Some review notes for the midterm

Some review notes for the midterm - Week one Study guide...

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Week one: Study guide for Guarneri, The Heart Speaks How would you characterize the experience(s) described in this volume? What is the nature of the author's conflict(s)? What is your reaction to this? What is the "Roseto effect" on heart disease? What is a stent? Narrative includes the transition in self concept with a diagnosis and the adoption of the role of a "patient". What is the stress of "unconscious living?" How is anger/hostility associated with heart disease? The 18 second interruption, the 17.9 minute visit vs the telling and receiving of stories that a diagnosis is found. How are depression and grief harmful to health? What is a potential mechanism? What is the Framingham study? p. 137 What is "heartmath"? p. 173 More women than men die of heart disease each year. What are some of the factors that contribute to this? p. 176 Study guide for Ogden lecture This lecture was explicit in cautioning that all estimates are just that. ..estimates What percentage of the American population is "insured", by whatever means? ANS 85% The number of "uninsured" is approximately 46-50 million, or 15%. Who are these people? 5 million undocumented citizens
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14 million individuals who are eligible but unrolled in Medicaid/SCHIP 13 million poor individuals 18 million individuals uninsured by choice (choose not to spend funds here) How does the US spend health care dollars? In 2007, it was estimated that we spent 2.24 trillion dollars. 71 % went to professional services 13 % to retail drugs and products 7 % government administration and private insurance 4 % investment in structures and equipment 3 % public health activities 2 % research In 2010, the US spends approximately 17 % of the GDP on health, and this is projected to be about 22 % by 2015. What is driving health spending? rising rates of obesity-associated chronic conditions (heart disease, diabetes, high blood pressure. ..) technology treatment fragmented care Some specifics: It has been estimated that less than 1 % of the US health dollar is spent on prevention; and 70% of avoidable mortality in the US involves the environment and behavior (30% involves genetics and health care). The rise of obesity and chronic conditions parallel the rise in health spending; estimates suggest obesity is related to a 27% increase in health expenditures between 1997 and 2005. 35% of the spending is due to five conditions (heart, trauma, cancer, mental disorders, lung diseases), with heart conditions in the lead.
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Increase in disease prevalence 1987-2005: high cholesterol increased by more than 800%. Other disease patterns include metabolic syndrome, 'mental disorders', lung diseases, back problems, and autoimmune diseases. What do these statistics tell you?
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Some review notes for the midterm - Week one Study guide...

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