SYO4402 Week 2 Lecture Notes: 1/19, 1/21
SYO4402 Week 2 Lecture Notes: 1/19, 1/21 SYO4402
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This 6 page Class Notes was uploaded by Courtney Adams on Monday January 18, 2016. The Class Notes belongs to SYO4402 at Florida State University taught by Dr. Nowakowski in Spring 2016. Since its upload, it has received 53 views. For similar materials see Medical Sociology in Sociology at Florida State University.
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Date Created: 01/18/16
Instructions on BB for assignment • Any of the readings from weeks 1-3 (easiest with research article) • 2 pages double spaced MAX (can structure as an essay of bullet form) • Must answer every question with detail to get credit • What is good for primary care? Trying to prepare our medical student to practice evidence based medicine • This has been a big shift in healthcare 1. Development of medicine A. Societies have held diﬀerent theories throughout history of how out bodies and minds work and inﬂuence each other a. Concepts of health isn't the same all around the world b. As history has progressed, thinking has evolved and plus we are learning more about the diﬀerent domains of health being interconnected B. Belief in the supernatural or divine forces often played a strong role --> still important for many cultures today a. These perspectives haven't come away from the fact that beliefs eﬀect diﬀerent health factors b. It's not as simple as if you are religious or not, it's more if you have a secure attachment or not c. Can't make any clear conclusions if region is good for health or not (can be both) d. Study: Diﬀerent ways to measure religion, compared them to each other and chronic diseases--> didn't ﬁnd any clear trend in region and chronic diseases e. Religion can shape the narrative of our faith C. Major breakthroughs --> germ theory disease (Louis Pasteur) a. Germs: impacted healthcare b. Pasteurize: super heat things to create bacteria c. Pasteur: found that there are tiny bacteria that are too small to even see 1. Intestines have millions and millions of living bacteria D. Can all health outcomes be explained by the germ theory? a. A very good way to look at health illnesses overtime b. A list of things caused by these pathogens (Ex: HIV) 1. HIV: gone from a death sentence to a chronic illness 2. Because of medical advancements 3. In other places in the world, it is still a death sentence 4. Deeply sociological explanation in the sense of urgency to ﬁx it beach of the germ theory. At ﬁrst people didn't care about the people because they felt they were being punished (for being a drug addict and gay). But once they realized it could be transferred to other people, they started to care c. Started looking at it from a diﬀerent standpoint 2. After germ theory A. Changes in medical authority --> rise of allopathy, hospitals, MCOs, etc a. Allopathy: ﬁeld that trains physicians to get an MD (focus on drugs) b. Osteopathy: ﬁeld that trains physicians to get a DO (takes a holistic approach) B. Shift from acute to chronic a. Context matters --> Why we are looking into the factors that causes health 1. Family history, genes, behavior factors b. Indigenous Americans being predisposed to alcoholism --> NOT TRUE (Very diﬃcult to debacle) 1. Relative diﬀerences are just as important as absolute health status 2. All these diﬀerent inﬂuences play a big role and the context of all these inﬂuences also play a role Infections Chronic Time / Industrial deviations A. Exploration of additional causes in Health a. Environmental exposures: settings that make us feel peaceful (outside), going to publix right before school starts (environments that inﬂuence stress) b. Behavioral factors c. Social and cultural inﬂuence d. Neighborhood characteristics e. Genetic diﬀerences 1. Cockerham 2007 A. Describing the sick role (parsons 1951) in detail a. The patient is 1. Exempt from usual obligations 2. Not responsible for their condition 3. Expected for attempt recovery 4. Responsible for seeking medical treatment b. Types of legitimacy: conditional, unconditional, illegitimate/stigmatized 1. Whether or not you actually look sick 2. You just know what you can see 3. Why it's so important to ask questions 4. Why when you hear hooves, think zebra to cover all the bases A. Stigmatized: when a condition looks like you are faking it, it sometimes attracts negative behavior c. Very consistent with most hospital care 1. Ex: giving birth in a hospital d. Often inappropriate for chronic conditions and marginalized populations 1. Very paternalistic narrative 2. Weiss 2009 A. Product changes in modern medicine B. Four precipitating factors a. "Epidemiological transition" (acute to chronic) b. Greater focus on behavioral factors c. Emphasis on patient provider relationships 1. Need to look at patients as people d. Complex structure of health care C. Inﬂuences of interest: cultural, social, institutional 1. Basic types of models A. Biomedical: emphasis on physical and genetics factors, mind-body dualism a. Not that accurate B. Sociological a. Emphasis on social factors, concern with inequality 1. Trying to address inequality itself and try to get rid of it 2. What can we do to help people deal with their circumstances C. Psychological a. Emphasis on emotional factors, misery and suﬀering 1. Some behavior health comes from this 2. TTM (Transtheoretical model or stages of change) suggest your move through 6 diﬀerent stages when you are wanting to change a behavior ex: patient is trying to quit smoking 3. 1. Contemplation 2. Plan, 3. action (implementing the strategy and seeing if it works, 3. maintenance, 5. relapse, 6. extinction (aren't smoking at all anymore) 4. Incorporates ideas from diﬀerent models A. Can move in and out of the stages, doesn't have to be in order D. Biopsychosocial a. All domains exert important inﬂuences on health 1. Also bringing in other perspectives: ecology, environment, etc. 2. A model that brings together multiple elements with the understanding that their are many other factors 2. More about models A. Multiple kinds of models a. Ecological b. Multilevel c. Elaboration model / path diagram 1. When we think about where health comes from 2. Think that a lot of things relate to another 3. Bivaribite model: A. SES --> smoking B. Mediators: Maybe they are related and cause the relationship or help inﬂuence it (eduction, job, etc) a. Ex: SES --> eduction --> smoking b. Ex: SES --> job --> smoking C. Moderator: There may also be something that isn't the cause but is related, shapes the relationship but isn't in the relationship a. Ex: culture d. Stochastic (Markow, etc) 1. Illustrate the ﬂow between the diﬀerent states and the inter relativeness between the states e. Decision trees 1. Another way of understanding movement, some choices may or not be more realistic 2. Ex: smoke now --> smoke later OR --> stop smoking f. Fixed vs random eﬀects 1. Idea that there is variation within the individual A. Ex: pain level, nausea, trips to the bathroom, fatigue (probably won't get the same everyday 2. Also variation between the individuals A. Ex: have a total of 91 people in our sample (try to compare and contrast diﬀerent small groups in the study --> gender, economic background, countries of origin, religion, ethnicity, etc. g. Cumulative vs path-dependent 1. Diﬀerent way of understanding diﬀerent processes 2. Cumulative: Grows and grows into its way more than the sum of its parts A. Ex: how does all that inequality add up overtime to really hurt people's health h. Integrative: idea that bring others ideas together 3. Group activity A. WHY did we break the cotton ball? a. An experience/exposure can really eﬀect someone b. Resources to put something back together is more than it took for those to break it c. Diﬀerent types of stressors coming into someone's life d. Whether you experience a stressful life event or just a chronic strain, it still eﬀects you e. Given resources sometimes you can buﬀer stress f. STRESS MATTERS FOR HEALTH IN MANY DOMAINS g. What kinds of stress are possible? 1. Environmental stressors and also diﬀerent types of environmental stressors that may be more acute 2. Stressful life events: emotional, physical, environmental 3. A primary stressor: mayor life event (someone dies) 4. Self inﬂicted stress event (anxiety with someone in an abusive relationship) 5. Chronic strain: living with racism, being discriminated against, transgender and bisexuals living in the closet, job stress --> physical or emotional 4. Pearlin 1989 A. Operating stress process B. Two major sources of stress a. Stressful life events b. Chronic strains C. Chronic strains usually stem from trouble negotiating roles a. Role conﬂict: all of the important things in your life conﬂict b. Role coping D. Resources to navigate role issues become more limited as privilege decreases a. Help you manage the conﬂict between roles b. Buﬀering stress with resources: directly engage in helping you process stress (venting to friends, loud music, doing for a run, dancing it out) 5. Freese 2008 A. Synergy between genetic and social determinants of health B. Genes impact and are impacted by all other aspects of our lives C. Ex of how cumulation modeling should work D. Sneak peak to "geneticization" is a speciﬁc form of medicalization a. There is a cumulative interplay between genes and social, that both play a role in determining health 6. Media Ex: 1 A. How stress impacts health B. One of the classic studies of stress and health C. Hierarchy stress D. The lower you were in the hierarchy, the lower you were for risk of disease and length of life E. Stress has consequences that are detrimental to health F. Stress ages us because our telomeres get stronger faster a. Cells cants divide as well and things can go wrong, myelin can also be depleted b. Ex: develop a tumor G. Stress and the resulting ﬂow of hormones, damage artery walls, leading to artheroscerosis and heart attacks H. Stress aﬀects memory (chronic: lose capacity to remember things, severe acute: makes it impossible for you to remember things you know perfectly I. Stress also makes us feel miserable (less dopamine: pleasure hormone)
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