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Pub Health Exam2

Dr. Mittak's 2nd Public Health Exam

How many Americans suffer from a mental illness? 50 million
Mental illness is more common than ________ (3) and is _______ 1. cancer 2. heart disease 3. diabetes; treatable
What is the number 1 reason for hospital admissions nationwide? Psychiatric disorders
What are biological causes of mental illness? Biochemical disturbances, genetics, infections (can cause brain damage), brain defects or injury, prenatal damage, poor nutrition, exposure to toxins
What are psychological causes of mental illness? Severe psychological trauma suffered as a child (emotional, physical or sexual abuse), important early loss (i.e. parent), neglect, poor ability to relate to others.
What are environmental causes of mental illness? Death or divorce, dysfunctional family life, poverty, feelings of inadequacy, low self-esteem, anger, anxiety or loneliness, changing jobs/schools, social/cultural expectations, substance abuse self/parents.
Where can stress come from as a cause of mental illness? Academic, homesickness, peer relationships, family, identity, work, illness
What is the most common barrier for people seeking mental health treatment? Shame
What are the types of mental disorders? Mood, Anxiety, Psychotic, Personality, Impulse control/Addictive, Eating disorders/body image, Other
What can be included in Anxiety disorders? Panic disorder, OCD, PTSD, Social anxiety disorder, specific phobias, Generalized anxiety disorders
What are symptoms of anxiety disorders? Panic, fear, uneasiness; obsessive thoughts; repeated thoughts or flashbacks; nightmares; ritual behaviors; sleep problems; clammy hands; shortness of breath; palpitations; can't be still and calm; dry mouth; numb/tingling in hands/feet; nausea; m tension
How common are anxiety disorders? ~19 million American adults affected; begin in childhood, adolescence and early adulthood; more often in women and caucasians, blacks and hispanics equally affected
How are anxiety disorders treated? Medication Psychotherapy Cognitive-behavioral therapy
How does medication treat anxiety disorders? Used to reduce the symptoms of anxiety disorders include anti-depressants and anxiety reducing meds
How does psychotherapy treat anxiety disorders? Addresses the emotional response to mental illness. Trained mental health professionals help people by talking through strategies for understanding and dealing w/ their disorder.
How does cognitive-behavioral therapy treat anxiety disorders? Person learns to recognize and change thought patterns and behaviors that lead to troublesome feelings.
What are the types of depression? Situational/adjustment; bereavement; seasonal; clinical depression; psychotic depression; bipolar; dysthymia; post-partum
What is situational/adjustment depression? Variable mood correlated to circumstances; minimal change in sleep, appetite, energy; no change in self-attitude; suicidal thought unlikely; lasts <1 month
What is seasonal depression? Occurs each year at the same time, starting in fall or winter and ending early spring or summer
What are symptoms of SAD? Fatigue, increased need for sleep, decreased levels of energy, weight gain, increase in appetite, difficulty concentrating, increased desire to be alone.
What is dysthymia? Chronic depression, less evere form of depression but symptoms linger for long period; usually able to function normally but seem consistently unhappy
What are symptoms of dysthymia? difficulty sleeping, loss of interest or ability to enjoy oneself, excessive feelings of guilt or worthlessness, loss of energy or fatigue, difficulty concentrating, thinking or making decisions, change in appetite, thoughts of death/suicide
What is clinical depression? An illness not a weakness, serious disturbances in work, social and physical functioning including suicidal thought, not relieved by circumstances, can last long time, persistent and intense mood changes.
Of the 1.5 million young adults who have clinical depression how many are men or women? 1 in 4 women, 1 in 10 men; begins in early adult years; family history, substance abuse and stress increase risk
What are s/s of clinical depression? Extreme sadness, guilt, shame; dec. concentration, poor academic/work performance; dec. interest/enjoyment in daily activities; inc. irritability, arguments; change in sleep, appetite, energy; social withdrawal; hope/helplessness and suicidal thoughts
What treatment is available for clinical depression? Anti-depressant medications, psychotherapy, day Tx or hospitalization, exercise, sleep hygeine, light therapy, ECT
How many people have psychotic depression? About 25% who are hospitalized for depression
What are symptoms of psychotic depression? Anxiety; agitation; paranoia; insomnia; physical immobility; intellectual impairment; psychosis
What is bipolar disorder? 2% general pop. over lifetime; half begin before 20 y/o; episodic extremes b/w states; strong family linkage; affects men and women equally.
What are the 2 states seen with bipolar disorder? Depressed state and excitable; euphoric/irritable, impulsive state
What are symptoms of the mania portion of bipolar disorder? Excessive happiness, hopefulness, excitement; sudden changes in mood; restlessness; rapid speech and poor concentration; inc. energy and less need for sleep; high sex drive; make grand plans; poor judgment; drug/alcohol abuse; inc. impulsivity
What are symptoms of the depressive portion of bipolar disorder? sadness, loss energy, feelings of hope/worthlessness, loss of enjoyment, difficulty concentrating, uncontrollable crying, difficulty making decisions, irritability, inc. need for sleep, insomnia, change appetite, thoughts and attempt at suicide.
How is bipolar disorder treated? Mood stabilizer medication Psychotherapy May require emergency hospitalization
What are facts about suicide? 3rd leading cause of death in 15-24 y/o; men 4x more likely to succeed; highest rate in white men >65; alcoholism associated w/ 50%; mood disorders account for 60-80%; 50-75% seek help but 50% never see a psychiatrist
Who is at risk for suicide? Males>females Family history of suicide Native American Mood disorder or substance abuse White>black
What factors can increase risk for suicide? (5) 1. Humiliating life events (15-24 y/o) 2. Loss (elderly) 3. History of childhood abuse 4. Interpersonal discord 5. Social Isolation
How is suicide prevention done? (6) 1. Decrease social isolation 2. Identify victimization, rejection, mental illness, substance abuse 3. Reduce hopelessness 4. Skill building around mood regulation 5. Secure or remove firearms 6. Decrease barriers around help seeking
How can post traumatic stress disorder develop? Can develop after a person has experienced or witnessed a traumatic or terrifying event in which serious physical harm occurred or was threatened.
What is PTSD a consequence of? Traumatic ordeals that cause intense fear, helplessness or horror like sexual/physical assault, unexpected death of a loved one, an accident, war or natural disaster.
Who can develop PTSD? Victims of trauma related to physical and sexual assault at greatest risk. Also, families of victims, emergency personnel and rescue workers.
When can symptoms of PTSD develop? w/in 3 months of the event, but could be years later, severity and duration vary.
What 3 categories can PTSD be grouped in? 1. Re-living 2. Avoiding 3. Increased arousal
What is re-living in PTSD? May include flashbacks, hallucinations and nightmares (MC). Also may feel great distress when certain things remind them of the trauma.
What is Avoiding in PTSD? May avoid people, places, thoughts or situations that may remind them of the trauma. Have feelings of detachment and isolation from family and friends.
What is increased arousal in PTSD? Excessive emotions; problems relating to others, including feeling or showing affection; difficulty falling or staying asleep; irritability, outbursts of anger; difficulty concentrating and being jumpy or easily startled & physical symptoms.
How common is PTSD? 3.6% of adult Americans (5.2 million people) suffer during a year and 7.8 million may experience PTSD sometime in their lives. Women more likely since tend to be victims of domestic violence, abuse and rape.
What are treatments available for PTSD? Psychotherapy (counseling), medication or both.
What types of therapy is used for PTSD? Cognitive-behavior therapy, Psychodynamic therapy, Family therapy, Group therapy
What are common obsessions w/ OCD? Fear of dirt or contamination by germs, Fear of causing harm to another, fear of making a mistake, fear of being embarrassed/socially unacceptable beh., fear of thinking evil/sinful thoughts, need for order, symmetry or exactness, excessive doubt
What treatments are available for OCD? Therapy: various types of psychotherapy: individual, group and family. Medication: Anti-anxiety drugs like paxil, prozac, zoloft and xanax are most commonly prescribed
What do people with personality disorders have? Extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school or social relationships.
What can cause interference w/ a person's normal functioning if they have a personality disorder? Pattern of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere w/ normal function.
What are 8 types of psychotic disorder? 1. Schizophrenia 2. Schizoaffective disorder 3. Schizophreniform disorder 4. Brief psychotic disorder 5. Delusional disorder 6. Substance induced psychotic disorder 7. d/t medical cond'n 8. Paraphrenia
What is schizophrenia? People who have changes in behavior and other symptoms (delusions and hallucinations) that last longer than 6 months, w/ a decline in work, school and social functioning.
What is Schizoaffective disorder? Symptoms of schizophrenia and a serious mood or affective disorder like depression, mania, or bipolar.
What is Schizophreniform disorder? Symptoms of schizophrenia but symptoms last <6 months.
What is Brief psychotic disorder? Sudden, short periods of psychotic behavior, usually in response to a very stressful event, recovery usually quick.
What is delusional disorder? Have delusions involving real life situations that could be true like being followed, conspired against or having a disease.
What is substance-induced psychotic disorder? Caused by use or withdrawal of substances like alcohol and crack may cause hallucinations, delusions or confused speech.
What is psychotic disorder d/t a medical condition? hallucinations, delusions or other symptoms d/t another illness that affects brain function like head injury or brain trauma.
What is paraphrenia? Type of schizophrenia that starts late in life and occurs in the elderly.
What is a hallucination? Unusual sensory experiences or perceptions of things that aren't actually there, like seeing things, hearing voices, smelling odors, having a funny taste in mouth and feeling sensations to skin w/o any stimulus.
What is a delusion? False beliefs that are persistent and organized and that do no t go away after receiving logical or accurate information.
What are other symptoms of psychotic disorders? Disorganized or incoherent speech; confused thinking; strange dangerous beh.; slowed or unusual mvmts; no interest in hygiene; no interest in activities; problems at school, work, & w/ relationships; cold detached manner; mood swings or mood symptoms.
How many people suffer from psychotic disorders and when do the symptoms appear? About 1% worldwide; late teens, 20s or 30s
What is involved w/ eating disorders? May involve extreme emotions, attitudes and behaviors involving weight and food. Anorexia nervosa, Bulimia nervosa, binge eating disorder are most common.
There are 6 briefly described disorders on pg 17-18 self explanatory
What 4 problems can drug abuse lead to? Addiction, Medical, Social, Economic
What is the total estimated cost to society from substance abuse and addiction? Illegal drugs: $181 billion/year Alcohol: $185 billion/year Tobacco: $158 billion/year Total: $524 billion/year
What are contributors to the economic costs of substance abuse and addiction? Health care expenses: abuse services and medical consequences; Productivity loss; other impacts: crime, social welfare admin., MVAs
What have advances in science shown us about drug abuse and addiction? It is a preventable behavior and addiction is a treatable disease.
What is addiction? A brain disease expressed as a compulsive behavior, continued abuse of drugs despite negative consequences, chronic, potentially relapsing disorder.
What can impact a person's vulnerabilty to becoming addicted to/abusing drugs? Genetics and environmental influences.
What pathways are affected w/ abused substances? Most abused drugs enhance the dopamine and serotonin pathways
What can brain changes do to someone w/ prolonged drug use? May compromise mental and motor functions.
Define violence. 1. Physical force exerted for the purpose of violating, damaging or abusing 2. the act or an instance of violent action or behavior 3. Intensity or severity, as in natural phenomena 4. abusive or unjust exercise of power.
What are the stats on violence in America, deaths, injuries, hospital treatments? 50,000 deaths each year and 2.5 million injuries; homicide and suicide are the 2nd and 3rd leading causes of death in 15-34 y/o; ERs treat ~55 people for injuries every minute.
What is the cost of interpersonal violence and self-inflicted violence? $37 billion; $33 billion
What categories can violence be based on? (5) 1. Agents of violence 2. Victims of violence 3. Relationship b/w aggressor and victim 4. Perceived causality 5. Type of harm; these are combined to examine forms of violence.
What is included in "violent crimes" and who experiences the highest rate? Murder, rape and sexual assault, robbery and assault; teens and young adults experience highest rates of violent crime.
What type of crime is more often experienced by someone over 65? Property crime not violence
Who causes infanticide? Parent in most homicides of children under 5; fathers, mothers, male acquaintances, other relatives, strangers (in decreasing amount guilty of infanticide); most children killed were male as were most offenders
What is included in intimate homicide and what happened to the rate of occurrence? Spouses, ex-spouses, boyfriends and girlfriends; steady decline in homicide of intimates.
What % of murder victims are killed by an intimate and who is usually involved? 11%; female murder victims more likely than males to have been killed by an intimate; most intimate homicides involve spouses.
What is the most common weapon in intimate homicide and what weapons are usually used depending on type of relationship? Guns most often; spouse/ex-spouse killed by guns; boyfriends most likely killed by knives and girlfriends more likely to be killed by force.
Family violence accounted for __% of all reported and unreported violence. 11%; 49% crime against a spouse, 41% offense against another family member, 11% parent attacking a child.
Who are more commonly victims and committers of family violence, what is the most frequent type? 73% victims were female; 76% of ppl who committed violence were male; simple assault most frequent type; drugs/alcohol involved in 39% and 20% involved weapons.
Why don't victims report family violence? Matter is private or personal or to protect the offender.
Who encounters the most workplace violence, what type of victimizations in work violence and 80% of workplace homicides committed w/ what? Police officers; intra-racial but assailants (6 in 10) are of same race; firearm.
What are hate crimes motivated by and what do they involve? race, ethnicity, sexual orientation or disability involved a violent offense while 2/3 of incidents motivated by religion involved a property offense.
What is environmental health? A branch of public health that deals w/ human health issues associated w/ factors in the environment.
What are the areas of environmental health? Air pollution Water pollution Solid waste Hazardous waste Noise pollution
When did congress create the EPA and what followed? 1970; passed clean air act giving fed. gvmt. authority to clean u air pollution in this country since then a variety of programs have been formed to reduce air pollution in America
What is the relationship b/w air pollution and the environment? Air pollution is damaging to the environment. Toxic air pollutants and chem. that form acid rain and ground-level ozone can damage trees, crops, wildlife, lakes and other bodies of water. Can harm fish and aquatic life.
What are the 6 common air pollutants? 1. Particle pollution 2. Ground-level ozone 3. CO 4. Sulfur oxides 5. Nitrogen oxides 6. Lead
What can air pollutants do and which are the most threatening? Harm your health and the environment and cause property damage. Particle pollution and ground-level ozone most widespread health threats.
What is included in particulate matter? very fine dust, soot, smoke and droplets formed from chemical reactions and produced when fuels like coal, wood or oil are burned.
What causes particulate matter i.e. what is burned to make what? Sulfur dioxide and nitrogen oxide gases from motor vehicles, electric power generation, and industrial facilities react w/ sunlight and water vapor also from fireplaces, wood stoves, unpaved roads, crushing and grinding operations; blown into air by wind
Who are susceptible to health problems caused by breathing fine particles? elderly, children, asthmatics, persons w/ pre-existing heart or lung disease.
What can particulate matters also produce? Haze in national parks and wilderness, suspended in air and travel to form haze, also make statues and buildings dirty.
What is a primary component of smog and what can it cause? Ground level ozone; human health problems, children at risk since outside and lungs still developing, ppl can experience reduction in lung function from this.
What are the 2 chemicals that are main ingredients forming ground level ozone? Volatile organic compounds and nitrogen oxides.
Where do VOCs and NOx come from? VOCs released by cars burning gas, petroleum refineries, chemical manufacturing plants and other industrial facilities; NOx result from burning fuels causes the reddish brown color in smog.
What are responsible for VOCs and Nox emissions in the US? Motor vehicles and also account for 75% of CO emissions
What causes acid rain? Sulfur dioxide and nitrogen oxides these are released into the air and react w/ water vapor to form acids that fall back to the earth.
What are sources of acid rain? power plants (SO2), cars, buses, trucks and other transportation, power plants (NOx)
What are health risks for radon exposure? Number one cause of lung cancer among non-smokers, 2nd leading cause of lung cancer.
What has pollution control programs like wastewater standards and water quality standards in surface water? Clean water act, EPA.
What is nonpoint source pollution? Non-specific, unknown source. A point source is a source already known. From many diffuse sources, rainfall and snow melt runoff that carries what it picks up depositing them in water.
What are sediments? Fragmented materials that originate from weathering and erosion of rocks or unconsolidated deposits and are transported by, suspended in or deposited by water.
What are contaminated sediments? Many sediments have been contaminated by pollutants some released years ago and others enter water every day. Some flow in water, others from runoff and others carried through the air.
What are suspended and bedded sediments? Particulate organic and inorganic matter that suspend inor are carried by water &/or accumulate in a loose, unconsolidated form on bottom of water bodies.
What is source water protection? We get our drinking water from water in the area, requiring some treatment so need protection; protection of drinking water from public water systems, communities, resource manager and the public.
What act ensures we have clean drinking water from source to sink? Safe drinking water act; requires states to develop EPA approved programs to assess the waters in the state.
What sources are regulated by the national pollutant discharge elimination system? Municipal separate storm sewer systems, construction activities and industrial activities. Permits are needed before discharge as most are point sources; permits designed to prevent stormwater runoff from contaminating local water sources.
What is wastewater? Used water includes human waste, food scraps, oils, soaps and chemicals. Also includes storm runoff, harmful substances that wash off roads, lots and rooftops can harm rivers and lakes.
What is "effluent" in wastewater treatment? What is left after as many suspended solids are removed as possible.
How much suspended solids do "primary treatment" and "secondary treatment" remove in wastewater treatment? Primary removes about 60% of suspended solids (aeration occurs in this step) Secondary removes more than 90%.
What can wastewater pollutants do to aquatic life? Use of O2 in a lake so fish and other organisms cannot live, excessive nutrients like P and N cause eutrophication toxic to aquatic organisms -> excessive plant growth, alter habitat and decline in certain species; chlorine can be toxic to aquatic life.
What are biosolids? Nutrient-rich organic materials resulting from the treatment of domestic sewage in a treatment facility. These residuals can be recycled and applied as fertilizer to improve and maintain soils and stimulate plant growth.
What are landfills? Engineered areas where waste is placed into the land. Usually have liner systems and safeguards to reduce groundwater pollution.
What can combustion of municipal waste do? Reduce amount of landfill space needed and generate electricity.
What is hazardous waste? Waste that is dangerous or potentially harmful to our health or the environment. Can be liquids, solids, gases or sludges. Can be discarded commercial products like cleaning or pesticide agents or by-products of manufacturing.
What is the F-list in hazardous waste? Non-specific source wastes; identifies wastes from manufacturing and industrial processes like solvents or degreasers; known wastes from non-specific sources from industry.
What is the K-list in hazardous waste? Source specific wastes: Certain wastes from specific industries like petroleum refining or pesticide manufacturing. Sludges and wastewaters from tx and production porcesses in these industries are examples.
What are the P-list and U-list in hazardous waste? Discarded and commercial chemical products: Include specific commercial chemical products in an unused form. Some pesticides and pharmaceuticals become hazardous when discarded.
What is characteristic waste? Waste that have not been specifically listed may still be considered hazardous if it exhibits: ignitabilty, corrosivity, reactivity and toxicity.
What is ignitability? Ignitable wastes can create fires under certain cond'ns, are spontaneously combustible or have a flash point less than 60C.
What is corrosivity? Corrosive wastes are acids or bases that are capable of corroding metal containers like storage tanks, drums and barrels.
What is reactivity (characteristic waste)? reactive wastes considered unstable under normal conditions. Can cause explosions, toxic fumes, gases or vapors when heated, compressed or mixed w/ water.
What is toxicity (characteristic waste)? Toxic wastes are harmful or fatal when ingested or absorbed. When toxic wastes are land disposed contaminated liquid may leach from waste and pollute ground water.
What is noise pollution? Unwanted or disturbing sound. Sound becomes unwanted when it either interferes w/ normal activities or disrupts/diminishes one's quality of life.
What is the m ost common and often discussed health affect? Noise induced hearing loss; but research shows that exposure to high levels or constant noise can cause adverse health affects.
What was established under the clean air act to investigate and study noise and its affects on human life? Office of noise abatement and control later moved to state and local governments. EPA still investigates noise effects and disseminates the information.
What does the noise control act do? Establish means for effective coordination of federal research and activities in noise control, authorize establishment of federal noise emission standards for products of commerce, provide info to the public about noise and its effects
What authorized the EPA to provide grants to state and local governments for noise abatement? Quiet Communities Act of 1978
Created by: kabrown