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Med soc > Final Quiz > Flashcards

Final Quiz Flashcards

1
Q

____ of Do Not Resuscitate orders are written within ____ days of death

A

1/2, 2

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2
Q

Need for Palliative Care (late 1800s)

A
  • little to offer patients beyond easing symptoms
  • most died at home care for by family within days of illness onset
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3
Q

Need for Palliative Care (early to mid 1900s)

A
  • health care shift from comfort to cure
  • death became equated with medical failure
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4
Q

Medicine’s focus shifted from _____ (early 1990s) to _____ (current)

A

Comfort; cure

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5
Q

Site of death/caregivers shifted from ___/____ (early 1900s) to ____/_____ (current)

A

Home/family; institutions/health care providers (strangers)

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6
Q

4 dimensions of dying

A

1) physical
2) social
3) psychological
4) spiritual

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7
Q

4 paths to death in Palliative Care

A
  • slow decline, periodic crises
  • lingering, expected death
  • sudden, unexpected death
  • steady decline, short terminal phase
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8
Q

Barriers to Quality Care at the End of Life

A
  • failure to acknowledge the limits of medicine
  • lack of training for health care providers in discussing dying
  • hospice/palliative care services are poorly understood
  • rules and regulations
  • denial of death
  • inadequate pain/symptom management
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9
Q

D- Hospice

A

A delivery system that provides palliative care for patients with limited life expectancy who require comprehensive medical, psychosocial & spiritual support

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10
Q

Hospice includes…

A
  • interdisciplinary care
  • medical appliances and supplies
  • drugs for symptom and pain relief
  • short-term inpatient and respite care
  • homemaker/home health aid to relieve caregiver burden
  • counseling, spiritual care, bereavement services
  • volunteer services
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11
Q

The number of hospices has increased by ____% since 2014

A

13.4

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12
Q

General Principles of Palliative Care

A
  • patient & family as a unit and they set the goals, their education & support is focus
  • attention to physical, psychological, social & spiritual needs
  • interdisciplinary team approach
  • extends across illnesses and care settings
  • continues after death with bereavement support
  • both curative and life-prolonging care might be offered with palliative care (unlike hospice)
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13
Q

Interdisciplinary team for Palliative Care

A
  • volunteers
  • physicians
  • counselors
  • social workers
  • spiritual & bereavement counselors
  • hospice aides
  • therapies
  • nurses
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14
Q

What does palliative care do?

A
  • addresses suffering (physical, psychological, spiritual/existential
  • improves quality of life (assess/manage pain and other symptoms)
  • provides a team approach to their care (patient and family decide what their goals of care are (not the healthcare team))
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15
Q

Impact of Palliate Care (life span)

A

Those who received earlier palliative care lived longer

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16
Q

Role of nurse in improving palliative care

A
  • some things cannot be “fixed”
  • use of therapeutic presence
  • comfort care (pain, secretions, wounds, constipation, etc)
  • administration of medications, therapies
  • patient, family needs
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17
Q

Payment for Hospice

A
  • medicare
  • Medicaid
  • most private health
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18
Q

Payment for palliative care

A
  • philanthropy
  • fee-for-service
  • direct hospital support
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19
Q

Hospice Medicare Benefit Eligibility Criteria

A
  • patient’s doctor and hospice medical director us their best clinical judgment to certify that the patient is terminally I’ll with a life expectancy of six months or less, if the disease runs its normal course.
  • the patient chooses to receive hospice care rather than curative treatments for his/her illness
  • the patient enrolls in a Medicare-approved hospice program
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20
Q

Is Palliative care cheaper?

A

Yes, because fewer lab/diagnostic tests & medications were prescribed

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21
Q

3 problems preventing the practice of palliative/hospice care

A

1) insufficient attention to palliative care in medical and nursing school criteria
2) educational silos that impede the development of inter professional teams
3) deficits in equipping physicians with sufficient communication skills.

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22
Q

Some states allow terminally ill patients decide ____________________________________ if their suffering becomes unbearable (not legal in PA).

A

How and when they will end their life

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23
Q

COVID: Quarantines of large cities and home confinement occured even for ___________ persons

A

Unaffected

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24
Q

COVID: Despite lack of evidence, _______ demands for buying masks occured _______.

A

Enormous; world-wide

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25
Q

COVID: in rare event, some countries ____ their borders and _____ their flights

A

Closed, restricted

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26
Q

COVID: one of the most important consequences of coronavirus is the creation of _________ _________ world-wide

A

Social anxiety

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27
Q

D- risk society

A

A systematic way of dealing with hazards and insecurities induced and introduced by modernization itself

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28
Q

Coronavirus outbreak shows that risk society leads to a ______ _______

A

Vulnerable society

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29
Q

COVID cause vulnerable society because (3 reasons)

A
  • social interactions
  • institutions
  • cultural values
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30
Q

Why was the COVID outbreak different from any other disease outbreak?

A

It caused a world-wide sense of fragility of human biological life and created demands for “sterile society” (safe from any hazards)

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31
Q

“Sterile society” is founded in human demand for _____ and _______.

A

Eternity, perfection

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32
Q

COVID responses in some countries were ________ _________ policies

A

Rediculous; nonscientific

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33
Q

COVID: Fouchi said ___% of cases were mild in the beginning of the pandemic

A

85

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34
Q

COVID: What is needed to have a change in both behavior to environment and actions in facing crisis

A

A new interdisciplinary approach with cooperation of sociologists, philosophers, anthropologists, virologists, epidemiologists, and public health experts.

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35
Q

COVID: current societies are vulnerable both __________ and _________, so resilience needs to be improved on the _____, ______, ________, and _______ level.

A

Biologically; mentally; biological; mental; social; spiritual

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36
Q

The US had the worst records of ______ and ________ to COVID

A

Response; spread

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37
Q

Sweden did not lock down (accepted high _____) in response to covid because they wanted ________.

A

Risk; Heard immunity

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38
Q

D- heard immunity

A

Form of indirect protection from infectious disease that occurs when a sufficient percent of a population has become immune to an infection, whether through vaccinations, or previous infection, thereby reducing likelihood of infection for individuals who lack immunity.

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39
Q

COVID: There is ______ evidence that masks & lockdowns stopped the spread

A

No

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40
Q

COVID: ________ is not equipped to handle the pandemic, despite its ideas circulating in public discussions

A

Sociology

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41
Q

3 Factors of Medicalization

A

1) powerful medical authority
2) social movements
3) organizational/professional activities (competing authority for defining/treating problems)

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42
Q

Historical evolution of the Sociology of Deviance and Social Control

A

Sin —> crime —> illness

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43
Q

D-Medicalization

A

The process by which nonmedical problems become defined and treated as medical problems, usually in terms of illness and disorders

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44
Q

Growth of medical jurisdiction (where/when it mainly happened)

A

20th century in the West

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45
Q

Conrad’s point is to understand the ______ _______ of the expansion of _______ ________ and the ________ __________ of this development, so it is the ________ of the designation rather than the ________ of the diagnosis that is of greater sociological concern.

A

Social underpinnings; medical jurisdiction; social implications; viability; validity

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46
Q

Agents of social control

A

Police officer
Priest
Physician
Judge
* more people today can exercise social control

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47
Q

Where do agents of social control get their power

A

They are able to define something that people don’t know (knowledge is power)

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48
Q

Social factors that contributed to the process of medicalization

A
  • faith in science, rationality and progress
  • increased prestige of the medical profession
  • Americans’ love of individual and technological solutions
  • the humanitarian trend (take blame of ppl’s bad deeds off them and place it on their “illness”)
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49
Q

Medicalization is not a ________ process, its _________.

A

Unidirectional; bidirectional

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50
Q

_______ _______ and _______ _______ are often considered steps towards the “De-medicalization” of a condition or illness

A

Holistic health; alternative medicine

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51
Q

Masterbation

A

Was medicalized in the 19th century until being de-medicalized

52
Q

Medicalization is profitable for ________ and ________ companies

A

Pharmaceutical; biotechnology

53
Q

By the 1980s, ______ _______ had eroded, and health policy shifted from ______ to ____ ______ and ______ _______

A

Medical authority; access; cost control; Managed care

54
Q

In the 1980s, doctors remained dominant in the process of medicalization, and were joined by…

A
  • patients
  • pharmaceutical companies
  • insurance companies
55
Q

“Third Party Payers”/Insurance companies ______ but don’t _______ medicalization

A

Limit; undermine

56
Q

Medical Markets as a model

A
  • advertising designer drugs (DTC)
  • standardization of medical services into “product lines”
  • patients = consumers
57
Q

Cosmetic psychomarmacology

A

Cosmetic surgery (medicalization + medical markets)
- not covered by insurance
- many take out loans for it (nose job or car?)
- lots of advertising
- makes you feel better about yourself/improves mental well-being –> illness

58
Q

SSRIs

A
  • selective serotonin reuptake inhibitor
  • among most perscribed psycho-active drugs, include Paxil and Prozac
59
Q

What began the beginning of the “depression market” of drugs?

A

Paxil

60
Q

DSM-IV (anxiety)

A

Recognized Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD) as “illnesses/disorders,” leading to a new era where Medicalization begins to market diseases.

61
Q

“Post-Prozac” Era

A

Marketing diseases and then selling drugs to treat those diseases in now common

62
Q

DTC ADs for Paxil…

A

Promote validity of a condition and explained it could happen to anyone (was common but wrong)

63
Q

Backlash of Paxil

A

2002- Federal judge ordered temporary halt to Paxil ads over the claim that Paxil is not habit forming

64
Q

“The case of Paxil demonstrates how ________ _________ are marketing _____ not just _____.”

A

Pharmaceutical companies; diseases; drugs

65
Q

“Ask your doctor if [x] is right for you”

A

Physicians role in medicalization decreases and pharmaceutical influence increases.

66
Q

Food and Drug Administration Modernization Act of 1997 (FDAMA)

A

When a drug is not FDA approved, doctors can recommend it to anyone, so commercials can advertise off-label uses and include less risk information

67
Q

Social Anxiety Disorder Prevelance

A

3-13% of Population - American Psychiatric Association
3.7% - National Institution of Mental Health

68
Q

Male bodies are ________ but _________ medicalized

A

Increasingly, partially

69
Q

Women’s bodies (medicalization

A
  • more medicalized than men
  • b/c their processes are more visible —> higher vulnerability
70
Q

Increased _______ _______ __ ___ _____ as a realm of inquiry, considering demand for products dealing with the Aging process and the body as an “artifact”

A

Sociocultural construction of the body

71
Q

Bodily production of testosterone ______ ________ with advancing age

A

Naturally declines

72
Q

1889 - endocrinologist Charles Edouard Brown Sequard does what?

A

Makes the connection between testosterone and aging by injecting himself with testicular fluids from animals

73
Q

Researchers are more interested in ______ than ______.

A

Masculinity; femininity

74
Q

While _____ includes the lists of fertility as the primary pathological event in its definition, ________ does not include declines in fertility in its definition

A

Menopause; andropause

75
Q

Researchers are working to prevent the “_____” decline in Testosterone with age in order to preserve _____.

A

Abnormal; masculinity

76
Q

Decline in testosterone causes…

A
  • lower libido
  • depression
  • fatigue
  • loss of gonad function (NOT UNIVERSAL)
77
Q

ADAM (acronym)

A

Androgen Deficiency in Aging Males

78
Q

Doctors are _____ if andropause exists

A

Unsure

79
Q

Testosterone (T) Therapy (pros/cons)

A

Pros:
- provides hope for men
- provides media interest
- provides potential profit
Con:
- can cause liver failure
- not sure about safety/efficacy

80
Q

~ _________ American men take Testosterone supplements

A

1.5 million

81
Q

Losing one’s hair, or “__________ ______” is a _______ or ______ bodily occurrence

A

Androgenic alopecia; normal; common

82
Q

Who is the standard studied for measuring health

A

White, European, middle-class, heterosexual, males

83
Q

Dihydrotestosterone

A

Hormone that causes hair follicle to produce fine, unpigmented hair common in baldness

84
Q

“Androgenic Alopecia” becomes a medical condition when hair loss is ______.

A

Excessive

85
Q

Possible cures for baldness

A
  • hair transplants
  • medications (Rogaine & Propecia)
86
Q

Rogain (baldness)

A
  • $300/year
  • medication initially made to lower heart rate
  • causes thick hair to grow
  • 1996: FDA approved OTC use
87
Q

Propecia

A
  • $600/year
  • stops progress of balding (must take for rest of life to prevent balding)
88
Q

In 1992, erectile dysfunction was officially recognized as ____ and not _______.

A

Biogenic; psychological

89
Q

ED treatments before viagra

A

Penile surgery, implants, injections

90
Q

March 1998 - FDA approves _____ as a treatment for ED

A

Viagra

91
Q

Market for viagra

A

Aging “baby-boomers”

92
Q

~___________ men have ED in the US

A

10-20 million

93
Q

Keys to Viagra (and other ED meds) success

A
  • DTC advertising
  • focus on sexual enhancement
  • focusing on ED
94
Q

Viagra __________ ED through advertising

A

De-stigmatized

95
Q

Insurance companies ____ __ ____ ___ cover viagra

A

May or may not

96
Q

Most criticism of ADHD comes from ______ and ______ of middle-aged men.

A

Overdiagnosis; treatment

97
Q

___% prevelance of ADHD in adult men

A

44

98
Q

Media prevalence (lay groups) and influence caused adults to ______ ________ with ADHD —> medicalization

A

Self-diagnose

99
Q

Forces behind medicalization

A

Biotechnology, consumers, and managed care

100
Q

Every $_ spent on DTC advertising, pharmaceutical industry makes $___ in sales

A

$1, $4.20

101
Q

Managed care came to dominate the US healthcare delivery system because of _______ _____

A

Market-driven costs

102
Q

Physicians have ___ power but are the ______ of medicalization; big pharma is the new _____ ______ in the process

A

Lost; gate-keepers; major force

103
Q

3 most widely recognized medicalization drugs

A

Paxil, Viagra, Claritin

104
Q

Pharmaceutical companies BOTH _____ __ and ____ ___ medicalization

A

Invest in; profit from

105
Q

Socialized medicine (unlike managed care)

A
  • no preapprovals
  • no constraints on docs/patients
  • frees limits on all types of care
106
Q

Managed care: ____ over patient

A

Profits

107
Q

Managed care/insurance affects Medicalization by…

A

What is not covered

108
Q

Medicalization driven by _______ and _____ interests, not professional claim-makers

A

Commercial; market

109
Q

Lifestyle orientation arguments have included:

A
  • LGBT
  • anorexia
  • obesity
110
Q

Medicalization has ______, and ______ ______ involved are fueling its _______.

A

Increased; powerful forces; expansion

111
Q

Conrad is concerned about _____-medicalization with _____ _______.

A

Over; no end

112
Q

Conrad two important points about his work

A

1) doesn’t argue if problems are really medical (not qualified), but that not inherently medical problems are medicalized
2) does not deny the possibility of biological & physiological bases for problems

113
Q

Benefits of medicalization

A
  • harm reduction
  • blame reduction
  • increased life opportunities
114
Q

Critical concern with widespread medicalization

A

The transformation of many human differences into pathologies
Any difference is at risk of being medicalized, which erases tolerance and appreciation with the diversity of human life

115
Q

No matter how much _____ __ _______, the reporting of ______ ______ continues to rise

A

Health is improved; health problems

116
Q

Americans have increased advocacy for medicalization because they have decreased…

A

Tolerance for uncomfortable body states

117
Q

Medical definitions of normality

A
  • should medicine define “normal”?
  • should we maintain prime (youthful) body functions until death?
  • reasonable to treat kids for acting up/being energetic/challenging authority?
  • should big pharma be able to make and produce medications for these markets?
118
Q

D-“Medical surveillance”

A

Increased monitoring of individuals for illness/potential illness/genetic susceptibility

119
Q

Social medical control is _____.

A

Expanding

120
Q

D-“The medical excuse”

A

More forms of behavior are no longer deemed the responsibility of the individual

121
Q

D-“the individualization of social problems”

A

Where the focus is on the individual rather than the social context

122
Q

___ _____ Movement and ___ _______ movement fought for demedicalization

A

Gay rights; disability rights

123
Q

Conrad: unlikely that DTC advertising will ______.

A

Subside

124
Q

D- current risk society

A

Characterized by obsessions with insurance and security— people may not have symptoms, but their condition may still be medicalized

125
Q

Forces of medicalization (companies, docs, insurance, patients, etc) ____ recognize aging as inevitable and untreatable my medicine

A

DON’T

126
Q

There _____ agreement among medical professionals, physicians, and scientists around the world about Conrad’s POV on medicalization

A

ISN’T

Med soc (4 decks)

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