HEP Flashcards
associated with accelerated telomere shortening
coping poorly with being the stress of a carer
pemissism
chronically poor sleep
workplace stress
a wandering mind -The greater the level of mind wandering, the greater the level of telomere shortening
DatarelatesCADriskto5specificpsychosocial domains
depression anxiety personality factors (anger n hostility, not Type A) social isolation chronic life stress
associated with shorter telomeres
smoking processed meat red meat in absences of resistant starch high BMI high homocysteine
associated with longer telomeres
VIT D folate omega 3 fatty acid vit C vit E
doctors get
liver cirrhosis
suicide
self care=\
good
self prescribe/self managing=bad
self care=good
self prescribe/self managing=bad
Workplace stress has been related to three main domains (Karasek and Theorell)
– Control
– Support – Demands
Lack of &
predictive factors for depression and anxiety
among mental health students
autonomy (control) & connectedness
reasons for using complementary med
enhance outcomes
reduce side effects
reduce costs
excessive noise is also associated with
decreased wound healing, sleep deprivation and cardiovascular stimulation
burnout
Emotional exhaustion, lack of personal accomplishment and depersonalisation
% of people using CAM for “serious medical conditions” were getting treatment from their doctor at the same time% did not inform their doctor
89
use of cam
prefer natural treatment
Dissatisfaction with conventional treatments,
Other studies suggest that patients were not generally dissatisfied with orthodox medicine
Looking for more holistic, natural and safer treatments
why pt use cam, most reason
phylosophical, cultural
least=more educated
ornnish program
group support
– stress management consisting of meditation and yoga – a low fat vegetarian diet
– moderate exercise
– stopping smoking
Mental health problems predicted to be the …..single burden of illness in Australia within 10-20 years
largest
• Prolongedstress(activationoftheSNS)leadsto
wear-and-tear on the body (allostatic load)
stress n immunity
Changes in white cell numbers and function start to occur within _ of the stressful event.
5 min
acute stress
activaite immunity
prolong stress
suppress immunity
Those who perceive that they have some control over their situation are buffered from stress and the consequent immuno-suppression
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during exam period get lowered — (these r immune stuff)
90% reduction in gamma interferon
S-IgA levels reduce too
Relaxation training associated with reductions of cortisol levels
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exercise
behaviour with highest advantage in NK cell activity (47 &
The greater the level of mind wandering, the greater the level of telomere shortening (a marker of biological age)
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Ifapersonwithheartdiseasehashelpwithstress management and social support they are far less likely for their CVD to progress
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default state n dementia
both have same regions in brain affected
Greater participation in cognitively stimulating activities
(particularly in early and middle life) associated with reduced amyloid uptake
leisure activities n dementia
Basic assumptions of mindfulness-based approaches
People generally operate on automatic pilot and unaware of moment-to moment experience
- We are capable of developing sustained attention
- Development of this ability is gradual, progressive and requires practice
- Awareness makes life richer and more vivid and replaces unconscious reactiveness
- Gives rise to veridicality (accuracy) of perceptions
- Awareness enhances perceptiveness, effective action and control
Mindfulness-Based Cognitive Therapy reduced relapse from 78% (what you would expect with usual treatment) to 36%
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Mindfulness-based stress reduction (MBSR) program =decrease in afternoon cortisol level
Mindfulness and cancer
Mindfulness and sleep
Better subjective sleep quality – Faster sleep latency
– Longer sleep duration
– Less use of sleep medications
Exercise activity tends to drop substantially from the age 18- 24 years to 25-34 years but then remains static
Least amount of activity is undertaken by middle-aged Victorians (45-54 years)
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In Australia inactivity ranks second to tobacco smoking in causing disability and death
– Inactivity accounts for:
• 6% of disease burden in males (second highest factor)
• 8% in females (highest factor)
inactivity n health
physical activty
= live longer
=if have cancer, reduce risk of death (increase cancer survival)
=decrease incidence of cancer
=Likelihood of mortality from a heart attack halved
=BMR n TEE increase
=reduced incidence of diabetes
=in healthy children profoundly alters: Stress/Immune, and inflammatory mediators / Oxidative mediators
=increased fertility
=reducing acute and chronic pain
=Very intense or prolonged exercise can reduce immunity
=protective against cognitive decline and stimulates neuronal growth particularly in the hippocampus
exercise Reduces risk of Alzheimer’s disease by half
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For non-exercisers a one unit increase in the stress scale related to a 15-fold increase in the odds of having short telomeres (a marker of rapid ageing and chronic illnesses)
For exercisers, perceived stress was unrelated to telomere length (i.e. exercise buffered against the effects of emotional stress on ageing)
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Overall recommendation is Benefit increases with
60-70% of VO2 max 3-7 times per week for 30-45 mins per day
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Caloric (or dietary) restriction (CR) extends lifespan and lowers risk for age associated diseases.
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empty calories’ – food with high energy load (sugars and fats) but little fibre and nutritional value due to food processing
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CR (calorie restriction) is not under-nutrition but rather eating a diet which is nutritionally rich and does not contain calories excess to requirements (empty calories)
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low levels of vitamin D are associated with poor mood.
llinkedwit low vit d -depression
Low vitamin D strongly associated with mood disorder (OR 11.7)
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Those with the highest intake of soy protein had a 29% lower risk of death
soy n cancer
cancer n food
soy, antioxidants, cruciferous vegetables, vit D, ornish program
help with cancer one way or another
what is a healthy diet
reduce total fat intake to less than 30% of calorie intake; reduce saturated fats
plus heaps of other stuff
83% of patients wanted doctors to ask about spiritual beliefs in various circumstances
Life-threatening illnesses (77%) – Serious medical conditions (74%) – Loss of loved ones (70%)
religious commitment protective for
Depressionandsuicide
– Substanceabuse
– Physical illness
– Longevity/mortalityrates
the most important protective factors for mental health and reduced risk of harm were ‘connectedness’ (esp. home and school) and ‘spirituality’- for Adolescents
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Religiosity
= protective agiasnt suicide (non church goes had 4x risk of suicide) =reduced risk for alcohol and drug abuse =live longer =protective against all-cause mortality =lower risk of CVD =reduced risk of colo-rectal cancer
Being unaffiliated with a religious group in medical school was the strongest predictor of future development of an alcohol problem
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Stress did not predict mortality risk among individuals who provided help to others in the past year (HR = 0.96), but did predict mortality among those who did not provide help to others (HR = 1.30)
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Fine particulate and SO-related pollution associated with all-cause, lung cancer, and cardiopulmonary mortality
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if diazanon was present in the men’s urine men they were ten times more likely to have low sperm count (infertility)
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sound leads to
Decreased wound healing – Sleep deprivation
– Cardiovascular stimulation.”
Too much sunlight – BCC, SCC – Premature ageing of skin – Cataracts Sunburn – Malignant melanoma
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1/3 of Australian population now vitamin D deficient
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Social isolation associated with double death rates independent of other lifestyle variables
Protective factors for health are:
– Marriage (unless very unhappily married) – Contact with family and friends
– Religious dimension / affiliation
– Group affiliation
Changes found in adolescents with significant depression such as smaller hippocampi indicating a reduction the brain’s production of hormones like brain- derived neurotrophic factor
BDNF is important for stimulating and maintaining brain cells
Mindfulness-based practices shown to produce positive changes on the brain including:
– Quietening the amygdala
– Enhancing executive functioning (e.g. attention regulation, emotion regulation)
– Stimulation of BDNF
– Thickening of grey matter in the memory and learning regions
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childhood issues e.g. parent loss = increased CHD issues in future throughout life e.g. high bp
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Family stresses and poor parental style associated with increased risk
of expressing a genetic disposition to asthma
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antisocial girls at high risk of: – mortality – criminality (10-40 fold) – psychiatric morbidity – dysfunctional relationships – using health support services
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Marriage protective for both men and women
Marriage, even if it is only moderately happy, is protective for depression and other mental health problems and as a buffer against stress
Recalling of marital conflict, particularly for women, can have a significant effect upon blood pressure and autonomic activity (CHD ISSUES)
Following an AMI men were three times as like to die from their heart disease in the following six months if they were socially isolated
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