lifestyle and respiratory disease Flashcards
what is the epidemiology of illness/mortality of respiratory disease
20%
Onset and progression strongly linked to lifestyle and other health related behaviour
what is the common cold
Upper respiratory tract infections eg colds and influenza
Account for 50% acute illness
A major cause for morbidity and mortality worldwide
how is the cold the most common illness
Caused by over 200 viruses
Rhinoviruses account for 30-50% adult colds
what is the incidence of colds
Children – 6 colds per year
Adults 2-3 colds per year
does exposure mean a cold will develop
Exposure to virus doesn’t necessarily means development of clinical symptoms and illness (1 in 3 exposed to cold get symptoms)
Iceberg analogy
can being cold cause a cold
Present scientific opinion dismisses a simple-cause effect link between acute cooling of the body surface and the common cold
how could acute chilling of the feet be linked to the onset of cold symptoms
Acute cooling of body surface causes reflex vasoconstriction of nose and upper airways which inhibits respiratory defence
Onset of cold symptoms caused by a conversion of asymptomatic sub clinical infection into a symptomatic infection
how does sleep link to colds
A possible explanatory host factor
Sleep quality is an important predictor of immunity
Graded link between sleep duration and efficiency to development of cold
can vitamin c effect colds
placebo-controlled trials of vitamin c mega dose
>200mg where RDI 40 mg
Prophylaxis and cold incidence
No sig reduction RR= 0.97
subgroup of marathon runners, skiers and arctic soldiers
Sig reduction RR 0.48 (halved risk of cold, only works in extremes)
Prophylaxis and cold duration
Sig reduction in adults RR 0.92 and children 0.86
Therapy and cold duration
No sig difference from placebo
can echinacea effect colds
placebo controlled trials of it
Prophylaxis and cold incidence
no individual trials revealed a significant effect, pooled results showed a 10-20% reduction in risk
can echinacea effect cold duration
no sig effect
although prevention trial drop out rates are higher for echinacea than placebo
Available echinacea products differ greatly (majority not tested in clinical trials)
can stress affect colds
Chronic stress increases risk of common cold
Assessment of duration and type of stressors
Current infection
Followed by introduction of cold virus
Developing cold not predicted by acute stress but is by chronic
what is risk of developing a cold also related to
Smoking Lack of exercise Poor sleep efficiency Drinking more alcohol Plus sig associated between smoking and chronic stress
how are social factors effecting colds studied
Pre exposure measures and follow up to detect disease
Sociability assessed twice pre-exposure extraversion
how do social factors effect colds
Increased subjective SES associated wit decreased risk of colds
Associated independent of objective SES
Cog, affective and social factors
Poorer sleep and health behaviours among lower SES may mediate associated between subjective SES and colds
what is a major behaviour linked to colds
Systematic review of impact of hand washing
8 studies, risk reduction 6-44%
Pooled results indicate that cuts risk of resp infection by 16%
how can psychosocial intervention for hand washing reduce risk of respiratory disease
430 students in 4 halls of residence 2 control Intervention Alcohol gel dispensers Sig increase in hand hygiene behaviour Sig reduction in symptoms
what is asthma
One of most common chronic diseases in the world
Most common chronic disease among children in developed countries
WHO estimate 300 million have it (prevalence increasing)
Asthma episodes incur large economic costs (treatment, lost productivity and social security costs)
Once considered purely psychosomatic
how do psychosocial factors affect asthma
Symptoms exacerbated by stress
induces changes in immunity contributing to exacerbation of symptoms/triggering attacks
Dysregulation of cortisol response may be important in chronic asthma
chronic stress leading to infection leading to acute stress on asthma
how do anxiety disorders effect asthma
In NYC immediately post 9/11
Mod to sev asthma symptoms rose from 14 to 24 %
More primary care and a and e visits
Increase risk irrespective of pre 9/11 symptoms
Demographic characteristics
About physical exposure to attacks
what exacerbates asthma in children and adolescents
inter personal conflicts
what are people with asthma expected to do
People with asthma are expected to monitor symptoms and use inhaler appropriately
Majority are unable to detect changes in lung function
No match between peak flow and self rated asthma
are psychological interventions for asthma effective
yes, Individualised asthma self management education
Improves medical adherence and clinical markers of asthma control
how are symptoms and medical outcomes effected
Perception of symptoms and medical outcomes are affected by anxiety, pessimism and perceived stigma
Likelihood of hospitalisation and duration of stay predicted better by psychological factors than objective symptoms
what is the incidence of lung cancer
Cancer of lung and throat = 7% of male and 5% of female deaths
how is smoking linked to lung cancer
Dose response effects linking number of cigarettes, depth of inhalation
Over 90% of lung cancer may be avoided by quitting smoking
Declines in smoking prevalence reflected in declines in lung cancer cases
what are other causes of lung cancer
Other causes include exposure to asbestos, radon gas, other radioactive substances eg uranium
how have declines in smoking prevalence effected lung cancer
Due to Individual behaviour change (psychological) and structural change (social)
Smokers are 18% of men and 14% of women
More common in lower SES groups
what are smoking cessation aids
Nicotine replacement Buproprion (zyban) Smoking cessation groups Education (eg quit line) Buddy systems Hypnotherapy Self-help/bibliotherapy
