ages 45 and 50) Male Genital System - Continues to produce germ cells (sperm) and sex hormones (testosterone) well into old age, declining with advancing age - Size and firmness on the testes decrease - Reduced sperm production due to age-related fibrosis which constricts the blood supply - Fibrosis may also affect the penis since erection is a purely vascular phenomenon Week 11 Intro to the Canadian Healthcare System What we know - Doctors are self employed not government employed - Canada has a publicly-funded healthcare system - Vast majority of doctors do not work for the government - Patient is free to choose which doctor they wish to visit - Doctors earn money bt billing their provincial government for the services they provide to patients - “Canadian healthcare system”, has distinct health systems for each of the provinces and territories - Canada health act outlines the basic tenets for healthcare to be universal and accessible for essential physician and hospital health services across the country - Provincially determined  - Federal government has responsibility for aboriginal and veteran healthcare Timelines - Early 1920 (The Great Depression): 77.5% of people could pay for care, by 1929, 50% of people could pay - 1968: Pierre Trudeau implements Medicare - 1983: Canadian Health Act Public Administration - This criterion applies to the health insurance plans for the provinces and terittories (not to hospitals or the services hospitals provide - The Health care insurance plans are to be administered and operated on a non-profit basis by a public authority, responsible to the provincial/territorial governments and subject to audits of their accounts and financial transactions Comprehensiveness - The health insurance plans of the provinces and territories must insure all insured health services (hospital, physician, surgical-dental) and, where permitted, services rendered by other health care practitioners Universality - One hundred percent of the insured residents of a province or territory must be entitled to the insured health services provided by the plans on uniform terms and conditions - Provinces and territories generally require that residents register with the plans to establish entitlement Portability - Residents moving from one province or territory to another must continue to be covered for insured health care service by the “home” province during any minimum waiting period, not to exceed three months, imposed by the new province of residence - After the waiting period, the new province or territory of residence assumes health care coverage - Residents temporarily absent from their home provinces or territories, or from the country , must also continued to be covered for insured health care services Accessibility - The Canada Health Act of 1984 added accessibility to make five principles - The health insurance plans of the provinces and territories must provideL reasonable access to insured health care services on uniform terms and conditions, preclude or unimpeded, either directly or indirectly by:  ★ Charges (user charges or extra-billing) ★ Others (age, health status, SES). - Reasonable access in terms of physical availability of medically necessary services has been interpreted under the Canada Health Act using the “where ans as available” rule - Thus, residents of a province or territory are entitled to have access to insured health care services at the setting “where” the services are available in that setting; - Reasonable compensation to physicians and dentists for all the insured health care services they provide. And payment to hospitals to cover the cost of insured health care services CHA-The Conditions 1. Information: the provincial and territorial governments are to provide information to the Minister of Health as may be reasonably required, in relation to insured health care services and extended health care services, for the purposes of the Canada Health Act. 2. Recognition: the provincial and territorial governments are to appropriately recognize the federal contributions toward both insured and extended health care services CHA-Extra-billing and User Charges - The cost of the new plan were to be shared 50/50 by the federal and provincial governments - They were also to be shared in a way that would serve to redistribute income between the poorer and richer provinces 1. Extra-billing: this occurs if a physician or a dentist directly charges an insured person for an insured service that is in addition to the amount that would normally be paid for by the provincial or territorial health insurance plan ★ For example, if a physician were to charge patients five dollars for an office visit that is insured by a health insurance plan, the five-dollar charge would be extra-billing 2. User charges: these are direct charges to patients, other than extra-billing, for insured services of a province or territory’s health insurance plan that are not payable, directly or indirectly, by the health insurance plan ★ For example, of patients were charged a fee before being provided treatment at a hospital emergency department, the fee would be considered a user charge What is the money being spent on? - About 60% of total expenditure in 2017 was directed to hospitals, drugs and physicians Demands On The Healthcare System - Hospitals - Physician services - Specialized drugs such as biologics and antivirals - Chronic2 disease management for elderly  ★ 50 years ago..avg=27 focus on acute care ★ Now… avg age= 57, focus on chronic disease ★ Senior stay $1000/day vs $130/d in LTCvs $55/d for home care Cue Card 1 Q: What are the major health problems in Canada today? A: Obesity, diabetes, heart disease, and cancers Cue Card 2 Q: What are the leading causes of death among young people in Canada? A: Suicide/mental health issues, drug and alcohol addiction, accidents, and cancer. Cue Card 3 Q: What are the six dimensions of wellness? A: The six dimensions of wellness are: Physical Emotional Intellectual Interpersonal Spiritual Environmental Cue Card 4 Q: What is health literacy? A: The ability to read, write, and understand information related to your health. Cue Card 5 Q: What are the steps of the Evidence-Informed Decision Making Model (EIDM)? A: The steps are: Define Search Appraise Synthesize Adapt Implement Evaluate Mnemonic: "Dave Sees All Small Animals In the Evening" Cue Card 6 Q: What is a systematic review? A: A scholarly synthesis of research evidence that identifies, defines, and assesses research on a specific topic. Cue Card 7 Q: What factors are associated with resilience? A: Factors associated with resilience include: Having caring and supportive relationships Capacity to carry out realistic plans Positive self-view and confidence in abilities Communication and problem-solving skills Ability to manage feelings and impulses Cue Card 8 Q: What is the most common psychological disorders among Canadians? A: Anxiety disorders Cue Card 9 Q: What are the symptoms of depression? A: Symptoms of depression can include: Sadness and hopelessness Loss of pleasure in usual activities Poor appetite or weight loss Insomnia or disturbed sleep Fatigue or restlessness Thoughts of worthlessness or guilt Difficulty concentrating Thoughts of death or suicide Cue Card 10 Q: What is the reward pathway of the brain? A: The Ventral Tegmental Area (VTA) Cue Card 11 Q: What are the Social Determinants of Health? A: The Social Determinants of Health include: Income/income distribution Education Unemployment/job security Employment and working conditions Early childhood development Food insecurity Housing  Social exclusion Social safety net and network Health services Gender Race Disability Cue Card 12 Q: What is the difference between a habit and addiction? A: A habit involves no compulsion or need to increase the dose, whereas addiction includes craving, loss of control, compulsion to use, and use despite negative consequences. Cue Card 13 Q: What are the chronic health effects of marijuana use? A: Chronic health effects of marijuana include: Carcinogenic effects (oral cancers, esophageal cancers, leukemia, testicular cancers) Impaired immunity and decreased resistance to infection Chronic bronchitis Potential decrease in testosterone and sperm production Disruption of ovulation Cue Card 14 Q: What are the risk and protective factors for drug abuse and addiction? A: Risk Factors: Aggressive behavior in childhood, lack of parental supervision, poor social skills, drug experimentation, availability of drugs at school, community poverty. Protective Factors: Good self-control, parental monitoring and support, positive relationships, academic competence, school anti-drug policies, neighborhood pride. Cue Card 15 Q: What are the population-specific guidelines for alcohol use in Canada? A: Delay youth drinking until their late teens. Young adults should avoid excessive drinking and have non-drinking days. Older adults should be aware of their prescriptions and follow guidelines for limited alcohol intake. Cue Card 16 Q: What are the immediate effects of alcohol on health? A: Impaired judgment, weakened sensory perception, reduced inhibitions, impaired motor coordination, increased aggressiveness, and impaired decision-making, particularly regarding sexual activity. Cue Card 17 Q: What are the chronic health effects of alcohol? A: Chronic health effects include: Alcohol-induced fatty liver disease (affects 80% of heavy drinkers) Steatohepatitis (liver inflammation) Cirrhosis (scarring of the liver) Increased risk of cancers and stroke Cue Card 18 Q: What is nicotine addiction, and what are the acute effects of smoking? A: The dependence on the nicotine found in tobacco. Acute effects include: Release of tar and carbon monoxide (CO) CO binds to hemoglobin, preventing oxygen transport to tissues Heat and toxic gasses damage tissues, contributing to cancer risk Cue Card 19 Q: What are the methods of harm reduction for substance use? A: Harm reduction methods include: Teaching safer ways to use substances Recognizing signs of overdose Providing clean needles to reduce infection risks Substituting safer drugs (e.g., methadone for heroin) Cue Card 20 Q: What are the gender differences in alcohol use and addiction? A: Men are more likely to exceed Canada's low-risk drinking guidelines. Women tend to become addicted later in life but have fewer years of heavy drinking. Women experience more severe health effects with the same level of alcohol consumption due to biological differences. Cue Card 21 Q: What is the Mental Health Continuum? A: The range of mental health states, from optimal psychological wellness to mental illness. Cue Card 22 Q: What are the effects of chronic smoking on health? A: Chronic smoking increases the risk of: Stroke Various cancers (mouth, larynx, throat, esophagus) Leukoplakia from smokeless tobacco use Impaired sense of taste, gum disease, tooth decay, and damage to the jawbone Cue Card 23 Q: What is resilience, and what factors promote it? A: The ability to adapt and "bounce back" from adversity. Factors include supportive relationships, self-confidence, realistic planning, and problem-solving skills. Cue Card 24 Q: What is the connection between mental and physical health? A: Poor mental health can be a risk factor for chronic physical conditions, and people with serious mental health issues are at higher risk for physical health problems. Cue Card 25 Q: What are the components of the Hierarchy of Evidence Pyramid? A: 1. Systematic Reviews 2. Randomized Controlled Trials 3. Cohort Studies 4. Case-Control Studies 5. Case Series, Case Reports 6. Editorials, Expert Opinions Cue Card 26 Q: What is the difference between a Randomized Controlled Trial (RCT) and a Cohort Study? A: Randomized Controlled Trial (RCT): A scientific experiment where factors not under direct control are randomized to assess the effect of an intervention. Cohort Study: An observational study that follows a group of participants over time to examine how certain factors affect health outcomes. Cue Card 27 Q: What is positive psychology? A: Positive psychology is the study of strengths that allow individuals and communities to thrive. It is based on the belief that people want to lead meaningful lives, cultivate their best qualities, and enhance experiences of love, work, and play. Cue Card 28 Q: What are anxiety disorders, and what types exist? A: Anxiety disorders are characterized by excessive fear and worry. Types of anxiety disorders include: Simple (or specific) phobia: Fear of something definite (e.g., snakes, heights) Social phobia: Fear of humiliation in social settings Panic disorder: Sudden unexpected surges of anxiety Agoraphobia: Fear of open spaces or leaving home Generalized Anxiety Disorder (GAD): Uncontrollable worry about various things Obsessive-Compulsive Disorder (OCD): Recurrent thoughts (obsessions) and repetitive actions (compulsions) Cue Card 29 Q: What are the signs of a panic disorder? A: Signs of a panic disorder include: Sudden surges in anxiety Rapid, strong heartbeat Shortness of breath Loss of physical equilibrium Feelings of losing mental control Cue Card 30 Q: What is PTSD, and how does it manifest? A: Post-Traumatic Stress Disorder (PTSD) is a psychological reaction to a traumatic event. It manifests through reliving the event via flashbacks, dreams, or hallucinations. Cue Card 31 Q: What are the treatments for anxiety disorders? A: Treatments for anxiety disorders include: Medication (e.g., anti-anxiety medications) Psychological interventions (e.g., Cognitive Behavioral Therapy - CBT) Alternative therapies (e.g., meditation, yoga) Cue Card 32 Q: What are mood disorders, and what are common types? A: Mood disorders are mental health conditions that affect a person’s emotional state. Common mood disorders include: Depression Dysthymia Mania/Bipolar Disorder Cue Card 33 Q: What are the warning signs of suicide? A: Warning signs of suicide include: Expressing a wish to be dead Social withdrawal and isolation History of previous suicide attempts Substance abuse or eating disorders Serious medical problems Access to means of committing suicide Cue Card 34 Q: What are the acute neurophysiological effects of marijuana? A: Memory impairment, altered judgment, and altered perception of time and space. It affects the amygdala, which is involved in emotional learning and fear generation, and the hippocampus, responsible for memory. Cue Card 35 Q: What factors affect alcohol absorption in the body? A: Factors affecting alcohol absorption include: Carbonation (increases absorption) Food in the stomach (slows absorption) Alcohol concentration Gender (women absorb alcohol faster) Body size and composition (body fat, body water content) Menstrual cycle (faster absorption during premenstrual phase) Cue Card 36 Q: What is binge drinking, and what are its consequences? A: The consumption of 4 drinks for women or 5 drinks for men within about two hours. Consequences of binge drinking include: Increased risk of unplanned or unprotected sex Increased likelihood of driving after drinking Greater risk of injury or accidents Cue Card 37 Q: What is harm reduction, and what are some examples? A: Harm reduction is an approach aimed at reducing the negative consequences of drug use. Examples include: Providing clean needles to prevent infection transmission Teaching safer substance use practices Offering overdose recognition education Substituting safer drugs (e.g., methadone for heroin) Cue Card 38 Q: What is nicotine, and how does it affect the body? A: Nicotine is the addictive chemical found in tobacco products. Increasing heart rate, constricting blood vessels, and triggering the release of dopamine in the brain's reward system. Cue Card 39 Q: What are the long-term effects of tobacco use? A: Long-term effects of tobacco use include: Increased risk of stroke Cancer (mouth, throat, larynx, esophagus) Leukoplakia from smokeless tobacco use Gum disease, tooth decay, and jawbone damage Cue Card 40. Q: What are some methods to quit smoking? A: Methods to quit smoking include: “Cold turkey” cessation Counseling and motivational interviewing Quit-smoking apps Medications (e.g., Champix, nicotine replacement therapy - NRT) Programs like “Run to Quit” Week 6 [Review diagrams, graphs & images in lecture slides] Cue Card 1: Anorexia Nervosa Definition: Intense fear of gaining weight, leading to restrictive eating and excessive concern with body image. Cue Card 2 Term: Bulimia Nervosa Definition: Characterized by cycles of binge eating followed by purging behaviors (vomiting, laxatives, enemas). Cue Card 3 Term: Binge Eating Disorder Definition: Binge eating episodes without purging, often leading to feelings of guilt or shame. Cue Card 4 Term: EDNOS (Eating Disorder Not Otherwise Specified) Definition: Eating disorder that doesn’t fit the specific criteria for anorexia, bulimia, or binge eating disorder. Cue Card 5 Term: Body Dysmorphic Disorder Definition: Preoccupied with perceived flaws in appearance, impacting daily life and mental health. Cue Card 6 Topic: Risk Factors for Eating Disorders Details: Family and genetic factors  Being female Life stage (e.g., adolescence) Personality traits (e.g., perfectionism) Participation in certain sports Cue Card 7 Term: Excessive Exercise Definition: Over Exercising as a sign of an eating disorder, which may lead to overtraining, injury, sleep disturbances, amenorrhea, and mental health issues. Cue Card 8 (OMIT) Topic: Case Study (Marlene) Key Points: §Weight does not need to be the primary focus. Other fitness goals: strength, endurance, and body composition changes. Distribution of fat matters, with abdominal fat linked to higher health risks. Cue Card 9 Term: Body Mass Index (BMI) Formula: Weight (kg) / height (m²) Pros: Quick, inexpensive, widely used for classifying health risks. Cons: Does not account for fat distribution or body composition. Cue Card 10 Term: Waist Circumference (WC) & Waist-to-Hip Ratio (WHR) Definition: Measures visceral and subcutaneous fat; used with BMI for risk prediction. Cut-Offs: WC: >102 cm for men, >88 cm for women WHR: >0.95 for men, >0.80 for women Cue Card 11 Term: BodPod (Air Density Plethysmography) Definition: Measures body composition by air displacement. Pros: Accurate body fat % assessment Cons: Costly, some may feel claustrophobic. Cue Card 12 Term: DXA (Dual X-ray Absorptiometry) Definition: Uses x-ray absorption to determine % body fat and tissue composition. Pros: Detailed body composition analysis Cons: Expensive, exposure to radiation. X-ray absorption: (reduction in intensity of x-rays as they pass through a material — think of it as light passing through layers, more layers → less light that passes through) Cue Card 13 Term: Bioelectric Impedance Analysis (BIA) Definition: Measures body composition by passing a small current through the body. Pros: Affordable, measures % body fat. Cons: Affected by hydration levels, less accurate than other methods. Cue Card 14 Topic: Factors Contributing to Excess Fat/Obesity Details: Genes: Influence body size, fat distribution, metabolic rate Metabolism: Affected by weight, body composition Hormones: Leptin (hunger suppression), Ghrelin (hunger initiation) Fat Cells: Number and size vary by individual Eating Habits: Frequency, reasons (e.g., emotional eating) Physical Activity: Sedentary lifestyle contributes to weight gain Cue Card 15 Topic: Obesity Risk Factors Details: Genetics: BMR, fat distribution Hormones: Leptin and ghrelin levels Environment: Stress, sleep, portion sizes, sedentary habits, eating while distracted Week 7 [Review diagrams, graphs & images on lecture slides] Cue Card 1 Topic: Consequences of Excessive Body Fat Details: Higher risk of early death, Type II diabetes, cancer, cardiovascular diseases Associated with triglyceride/cholesterol imbalances, hypertension, musculoskeletal issues Pregnancy complications, fertility issues, depression, low self-esteem Cue Card 2 Term: Diabetes & Insulin Definition: Metabolic disorder characterized by elevated blood glucose levels. Types include Type I, Type II, and gestational diabetes. Insulin: a hormone made by the pancreas that permits cells to use glucose for energy. Cells cannot utilize glucose without insulin. Cue Card 3 Topic: Diabetes Diagnosis Criteria Details: Type II Diabetes Indicators: HbA1C ≥ 6.5%, Fasting Blood Glucose ≥ 7 mmol/L Cue Card 4 Term: Type 1 Diabetes Definition: Autoimmune condition where the pancreas produces little or no insulin, leading to glucose buildup in the bloodstream. Requires insulin therapy. Cue Card 5 Term: Type 2 Diabetes Definition: Condition where insulin is insufficient or body cells are resistant to it, leading to elevated blood glucose levels. Cue Card 6 Term: Gestational Diabetes Definition: Temporary form of diabetes during pregnancy, increasing future diabetes risk for mother and child. Higher prevalence in certain populations. Cue Card 7 Topic: Symptoms of Diabetes Details: Frequent urination, excessive thirst and hunger, unexplained weight loss, fatigue, blurred vision Frequent infections, slow healing, tingling/numbness in extremities Cue Card 8 Term: Cardiovascular Disease (CVD) Definition: Group of diseases affecting the heart and blood vessels, including heart disease and stroke, which are major causes of death in Canada. Cue Card 9 Topic: Risk Factors for CVD Details: Modifiable: Tobacco use, hypertension, high cholesterol, physical inactivity, obesity, diabetes Non-modifiable: Genetics, age, gender, ethnicity Cue Card 10 Term: Atherosclerosis Definition: Thickening and hardening of arteries, often leading to coronary heart disease and increasing heart attack risk. Cue Card 11 Term: Heart Attack Definition: Occurs when coronary artery blockage prevents blood flow to the heart, damaging or killing heart muscle. Cue Card 12 Topic: Tobacco Use Affecting CVD Details: Smoking damages arteries, increases blood pressure and heart rate, reduces HDL, raises LDL and triglycerides Contributes to clotting and accelerates plaque formation in arteries Cue Card 13 Term: Hypertension (High Blood Pressure) Definition: Sustained elevated pressure against arterial walls, a major CVD risk factor. Categories: Normal (120-129/80-84), High-normal (130-139/85-89), High (140/90 at clinic, 135/85 at home) Cue Card 14 True Term: Angina Pectoris Definition: Chest pain caused by insufficient blood flow to the heart muscle, often affecting the left arm and shoulder. Cue Card 15 Term: Arrhythmia Definition: Abnormal heart rhythm, which can cause sudden cardiac death if left untreated. Cue Card 16 Term: High Cholesterol Definition: Excessive cholesterol, a fatty substance necessary for cell membranes and hormones, increases CVD risk. LDL ("Bad" Cholesterol): Transports cholesterol to tissues HDL ("Good" Cholesterol): Returns unused cholesterol to liver Cue Card 17 Topic: Managing Cholesterol Details: Lower LDL levels and increase HDL levels to reduce CVD risk Lifestyle improvements: more fiber, fruits, vegetables, whole grains, and exercise Cue Card 18 Term: Triglycerides (Probable OMIT) Definition: Fat in the blood, with levels above 1.7 mmol/L linked to higher heart disease risk. Cue Card 19 Topic: Physical Activity and CVD Details: Reduces blood pressure, resting heart rate, LDL; increases HDL Helps manage weight and control diabetes Cue Card 20 Topic: Diabetes & CVD Connection Details: Men with diabetes: 2x risk of CVD Women with diabetes: 3x risk of CVD Common CVD-related factors: hypertension, obesity, high blood lipids Cue Card 21 Topic: Contributing CVD Risk Factors Details: Lifestyle: Alcohol, drugs Psychological/Social: Stress, chronic anger, depression, low socioeconomic status Cue Card 22 Topic: Non-Modifiable CVD Risk Factors Details: Genetics: Influence cholesterol, clotting, and obesity Age: Higher risk over age 65 Gender: Men are at higher risk earlier Ethnicity: Certain ethnic groups have higher CVD rates  Week 8 [Review diagrams, graphs & images on lecture slides] Cue Card 1 Question: What is cancer? Answer: Cancer is the abnormal, uncontrolled multiplication of cells. Cue Card 2 Question: What are the main types of cancer by tissue origin? Answer: 1. Carcinomas: From epithelial cells (most common) 2. Sarcoma: From connective and fibrous tissue (e.g., bone, fat) 3. Leukemia: From blood-forming cells in the bone marrow Cue Card 3 Question: How do cancer cells behave in the cell cycle? Answer: Cancer cells cannot enter the resting stage and continue to divide uncontrollably. Cue Card 4 Question: What is the difference between benign and malignant tumors? Answer: Benign tumor: Non-cancerous; enclosed in a membrane that prevents tissue invasion. Malignant tumor: Cancerous; has the ability to invade surrounding tissues. Cue Card 5 Question: What are the two main types of DNA mutations related to cancer? Answer: 1. Sporadic/Spontaneous: Occur by chance and accumulate over time; caused by mutagens or carcinogens. 2. Inherited: Passed from parent to child, responsible for 5-10% of cancers (e.g., BRCA 1 and 2). Cue Card 6 Question: What are the "on" and "off" switches for cell division? Answer: Oncogenes: When damaged, they promote cancer cell growth. Tumor Suppressor Genes: Protect against cancer cell growth by stopping it through apoptosis. Missing suppressor genes are involved in about 50% of cancers. DNA Repair Genes: Repair DNA damage; when ineffective, mutations accumulate and can lead to cancer. Cue Card 7 Question: What are the stages of cancer? Answer: Stage 0: Carcinoma in situ – early form Stage 1: Localized Stage 2: Early locally advanced  Stage 3: Late locally advanced Stage 4: Metastasized Cue Card 8 Question: What is the lifetime probability of developing cancer for males and females in Canada? Answer: Males: 46% (1 in 2.2) Females: 41% (1 in 2.4) Cue Card 9 Question: What are the four most common cancers and their detection methods? Answer: 1. Colorectal Cancer: Screening at 50 (stool blood test, colonoscopy if positive). 2. Lung Cancer: X-rays, CT scans; symptoms include persistent cough, chest pain. 3. Breast Cancer: Mammogram (50+), clinical and self-exams. 4. Prostate Cancer: Digital rectal exam and PSA blood test; symptoms include urinary changes, painful urination. Cue Card 10 Question: What are carcinogens and free radicals? Answer: Carcinogens: Substances that cause DNA mutations leading to cancer (e.g., acetaldehyde, tobacco). Free Radicals: Atoms or molecules with unpaired electrons, which damage DNA, proteins, and membranes. Cue Card 11 Question: What nutrients help reduce cancer risk? Answer: Folate (Vitamin B): Aids in DNA repair Carotenoids (Vitamin A): Supports normal cell division Selenium: Antioxidant, scavenges free radicals Lycopene: Antioxidant, scavenges free radicals Cue Card 12 Question: What foods may increase cancer risk? Answer: Red meat: Carcinogens produced during cooking Alcohol: Increases penetration of carcinogens through GI epithelial cells Cue Card 13 Question: What are the Environmental Working Group's "Dirty Dozen" and "Clean Fifteen"? Answer: Dirty Dozen: Produce with high pesticide residues (e.g., strawberries, spinach). Clean Fifteen: Produce with low pesticide residues (e.g., sweet corn, avocados). Important Slides/ Diagrams: