public health final
Terms
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- leading cause of death
- tobacco--but not regulated by the FDA
- how many tobacco deaths per year?
- 400,000-425,000
- how many deaths from second hand smoke?
- 4,000-8,000
- how many deaths per day?
- 1200
- lowest tar cigareets have
- the highest nicotine
- what percent are smokers
- 29% of those 12 or older
- three main ingredients in cigarette
- tar, carbon monoxide, nicotine
- six factors affecting tobaccor absorption
- exact composition of tobacco used, density of packing, length of cigarette, filter or not, volume inhaled, number of cigs smoked in day
- what factors influence tobacco use?
- availability, age, SES, gender, advertising
- three roles of tobacco advertising
- increase number of existing smokers, replace smokers who quit or die, and reasure smokers about health worries
- methods of smoking cessation
-
cold turkey, clinic or group settings, work site quitting programs, self help programs,
chemically assisted (nicoderm, etc.) alternative assisted (hypnosis, herbs, accupuncture) - mystification
-
redefinition of everyday medical problems as medical conditions that require treatement (if you take this....)
keep consumers in dark, don't tell whole truth or complete picture - who is involved in mystification
- patients/consumers, advertisers, pharmaceutical, medical, herbal, government
- which catergories are involved in mystif
- OTC, including herbal, black market, prescription, licit and illicit, gray market
- gray market
- using a legal drug illegally---using someone else's prescription
- why be wareful of dietary supplements
- safety or efficacy of the product doesn't have to be proven before it's put on market
- what are the five supplements that the FDA warns about?
-
belladonna: used to treat intestinal problems and asthmas--overdoes can cause death
broom: used to treat low blood pressure and various heart ailments
comfrey: used to treat blunt injuries (broken bones, cuts, and bruises)
lobella: treat asthma and induce vomiting
pennyroyal: used to treat indigestion, liver and gallbladder problems - four main influences of drug mystif
- over manufacture, over advertise, over prescribe and over consume
- suggested solutions to mystification
- regulate advertising, limit production, detail persons should have drug training, continuing education, consumer responsibility
- consumer friendly ad
- describe prescription, risks and benefits, success rates, lifestyle changes, costs
- Fetal alcohol syndrome vs. exposure
- less exposure in exposure---less severe
- distinguishing characteristics of FAS/FAE
- weigh less, shorter than normal, small heads, deformed facial features, abnormal joints and limbs, poor coordination, problems with learning, short memories
- FAS is the leading cause of what
- mental retardation in newborns
- safe amount of alcohol?
- NO SAFE AMOUNT
- FAS more likely with what
- heavy drinkers, other drug use, correlated with other lifestyle factors, poor medical care,
- which is easier to diagnose
- FAS--more physical characteristics FAE--more subtle effects---invisible
- victims of FAS often experience
- mental health problems, disrupted school performance, inappropriate sexual behavior, trouble with the law, alcohol and drug problems, difficulty caring for themselves, homelessness
- undeserved population
- an identified group whose chemical dependency needs are not being met
- what populations have special treatment needs
- elderly, adoles, women, native amer., hispanic, A.A. lesbian/gay
- common problems with special groups
- different access points, needs not being met, need to prepare to function in own community, may require separate programs, lack of insurance
- access point
- places where people can recieve help
- elderly
- alcohol and prescrips
- adolescents
- captive populations, habilitation, insurance problems, fam participation, labeling
- women
- 60% of prescrips for women, programs designed for men may not fit women's needs, isolation in home setting, incest rape, child care
- african americans
- different access points, role of church 3-4% of minnesotans, not just crack and heroin
- native americans
- roughly 40% have chemical dependency problems, usually must leave community for treatment, cultural diffs important
- hispanic
- organization a problem, vast diffs among groups, role of church
- gay/lesbian
- few treatments regarding orientation, little known about lesbian dependency, gay male's socialization
- habilitation for adolescents
- teaching new skills
- aftercare
- after primary treatment
- characteristics of aftercare
- must reinforce new lifestyle learned in treatment, six months to year, AA most common, family, new friends, new activities, avoid new enviroments
- characteristics of self help groups
- low status affliction, voluntary, no professionals, anonymous
- self help success
- higher success rates than individual help
- chemical dependency
- craving that must continue to be satisfied by repeating the experience for its usually pleasureable effects even when non pleasureable accompany or result
- adaptive impoverishment
- life is so screwed up it feels normal to you
- surreptitious use
- sneaky use...hiding
- social user
-
one who uses alcohol simply to enhance the pleasure of normally pleasureable situations
experiences no negative consequences, nor surprises, no loss of control, no complaints, no need for limit setting - substance abuser
- uses to enhance pleasure or compensate for something negative, such as physcial or emotional pain experiences neg consequences, limit settings, promises that are made and kept, complaints that are heard and dealt with
- addict
- one who uses to celebrate, compensate, or for any other reason, legitimate or not. experiences neg consequences recycled, limit setting and promises broken, complaints denied, reliable symptoms of addictive disease
- addictive cycle
- negative consequences->one's intention to control use->failure to control use->denial and other defenses->continued use despite consequences->same cycle
- how many chemically dependent
- 5-10% 14-28 million
- society is screwed up theory
- high unemployment, racism, poverty, lead to increased drug use
- genetic theory
- risk of becoming chemcially dependent increases 4-8 times with a bio mother or father who was/is dependent
- personality theory
- no good measurement--psycoanalytic theory
- deviant behavior theory
- rewards for being different, people pay attention to you
- cultural theory
- history and tradition of your people
- learning theory
- small behavior, small reward (smoking), small behavior large reward(cocaine)
- warning signs of chemical dependency
- increased tolerance, preoccupation, sneaking doses, rapid intake, memory blackouts, drinking alone, hiding doses, using to relieve symptoms of prior use, using more than intended
- overall goal of assessment
- solve problems, not stop use
- what does cage stand for
- cut down, annoyed, guilty, eye opener
- problems facing physcians when it comes to screening for alcoholism
- not trained, don't want to lose patients
- how to screen and conduct brief interventions
- ask quantity frequency questions, ask CAGE, determine appropriate action, advise and assist, arrange followup, support
- keith influenced by what factors
- modeling peers, environemnt of bartending, genetics
- intervention
- expressing concerns and motivatin to change
- coercive and non coercive intervention
- no difference in success rates