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HSM330 nov 15 lecture

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Ryerson University
Health Services Management
HSM 330
Daolun Chen

Lecture#8HealthandAging • cannot separate mind from body • our biomedical system puts healthcare in compartments so if you have hurt your arm, you’d see an orthopedic specialist which does not assess how it affects the mind • if you have a psychological problem, therapist would likely not ask about physical problems • must take a holistic view, and look at the person in their entirety: body and mind • using humor is important as well; laughter is important for stress • the hangover clip showing stress • siegfried and roy are two people that work with tigers (stress related jobs); tiger attacked one of the people’s throats and both suffered from depression • the older we get, the more losses we have to deal with; losses of children, grandparents, parents, financial losses of jobs or businesses, loved ones • some people lose identity (language barrier or new way of living in a new country) • elderly must face loss of physical ability Currentevents • falls are most common cause of major injury that requires hospitalization for seniors • falls are responsible for 1/5 of all severe injuries to trauma facilities • 2004-2008 research: increase in # of severe injuries of falls in ontario; 20% increase from 04 and 08 • not having enough money causes stress; this is stressful for hospital administrators (health administrators); people can run hospitals; they run hospitals and there is a finite amount of money available; ontario hospitals have to cover a new expense: registered practical nurses and support staff at 60 facilities will be getting an incraese in salaries by 2%; problem is that budget awarded to hospitals was only a 1.5% increase; arbitrators 16 000 unionized workers; unionized workers are getting increases, whereas management and non-unionized workers do not, but we don’t have the money • in new year, likely lay-offs and service cuts will be prominent most probably • diet causes stress; research this past week shows women who drink 1 or more servings of sugary drinks or orange juice may be increasing risk for developing GOUT; gout doesn’t normally afflict women so this is a new revelation; gout is a type of arthritis and occurs when uric acid crystals form in joints (most common in big toe or ankle and causes pain and swelling for someone who has it); painful; risk of gout increases after menopause and so this research points out that as we age, we should be a little more aware of what we eat and drink • diet soft drinks were not associated with risk of developing gout • stress if occuring everyday • 2 weeks ago, someone in apartment on welsley street found a snake in their bed • you can’t avoid stress but you can learn to adapt to it • some people respond to stress in different ways: overeating, alcohol, drugs • smiling, laughing, enjoying life are things you can do to deal with stress • we need to learn how to talk about what is affecting us; this will be a stress relief if you don’t trust anyone, keep a journal; sometimes writing things out helps • • escaping from world helps; seeing a movie, taking a long walk, reading a good book • mcgill university, montreal: soldier would know stress (ruminate about things that happened before); PTSD is common among soldiers; neuroscientist Dr. Kareem Nadar investiaged effects of PTSD and he has been looking for ways to dull the pain or to turn a traumatic memory into something less intense; key is that we have to block the emotional response (cannot delete it but you can block some of it); there is an emotional stimulus that occurs that triggers emotion; once memory has formed, it is stored in brain and can’t be changed but now he has found that memory can be altered before it is filed away in brains and very act of remembering things can be changed so that memory can be changed; he calls this process memoryreconsideration -during reconsideration phase, that is the best time you can block the emotional response associated with memory; when you block it he calls it reconsolidation blockage; when we remember things, adrenaline is released and hormones can boost memory of certain events; knowing about effects of hormones, research that dr. nadar has been conducting has also led him to working with a psychiatrist and they are also using medication; this medication is propranolol (common medication - beta blocker developed 40 years ago) given to patients with angina or high blood pressure • research shows that if medication is given a few hours after trauma, there is a possibility that these people won’t develop pain of PTSD; when they conducted a study and recruited people that suffered from PTSD, researchers found that people who took propranolol showed a more muted response as a result of the trauma; nadar says that memory of event remains in tact but medication prevents emotional and physical response; this is ongoing research • another form of stress is prospect of losing a job; this is prevalent especially in our current economic situation; uncertainty causes people to lose their job; cardiologist in boston dr. michelle albert; she looked at people 17415 participants (all women) found that women suffering from stress were likely to suffer with blood pressure problems, heart disease, and problems with weight gain and cholesterol; women she looked at were healthy, 57 on average, working fulltime or part time, conducted study from 1999-2009, they were professionals from nurses aid to Ph. D and they filled out surveys rating their jobs and they were particularly looked at women who did not feel like they had much control over their job; research showed that women worried about losing jobs and those that worried the most, had more problems with blood pressure, cholesterol, body weight • stress causes the fight or flight response and these hormones cause inflammation and raise the blood pressure; according to participant (46 years old) said she was dealing in a call centre with a lot of stress; she suffered from heart problems of summer 2008 (chest pains and collapsed while walking one night); doctors gave nitroglycerin pills • in the past, men were focused on stress in job, but women experience it as well • exercise is great for relieving stress and learning how to relax is great • people should unwind and relax at home withou
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