Study Guide for KINE 260 with Professor O'Brien
Study Guide for KINE 260 with Professor O'Brien KINE 260
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This 21 page Study Guide was uploaded by Arianna Negri on Wednesday February 24, 2016. The Study Guide belongs to KINE 260 at California Polytechnic State University San Luis Obispo taught by in Spring 2015. Since its upload, it has received 140 views. For similar materials see Women's Health in Kinesiology at California Polytechnic State University San Luis Obispo.
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KINE 260 Women's Health Issues Study Guide Exam #3 Wednesday, June 10 – 4:00 pm Use this study guide to guide your reading and note taking in lecture Chapter 10 Understanding and Preventing Cardiovascular Disease and Cancer Cardiovascular disease (CVD) describe the basic functioning of the cardiovascular system (heart, blood vessels and blood) Cardiovascular system: heart, arteries, veins, and capillaries The Heart , located behind the sternum (breastbone). Four main chambers= right atrium, right ventricle, left atrium, and left ventricle. Right and left ventricles are the lower bloodpumping chambers. The right atrium and ventricle and the left atrium and ventricle are separated by a valve. The right atrium and ventricle are separated by the tricuspid valve; the left atrium and ventricle are separated by the bicuspid or mitral valve. Blood flows from the atrium through the valve to the ventricle below. Oxygen poor blood from throughout the body travels to the heart so that it can be pumped to the lungs for oxygenation. The oxygenpoor blood enters the right atrium of the heart from the inferior and superior vena cava (major veins). From the right atrium, blood flows through the tricuspid valve into the right ventricle where it is pumped to the lungs via the pulmonary arteries. In the lungs, carbon dioxide and waste products are removed from the blood and exchanged for fresh oxygen. The newly oxygenrich blood leaves the lungs via the pulmonary veins and flows into the left atrium. From the left atrium, it passes through the mitral valve into the left ventricle. The left ventricle contracts and forces the oxygen rich blood through the aortic valve into the aorta (the main artery) and from there throughout the major arteries, flowing gradually into and smaller and smaller arteries, arterioles and finally capillaries. From the capillaries, the oxygen poor but carbon dioxide rich blood flows into the venules and veins as it makes it way back to the heart. define CVD and its impact on women in U.S. society Comprises a group of diseases that affect the heart and blood vessels, including stroke, a condition that affects the brain’s blood vessels. → Leading cause of death worldwide, with over 17.3 million people dying in 2009. → US, more than 82 million living with CVD, 42 million of those are women → Every year about 420,000 U.S women die of CVD. (Stoke accounts for 1 in 18 deaths. Cost $300 billion in a year→ with women accounting for 38% of the cost, more than $100 billion) describe how race/ethnicity, socioeconomic status, & gender impact the incidence/outcomes for CVD Typically occur among Black women over 50 in low SES define and understand the risks and warning signs for the various types of CVD: stroke: Cerebrovascular Accident is a condition in which blood vessels leading to and within the brain become damaged. The process of blood flow blockage that occurs in the coronary vessels of the heart is similar to that which occurs in the brain. → Process: Vessel rupture often resulting from atherosclerotic vessels. Ischemic stroke: The most common type of stroke is caused by blockage; the clot in such cases is called a cerebral thrombosis or cerebral embolism. Hemorrhagic strokes are caused by ruptured blood vessels Warning signs: Sudden numbness or weakness of the face/arm/leg on one side of the body, sudden confusion or trouble speaking/understanding. sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination, sudden severe headache with no known cause hypertension: High blood pressure is a common condition in which the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. → a blood pressure that remains elevated above what is considered a safe level CHD: Congenital heart disease is an abnormality of the heart that is present at birth. → Can include… a hole in the septum, imperfectly formed blood vessels, valvular damage, left ventricular imperfections myocardial infarction: A heart attack. Occurs when arteries surrounding the heart become twisted and tortuous, they are particularly prone to developing atherosclerosis and when that occurs, a woman is at increased risk of having a heart attack= death of a portion of the heart, occurs when one or more of the coronary arteries in the heart becomes damaged or clogged and consequently the arteries close off. angina: Angina pectoris is chest pain resulting from an insufficient supply of blood and thus oxygen, to the heart muscle. Symptoms can range in severity from a milk cramping ache to crushing pain in the chest. The impairment of blood flow can result from atherosclerosis or a spasm of a normal artery. More common in women, and it’s a symptom of CVD. peripheral artery disease: PAD is a disease of the extremities (hands/arms/most commonly legs and feet) in which the blood supply is diminished, sufficient oxygen and nutrients do not reach these areas properly and waste products accumulate. → PAD symptoms in W: cramping and numbness to gangrene (tissue death). → Treatment: lifestyle modifications or meds arrhythmias:Improper beating of the heart, whether irregular, too fast, or too slow. → There may be no symptoms. Or, symptoms may include a fluttering in the chest, chest pain, fainting, or dizziness. congestive heart failure: CHF occurs when heart muscles are weak and cannot pump with proper vigor. In such a case, the heart loses its ability to contract properly or sufficiently to meet the demands placed on it. As a result, circulation suffers and fluids begin to accumulate in veins causing breathing problems, kidney problems, and swelling in the extremities. metabolic syndrome: A group of diseases that can occur together and increase risk for CVD. → Elevated waist circumference: Equal to go or greater than 35 inches in W → Elevated triglycerides: equal to or greater than 150 mg/dL → Elevated blood pressure: Equal to or greater than 130/85 mmHg → Reduced HDL cholesterol: Less than 50 mg/dL in W → Elevated fasting glucose: equal to or greater than 100 mg/dL and atherosclerosis: a form of arteriosclerosis, is the major culprit in CHD. It causes the heart vessels to become clogged, thereby impairing a woman’s heart’s ability to function. This can happen in a variety of ways… → The arteries can become clogged with waste, usually fat deposits (plaques). Low density lipoproteins (LDL) and other waste deposits penetrate the inner lining of the arteries. There they build up over years, impeding the flow of blood → The arteries become stiff with age or disease, rendering them less able to respond to the demands placed on them. If the blood flow is compromised, the area being fed by the particular artery or arteries does not receive proper nutrients and can become damaged or die. describe predictors for CVD – lipoprotein/cholesterol levels Cholesterol: High blood levels of cholesterol (greater than 240 mg/dL) are associated with an increased risk of mortality or morbidity from CHD → Body becomes overwhelmed and deposits unused cholesterol on the inner walls of the arteries…. the inner walls become clogged and brittle and pieces of the artery tear, leaving jagged edges. The liver and small intestine manufacture cholesterol, which moves throughout the body in a lipoprotein. → Consists of fats and proteins bound together in a chemical structure that enables them to be transported in the blood explain the incidence and impact of CVD on all women and how it compares to men Women present with signs and symptoms of the disease some ten to fifteen years later than men: between the ages of 2039, CVD is more prevalent in men, but by age 45 the rates of the disease of the heart in women begin to rise. These differences may in part stem from estrogen loss as women age. Estrogen appears to have a positive effect on the CD system. → more women die from CVD heart disease and stroke are the first and third leading causes of death describe how symptoms of heart disease varies from those symptoms of men Men/W symptoms: pain or discomfort in the chest region, pain or discomfort in the upper torso, shortness of breath, cold sweats, nausea and dizziness → Women appear more prone to other symptoms especially shortness of breath, nausea/vomiting, back or jaw pain or unusual fatigue. describe educational measures taken to decrease the risk of CVD for various populations Educate the public. Cancer define cancer→ a disease characterized by uncontrolled ceullular growth and reproduction. the 4 cancer types → The major types of cancer are carcinoma, sarcoma ,melanoma ,lymphoma , and leukemia. Carcinomas the most commonly diagnosed cancers originate in the skin, lungs,breasts,pancreas , and other organs and glands. Lymphomas are cancers of lymphocytes. Leukemia is cancer of the blood. It does not usually form solid tumors. Sarcomas arise in bone, muscle, fat, or cartilage and are relatively uncommon. Melanomas are cancers that arise in the cells that make the pigment in skin. and how cancer spreads → Stage 0 'in situ' "A cell that becomes a cancer cell usually does so in the company of other similar cells. Often, but not always, it can produce a tumour right there in that tissue, in a way that poses little or no threat to life. This is callin sitcancer; that is, cancer in the position where it started. It is probable that some cancers never go beyond this early stage."--> Stage 1: localised cancer "At the next stage, the cancer cells gain the ability to pass through the 'basement membrane', that is the thin, fibrous boundary to the tissue in which the cancer began, and to invade neighbouring tissue. This invasion is a serious step, because it indicates that the growing cancer cells may threaten life. "While the cancer remains a single lump, partly in the tissue where it began and partly in a neighbouring tissue, it is said to be in the localised stage.--> Stages 2 and 3: regional spread "Once a cancer cell has invaded, a common next step is for one of its daughter cells to invade through a lymph vessel (a vessel like a blood vessel that carries the clear fluid called lymph, which is all the time exuding into tissue from our blood capillaries (the smallest blood vessels), back to the blood stream). "On the way to the blood stream, the cancer cell can get caught in a lymph node, one of the powerhouses of the body's immune system. There it might provoke an immune response against it, which can go on to destroy it and the other cancer cells. Wonderful! "Sometimes, though, it divides and forms a lump in the lymph node. This stage is often referred to as regional spread. That is, the cancer has spread within the general region in which it first began but not to other parts of the body.--> Stage 4: distant spread "The next step can be quite varied. Cells from the lump in the lymph node may spread further through lymph vessels to more distant lymph nodes or on into the blood stream. Or cells from the original lump may invade a capillary and enter the blood stream that way. "Either way, once in the blood stream, the cancer cells can go just about anywhere in the body, form new colonies and spread further. This is the stage of distant spread." define benign conditions of the breast, cervix, uterus, and ovaries → A benign tumor is one that remains localized and confined in its original growth sitethat is, it does not invade the surrounding tissue or spread to distant body sites. Breast → Most breast lumps are not cancer. Fibrocystic breast disease, also called cystic mastitis, is the most common breast disorder and the most frequent cause of a breast lump in women younger than age 25. Only small subgroup with fibrocystic breast disease at increased risk for breast cancer, these women have an atypical cell condition known as hyperplasias which can be diagnosed in a breast biopsy Another nonmalignant form of breast tumor is fibroadenoma, produces a firm, movable, tender lump Cervix → Polyps are small benign growths that develop in the endocervical canal, often after the onset of menstruation. → Cervical dysplasia which involves abnormal changes in the cells of the cervix, is usually benign condition. It is considered precancerous, however because severe untreated dysplasia can result in invasive cervical cancer. Uterus → Fibroids are benign tumors composed of muscular and fibrous tissues in the uterus and have different names depending on the type of fibroid: fibromyomas, leiomyomas, or myomas. (fibroids are more common in black woman) → fibroids often begin developing in women between the ages of twenty five and thirty five. They are the primary cause of an abnormally enlarged uterus and one of the most common reasons for hysterectomy → Fibroids may grow under the influence of estrogen produced during pregnancy, oral contraceptives, or from HT (they often shrink and disappear with menopause. Ovarian >.Cysts are fluidfilled growths that are extremely common. Ovarian cysts are usually benign and rarely cause discomfort or pain. → Most common type results from the follicle that surrounds a mature egg. If the follicle does not rupture to release the egg during ovulation, it becomes a cyst. → Polycystic ovarian syndrome is a condition that affects women of reproductive age, causes the formation of numerous cysts in the ovaries. define risk factors associated with all types of cancer Breast → genetics: women with mothers/sisters who have had breast cancer are generally at double the risk for developing breast cancer mutations in the BRCA1 and BRCA2 genes → hormones: women who have early onset menstruation (less than 12 years of age) or later menopause after 50 years, never have kid/ have kid after 30, overweight/obesity, HT, oral birth control pills Cervical → primarily caused by persistent infection with certain highrisk strains of HPV lower immune system, suppression, having HIV/AIDS, having multiple sexual partners, having other sexual transmitted diseases, smoking cigarettes, having a mother who took DES, or having family history Uterus Endometrial cancer accounts for most uterine cancers being older than 55 risk factors involve excess stimulation of endometrial cell proliferation by estrogen in the absence of progesterone obesity, high blood pressure, diabetes, early menarche, never being pregnant, family history Ovarian a family or personal history of cancer, especially breast, uterine, colon, or rectal age greater than 55 years never been pregnant possibly the use of hormone replacement therapy, especially estrogen obesity fertility drugs describe diagnosis and treatments for cancer Breast DiagnosisBreast self examination: consists of the systematic palpation of the breast tissue of each breast while lying on one’s back (common sign: new lump/mass, swelling of breast, skin dimpling, nipple changes) Clinical breast examinations are conducted by a woman’s health care provider and should be performed every three years for women age 2039 and every year for women age 40 or older (feels for lumps, notice any change) Mammography: a low dose radiograph of the breast tissue can detect smaller breast lesions that cannot be felt through CBE or BSE Treatment → surgery is the primary treatment but may be combined with radiation therapy or hormone therapy Lumpectomy is often used for early stage localized tumors when it is possible to remove only the tumor and some surrounding tissue Partial/segmental mastectomy: removal of some breast tissue and some lymph nodes Simple mastectomy: complete removal of the breast but not the lymph nodes under the arm or chest wall muscles Radical mastectomy: removal of the entire affected breast, the underlying chest muscles, and the lymph nodes under the arm Modified radical mastectomy: removal of the entire affected breast, underlying chest muscles, and the lymph nodes under the arm → Adjuvant therapies include chemotherapy, hormone therapy, and radiation therapy Cervical DiagnosisEffectively preventable through regular screening → Paper Smear, provides a method of screening for the cellular changes before cancer develops and to detect cancer as its earliest stages HPV test that tests DNA Begin screening at age 21 → If a PAP smear is abnormal, regardless of the results of the HPV tests, the clinician will want to perform a colposcopy and possible a biopsy to view the cervical cells more closely. Treatment → Cryosurgery destroys tissue by a freezing process. Used to treat mild or moderate dysplasia → A cone biopsy or conization is considered to be both a diagnostic and a therapeutic procedure because it provides tissue for an accurate diagnosis while removing abnormal issue Colposcopy is performed in the physician’s office using a colposcope, a special microscope that permits close examination of the cervix and vagina as well as a biopsy Uterus Diagnosis pelvic exam/Pap smear/ vaginal bleeding after menopause/ pain in pelvic area/ pain during urination or intercourse/ change in bowel patterns endometrial biopsy at menopause Transvaginal ultrasound also has proven useful as a screening tool for endometrial cancer diagnosis of endometrial cancer is made by a biopsy, ultrasound, dilation and curettage, or hysteroscopy Treatment → removal of the uterus as well as the fallopian tubes and ovaries, combination of surgery and radiotherapy is effective in the treatment of localized disease regional spread of the cancer outside of the uterus is treatable by radiation advanced cancer is generally treated by the administration of progesterone which results in prolonged survival but not cure treatment for later stage disease includes removal of not only the uterus, fallopian tubes and ovaries but also the cervix, part of the vagina, and lymph nodes Ovarian “silent cancer” Diagnosis → cannot be detected by PAP smears Early detection is best through regular pelvic examinations, transvaginal ultrasound, and a lab test for an ovarian tumor marker in the blood called CA125 Symptoms: pelvic pressure, abdominal swelling, gas pains, indigestion, and vague abdominal discomfort but usually ASYMPTOMATIC Treatment → consists of surgery, radiation, and chemotherapy Surgical treatment involves removal of the uterus, fallopian tubes, and ovaries Chemo and radiation therapies are used after surgery to destroy remaining cancer cells and improve survival define breast cancer and know the most common form → Breast cancer is a malignant (cancer) tumor that starts in the cells of the breast. It is found mostly in women, but men can get breast cancer, too. explain the risk factors associated with breast cancer → genetics: women with mothers/sisters who have had breast cancer are generally at double the risk for developing breast cancer mutations in the BRCA1 and BRCA2 genes → hormones: women who have early onset menstruation (less than 12 years of age) or later menopause after 50 years, never have kid/ have kid after 30, overweight/obesity, HT, oral birth control pills describe how race/ethnicity and socioeconomic status impact the incidence, diagnosis and outcomes for breast cancer → White women have higher rates of breast cancer, African American women are most likely to die from the disease (lower likelihood of African American women with breast cancer being diagnosed in the early disease stages and a lower survival rate in women who disease has advanced) For some women of all racial and ethnic backgrounds, modesty is an issue and thus they may be reluctant to submit to a mammogram Wealthier and more educated individuals of any racial or ethnic group tend to have better health those less fortunate describe recommendations for screening/detecting breast cancer BSE, CSE, mammography, ultrasound, MRI, biopsy and liquid biopsy → BSE: American Cancer Society recommends that women over the age of 20 years examine their breasts monthly after menses and as the same time each month. For women who have reached menopause, regular BS should be done on a scheduled monthly basis. → CBE: should be conducted every 3 years for women ages 2039 and every year for women age 40 or older → Mammography: National Cancer Institute and the American Cancer Society recommend screening mammograms for women age 40 years or older every 1 to 2 years. → MRI: for women with increased risk → Biopsy: feel new lump describe standard treatments of breast cancer surgery is the primary treatment but may be combined with radiation therapy or hormone therapy Lumpectomy is often used for early stage localized tumors when it is possible to remove only the tumor and some surrounding tissue Partial/segmental mastectomy: removal of some breast tissue and some lymph nodes Simple mastectomy: complete removal of the breast but not the lymph nodes under the arm or chest wall muscles Radical mastectomy: removal of the entire affected breast, the underlying chest muscles, and the lymph nodes under the arm Modified radical mastectomy: removal of the entire affected breast, underlying chest muscles, and the lymph nodes under the arm → Adjuvant therapies include chemotherapy, hormone therapy, and radiation therapy describe how breast cancer tumors grow and how this impacts treatments methods Breast cancer stages…. Situ: diagnosed by mammogram but tumors too small to be felt (five year survival rate: 100%) Stage I: localized in breast, generally smaller than 2 cm, not spread to lymph nodes Stage II: tumors generally larger 2 to 5 cm but have not spread to the lymph nodes Stage III: tumors are growths that are larger than 5 cm in size or that have grown into the chest wall, skin, or distant lymph nodes Stage IV: tumors are classified as growths that have spread to other parts of body define skin cancer, colorectal cancer and lung cancer risk factors and prevention Lung Cancer Exposure to radon asbestos, radioactive materials, and some industrial compounds has been associated with lung cancer, cigarette smoking is clearly the most significant risk factor. → This risk factor is responsible for more than 90% of lung cancer cases and almost 80% of lung cancer deaths. Secondhand smoke also a risk factor → Prevention: Don’t smoke. duh. Diagnosis: persistent cough, weight loss, bloody sputum, recurring bronchitis/pneumonia, chest pain, voice changes → CT scans, chest radiograph, sputum tests, fiberoptic examination of the bronchial passages for more definitive diagnosis Treatment: surgical removal of affective regions, radiation and therapy Lobectomy removes a lobe of the lung, a pneumonectomy removes an entire lung and segmentectomy removes a section of a lobe of the lung Colorectal Cancer Risk Factors: Increasing age (more than 50), family history (familial adenomatous polyposis), dietary factors Warning signs: rectal bleeding, blood in stool, change in bowel habits, cramping in lower ab Diagnosis: Digital rectal exam, fecal occult blood test, sigmoidoscopy, colonoscopy, Treatment: surgery, chemo, radiation, targeted therapy Skin Cancer Melanoma: the melanocyte cells in the skin can form into cancer Basal cell carcinoma: formed in the outer layer of skin, most common for light skin Squamous cell carcinoma: formed on the skin surface in the squamous cells, most common for dark skin Prevention: wear sunscreen → limiting or avoiding sun exposure 10 am4 pm Risk Factors: ultraviolet radiation, lifetime exposure, severe sunburn, tanning, family history, dysplastic nevi moles Diagnosis: recognizing changes in skin growths, appearance of new growths, screening watch for asymmetry, border irregularities, color irregularities, diameter, evolution Treatment: surgery, radiation, electrodesiccation, cryosurgery, laser therapy Chapter 11 – Other Chronic Diseases and Conditions Osteoporosis define osteoporosis and the screening methods, prevention measures and treatment for osteoporosis → An age related disease characterized by a reduction in bone mass and structural deterioration of bone tissue Bone remodeling is the process that removes older bone (resorption) and replaces it with new bone (formation) to maintain a healthy skeleton Risk Factor: diet low in calcium and vitamin D, sedentary lifestyle, cig smoke, estrogen deficiency, low weight and body mass index, certain medications, abnormal absence of menstrual periods, anorexia nervosa/ bulimia, being female, increase age/postmenopausal, small frame and thin boned, white or asian race, family history Signs/symptoms: “silent” because only one out of four women are aware they have it → some women notice a loss of height as the vertebrae weaken, collapse, and consequently fracture Diagnosis: traditional tests measure bone density in the areas most susceptible to fractures caused by osteoporosis: the spine, the hip, and the wrist → women who should be tested include: all postmenopausal women younger than age sixty five who have one or more additional risk factors for osteoporosis besides menopause, all women age sixty five or older, postmenopausal women with fractures, women who are considering therapy for osteoporosis or who want to monitor the effectiveness of certain osteoporosis treatments Prevention/Treatment: lifestyle and personal behaviors are the key osteoporosis prevention strategies, a woman should not start smoking and or should quit → an inadequate supply of calcium over a woman’s lifetime is a major risk factor for developing osteoporosis, and vitamin D is essential treatment involves managing osteoporosis associated fractures, universal prevention measures and medical treatment of the underlying disease → FDA has approved several classes of medications that can help reduce or prevent the progress of osteoporosis; women with osteoporosis or at risk for developing osteoporosis should talk with their healthcare providers about these treatments define the four most common types autoimmune diseases in women – their prevention/treatment Lupus: an autoimmune disease that is still not fully understood, immune system forms antibodies that target healthy tissues and organs. → Treatment/Prevention: “flareups”, unpredictable and inconsistent symptoms People who are photosensitive should avoid sun exposure and regularly use sunscreen to prevent rashes, exercise is important to prevent muscle weakness and fatigue Treatment usually involves nonsteroidal anti inflammatory drugs to ease muscle and joint pain → corticosteroids are used on a short term basis to treat skin rashes Arthritis define arthritis – osteoarthritis, rheumatoid arthritis, and gout and their impact on women → “inflamed joints” Arthritis affects about 50 million adults in the US, making it the most common cause of disability in the country Osteoarthritis: also called degenerative joint disease is the most common form of arthritis affecting more than 27 million people. → a milder form of arthritis is seen in all age groups but is most common among older adults describe treatment and prevention of arthritis Rheumatoid arthritis: a chronic inflammatory disease with increasingly prevalent among older adults, currently affects 1.5 million people in the US and it is twice as common in women than men an autoimmune disease, person’s immune system attacks body’s own cells Gout: is a painful and potentially disabling form of arthritis that was first described more than 2,000 years ago by the Greek physician Hippocrates. symptoms of gout can appear, typically for a few days or a few weeks, and then disappear for long periods caused by an excess of uric acid in the body Autoimmune disease Define autoimmune disease and how they impact women The individual's own immune system attacks and destroys itself. In the case of type 1 diabetes, the insulinmaking cells in the pancreas are destroyed by their own immune system. The vast majority of people who have autoimmune diseases are women. Describe lupus, particularly systemic lupus erythematosus (SLE) Diabetes define type 1 diabetes – impairment of insulin production and treatment autoimmune disorder beta cells produce the hormone insulin, but with an autoimmune disorder the body treats the beta cells as a foreign invader and attacks them, this is why the body of a person with type 1 diabetes produces little to no insulin. Daily insulin injections, or insulin infusion, are required for survival Type 1 patients must monitor their diet and exercise define type 2 diabetes – impairment of insulin production or the concept of insulin resistance metabolic disorder Account for about 90% to 95% of all diabetics Either the pancreas does not make sufficient insulin or body cells are resistant to its effects (insulin resistance) historically associated with older people, but recently has become more and more of an epidemic amongst people over AND under the age of 45. caused by obesity, poor diet and physical activity, and family history of diabetes describe the incidence and impact of diabetes in the U.S. Diabetes is a disease characterized by abnormal glucose production or metabolism → deficiency of insulin or a decreased ability to use insulin almost one half of the people with diabetes are female, about 10.8% of women age 20 or older have diabetes women of color are the hardest hit by type two and gestational diabetes; the prevalence is at least two to four times higher among black, hispanic, american indian, and asian/pacific islander women that among white women the risk of diabetic ketoacidosis often called diabetic coma is 50% higher among women than men heart disease is the leading cause of diabetes related deaths. Adults with diabetes have heart disease rates and risk for stroke rates about two to four times higher than adults without diabetes describe how socioeconomic status impacts the incidence of diabetes in the U.S. people of low SES can’t receive right food/help they need and tend to suffer and be at risk for diabetes due to obesity describe risk factors associated with type 2 diabetes → being overweight, having hypertension, or abnormal HDL, or triglyceride levels African americans, hispanics and american indians/alaskan natives are at increased risk for developing type 2 diabetes (American Indians have the highest rate of diabetes in the US 16% of American Indians and Alaska Natives age 20 years or older and receiving care from the Indian Health Services have diabetes) describe how diabetes type 2 is diagnosed The routine test for diagnosing diabetes is a fasting plasma glucose test → A fasting glucose level of 100 and 125 mg/dL indicates prediabetes, as well as a higher chance of developing type two diabetes in the future describe treatment/management options for type 2 diabetes lifestyle changes may decrease risk/can manage diabetes when you have it ● weight loss (12 lbs per week) ● increased fittness just to where you meet the national guidelines ● adopting a healthy diet ○ whole grains (high fiber foods) ○ decreased consumption of fats (particularly saturated fats) treatment ● oral medications ● weight loss surgery (obviously try to avoid this) ● insulin injections may be necessary describe the incidence and impact of type 2 diabetes on women & ethnic minorities special concerns for women includes: family planning and pregnancy ● oral contraceptives can possibly not be effective because of the hormones and interference with extreme amounts of sugar in the blood menstrual cycle ● can be inconsistent because of hormone issues menopause ● extreme hormone levels hormone replacement therapy ● can be completely ineffective due to interference with insulin levels special concerns for ethnic minorities includes: poverty, lack of access to healthcare, cultural attitudes, and behaviors by third generation, ethnic minorities in the US have almost completely developed the bad habits of americans describe outcomes of unmanaged type 2 diabetes leading cause of kidney failure, lower limb amputations, and adult onset blindness most diabetics don’t die of diabetes, they die of cardiovascular disease (the number 1 killer in the US as well as diabetics) define gestational diabetes – risk factors and treatments occurs when women become intolerant to glucose during pregnancy, after pregnancy gestational diabetes usually goes away but may return during later pregnancies or as type 2 diabetes → women who’ve had gestational diabetes are at an increased risk of developing type 2 diabetes within the next 5 to 10 years Risk factor: overweight Treatments: diet control, exercise, and blood glucose testing, and for some people may entail oral medications or insulin. describe outcomes of unmanaged gestational diabetes for mom and baby Elevated blood glucose levles in mothers→ brings extra glucose to baby→ causes baby to put on extra weight outline the basic premise for food consumption patterns to prevent/treat diabetes type 2 outlined in the video “Tackling Diabetes With a Bold New Dietary Approach” by Neal Barnard a diet that’s vegetarian and free of added vegetable oils Chapter 13: Substance Abuse define drug use, misuse and abuse Drug Abuse: Is the overuse or misuse use of any drug → Illegal drugs directly cause about 38,000 deaths a year and contribute to deaths from accidents, homicides, and other causes Drug Use: the use of any substance other than food taken to affect body processes Recreational drugs: or drugs taken for pleasure, such as alcohol and caffeine can provide relief or enjoyment when used in moderation and their use has become an important part of many cultures Drug misuse: the use of a drug for a purpose for which it was not originally intended → drug misuse can be accidental or deliberate and includes taking more or less of a prescribed or OTC drug or using an outdated or a friend’s prescribed medication define psychoactive drug Psychoactive drug: is a chemical substance that acts primarily upon the central nervous system where it alters brain function, resulting in temporary changes in perception, mood, consciousness and behavior. describe the types/uses/routes of administration of drugs available in the U.S. Drugs typically enter the body through one of three ways… Oral administration: Swallowing a drug in capsule, tablet, or liquid form is the most common way of consuming a drug. Drugs taken orally do not reach the bloodstream as quickly as those taken by other means Through the lungs: The user sniffs a powder, such as cocaine; inhaled gases, aerosol sprays, or fumes from solvents or other compounds that evaporate quickly; or smokes a substance Use of a syringe: Drugs may be injected subcutaneously (under the skin), intramuscularly (into the muscle tissue), or intravenously (directly into the vein). An intravenous injection immediately introduces the drugs into the bloodstream. Intramuscular and subcutaneous injections are slower in action → In addition to the dosage and the route of ingestion, several factors influence the intensity and the duration of a drug’s effects: Physical conditions such as a cold, pregnancy, or menstruation may make the body more vulnerable to the effects of a drug Genetic differences among individuals may account for varying drug responses. Some people appear to be more sensitive than others to specific classes of drugs, or to drugs in general Mindset can also influence a drug’s effects. Someone who snorts cocaine to enhance sexual pleasure may feel more stimulated simply because that is what she expects to happen Social setting may influence drug effects. Drug effects at a noisy, crowded part are different from the effects produced at an intimate subdued event describe the process of addiction and withdrawal Psychological dependence: Habituation… a combination of physical and psychological dependence can greatly increase a person’s risk for addiction describe the impact of socioeconomic status on drug use in the U.S. → A person may become more likely to abuse drugs when there is a breakdown of protective factors, such as family, friends, or a supportive environment. The use and abuse of illicit drugs has a tremendous impact on American society, causing about $200 billion dollars a year in economic damages → Drug use has economic consequences at both the individual and the societal level… physiological changes mental dependence conflicts in relationships … social costs include… burden of drug related crime creation of treatment facilities loss of individual productivity care for children of drugdependent parents the policing of illicit drug availability treatment of medical complications resulting from inappropriate drug use describe the factors that influence drug use in women Factors that influence.. Significant life stresses (divorce, loneliness, and dissatisfaction w/ a career) sexual abuse and physical abuse, beginning before the age of 11 and occurring repeatedly mental illnesses such as anxiety, depression, or personality disorder Tobacco describe why women use tobacco → Women began to smoke openly in public settings, and female cigarette smoking prevalence rates rose from 2% in 1930 to 34% in 1965 Just over one in six women (17.3% currently smoke in the U.S) by far the highest among people of Native American descent (36%) After native americans the ethnic and racial groups most likely to smoke are people of mixed race, Whites, African americans, and hispanics. smoking also varies by education and poverty level with higher rates of smoking corresponding to lower levels of education and incomes below the poverty level → Women smoke to … lose weight, stay thin…. exc Women often initiate cigarette smoking in adolescence in the context of social interactions with peers adolescents are more likely to smokers if their parents, older siblings or peers smoke “give them something to do in social situations and/or to “fill time”” many women hesitate to quit smoking over a fear of unwanted weight gain → the average person gains between four and ten pounds upon quitting smoking women’s concerns about weight gain and the maintenance of their smoking behavior sadly reflect their willingness to risk long term detrimental consequences in exchange for dealing with body image and weight control issues explain the health effects of tar, nicotine, and carbon monoxide on women's health → Nicotine: Highly addictive, psychoactive substance, CNS stimulant, paralyzes cilia → TAR: tar is the carcinogenic particulate matter, paralyzed cilia become unable to clear out tar → Carbon monoxide: is a deadly gas that reduces the oxygen carrying capacity of red blood cells describe the health effects of smoking on women Women who smoke are often nicotine dependent, physically unhealthy, socioeconomically disadvantaged, and very often depressed → Cancer: lung, oral, cavity, pharynx, larynx (voice box), esophagus, pancreas, kidney, bladder, and uterine → Cardiovascular: double risk of CVD, blood clots, especially in smoking women + birth control pills → Respiratory diseases: 90% of chronic obstructive pulmonary disease (emphysema and chronic) → Reproductive and pregnancy complications: decrease fertility, ectopic pregnancy, LBW babies, stillbirths, enter menopause on average two years sooner than nonsmokers → Urinary incontinence → Wrinkles, bad breath and yellow teeth → Osteoporosis and depression describe the health effects of smoking on a developing fetus → It is estimated that smoking during pregnancy is responsible for 11% of stillbirths and 5% of newborn deaths smoking is believed to be a factor in 1730% of LBW babies, 14% of preterm deliveries, and 10% of all infant deaths Cigarette smoking during pregnancy retards fetal growth and is associated with miscarriage, stillbirth, SIDS, and infant mortality → Pregnant women who smoke are at additional risk. Nicotine and carbon monoxide are considered the two most important components in cigarettes that constitute major hazards to the fetus.. nicotine reduces fetal breathing movements and uterine blood flow, and increases fetal heart rate carbon monoxide reduces the amount of oxygen available to the fetus by as much as 25% describe how women and ethnic minorities are impacted by tobacco marketing/tobacco use → Tobacco is the only legally available consumer product that is harmful to one’s health when used as intended → Single most preventable cause of morbidity/mortality about 480,000 tobaccorelated deaths/year 41,000 due to secondhand smoke another 10 million suffer tobacco induced health disorders about half of all regular smokers die of smoking related disease → Race/Ethnicity: #1= American Indian Men=20.5% Women=15.3% Age 18 to 21: 18.7% 2544 : 20.1% 4564 years: 19,9% 65 years and older= 8.8% describe legal measures taken to decrease tobacco use in the U.S. and abroad → all 50 states and district of columbia… limit youth access, ban or restrict vending machine sales, considering how to approach advertising and promotion Tobacco Control Act: aims to decrease new, young users/ those not old enough to understand the risks and premature death describe the forms of tobacco → Tobacco Products: cigarettes, flavored cigarettes, cigars, hookahs, smokeless tobacco describe ecigarettes, possible health impacts and efforts to control the use in teens → Marketed as therapeutic device to quit smoking according to the FDA, there are no ecigs that can be recommended for tobacco cessation → How they work.. most ecigs consist of three different components including… a cartridge, which holds a liquid solution containing varying amounts of nicotine, flavorings, and other chemicals A heating device (vaporizer) A power source (usually a battery) puffing activates the batterypowered heating device describe impacts of environmental tobacco smoke and “thirdhand” smoking → the leftover nicotine and other chemicals that accumulate on walls, furniture, clothing and other surfaces in areas where smoking has occurred, also creates health risks. these chemicals may last on surfaces for weeks or months while third hand smoke does not appear to be as dangerous as secondhand smoke, it still may increase the risk for asthma , lung cancer, and other conditions outline treatment options or cessation programs → Quitting: Breaking the Nicotine Addiction seventy percent attempt to quit each year but only between 4 and 7 percent succeed options: going cold turkey, gradual reduction, short term programs based on behavior modification and a system of rewards, treatment centers combining several approaches has the most affect Symptoms of withdrawal: irritability, restlessness, nausea, vomiting, and intense craving for tobacco Nicotine replacement products: chewing gum, patches, nasal spray, inhales, smoking cessation Alcohol define alcohol and its affects alcohol is a central nervous system depressant impairs movement and thinking as alcohol concentrations increase, more functions are depressed and greater impairment occurs. describe the concept of a standard drink and alcohol proof proof measures the percent of alcohol (80 proof = 40% alcohol) In the United States, a "standard" drink is any drink that contains about 0.6 fluid ounces or 14 grams of "pure" alcohol. describe factors that influence alcohol absorption food in the stomach (the less you eat, the faster alcohol affects you, and the less it takes) gender (females get intoxicated easier) Age drug interaction cigarette smoking mood and physical condition alcohol concentration carbonation describe the process of alcohol absorption 2025% of the alcohol in a drink is absorbed into the blood stream from the stomach 7580% is absorbed through the upper part of the small intenstine between 210% of alcohol consumed is not metabolized and is excrete unchanged in breath, urine, and pores of the skin describe BAC Blood Alcohol Concentration Measure of the amount of alcohol in grams in 100 millileters of blood ex: 80 milligrams of alcohol in 100 milliliters of blood, the BAC would be .08%. understand how/why women use alcohol More women have adopted drinking behaviors similar to men. Women are generally more susceptible to the effects of alcohol and have a higher BAC than men due to the following: Less body weight Higher body fat percentage Less alcohol dehydrogenase Menstrual cycle Use of oral contraceptives describe how women/men are physiologically affected by alcohol consumption Alcohol and drugs can take a heavy toll on the human body. The same general statements can be made for both men and women about their longterm effects—for example, both genders incur liver problems resulting from alcohol abuse, respiratory impairment and lung cancer as a consequence of smoking, HIV/AIDS and hepatitis from injection drug use, and memory difficulties associated with the use of marijuana. Yet women have different physical responses to substances and greater susceptibility to healthrelated issues. Women differ from men in the severity of the problems that develop from use of alcohol and drugs and in the amount of time between initial use and the development of physiological problems describe problems associated with pregnancy and alcohol consumption (FASD) FASD (fetal alcohol spectrum disorder) is an umbrella term describing the range of effects that can occur in an individual whose mother drank alcohol during pregnancy These effects may include physical, mental, behavioral and/or learning disabilities with possible lifelong implications Native Americans have the highest rate of FASD Reasons History of poverty, lack of access to healthcare, young population describe the short and longterm health impacts of alcohol use SHORT TERM: Acute alcohol intoxication: lifethreatening blood alcohol concentration which can produce collapse of vital body functions Blackout: amnesia for the events of any part of a drinking episode, without loss of consciousness Hangover: the result of a common reaction to alcohol toxicity which causes a variety of symptoms LONG TERM: Heart Disease Stroke Abnormal heart rhythm Liver Disease (cirrhosis) Cancer Brain Damage Altered Immune System Malnutrition describe the societal norms of alcohol promotion and its negative impacts use is limited to 21 and older restrictions on driving and underage drinking binge drinking can be used to ease social inhibitions, to fit in with social groups, to imitate role models, or to celebrate, reduce stress or cope with pressure (acedemic or social). can also bring “adult status” Illicit Drug Use define the effects of drugs on the brain fun (not in the book just thought I’d add that in there lol) many addictive drugs act on neurons in three brain structures: the ventral tegmental area (VTA) in the midbrain nucleus accumbens prefrontal cortex describe women’s use of drugs and how it varies from men According to U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) women use illicit drugs and alcohol because they have: poor selfesteem a history of physical or sexual abuse depression, panic disorder and posttraumatic stress disorder family history describe the factors influencing the effects of the drug characteristics of the drug (different drugs are more intense/affect humans more) characteristics of the person (some people are more succeptable to the affects of drugs) characteristics of the situation (depending on someone’s mood and situation they can have a worse or better experience on drugs) describe the path to drug dependence you are dependent on the drug when physiolocial changes begin taking place in the brain and body chemistry describe drugs of abuse and their effects and risks to health There are three kinds of prescription drugs that are commonly abused: Opioids— painkillers like Vicodin, OxyContin, or codeine Depressants —like those used to relieve anxiety or help a person sleep, such as Valium or Xanax Stimulants —like those used for treating attention deficit hyperactivity disorder (ADHD), such as Adderall and Ritalin describe treatment options Detoxification: supervised withdrawal with or without medication Therapeutic Communities: highly structured, drug free environments Outpatient DrugFree Programs Selfhelp programs such as Narcotics Anonymous (NA) or Pills Anonymous (PA). describe demand reduction vs. harm reduction policies demand reduction incarceration for drug related crimes harm reduction seeks to reduce the harms associated with drug use and ineffective drug policies never will be a drug free society (because certain drugs are becoming legal ex: marijuana) treatment not prison terms end discrimination against all drug users by reducing the stigma: many are unable to access treatment, encountering insurance barriers, month long waitlists, or programs that dont meet their needs raise awareness about proven drug treatment models
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