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More of everything Flashcards

1
Q

Insulin resistance (/failure to produce enough insulin)

A

Adipocytes undergo hyperplasia and hypertrophy

This results in:

1) Overproduction and release of - leptin, retinol binding protein (prevents activation of glucose carrying proteins), EDGF (causes IR), inflammatory cytokines (e.g. TNFa, IL1/2), decreased adiponectin (that normal protects the endothelium), activation of the JNK and NFkB pathways
2) Muscle and hepatic fat deposition/TAG
3) Macrophages are recruited
4) Increased FFA in the blood stream - cause inflammation

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2
Q

Standard drinks

  • what is one standard drink?
  • how many drinks in standard bottles?
A

Standard drinks include:
12 oz beer, 5oz wine, 1.5oz 80 proof spirits

Bottles of:
750ml wine (5 drinks)
1L spirits (24 drinks)
750ml spirits (18 drinks)
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3
Q 
Sleep hormones at different stages:
Onset of sleep
First half of sleep
Second half of sleep
Awakening
A

At onset - melatonin rises
First half - melatonin continues to rise, leptin produced throughout sleep
Second half - melatonin gradually falls
Awakening - cortisol spike shortly after, cortisol gradually rises through sleep too

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4
Q

Stages of sleep

How many are there? And what are they?

A

4 stages:
Stages 1-3 of non-REM sleep
REM sleep

Stage 1 - several minutes, going from awake to asleep - high amplitude theta waves, very slow
Stage 2 - deeper sleep, slow brain waves with some brief bursts ‘sleep spindles’
Stage 3 - deepest sleep, slow waves, makes you feel refreshed ‘delta sleep’ (previously stages 3 and 4)

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5
Q

Benefits of MBSR programmes?

Whats the ACRONYM?

A

MBSR really (h)RELPS

1) Physical symptoms and psych symptoms
2) Loneliness in the elderly
3) Empathy and compassion
4) Resilience/ability to cope with stressors
5) Self-esteem

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6
Q

Nurses health study - how much physical activity is found to reduce all-cause mortality? By how much?

And how much doesn’t give any significant benefit?

A

1-1.9 hours a week gave all-cause mortality of 0.82

Whilst >7 a week didn’t give significant improvements

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7
Q 
Smoking quitting benefits?
Immediate
1 year
2-5 years
10 years
A

Immediate - 50% risk of acute MI
1 year - 50% of heart disease
2-5 years - stroke at baseline levels
10 years - cancer at 50% (lung)

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8
Q

Physical activity:

What benefits of RR of all-cause morality at what hours of exercise (The simple chart and the longer chart…)

And for MeTs and years of life gained?

At what level of MeTs is ‘most benefit’ achieved?

Another random stat - 150 minutes reduces mortality how much? 7 hours how much?

A

All-cause mortality and hours of exercise a week:

  1. 8 = 1.5 hours
  2. 7 = 3 hours
  3. 6 = 6 hours

Longer chart:

  1. 0 = 30mins
  2. 8 = 90mins (1.5 hours, same as above)
  3. 73 = 180 mins (3 hours)
  4. 64 = 330 mins (5.5 hours)
  5. 615 = 420 mins (7 hours)
In terms of MeTs and years of life
0-3.75/week = 75 mins = 1.8
3.75-7.5 = 90-150 = 2.5
7.5-15 = 200 = 3
15-22.5 = 400 = 4
\+22.5 = 500 = 4.5

10-20Met hours!

19% and 24%

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9
Q

Assessing fitness in the different domains:

Functional assessment?

Cardiorespirtatory (3 tests)?

A

Function - 6 minute walk test, compare pre and post intervention

CR fitness:

1) the step test - 3 minutes of stepping to metronome, rest for a minute, then measure heart rate, compare to charts
2) the rockport test - run/walk a mile, measure heart rate and time
3) sub ventilatory threshold test - easiest on treadmill, increase exercise going up by 5% heart rate until breathing rate changes, can’t say 5-10 word sentences

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10
Q

Physical activity intensities…

What different tests are there?
What are their different thresholds?

What thresholds correspond to what MeTs?

A

For each: very light/light, moderate, vigorous

Talk test: can sing/can talk/can’t talk

Maximum heart rate %: 63% or less, 64-76%, 77% or more

Heart rate reserve %: <40%, 40-60%, >60%

MeTs: <3, 3-6, >6

Borg scale of perceived exertion

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11
Q

USPSTF and alcohol

A

Grade B recommendation to assess and give brief advice

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12
Q

Epidemiology of sleep…

What is the average amount of sleep?
How many young adults get less than what duration of sleep?
What percentage gets less than 6 hours?

How many people have difficulty sleeping?
What percentage seek help?
What is the cost?

A

Average sleep is 6 hours 57

37% get less than 7 hours
20% get less than 6 hours

60 million
10% (6million)
60 billion dollars

ALL THOSE NUMBERS ARE LINKED

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13
Q

Results of low daylight?

On melatonin suppression?
On other aspects of life?

A
  • false blue light sensitivity

- decreased affect, mood, alertness and peak body temperature

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14
Q

The ACSM suggests how much exercise for obese patients?

A

250 minutes a week, with 60-90 minutes a day

Resistance twice a week

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15
Q

What is heavy drinking?

A
  • NIAAA defines heavy alcohol use as more than 4 drinks on any day for men or more than 3 drinks for women.
  • SAMHSA defines heavy alcohol use as binge drinking on 5 or more days in the past month.

I think the best for the course is exceeding 4/3 drinks in the past 30 days

Binge drinking and heavy alcohol use can increase an individual’s risk of alcohol use disorder.

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16
Q

Alcohol and the manual:

At what level do symptoms of impaired control develop?

What are the DSM thresholds for mild/mod/severe?

AUDIT thresholds and sensitivity?

A
  • Mild-mod is characterised by impaired control
  • 2-3, 4-5, 6+
  • 5-10 20%, 10-15 40%, 16+ 90%
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17
Q

AGEs - two things that make it more likely that I always forget…

conditions associated?

A

more trace minerals, more acidic or alkaline pH

Atherosclerosis, renal disease, poor wound healing, DM1 and 2

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18
Q

Poor sleep and mental health.

What factor is decreased?

What does poor sleep do in different diseases? (5)

A

BDNF is lower

Poor sleep associated with worsened depression, SAD, anxiety, PTSD (worse if sleep deprived) and TBI (worse if sleep deprived pre or post)

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19
Q

Treating diabetes mellitus…

Bypass - what remission at what time periods?

A

18-24 months - 39-83% remission (with weight losS)

5 years and 15 years - 30%

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20
Q

Physical activity and cancers…

Which cancers have evidence?
What threshold of exercise duration?
What % risk reduction?

A

(note that physical activity also reduces CAD by 20-30% in primary prevention)
Colorectal - 3-4 hours a week, 17-30%
Breast - 3-4 hours a week, 20-30%, also prevents recurrence and benefits treatment/side effects/mortality
Prostate - physical activity during and post treatment improves quality of life, symptoms, survival and cardiorespiratory fitness

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21
Q

Nutrition and cancer links…

A

Breast
Fruit and veg, soy
Obesity, red and processed meat

Colorectal
Fruit and veg, fibre, calcium
Red and processed meat

Prostate
Selenium, lycopene, whole food plant based

Gastric
Fruit and veg, antioxidants
Processed meat

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22
Q

The nurses health study showed what percentage of diabetes type 2 was attributable to what behaviours?

It also showed what about:
Meat consumption
Egg consumption

A

91% due to PI, smoking, obesity, poor diet, alcohol intake
(similar to the finings on 5 healthy behaviours and coronary artery disease risk)

Have regular meat or 5 eggs a week increased diabetes risk

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23
Q

Diabetes and physical activity - how much physical acitivity is sufficient to decrease risk?

What % decrease occurs? what about accounting for BMI?

Meta-analysis of brief advice vs structured exercise and HbA1c - what did it show?

A

150 minutes a week

31% and 17%

BA only works if diet advice also given, however structured exercise programmes had some HbA1c benefit

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24
Q

The nurses health study and health professional follow up study - diet/substitutions of saturated fat and heart disease…

1) Study by Joshipura showed what about fruit and veg intake?
2) Study by Li Y showed what about quintiles, and what about dietary substitutions?

A

1) Each serving gave a 4% decreased risk
2) The top quintile of intake, vs the bottom quintile for PUFA had 20% decreased risk, WG had 10% decreased risk, sugar and refined grains had 10% increased risk

Substituing 5% of daily intake of calories of saturated fat with PUFA gave 25% decreased risk, MUFA gave 15% decrease, whole grain gave 9%, whilst refined grains and sugar didn’‘t change anything

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25
Q

The nurses health study and health professional follow up study - substitution analysis of red and processed meats by Pan 2012

1) Diabetes - what did it show about meat? What about substitutions of meat?
2) Mortality substitutions?

A

1) HR for 1 serving of red meant is 1.12, processed is 1.32, total is 1.14, whilst 100g red meat gave HR 1.19, and 50g processed meat 1.51

Substituting with nuts/LF diary, wholegrain decreased this by 16-35%

2) Substriting nuts for processed meats gave HR 0.78, and red meat 0.83, and similar findings for other substitutions

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26
Q

Lyon heart study - follow up duration?
What outcomes?
What diets?

A

4 years follow up
Coronary event recurrence following MI (i.e. secondary prevention)
med diet protective vs AHA step 1 diet

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27
Q

Root causes analysis steps - beyond 3-5 why’s, so what and fishbone…

A

1) Analyse and discuss - what causes of main cause?
2) Research and interview IDT/patients, do process maps
3) Decide to address a few causes with PDSA cycles

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28
Q

Prescription for health

What is it?
Who did it?
Main findings or outcomes?

A
  • Study with 49 practices, looked at 4 behaviours (PI, tobacco, smoking, diet)
  • RWJF, AHRQ

4 findings:

1) Primary care is willing and able
2) Substantial practice redevelopment - patient-centred medical home
3) toolkit for health (defunct) and now ePSS
4) lots of studies

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29
Q

Chronic care models:

How many?
Name them…
Key principles

A

4 models

The chronic care model - MacColl institute and Ed Wagner - focusses on an activated patient and a proactive medical team, working with the community

The Innovative Care for Chronic Conditions - WHO - considers macro, meso and micro level care

Value based care

Chronic care manager model - AHRQ - patient centred care surrounded by IDT

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30
Q

Ed Wagners model…

Name it:
Key aspects?

A

The Chronic Care Model - MacColl institute and Ed Wagner

Community resources - co-ordinated and linked
Self-management - informed and activated patient
IT - decision support, integrated guidelines, reminder
Working under local and wider healthcare system

All together - productive relationships and better care

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31
Q

Group visits

What outcomes are improved?

A

1) Patient adherence
2) Peer support
3) Accessibility
4) Patient and provider satisfaction
5) Lower hospitalisation

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32
Q

What should the aims of an IDT be?

8

A

1) Advocate for LM
2) Utilise eMR and tech
3) Support self-efficacy
4) Optimise patient time/support/counselling
5) Utilise group visits
6) Utilise patient registries
7) Attain adherence
8) Implement good office workflows

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33
Q

Diseases of sleep

A

BIISS

Narcolepsy

Insomnia 3+, 6 months

Restless legs

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34
Q

Obstrutive sleep apnoea:

Prevalence, how many not diagnosed?

What is a positive STOP screening score?

Diagnostic test and cut off values?

A

Prevalence 26%
Undiagnosed 80%

STOP 2+ is high risk

Diagnosis based on sleep polysomnography - AHI/apnoea hypopnea index - <5 none, 5-15 mild, 15-30 mod, 30+ severe

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35
Q

NHANES III - 10000 people with BP

What did it show about counselling?

A

33% counselled on physical activity

71% followed the advice

36
Q

Intensive sleep therapies -

Which are evidence based?

A

Sleep restriction - EB and RCT support
Stimulus control - partially EB, RCT support
Relaxation training - not EB, RCT support
Sleep hygiene - no EB and no RCT

37
Q

Uses of melatonin - there are 2…

What causes an acute altering affect?

A

Jet lag
Circadian rhythm disorders

With B6 supplements (pyridoxine)

38
Q

Beta cell death:

How many factors kill them?
What are they?

A

5 factors in the book - LLONG (lipids, leptin, oxidative, glucotoxicity, NFkB)

1) Dyslipidaemia - V/LDL are pro-apoptotic
2) Glucotoxicity - IL1beta causese inflammation
3) Leptin - activates cytokine pathways
4) NFkB and JNK pathways
5) Oxidative stress - FFA, BM, NFkB, JNK

(note - others are mentioned at other times - e.g. macrophages, TAG - but this is the list they produce under the title of Beta cell death)

39
Q

B12 sources?

Folate sources?

A

B12 source is bacteria – found in animal products only - also supplements, fortified products

Folate - green leafy veg, peas, cruciferous veg

40
Q

Depression and CAD

What kind of RF is depression for what kind of CAD?

What does treating depression do?

What does having depression do? (3 different stats!)

A

It is a primary risk factor for developing CAD, and a secondary risk factor prognosis.

Treating increased quality of life, benefits symptoms, but no clear affect on survival

Our different stats:

1) twice risk of events - controlling for number of blocked arteries
2) Increased risk by 15-20% in CAD
3) OR of 2.5 for death/resus/arrest/MI in CAD

41
Q

How does depression compare to smoking in its relationship with mortality?

A

They are both equal and independent risk factors!

42
Q

Smoking and medicare - what can they get?

A

Prescribed and not over the counter NRT

They can try to quit twice a year, receiving 4 counselling sessions per attempt

43
Q

Intensity of counselling in medicare smoking cessation:

A

3-10minutes is intermediate

10 minutes or more is intense

44
Q

Alcohol use disorder and 12 month prevalence - split by gender

For mild AUD?

For mod-severe?

A

Mild - 10% male, 5% female

Mod-severe - 6% male, 2% female

(female about half both times)

45
Q

Anti relapse medication for alcohol use disorder:

What are the licensed and useful meds? (2 meds, 2 effects each)

What benefits do they provide?

What are the other 3 meds?

A

1) Naltrexone - reduces heavy drinking by 83%, overall drinking by 4%
2) Acamprosate - RR of any drinking 0.86, increases abstinence by 11 days, no effect on heavy drinking

Other meds:
(DONT use) Disulfuram - not tolerated/used
Gabapentin - abuse potential
Topirimate

46
Q

AUD interventions in Mild/at risk patients

3 interventions:

A

At risk/mild - brief advice, naltrexone, follow up booster sessions

47
Q

AUD interventions in mild-moderate groups

3 intervention points:

What is the comparison of medication and counselling?

What characterises this group of patients?

A

Mod:
Can be primary care led
ARM = counselling (=SSRI in depression)
Behaviour modification

Characteristic is features of impaired control of use developing - normally it is a 3-4 year episode and isolated.

48
Q

AUD interventions in severe: 3 interventions?

When do you refer?

What are risk factors for developing severe AUD?

A

Counselling, ARMs and manage withdrawal

Refer if impairment, failure or relapse

RFs include: family history, early onset, psychiatric disease, adverse childhood events

49
Q

Physical activity and obesity…

How many years of life lost comparing:

1) those who are overweight and sufficiently physically active with normal weight and sufficiently physically active?
2) Those who are obese and sufficiently physically active with normal weight and inactive?
3) Specific years of life lost for active obese II vs inactive normal weight?

A

1) they are the same
2) they are the same!
3) 4.7 and 4.5

50
Q

Sedentary behaviour

How does it compare to common other conditions?

Mortality contribution, what study follow up period?

Hazard ratio of TV watching?

Breaking it up helps how?

A

1) Prevalence at least twice HTN, smoking, hyperlipidaemia
2) 6.9% in a 2.8 year follow up of 222 thousand patients
3) 4 hour of TV a day - 1.5 (same as not being physically active)
4) 2 min walk in overweight 45-65 years olds every 20 minutes, lowered BM and insulin

51
Q

Physical inactivity is the 4th leading worldwide risk factor for premature death…

What % of premature death does it account for?
How about for different conditions (4)?
Reducing physical inactivity by how much would save how many worldwide deaths?

A

Reduce physical inactivity by 25% - save 1.3million deaths a year

10% of premature deaths

6% CHD, 7% DM2, 10% breast and colorectal cancer

52
Q

Sleep prescription - going EAST

Easier or harder than WEST?

Treating jet lag requires advancing or delaying your body clock?

What would you prescribe?

A

Travelling East is HARDER - when you arrive it feels EARLIER than the local time - and the body clock needs to be ADVANCED

Dim light at sleep time (which is easy because it’s naturally dim - e.g. you’ll think it’s 5pm but it’s actually 10pm)
Avoid bright light until ideal wake up time. Then get bright light.
Breakfast 30-45 minutes after ideal wake up time.
Melatonin 1 hour before sleep.

53
Q

Sleep prescription - going WEST

Easier or harder than EAST?

Treating jet lag requires advancing or delaying your body clock?

What would you prescribe?

A

It feels LATER than the actual local time. EASIER than going east. You need to DELAY your body clock.

Get bright early evening light.
Dim light only 1 hour before sleep (which is hard, because you’ll be tired having had a long day)
Complex carbs dinner 2-3 hours before sleep.
Breakfast 30-45 minutes after ideal wake up.
Melatonin 30-60mintues before sleep.
Bright light on waking

54
Q

Ornish - effects of lifestyle on telomeres…

Study length?
Patient group and number?

Key findings?

A

1 and 5 year follow up

Men with low risk prostate cancer 10 intervention, and 25 control

Findings:

1) Telomere length increased in Ix group by 0.06, and decreased in control by 0.03
2) Telomerase activity decreased in Ix by 0.25 and in controls by 1.08
3) Combined data showed adherence is related to telomere length

55
Q

Advanced phase body clock

A

Fall asleep early, wake up early.

Body clock is less than 24 hours.

56
Q

Delayed phase body clock

A

Most people have this, 24 hours and 8 minutes

Stay up late, wake up late

57
Q

Epidemiology of smoking:

Costs?

Total proportion of US deaths?

Disease burden:
CVD
COPD
Lung cancer

Kills what proportion of users?

A

Cost - 150 direct, 130 indirection (bn dollars)

1/5th of US deaths (twice that of physical inactivity)

CVD - 32%
COPD - 80%
Lung cancer 87%

Kills 50% of users

58
Q

From the US 2018 physical activity guidelines what are the key benefits mentioned from the following…

A single episode of exercise?

Within days-to-weeks?

What specifics does physical activity benefit…

A

1) A single episode improves - ABCDS - anxiety, blood pressure, cognition, insulin sensitivity (diabetes), sleep
2) Within days to weeks - lower disease risks, better function
3) Conditions benefitted (ABCDDDEF) arthritis, blood pressure, cancer, dementia, depression, diabetes, everything (Quality of life), fat (weight maintenance)

59
Q

Balance training - what is suggested?

For adults?
For older adults?

A

20-30minutes a day for adults.

60 minutes 3 times a week for older adults.

60
Q

Physical activity:

How much does it cost to transform someone from inactive to sufficiently active?

Being inactive costs how much extra a year?

An extra day of physical activity saves how much in health costs?

A

1) $500-5000
2) $1543 a year
3) 4.7% (essentially 5%)

the RULE OF 5s!

61
Q

Benefits of resistance exercise?

9 in total, split into 3 groups

A

3 musculoskeletal

  • Injury prevention
  • Bone mineral density and QoL in early post-menopause
  • Arthritis pain

4 weight and metabolic

  • Increased basal metabolic rate
  • Body fat and weight maintainance
  • NAFLD, independent of weight loss
  • Improved BM and cholesterol

2 others

  • Sleep and fatigue
  • Heart muscle function
62
Q

Benefits of balance exercise in a systematic review:

4 groups…

A

Reductions in the following:

Falls resulting in injury - 37%
Falls resulting in medical care - 30%
Falls resulting in severe injury - 43%
Falls resulting in fracture - 61%?

63
Q

Benefits of flexibility…

In OAPs?
In diabetes?

A

in OAP - hip flexor stretch improves gait

in diabetes type 2 gives a small improvement in BM (post prandial and fasting) and HbA1c

64
Q

The Israeli Health study showed what?

How many Drs and how many patients?

A

A 13.7% (max) relative improvement in patients if doctors complied with screening and vaccination practices (8 practices looked at)

429 and 1621 respectively.

65
Q

When considering the minimum amount of exercise…

Does standing help?

What did the Shanghai Women Health study show?

The nurses health study showed what about RR and moderate physical activity?

In cardiovascular disease what was the relative risk and life expectancy gain of low active vs inactive patients?

A

2 hours standing a day - 10% decreased all cause mortality

SWHS - 4 hours NEAT (HR 0.6), 1 hour walk (HR 0.65) - both 40% reduction

NHS showed RR 0.82 for 1-1.9hours a week, minimal significant improvement over 7 hours

Low active (15mins/day, 90/week) had RR 0.86 and 3 years increased life expectancy

66
Q

What is the FRIEND database?

A

A national VO2 max database

67
Q

Sleep:

When do you stop working?
When do you wind down?

What intensive therapies are there?

A

Stop working 90 minutes before bed
Wind down 60 minutes before bed

CBTI - CBT for insomnia - first line over medication for insomnia

Also sleep restriction, and stimulus control

68
Q

Sleep fragmentation:

A

Dark room, allow to cool, water by bedside
Red light if necessary when getting up
Increase late afternoon hydration, avoid after dinner

69
Q

Waking up too early

A

Use blue spectra until one hour pre bed
Don’t have caffeine until 30-60minutes after wake up
Carbs at dinner

70
Q

Grandes et al study

Patient population and how many?
Main findings?

What % are meeting the guidelines? OVerall and with prescription by age?

A

29 and 27 practices, 2248 and 2069 physically inactive patients. 6 month follow up, 7 day PA recall.
Brief intervention, 30% with prescription Vs current care

Overal: 18.1 minutes increased PA more than controls, 3.9% more meeting guidelines (NNT 26)

With prescription: +131mins (actually 67) for >50s, +31.5 for <50s, 11% and 7% meeting guidelines

3.9, 7, 11

71
Q

Grandes study:

Just tell me the %s that met guidelines

A

3.9%, 7% and 11%!

72
Q

Primary care physical activity counselling, Orrow, meta analysis (published BMJ):

OR for effectiveness at how many months?
NNT for sedentary to meet guidelines at how many months?

A

In 13 trials presenting self reported physical activity:
Positive intervention effects at 12 months (odds ratio 1.42).
NNT = 12 at 12 months

73
Q

Health promotion clinics - the study

what did they do? main conclusion?

A

66 primary care practices bs control group

Given resources and pedometers

31% increased recall of patients being given advice

Therefore advice and resources possible in PCP

74
Q

Exercise versus medication…

4 conditions and medication comparisons.

Study by Naci and Ioannadis - how did they do the study?

A

Exercise better treating post stroke

Equivalent post MI and in pre-diabetes

Worse than medication in heart failure (though meds + lifestyle probably best)

305 RCT meta-analysis, n=339000

75
Q

Physical activity and ischaemic heart disease prevention - what are the key stats on:

What percentage primary prevention?
Number of calories?
Active commuting?
What vascular conditions are affected?

A

20-30% primary prevention - the same as breast and colorectal (17-30%)
550cals a week, dramatic redcution
HR of active commute 0.892
IHD, PVD, CVA, HF - complications and mortality decreased

76
Q

Wellbeing self-management - 5 techniques

A

PATCH!

Problem solving
Assertiveness
Time-management
CBT techniques
Humour (sense of humour development)
77
Q

Nutrition specifics in depression:

1) How do specific fats relate to depressive symptoms
2) In ___ women ____ is lower…
3) Do omega 3s help? In which populations (2)?
4) Some evidence the folate and fish oil may benefit…

A

1) Transfats associated with higher depression, poly/mono-unsaturated fats are associated with decreased depression (weakly)
2) Child-bearing age - various nutrients deficiencies increased risk of depression
3) Some evidence that omega 3s work in patients with bipolar for managing depressive periods. Additionally, if they are low in pregnancy then depression is more likely.

78
Q

How to escape suffering?

A

COATEd

  • Connect not disconnect
  • live in ORDER
  • Attention not inattention
  • be aware of THOUGHT PATTERNS
  • Ease not dis-ease
79
Q

In intensive lifestyle interventions, what 3 scores/aspects of mental health have been shown to improve?

In what studies?

A

Beck depressive index, social function and mental health

In Thiezen looking at CHIP, and in Kelly using a multi-centre study

80
Q

Making an emotional action plan:

4 stages - it has a 4 letter acronym

A

PATS

1) What emotional problem?
2) What action?
3) What timeline/follow up?
4) What support?

81
Q

The stages of changed - stage matched interventions:

Pre

Cont

Plan

Act

Main

A

P - discuss general risks of specific behaviours

C - specific to patient, benefits/risks/impact

P - work on confidence/readiness, collaborative action plan, modify environment

A - CBT/problem solve, refine action plan, improve confidence, identify support

M - revise goals/motivation, revisit values

82
Q

10 causes of death in the US

One ridiculous acronym

A

Having Cancer Can Affect Some Armadillos During Itchy Nose International

Heart disease
Cancer
COPD/chronic resp diseases
Accidents
Stroke
Alzheimers
Diabetes
Influenza and pneumonia
Nephritic and other renal issues
Intentional injuries/suicide
83
Q

2 key determinants of behaviour - relating to doctor/patient/community relationships

A

Good provider-patient trust

Support system including IDT, social, and community

84
Q

The longer PA mortality chart…

A

Longer chart:

  1. 0 = 30mins
  2. 8 = 90mins (1.5 hours, same as above)
  3. 73 = 180 mins (3 hours)
  4. 64 = 330 mins (5.5 hours)
  5. 615 = 420 mins (7 hours)
85
Q

ACSM guidance on increasing physical activity:

Name the phases…
And detail the phases…

A

Initiation (2-8 weeks)- intervals, 15-30 minutes, 2-3 per week, 40-60% HRR

Improvement 4-8 months :
Increase HRR by 5% every 6 sessions
Increase duration by 20% a week

Maintenance:
When 50th centile

86
Q

USPSTF guidelines on depression

USPSTF on anxiety

A

Grade B - you must screen if you have resources to help

No recommendations on anxiety

87
Q

Whats the other model like the transtheoretical model?

A

Precaution model - 7 stages - linear

aBaSLM (10 decks)

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