Kin 1010 Notes PDF

Week 1, Sep 4 , 2024 Intro to health and wellness What are the major health problems in canada 1.​ Cancer a.​ 80,973 2.​ Heart disease a.​ 53,704 3.​ Covid 19 a.​ 16,151 Dimensions of wellness 1.​ Physical 2.​ Emotional 3.​ Intellectual 4.​ Int...

Week 1, Sep 4 , 2024 Intro to health and wellness What are the major health problems in canada 1.​ Cancer a.​ 80,973 2.​ Heart disease a.​ 53,704 3.​ Covid 19 a.​ 16,151 Dimensions of wellness 1.​ Physical 2.​ Emotional 3.​ Intellectual 4.​ Interpersonal 5.​ Spiritual 6.​ Environmental Optimal Mental health with mental illness>Poor mental health without mental illness -​ Reason being is because Option 1 means that this person has taken action to resolve their mental illness. Option two means that they haven't done anything and are suffering and are not happy. Social Determinants of Health -​ Income/income distribution -​ Education -​ Unemployment -​ Employment and working conditions -​ Early childhood development -​ Food insecurity -​ Housing -​ Social exclusion  -​ Social safety net and network -​ Health services -​ Gender -​ Race -​ Disability Lifespan The average expected of a humans life The Golden rule of exercise science -​ “If you don't know, consulate the literature” Eidm -​ A Model for Evidence-informed decision making -​ Hierarchy of Evidence Pyramid Systematic Reviews (Reviews the results of multiple controlled trials) Randomized controlled trials (Randomized variables are controlled experiments) Cohort Studies (Group of people that have something in common) Case control studies (Few people that have might not have something in common) Case series, Case reports (Retelling evidence) Editorial(Article) and expert opinion Week 2, Sep 11, 2024 Mental health and Psychological Disorders Psychological health -​ Important to every dimension of wellness -​ Mutivarent- Several variables which contribute to an outcome -​ 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 Achieving healthy self-esteem -​ Begins in childhood by feeling loved, feeling one can give love, and having a sense that one can accomplish goals -​ Interaction, or feeling that one has created their own self concept rather than adoption 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 -​ Cognitive dissonance- Is when your actions don't align with your beliefs about yourself 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 -​ Seneca- “The tress with the strongest roots face the greatest resistance Resilience -​ Adapting well in face of adversity, trauma, tragedy, stress -​ Self ethicacy is the ability to believe in your own ability to face new challenges and overcome them. -​ It's not a personality trait, Resilience is a set of behaviors, actions, thoughts that people use to get through these stressful and traumatic life events -​ What factors are associated with resilience -​ Support -​ Resistance -​ Parental support -​ Capacity to Carry out realistic plans -​ Positive view of self and self-confidence in abilities -​ Being able to manage feelings and impulses 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 Psychological Disorders -​ Generally the result of many factors and can include genetics, learning and life events, exposure to trauma, and parental and peer influences Anxiety -​ 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 actually danger, it can be considered a problem -​ Anxiety disorders are the most common disorders -​ Simple, Specific or even phobias -​ Fear of something definite (Snakes, Height) -​ Social phobia -​ Public speaking -​ Panic disorders -​ Sudden unexpected surges in anxiety -​ Rapid and strong heartbeat -​ Shortness of breath 45 -​ Generalized Anxiety Disorder (GAD) -​ Excessive, uncontrolled worry about a variety of things -​ Anxiety in many situations -​ Obsessive-compulsive disorder (OCD) -​ Obsessions -Recurrent unwanted thoughts -​ Compulsions- Repetitive, unwanted actions -​ Behavioral addictions -​ Urges to engage in behavior creates anxiety; engaging in the behavior brings relief -​ Post traumatic stress disorder (PTSD) -​ Reaction to a servery traumatic event by reliving it through dreams, flashbacks, hallucinations  -​ Treating Anxiety disorders -​ Medication (Ex. Anti-Anxiety medication) -​ Psychological interventions (Ex. Cognitive behavioral therapy) -​ Alternative therapies(Ex. Yoga, Meditation) Mood disorders -​ Depression affects about 11% of canadians at some point during their lifetime -​ Women have depression rates that are 2x higher than men -​ Depression takes different forms but usually involves demoralization can include: -​ A feeling of sadness -​ Loss of pleasure in doing usual activities -​ Poor appetite -​ Insomnia -​ Restlessness or fatigue -​ Dysthymic disorder -​ May be diagnosed in those who experience persistent symptoms of mild or moderate depression for two years or longer -​ Suicide one of the principal dangers of severe depression -​ Although a suicide attempt can occur unpredictably Recognizing the warning signs of Suicide -​ Expressing the wish to be dead -​ Increasing social withdrawal/isolation -​ Sudden inexplicable lightening of mood -​ Serious medical problems Treating depression -​ 80% of canadians respond well to treatment, however only 10% of them seek treatment -​ Treatment can be drug therapy, psychotherapy or a combination -​ Severe depression may be treated with electroconvulsive therapy (ECT) Schizophrenia -​ Disorganized thoughts -​ Inappropriate emotions -​ Delusions -​ Auditory hallucinations -​ Deteriorating social and work function  Week 3, Sep 18, 2024 Drugs, Opioids and Marijuna (Exam question) *What are the types of literature you should look for -​ Systematic review Addiction -​ Use despite consequences -​ Cravings -​ Loss of control -​ Compulsion to use -​ If just a habit​ -​ There would be no impulsion -​ No need to increase dose -​ Characteristics of addicts -​ Reinforcements -​ Loss of control -​ Escalation -​ Negative consequences Risk and protective factors for addiction Risk factors Protective Factors Aggressive behavior in childhood Good self control (Child is exposed to aggressive behavior from parents and their actions) Lack of parental supervision Parental monitoring and support (Child can do whatever they want if there is no supervision) Poor Social Skills Positive relationships (Not socially interacting and don't know how to communicate to others) Drug Experimentation Academic competence Availability of drugs at school School anti-drug policies Community poverty Neighborhood pride Neurophysiology of addiction 1)​ Limbic System (Controls emotions) 2)​ Reward System Reward path of the brain: -​ Ventral tegmental area (VTA) -​ Neurons contain dopamine -​ Dopamine released in nucleus accumbens and prefrontal cortex Frontal lobe -​ Helps with making decisions -​ Amygdala -​ Emotional part of the brain -​ Limbic system (inside the Amygdala) -​ Ventral tegmental area -​ Neurons contain dopamine -​ Dopamine released in nucleus accumbens and prefrontal cortex Effects of drugs on our bodies 1.​ Brain chemistry a.​ Neurotransmitters and receptors -​ Ex. Cocaine blocks the removal of dopamine from A synapse; the resulting buildup of dopamine Causes continuous stimulation of the Receiving neurons 2.​ Drug facts a.​ Dose response b.​ Time action c.​ Tolerance d.​ Method of administration  3.​ Individual factors Men Both Women Foot intake Stress Analgesia Energy homeostasis Impulsivity Motor activity Downward Sexual Cognition Increase sexual activity behavior Hypothermia Depression Learning Anxiety Addiction reward Memory Harm reduction -​ “Policies, programs and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop -​ Speed cameras -​ Red light cameras -​ Safe injection sites -​ Non-alcoholic beer -​ 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 for drug use -​ Substituting a safer drug for the one a person is using -​ As perception of risk increases, uses of drugs decreases Marajuna  -​ Psychosis are things that affect the mind. -​ So the higher you SAPS score is, the less memory you have (Hippocampus controls memory) Carcinogenic -​ Oral cancers, esophagus, Leukemia, testicular -​ Impair immunity, decrease resistance to infection -​ Chronic bronchitis -​ Possibly lowers testosterone and sperm production, disrupts ovulation Week 4, Sep 25, 2024 Alcohol and Tobacco Substance abuse: Alcohol Monitoring the Future Study: Trends in prevalence of Alcohol for 8th graders, 10th graders and 12th graders Drug Time period 8th graders 10th graders 12th graders Alcohol Lifetime 27.80 52.10 68.20 Past year 22.10 47.10 62.00 Past month 10.20 25.70 [39.20] Alcohol use and Canada's low risk alcohol drinking guideline -​ 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 for women consumed within about two hours (BAC> 0.08) -​ 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 -​ *Absorption - how quickly alcohol goes from being consumed into the blood -​ Rates of absorption is affected by many factors -​ Carbonation -​ Food in the stomach -​ Alcohol concentration -​ Factors affecting absorption 1.​ Women have proportionally more body fat than men- alcohol is not very fat soluble -> Enters 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/Oxidation (Removing a hydrogen) (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 a.​ Slow down rate of alcohol elimination Metabolism and Excretion -​ Main site is the liver The effects of Alcohol  BAC (Percent) Common behavioral effects Hours required to metabolize alcohol 0.00-0.05 Slight change in feelings usually 2-3 relaxation and euphoria Decreased alertness 0.05-0.10 Emotional instability, with 3-6 exaggerated feelings and behavior Reduced social inhibitions Impairment of reaction time and fine motor coordination Legally drunk at 0.08% and subject to license suspensions at 0.05 percent and over 0.10-0.15 Unsteadiness in standing and walking 6-10 Loss of peripheral vision Driving becomes extremely dangerous 0.15-0.30 Staggering gait 10-24 Slurred speech Pain and other sensory perceptions greatly impaired More than 0.30 Unconsciousness More than 24 Anesthesia Death possible at 0.35 percent and above Gender, Setting and population -​ 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 then men and have fewer years of heavy drinking 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, meakended 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 drugs -​ Alcohol seriously affects your ability to make 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 occur at 19 -​ Dose-response function -​ Driving with a BAC of 0.14% is more than 40 times 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 of the liver Tobacco Nicotine addiction 1.​ Nicotine rewards smoking a.​ Dopamine release signal to notice and repeat 2.​ Nicotine alters the brain a.​ Acquired ‘drive’ (hunger) urge to smoke if abstinent for a while reminders (cues) increase urge pairing of stimuli 3.​ Psychological and social forces are at work a.​ Beliefs about stress control identity Camaraderie Acute health When a Cigarette burns 1.​ Tar is released 2.​ Carbon Monoxide a.​ Most harmful component of tobacco smoke b.​ CO attaches to hemoglobin in the blood -> forms carboxyhemoglobin - unable to transport oxygen to the tissues and cells 3.​ Heat a.​ Hot gasses and vapors damage/weaken tissues and contribute to cancers Chronic health effects -​ Every cigarette reduces life expectancy by 11 minutes, one carton represents a day and half of lost life -​ Smoking contributes to 12% to 14% of all stroke deaths -​ Smoking increases stroke risk -​ Acutely: Effects on rhombus formation -​ Chronically: Increased burden of atherosclerotic disease Smokeless tobacco -​ Dip/chew -​ Contains more nicotine than cigarettes -​ Major risk of 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 campus -​ Smoke free housing Quitting  -​ By quitting smoking, you can reduce your risk of: -​ Diabetes -​ Lower cholesterol -​ Improve muscle strength -​ Add year into your life 20 Minutes -​ Heart rate and blood pressure drop to more normal levels 12 hours -​ Carbon monoxide levels return to normal 48 hours -​ Nerve endings begin to regenerate – you can smell and taste better 2 weeks -​ Lung function begins to improve 1 month -​ Coughing and shortness of breath decrease 1 year -​ Risk of coronary heart disease is half of a smokers risk 5 years -​ Risk of stroke decreases to that of a non smoker 10 years -​ Risk of dying from lung cancer is about half of a smokers Week 6, October 9th, 2024 What is a healthy weight ? -​ A weight at which health risk are minimized -​ BMI = weight (kg)/height (m squared) Disordered eating and exercise 1.​ Anorexia nervosa: fear of gaining weight 2.​ Bulimia nervosa: Binge eating and purging (vomiting, laxatives) 3.​ Binge eating disorder: Binge eating no purging 4.​ EDNOS (eating disorder not otherwise specified; diagnosis for significant eating disorders that don't fully meet the criteria for specific disorder) 5.​ Body dismorphic disorder: Obsession with body flaws, to the point of interfering with daily activities Risk factors -​ Family (Past family members, eg. Mom, Dad) -​ Genetics/Being a female -​ Life stage (More vulnerable to the emotions) -​ Personality characteristics -​ Sport Excessive exercise -​ Sign of an ED -​ Overtraining -​ Injury -​ Sleep disturbance -​ Mental health -​ Amenorrea in women Ideal body weight  1.​ BMI 2.​ Waist circumference, WHR (Waist to hip ratio) 3.​ Bodpod 4.​ DXA (Duel x-ray absorptiometry) 5.​ BIA (Bioelectrical impedance) Pros and cons of BMI Pro: -​ Roughly classifies people according to disease risk -​ Fast, cheap -​ Reproducible (Scale and stadiometer) Con: -​ Does not consider distribution of fat -​ Does not consider composition of body Waist circumference and WHR -​ Index of subcutaneous (superficial) and visceral (deep) adipose tissue around abdomen and hips -​ Waist circumference + BMI for risk prediction -​ WC cut-off>102 cm for men, > 88cm for women -​ WHR cut off > 0.95 for men, > 0.80 for women Pros and cons of WHR and WC Pros -​ Easy to access -​ Cheap -​ Index of visceral and subcutaneous fat -​ Beyond BMI, risk stratification Cons -​ Error between assessors (different protocols) -​ Does not differentiate between visceral, subcutaneous fat, ectopic fat *Some studies show that WHR might be superior to WC -​ Adipose tissue is commonly known as body fat -​ It can be found under the skin (subcutaneous fat) -​ Packed around internal organs (visceral fat) -​ Stored in places where fat is not normally, Ex. Liver (Ectopic fat) Bodpod (AKA air density plethysmography) -​ Measures air displacement -​ Uses variation in Pressure and Volume in chamber to estimate body density and body fat % Dual x-ray absorptiometry (DXA) -​ Works by passing x-ray through body -​ Attenuation of x-rays is related to type of tissue -​ Determine % body fat Bioelectric impedance analysis (BIA) -​ Passes electrical current through body and measures resistance to the flow -​ Adipose tissue - lower content, more resistance -​ Skeletal muscle - Higher water content, less resistance Pros and cons of BodPod, BIA, DXA Pros -​ All assess % body fat -​ Could contribute to risk stratification Cons -​ Does not differentiate between subcutaneous fat, ectopic fat and visceral fat -​ More expensive (Cheapest = BIA) -​ BIA→ influenced by hydration -​ DXA → Radiation -​ BodPod → claustrophobia, wear minimal clothes Risk factors for obesity -​ Genetics: BMR, fat distribution  -​ Hormones: Leptin (Suppresses hunger) -​ Obesogenic environment: -​ Stress -​ Sleep -​ Portion sizes -​ How we eat (Tv dinners, eating at computer) -​ Sedentariness Excess Body fat People who are obese have: -​ 50-100% chance of early death from all causes, compared to healthy weight people -​ Increased risk for type 2 diabetes, cancer, cardiovascular diseases -​ Increased risk for unhealthy triglyceride and cholesterol levels, hypertension, impotence, back pain, arthritis and other musculoskeletal diseases -​ Psychological issues such as depression, low self-esteem and body image issues Week 7, Wednesday, Oct 23rd What is Diabetes  -​ Diabetes is a metabolic disorder characterized by elevated blood sugars (Blood glucose) -​ Insulin - A hormone made by the pancreas that permits cells to use glucose for energy. Cells cannot utilize glucose without insulin -​ Symptoms: -​ Frequent urination -​ Extreme thirst and hunger -​ Unexplained weight loss -​ Extreme fatigue -​ Blurred vision 3 types of Diabetes Type 1 -​ Usually diagnosed in childhood or adolescence -​ The pancreas is unable to produce insulin -​ People with type 1 diabetes are therefore insulin dependent Type 2 -​ Usually diagnosed in adulthood (Increasing prevalence in children) -​ Occurs when the pancreas does not produce enough insulin or when the body does not effectively use insulin Gestational -​ Temporary condition that occurs during pregnancy in which a woman without diabetes develops high blood sugar levels during pregnancy. -​ Affect 3.7% of pregnancies -​ Increases risk for both mother and child -​ Hormones produced pregnancy may increase insulin resistance -​ Risk factors for Gestational Diabetes -​ Maternal age -​ Race/ethnicity -​ BMI  -​ Hypertension Cardiovascular Disease (CVD) -​ Cardiovascular Disease remains the leading cause of death in Canada and are the most common life threatening manifestations -​ CVD is the collective term for various diseases of the heart and blood vessels -​ Heart disease and stroke claim one life every 8 minutes -​ Heart attacks and strokes are the second and third leading causes of death in Canada -​ CVD is largely due to our way of life -​ Unhealthy diet -​ Overweight -​ Sedentary (Not moving) -​ Smoke -​ Uncontrolled high BP Prevalence -​ 20% Canadian adults have hypertension -​ Only 66% have it controlled Treatment -​ Cannot be cured, but can be controlled (Change lifestyle) -​ Have blood pressure tested once every two year Major forms of Cardiovascular Disease Atherosclerosis -​ Thickening and hardening of the arteries Coronary Heart disease -​ Heart disease caused by atherosclerosis and it is reduction of blood flow to the cardiac muscle Heart Attack -​ What attacks occurs when a coronary artery becomes blocked -​ Damage to, or death of, the heart muscle occurs when coronary arteries fail to deliver enough blood to the heart Risk factors for Cardiovascular Disease -​ Two categories of increased risk of CVD -​ Major risk factors -​ Contributing risk factors -​ Major risk factors that can be changed -​ Tobacco use -​ 1 in 7 deaths from CVD is attributable to smoking -​ In 2007, an estimated 5.2 million Canadians were tobacco users -​ Smoking contributes to 37,000 deaths annually in Canada (11,000 are CVD related) -​ High blood pressure -​ Hypertension (occurs when the force of blood in your arteries is consistently too high) -​ Sustained abnormally high Blood pressure -​ Risk factor for many forms of CVD -​ Too much force exerted against arterial walls  -​ Causes -​ Atherosclerosis (Arteries become clogged and narrow) -​ Scarred and/or hardened arteries -​ Weakened and enlarged heart -​ Health Risks -​ Silent Killer -​ Primary hypertension (genetics, environment, lifestyle) -​ Secondary hypertension (underlying illness) -​ High cholesterol -​ Cholesterol is a fatty, wax-like substance that circulates through the bloodstream -​ Excessive cholesterol clogs the arteries and increases the risk of CVD Low-Density Lipoproteins High-Density Lipoproteins (LDL) (HDL) “Bad” cholesterol “Good” cholesterol Shuttle cholesterol from the liver to Shuttle unused cholesterol back to the the organs and tissues liver for recycling If there is more than the body can use, it is deposited in the blood vessels Benefits of controlling cholesterol -​ Cut heart attack risk by 2% for every 1% reduction in total blood cholesterol levels -​ Primary goal should be to reduce LDL to healthy levels -​ Increase fiber intake -​ Substitute unsaturated for saturated and trans fats -​ Eat more fruits, vegetables, fish, whole grains -​ Exercise regularly  -​ Physical inactivity -​ Sedentary activity increases the risk for CVD -​ Exercise reduces risk by: -​ Decreasing blood pressure and resting heart rate -​ Increasing HDL levels -​ Maintaining weight -​ Improving the condition of blood vessels -​ Helps prevent or control diabetes -​ Diabetes -​ Doubles the risk of CVD for men -​ Triples the risk of CVD for women -​ Most common cause of death in adults with diabetes -​ Higher rates for other CVD risk factors: -​ Hypertension -​ Obesity -​ Unhealthy blood lipid levels -​ Damaged endothelial cells -​ More vulnerable to atherosclerosis -​ Contributing Risk Factors That Can Be Changed -​ High Triglyceride Levels -​ Reliable predictor of heart disease -​ Psychological and Social Factors -​ Stress -​ Chronic hostility and anger -​ Suppressing psychological distress -​ Depression -​ Anxiety -​ Social isolation -​ Alcohol and drug use Major Forms of Cardiovascular Disease -​ Angina pectoris is pain in the chest, and often in the left arm and shoulder, caused by the heart muscle not receiving enough blood  -​ Arrhythmia is a change in the normal pattern of the heartbeat -​ If the electrical conduction system of the heart is disrupted, the heart may beat too quickly, too slowly, or in an irregular fashion. -​ Sudden cardiac death, or cardiac arrest, is most often caused by an arrhythmia Week 8, Wednesday Oct 30 What is cancer? -​ Abnormal, uncontrolled, multiplication of cells 1.​ Carcinomas - From epithelial cells *Most common 2.​ Sarcoma - from connective and fibrous tissue, such as a bone, fat 3.​ Leukemia- From blood forming cells in the bone marrow The cell cycle -​ Cell are either resting or dividing (mitosis) -​ Cancer cells cant enter resting stage -​ A benign tumor (Non cancerous) is a mass of cells enclosed in a membrane that prevents their penetration of other tissues -​ A Malignant tumor (cancerous) has the ability to invade surrounding tissues Mutations in DNA Sporadic/spontaneous -​ Occur by chance -​ Build up throughout lifetime -​ Caused by mutagens or carcinogens (Smoking, chemicals, radiation, viruses) Inherited -​ Passed from parent to child at conception -​ Men and women who carry a mutation have 50% chance of passing it to child -​ Responsible for only 5-10% of cancers  -​ Example: BRCA 1 and 2 On and off switches for cell division Oncogenes -​ When damaged, promotes cancer cell growth -​ Cause cells to grow out of control Tumor suppressor genes: -​ When healthy, protect against cancer growth -​ Stop cell growth via Apoptosis -​ Missing tumor suppressor gene 0- responsible for around 50% of cancers DNA Repair genes -​ Each cell has ability to spot changes in DNA and fix them before they passed on -​ Typically, cells need at least 6 mutations to occur before healthy cell turns malignant -​ But, mutations can build up when the cell mechanic doesn't make these repairs Cancer stages Stage 0 -​ Carcinoma in Situ - Early form Stage 1 -​ Localized Stage 2 -​ Early locally advanced Stage 3 -​ Late locally advanced Stage 4 -​ Metastasized 4 most common cancers 1.​ Colorectal Cancer Detection -​ Regular screening at age 50 (stool blood test) -​ If positive for blood, colonoscopy 2.​ Lung Cancer Detection -​ No Screening programs -​ Symptoms - Persistent cough, chest pain, recurring bronchitis -​ X-ray , CT scans 3.​ Breast cancer -​ Mammogram (Women>50) -​ Clinical breast exam (Women 40+/2yr) -​ Breast self exam 4.​ Prostate cancer Detection -​ Early prostate cancer has no symptoms -​ CHanges in urinary frequency,weak or interrupted low, painful urination, blood in the urine -​ Digital rectal exam and prostate specific antigen (PSA) blood test Common risk factors Breast Prostate Lung Colorectal  Tobacco use Physically inactive Overweight/obesity High alcohol consumption Does not get screened Exposure to chemicals Carcinogens and free radicals ​ Carcinogens: Things that can lead to cancer by causing mutations in DNA -​ Acetaldehyde -​ Asbestos -​ HPV -​ Tobacco -​ DEET Free radicals: Created when atom or molecule gains or loses an electron -​ Damage DNA, proteins and membranes Diet and Cancer risk -​ Folate (Vitamin B) → helps with DNA repair -​ Carotenoids (vitamin A) → Normal cell division -​ Selenium → Antioxidant, free radical scavenger -​ Lycopene → Antioxidant, free radical scavenger Other potentially detrimental foods: -​ Red meat → Carcinogens produced when cooking the meat -​ Alcohol → Increase penetration of carcinogens through Gi epithelial cells Week 9, Wednesday, Nov 13 Immune system Most prevalent diseases worldwide Disease Approximate Number of deaths per year Pneumonia 3 884 000 HIV/AIDS 2 777 000 Diarrheal diseases 1 798 000  Tuberculosis 1 300 000 - 2 000 000 The chain of infection Ways to break chain of infection Pathogen -​ Pasteurization of milk -​ Chlorination of drinking water -​ Disinfectants Reservoir -​ Medical treatment and testing -​ Insect and rodent eradication -​ Quarantine Portal of exit -​ Condoms -​ Masks -​ Covering mouth while coughing Means of transmission -​ Handwashing -​ Avoiding infected individuals -​ Safe sex -​ Sanitary practices Portal of entry -​ Condoms -​ Masks -​ Insect repellent  Newhost -​ Immunization -​ Health promotion -​ Medical treatment Our defense system 1.​ Physical and chemical barriers 2.​ Immune system The immune system Antibodies- specialized proteins produced by white blood cells that can recognize and neutralize specific microbes Autoimmune disease- A disease in which the immune system attacks the person’s own body Antigens - Markers on the surface of a foreign substance that immune system cells recognize as non-self and that trigger the immune response Viruses -​ 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 The common cold -​ May be caused by 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 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 immunity to a pathogen by administering a vaccine -​ A Vaccine is a preparation of killed or weakened microorganisms inactivated toxins 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 way s -​ 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 cause by: -​ HIV -​ Influenza -​ Herpes -​ Simplex -​ HVC Emerging infectious diseases -​ Infections whose incidence in huma has increased or threatens to increase in the near future -​ West nile virus -​ SARS -​ Rotavirus -​ E.Coli -​ Ebola Factors contributing to emerging infections -​ Drug resistance -​ Poverty -​ Breakdown of public health measures  Supporting your Immune System Eat a balanced diet Practice safe sex Get enough sleep Avoid contact with disease carriers/contagious people Exercise Do not use injectable drugs of any kind No smoking Receive all recommended vaccines Vitamin D Washing hands Week 10 – Physiological Changes with AGING Senescence -​ all post maturationalD 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 Age–Related physiological Changes At age 75, The average person compared to age 30: -​ 92% of brain weight -​ 84% basal metabolism -​ 70% kidney filtration rate -​ 43% of maximum breathing capacity Changes in the skin -​ To most people, the condition of the skin, hair, and connective tissue collectively represents the ultimate indicator of age: -​ Skin wrinkles -​ Veins are more prominent -​ Nails thickness Skin: Wrinkling -​ Loss of subcutaneous fat -​ > vulnerability to pressure sores -​ less insulation of body to cold (also affected by diminished blood flow to skin & extremities) & heat Skin and Nails -​ Atrophic Changes in sweat glands -​ Thickened fingernails & toenails -​ Generalized loss of body hair and head hair -​ Decrease in # of functioning pigment-producing cells– >graying -​ Some remaining pigment cells enlarge--> “age spots” -​ Skin changes increase. vulnerability to infections/disorders Skeletomuscular System changes -​ Arthritis & 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 & is one of the oldest known diseases 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 -- most common onset between 20 & 50 Muscluloskeltal -​ Osteopenia --> Osteoporosis: -​ Gradual loss of bone that reduces skeletal mass without disrupting the proportions of minerals & organic materials -​ For many, it is 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 Atherosclerosis VS Arteriosclerosis -​ Atherosclerosis -​ Developed by an overwhelming # 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 passageway--even to the pt 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 Urinary system -​ The bladder of an elderly person has a capacity of less than half (250ml) that of a young adult (600 ml) and often contains as much as 100 ml of residual urine” -​ Micturation reflex is delayed-- usually activated when bladder is half full; in OAs, not until bladder is nearly at capacity Respiratory System -​ Airways & tissues become less elastic & more rigid with age -​ Osteoporosis may alter the size/shape of the chest cavity -​ Power of respiratory & abdominal muscles becomes reduced– hinders diaphragmatic movement Genital system changes Female Genital tract -​ External genitalia -​ Folds become less pronounced -​ Skin becomes thinner -​ Vascularity and elasticity decrease -​ Becomes more susceptible to tissue trauma  -​ International reproductive organs -​ Uterus decreases in size & becomes more fibrous -​ Uterus has fewer endometrial glands -​ Cervix reduced in size -​ Uterine tubes become thinner Male Gential system -​ Continues to produce germ cells (sperm) and sex hormones (testosterone) well into old age, declining with advancing age -​ Size & firmness of 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 Mancato in minnesota - Nuns live there and get together 3 times a week to read the bible -​ Reading like this can help stay cognitive, and lowest incidents of neurodegeneration incidents Wed Nov 27, Intro to the canadian Healthcare system What we know -​ Doctors are self-employed, not government employees -​ 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 by billing their provincial government for the services they provide to patients -​ “Canadian healthcare system” has a 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 1968 - Pierre elliot trudeau implements Medicare -​ First real plan that started public health care Public administration -​ Public pays for it -​ Apples to the health insurance plans of the provinces and territories (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 government 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 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 services 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 Accessibility -​ The canada health act of 1984 added accessibility to make five principles -​ The health insurance plans of the provinces and territories must provide: reasonable access to insured health care services on unifor terms and conditions, preclude or unimpeded, either CHA – The conditions 1.​ Information – the provincial and territorial governments are to provide information to the Minister of health as may be reasonably required 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 pan 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 a.​ 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  2.​ User Charges a.​ 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 b.​ For example, if patient 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 hospital, drigs and physicians Out of pocket health expenditure Demands on the healthcare -​ Hospitals -​ Physician services -​ Specialized drugs such as biologics and antivirals -​ Chronic disease management OHIP + -​ Children and youth pharmacare -​ More than 4,400 drug products free for anyone 24 years and under