What are the US Surgeon General's current priorities? (4)
- Disease Prevention (Obesity, increasing physical activity, HIV/AIDS, Reduce tobacco use)
- Eliminating Health Disparities
- Public Health Preparedness
- Improving Health Literacy
How does diet affect cardiovascular disease?
Diet affects serum cholesterol, obesity, diabetes, and high blood pressure. Consumption of total fat, cholesterol and saturated fat should be decreased. Consumption of whole grains, legumes, veggies, fruits, and skim milk products should be increased.
Which cancer sites are affected by diet?
Diet affects cancers of the GI tract, cancers of some sex-hormone responsive sites (breast, prostate, endometrium, ovary) and possibly cancers of the respiratory and bladder.
It is estimated that ___% of cancers may be attributable to dietary factors.
Obesity is a risk factor for which cancers?
Breast, colon, endometrium, esophagus, kidney
Which foods can decrease risk for cancer?
- Dietary fiber (colorectal cancer)
- Cellulose and bran (colorectal cancer)
- Cruciferous veggies (broccoli, brussel sprouts, cabbage, cauliflower) and dark green and deep yellow veggies rich in carotene (decreased cancer at several sites)
- Flavoproteins (anti-carcinogenic and anti-mutagenic)
According to the National Academy of Sciences, dietary changes could reduce the incidence of cancer by ___.
Foods that may prevent illness (in general)
- Berries: contain vitamins, phytochemicals (may help prevent diseases or treat some disorders), lutein (healthy vision)
- Olive Oil: lowers LDL cholesterol levels; 2 tbsp/day may reduce risk of CAD due to the monounsaturated fat in olive oil
- Cruciferous Veggies: one cup daily can strongly prevent cancer
- Whole Fruits, Yellow-Orange -Red Veggies, Processed Tomato Porducts: cancer-fighting properties
- Fish and Fish Oils: Omega-3 FAs (prevention/treatment of coronary heart disease, hypertension, cancer, psoriasis, arthritis); may prevent Alzheimer's, depression, bipolar disorder (omega-3's help maintain proper functioning of dopamine and serotonin); 2 fish meals per week and use vegetable oils containing alpha-linolenic acid
- Vitamin A: aka Retinol; fights vision problems, important for reproduction, bone growth, cell division, cell differentiation, regulate immune system; in fish oils, liver, eggs, fortified dairy products; fruits and veggies with carotene
Psycholigcal principles and techniques that may be useful to prevent disease (4)
- Psychological Assessment
- Stress Managment
What is the most dangerous form of skin cancer? How have its rates changes in the last 30 years?
Malignant melanoma. Rates have douled in the last 30 years. 1.1 million annual cases in the US.
What is bruxism?
Grinding, gnashing or clenching your teeth. Can lead to jaw disorders, headaches, damaged teeth and other problems.
What dietary changes can one make to improve their dental health?
Avoid sticky sugar consumption and excessive carbonation
What is behavioral optometry?
Uses preventative visual health care approach and behavioral treatments for visual disturbances. Visual training and "plus" lenses when under stress may help to prevent development of myopia.
How can one improve bone health?
- Eating foods that provide calcium in an easily absorbable form
- Getting enough vitamin D
- Staying physically active throughout life
What is the leading cause of injury in women ages 15-44?
Domestic violence (13 million people, or 5% of US, are victims of crime every year)
Injuries are the leading cause of morbidity and mortality for persons aged ___ to ___ and account for ___% of fatalities between ages 1 and 24.
Define compliance, medical compliance and adherence.
- Compliance: giving in to a request or demand; acquiescence
- Medical Compliance: the extent to which a person's behavior in taking medications, following diets, or executing lifestyle changes, coincides with medical or health advice
- Adherence: refers to the extent to which a person's behavior is consistent with or follows from expert advice
(Majority, minority, 50/50)
1. Number of patients that correctly follow physicians' advice
2. Number of appointments scheduled by health-care providers that are missed (except when children are patients)
3. Compliance with long-term medication regimens.
4. Compliance with physician-directed dietary restrictions.
5. Number of patients that stop taking medications before they are supposed to stop.
6. Number of patients that drop out of various lifestyle change programs.
7. Number of people who relapse to unhealthy lifestyles
8. Number of patient-initiated appointments are kept.
- **Just know that everything is 50/50 except for patients correctly following physicians' advice (minority), people who relapse to unhealthy lifestyles (majority), and number of patient-initiated appointments that are kept (majority).
- 1. minority (33%)
- 2. 50/50 (50%)
- 3. 50/50 (50%)
- 4. 50/50 (50%)
- 5. 25-60%
- 6. 20-80%
- 7. Majority (75-95%)
- 8. Majority (75%)
List some physician behaviors and interventions that can increase compliance.
- **Listen to the patient
- Ask patient to repeat what has to be done
- Keep prescriptions simple
- Give clear instructions
- Prescribe self-care regimen that fits into patient's daily schedule
- Emphasize importance of adherence to each visit
- Gear frequency of visits to adherence needs
- Acknowledge patient efforts at adherence at each visit
- Involve spouse or other family members
- Emphasize importance of instructions and advice
- Use short words and short sentences
- Categorize info
- Make advice as specific, detailed and concrete as possible
- Find out what the patient's worries and expectations are
- Provide info about diagnosis and cause of illness
- Adopt friendly rather than businesslike attitude
- Avoid medical jargon
- Spend time in conversation about non-medical topics
HPV is responsible for nearly ___% of all cervical cancer and ___% of all genital warts.
List insitutionally-based interventions.
- Remind patients of appointments with post cards or telephone calls
- Reduce waiting times for appointments
- Call the patient if an appointment is missed
- Use nurses and technicians to reinforce physician communication
- Make use of special reminder pill containers and calendars
- Provide communication training for physicians and all staff
- Have patient information handouts readily available