Secondary Prevention Final Study Guide combined

Secondary Prevention Final Study Guide combined - Assessing...

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Assessing Depression and Anxiety including Rates of depression Rate of depression among the medically ill is: 5 to 10% Up to 14% of hospitalized patients More severe medical illness more severe depressive symptoms Specific conditions: Heart disease : 40-65% after MI Stroke : 10-27% in first year; 15-40% experience some symptoms Cancer : 1 in 4 patients Diabetes : 25% ; up to 70% with complications DSM-IV criteria for depression Dysphoria Anhedonia Self-esteem Hopelessness Guilt or worthlessness Concentration Changes in appetite, sleep, energy Psychomotor retardation or agitation Suicidal ideation Criteria Major: At least 5 s/s Dysthymia: At least 3 s/s NOS: Between 2-5 At least one must be dysphoria or anhedonia Symptoms must: affect functioning occur most of the time last > 2 weeks dysthymia: last > 2 yrs Substance Abuse and Addictive Behaviors including Common definitions, DSM-IV criteria for abuse and dependence Alcohol: current drinkers - at least one drink in past 30 days 51.8 % of US population aged 12 or older binge drinking – 5+ drinks on the same occasion at least once in past 30 days 22.7% of US population aged 12 or older heavy drinking - 5+ drinks on the same occasion on each of 5+ days in the past 30 days 6.6 % of US population aged 12 or older Illicit drugs: Current use - at least one use in the past month 8.1% of Americans aged 12 or older Diagnostic and Statistical Manual ( DSM-IV ) criteria: when substance use becomes a disorder Substance Abuse One or more within a 12 month period Failure to fulfill major role obligation
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Recurrent use in hazardous situations Recurrent legal problems Recurrent social or interpersonal problems Substance Dependence* Three or more within a 12 month period Tolerance Withdrawal Larger amount/longer time than intended Persistent desire to control use Great deal of time spent in activities related to use Other abuse criteria Secondary Prevention of Cancer Cancers Appropriate for screening 1. The cancer must present a clear threat to morbidity and mortality 2. The cancer must have a preclinical phase that has high prevalence and incidence as well as a natural history and biology that can be predicted. 3. Effective treatment for early stage cancer must be available so that early discovery of a cancer leads to treatment that will decrease mortality 4. The screening test must be accessible and acceptable to both patients and health care providers so that adherence to screening can be achieved 5. The test should be able to be delivered to an asymptomatic population in a cost effective manner Three cancers are generally accepted as appropriate for asymptomatic and population based screening based on scientific research: cervical cancer, breast cancer, and colorectal cancer USPSTF Screening for Cervical Cancer s Summary of Recommendations
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Secondary Prevention Final Study Guide combined - Assessing...

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