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SCHOOL OF HEALTH SERVICES ADMINISTRATION

Faculty Notes

HCS/245 Version 6

Introduction to Health and Disease

Program Council

The Academic Program Councils for each college oversee the design and development of all University of Phoenix curricula. Council members include full-time and practitioner faculty members who have extensive experience in this discipline. Teams of full-time and practitioner faculty content experts are assembled under the direction of these Councils to create specific courses within the academic program.

Copyright

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Edited in accordance with University of Phoenix® editorial standards and practices.

Module Revision History

|MODULE CODE |REVISION(S) DETAIL |

|HCS245r1 |New course |

|HCS245r2 |TEU |

|HCS245r3 |Complete revision of course, topics and objectives, assessments and new text |

|HCS245r4 |Assignments have been added to enhance course materials. |

|HCS/245r5 |Hard copy textbook was converted to an e-book. Faculty Notes updated and enhanced. Time on Task was |

| |reviewed using new rules. Extraneous assignments were removed. |

Course Overview

COURSE DESCRIPTION

THIS COURSE INTRODUCES STUDENTS TO THE BASIC PRINCIPLES OF ILLNESS AND DISEASE AS WELL AS THE IMPACT OF DISEASE TRENDS ON THE DELIVERY OF SERVICES. THE CLINICAL MANIFESTATIONS OF DISEASES COMMONLY SEEN IN THE HEALTH CARE ENVIRONMENT WILL BE REVIEWED. THE IMPACT OF HEALTH PROMOTION AND WELLNESS PROGRAM PERSPECTIVES WILL BE PRESENTED.

TOPICS AND OBJECTIVES

TRENDS IN DISEASE

• Identify disease trends that affect the population.

• Describe the global impact of diseases.

• Differentiate between primary, secondary and tertiary prevention.

Mental and Behavioral Health

• Examine common mental and behavioral health diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of mental and behavioral health diseases on health care resources.

Cardiovascular Diseases

• Examine common cardiovascular diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of cardiovascular diseases on health care resources.

Endocrine Diseases

• Examine common endocrine diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of endocrine diseases on health care resources.

Respiratory Diseases

• Examine common respiratory diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of respiratory diseases on health care resources.

COURSE Curriculum Design Notes

THE CONCEPTS OF HEALTH AND DISEASE IN RELATION TO DISEASE TRENDS IN VARIOUS POPULATIONS WILL BE INTRODUCED THROUGHOUT THIS COURSE. INDIVIDUALS WHO INTEND TO WORK IN THE HEALTH CARE INDUSTRY, REGARDLESS OF ROLE, WILL ACQUIRE A BASIC UNDERSTANDING OF THE PRINCIPLES OF ILLNESS AND DISEASE AS WELL AS AN UNDERSTANDING OF THE IMPACT OF HEALTH PROMOTION AND WELLNESS STRATEGIES WITHIN THE INDUSTRY. STUDENTS WILL ALSO BE INTRODUCED TO PRINCIPLES RELATED TO GLOBAL AND CULTURAL VARIATIONS IN HEALTH PRACTICES AND A VARIETY OF TREATMENT MODALITIES.

You may notice many enhancements that have been newly added in this course. Enhancements may include videos, simulations, articles websites, and other resources. Realize that not all enhancements in this course are specifically aligned to health care. Therefore, it will be important for you to ensure that you draw out the core principles from these enhancements and help students relate those principles to the health care industry. Enhancements are plainly identified as such in the classroom.

Week One Faculty Notes

Trends in Disease

• Identify disease trends that affect the population

• Describe the global impact of diseases today

• Differentiate between primary, secondary and tertiary prevention.

Course Development Rationale

THE CONTENT AND ASSESSMENTS FOR THIS WEEK WERE DESIGNED TO PROVIDE STUDENTS EXPOSURE TO DISEASE TRENDS AND ISSUES THAT SHAPE THE BUSINESS SIDE OF HEALTH CARE IN TODAY’S INDUSTRY. THIS WEEK IS NOT DESIGNED TO PROVIDE STUDENTS A COMPREHENSIVE OR IN DEPTH VIEW OF ANATOMY, PHYSIOLOGY AND THE EFFECT OF DISEASE ON THE HUMAN BODY. SUBSEQUENT WEEKS FOCUS ON COMMON DISEASES, THE BODY SYSTEMS THEY AFFLICT AND THE RESOURCE ALLOCATION THAT THEY DEMAND.

Content outline

• TRENDS IN DISEASE

1. Identify disease trends that affect the population.

a. What is disease?

1) How do you define/describe it?

a) Disease is used as a medical term to describe an illness or condition- the physician or health care provider listens or observes your symptoms and may run some tests and this is then labeled an illness or disease that they can use to frame treatment

b. What is population?

2) How is it defined and how would you describe/define population?

a) Age

b) Race

c) Gender

d) Socioeconomic

e) Geographic details

f) Cultural

c. What is the effect that disease trends have on population?

a. Political

i. Political actions, laws/regulations enacted, defeated and/or ignored impact what type of healthcare will occur within the political area of influence.

1. Immigration policy and international visitor

ii. Medicare/Medicaid, CHIP and other support system funding (local, state, federal)

iii. Funding prevention versus disease treatment

b. Economic- Accessibility to health services, disease trends may be higher in low income countries.

c. Social-Access to and acceptance of education about disease.

d. Technology- to detect and treat diseases.

e. Legal

i. HIPAA (Health Information Portability and Accountability Act)

ii. Health care regulations-mandate those regulated must act in a specific manner.

1. Example: Public health- sanitary rules/regulations

2. Childhood immunizations

f. Environmental-Conditions in which people live. Migration and immigration of people in a region.

g. Demographic (study of populations)

i. Increasing chronic diseases versus acute

ii. Graying of America- Baby Boomers

1. General population

2. Health care workers

iii. Poor versus Middle class versus Upper class access

2. Describe the global impact of diseases today.

a. Global travel and global trade have contributed to increased spread of many diseases.

1) Travel

a) Air travel ease and speed increasing the spread of disease

b) Travel to countries with less sanitation than the United States

c) Immigration from countries where the population lacks population health

d) Travel to other countries for medical procedures

e) Cultural and customs issues related to immigration populations

f) Culture and Customs can impact how people react to an illness as well they may use home remedies as a first route to treat something

2) Immigration

a) Regulations

b) Health checks

c) Inoculation

d) Immunization

3) Aging – what is the impact of an aging population that is living longer?

a) Population aging in general

b) Change of health delivery

c) Multigenerational homes

1) Building plans changing to accommodate such family types

d) Pros- Social networking becomes important, more motivated

e) Cons- Increased disease rates and depression, living.

4) Trade

a) Importing a large amount of our food and products from other countries

b) Other countries can use pesticides banned in the United States

c) Products – use of lead paint or contamination of products

1) Agricultural Issues

d) Communication

1) Technology differences from nation to nation

5) Environmental factors

a) Natural disasters

1) Relocation

2) Migration

b) Global climate changes

c) Urbanization and living conditions

d) Not exclusively environmental – aftermath of terrorism attacks

3. Differentiate between primary, secondary, and tertiary prevention

a. Differentiate between primary, secondary, and tertiary prevention

1) Primary – pre-disease

a) goal decrease new cases through health promotion, immunization

2) Secondary – latent disease

a) goal decrease severity/complications by recommending pre-symptomatic diagnosis & treatment

3) Tertiary – symptomatic disease

a) goal decrease impact/deaths by providing programs and support groups.

b. Acute – usually short and self-limiting, but can escalate into more serious diseases

1) Cold can become bronchitis or pneumonia

2) Food poisoning – can have a devastating impact on children or the elderly and be much more severe

3) Flu – can also have more of a severity impact on people who have other pre-existing conditions

4) Fungus infection – i.e. valley fever

5) Infectious disease – i.e. measles, shingles

6) Communicable diseases

c. Chronic - usually develops slowly and can last a long time; irreversible, yet with treatment, may result in a varying degree of quality of life; typically a progression from the acute stage

1) Heart disease

2) Hypertension/stroke

3) Diabetes

4) Cancer

5) Tuberculosis

6) Alzheimer’s

7) Arthritis

8) HIV or other related STDs

Discussion Starters:

• What is the mission of the World Health Organization and the Centers for Disease Control? What roles does each take in addressing disease outbreaks such as the recent Ebola threat (include overlapping and areas of cooperation)?

• Why is it important to learn about disease trends? How does such awareness/sensitivity assist healthcare organizations in responding to disease trends?

Learning Activity Notes (optional)

Websites available to learn about diseases/references:

1.

2.

3.

4. (WHO – Health & Human Rights)

Look up these sites and discuss as a group.

Week Two Faculty Notes

Mental and Behavioral Health

• Examine common mental and behavioral health diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of mental and behavioral health diseases on health care resources.

COURSE Curriculum Design Notes

THIS WEEK’S CONTENT FOCUSES ON THE IMPACT OF COMMON MENTAL DISEASES AND BEHAVIORAL DISORDERS ON SOCIETY’S RESOURCES, CULTURAL BELIEFS AND PRACTICES, AND THE COMMUNITY HEALTH PROMOTION AND WELLNESS STRATEGIES DESIGNED THAT ADDRESS SUCH AFFLICTIONS. ASSESSMENTS WERE CREATED AND RESOURCES ADDED TO SPECIFICALLY COVER THESE TOPICS.

Note. Only common diseases will be mentioned – there is no intent to be all-inclusive.

Faculty should also focus on the cultures that are most important to the geographical area. For example: Native American, African American, Korean, Hispanic, Homosexual, Poor, Wealthy, etc.

Content outline

MENTAL AND BEHAVIORAL HEALTH

1. Behavioral Health

a. Examine common behavioral and mental health diseases and their treatment modalities.

1) Developmental Mental Health Disorders

a) Autism

b) Attention deficit hyperactivity disorder

2) Substance-related mental addictions

a) Alcohol, marijuana, cocaine, caffeine, nicotine, sedatives, depressants, amphetamines, hallucinogens, narcotics, and inhalants

1) Leading to an ultimate change in behavior

3) Organic mental disorders

a) Dementia

b) Delirium

c) Alzheimer’s

4) Psychosis

a) Schizophrenia – split mind

b) Delusional disorders

5) Mood or affective disorders

a) Depression

b) Seasonal Affective Disorder

c) Bi-Polar Disorders

6) Eating disorders

a) Anorexia Nervosa

b) Bulimia

1) Orthorexia

c) Pica

7) Common mental health treatments

a) Prevention

1) “Maintain your Brain” –Alzheimer’s foundation

2) Proper diet

3) Staying alert

4) Practicing new skills

b) Psychotherapy

1) The main treatment for many mental disorders is psychotherapy.

1) Cognitive behavioral therapy (CBT) – Widely used, patterns of thoughts and behavior associated with disorder are modified

2) Psychoanalysis – patient addresses repressed emotions and experiences.

3) Systemic therapy or family therapy – Addresses the interactions of an individual and significant members of the family unit.

c) Medication

1) The main treatment option for many mental disorders is psychiatric medication.

1) Antidepressants – used for patients with moderate to severe depression, anxiety and clinical depression

2) Anxiolytics – used for anxiety disorders

3) Mood stabilizers – used in bipolar disorder treatment to prevent high and low episodes (Lithium and Lamictal are most common)

4) Antipsychotics – used for psychotic disorders (i.e. schizophrenia)

5) Stimulants: – commonly used for ADHD

d) Other treatments

1) Psychoeducation information given to patients to help them understand and manage their problems.

e) Alternative/Complementary Treatments/Integrative Healthcare

1) Creative therapies:

1) music therapy

2) art therapy

3) drama therapy

2) Lifestyle adjustments and supportive measures,

1) Peer support

2) Self-help groups for mental health

3) Supported housing or supported employment

b. Discuss the effects of cultural beliefs and practices on disease manifestation and management.

1) Varied religious and cultural beliefs and superstitions

2) Values

3) Traditions

4) Societal norms – the stigma involved in mental illness

5) Class

6) Cultural barriers include multiplicity of languages

7) Economic barriers include poverty

8) Education

9) Health risks

10) Dietary habits

11) Compliancy based on cultural views/expectations

12) Cultural differences in symptom management

c. Identify community health promotion and wellness strategies.

1) Community education on mental illness

2) Counseling

3) Support groups

a) Work support groups

b) Meetings targeting addiction

1) Alcoholics Anonymous

2) Al-Anon – the generations that can effectively change and deal with the behavior

3) Narcotics Anonymous

4) Gamblers Anonymous

4) Psychiatrists and psychologists

a) Health insurance

b) Employee assistance programs

c) Work support groups

d. Identify the impact of mental and behavioral health diseases on health care resources.

1) Impact on Patient

a) Compromised education; less likely to attend and graduate from school

b) Lowered productivity and poverty

c) Social problems

d) Vulnerability to abuse

2) Impact on Caregivers

a) Economic struggles- generally cannot work full time

b) Increased stress

c) Disruption of household

d) Increase emotional issues

3) Impact on Workforce

a) Lowered individual productivity due to unemployment,

b) Increased time missed at work

c) Increase poverty risk

1) Reduced earnings

2) Employment potential decrease

d) Missed work or reduced productivity at work.

4) Impact on Health Care

a) Increased risk to other health issues

i) Decreased adherence to medical treatment plans

ii) Low quality providers accessed for care

1) Abuse and human rights violations

2) Social stigma ramifications

5) Statistics

a) WHO estimates that 1 in 4 families have a member that have a mental or behavioral health disorder.

6) Costs

a) Developed nations spend between three and four % of Gross National Product. WHO (2001)

b) Mental illness in the United States has cost:

1) more than 4 million workdays and

2) 20 million “work cutback days” due to mental illness. Harvard Medical School (1997)

Discussion Starters:

• What is the difference between mental health and behavior disorders? Identify two mental health conditions and two behavior disorders.

• Demographic projections predict a dramatic increase in the size of the senior population. What are the implications of this “graying of America” on the healthcare system and what actions might be taken to proactively address them?

• Alcoholism: disease or disorder? What are mental models and how does the classification impact treatment, societal view, impact resource availability?

Learning Activity Notes (optional)

Discuss the various treatments and technologies related to mental health disorders. What are the pros and cons of new treatments and technologies as they relate to managing mental health disorders?

Website of interest:

(Healthy People 2020 – Mental Health)

Week Three Faculty Notes

Cardiovascular Diseases

• Examine common cardiovascular diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of cardiovascular diseases on health care resources.

COURSE Curriculum Design Notes

THIS WEEK’S CONTENT FOCUSES ON THE IMPACT OF COMMON CARDIOVASCULAR DISEASES ON SOCIETY’S RESOURCES, CULTURAL BELIEFS AND PRACTICES, AND THE COMMUNITY HEALTH PROMOTION AND WELLNESS STRATEGIES DESIGNED THAT ADDRESS SUCH AFFLICTIONS. ASSESSMENTS WERE CREATED AND RESOURCES ADDED TO SPECIFICALLY COVER THESE TOPICS.

Faculty should also focus on the cultures that are most important to the geographical area. For example: Native American, African American, Korean, Hispanic, Homosexual, Poor, Wealthy, etc.

Content outline

CARDIOVASCULAR DISEASES

Note. Only common diseases will be mentioned - there is no intent to be all-inclusive.

1. Examine common cardiovascular diseases and their treatment modalities.

a. Basic anatomy and physiology of cardiovascular system

1) Heart

a) Aorta

b) Inferior Vena cava

c) Right and Left Pulmonary Artery

d) Right and Left Pulmonary Vein

9) The Conduction system

10) Circulatory system

a) Aorta

a) Vena Cava

b. Signs and Symptoms of cardiac disease

1) Shortness of breath- difficulty breathing

7) Irregular heartbeat

a) Tachycardia – Fast heart rate

b) Bradycardia – Slow heart rate

11) Chest pain – the usual location but pain can also be felt in the jaw or neck area as well as radiating down the left arm; can be severe or feeling like constant indigestion

12) Pain in the extremities, often due to poor blood flow

13) Sweating, nausea, and/or vomiting

14) High blood pressure

15) Swelling of the extremities (legs)

c. Common cardiac diseases

1. Hypertension – can be a symptom as well as a chronic disease

a) Often patient reports no symptoms – disease usually has a gradual onset and found when the doctor takes their blood pressure.

b) Effect of high blood pressure – pumping of blood causes the heart to work harder. Can cause damage to blood vessels.

c) Risk factors for this disease – heredity, diet, obesity, smoking, and age

2. Heart Attack (Myocardial Infarction) – a condition that causes blockage in the blood vessels that transport blood to the heart muscle causing the heart muscle to die from a lack of oxygen

a) The onset of symptoms are usually sudden/acute and if not treated can lead to major complications or death.

b) Severity of the heart attack depends on the size and location of the blockage of oxygen to the heart muscle.

c) Heart disease, strokes and diabetes account for 36.6 % of deaths in the United States, risk for these diseases can be significantly reduced by changing 3 risk factors: quitting smoking, increase in exercise, and dietary changes

d) After the heart attack, muscle tissue becomes scar tissue and will never work at the same capacity again

3. Congestive Heart Failure – The heart fails to pump an adequate amount of blood to the body.

a) A chronic disease that develops slowly; usually caused by something else such as a heart attack or hypertension

b) Patients experience a gradual increase in shortness of breath, rapid heart rate, swelling in the legs or neck veins, and if the left side of the heart is the part failing to work correctly then the patient will experience a buildup of fluid in their lungs makes it more difficult to breath.

4. Stroke – poor blood supply to the brain; caused by a blood clot or a ruptured artery in the brain; similar to how a heart attack is to the heart

a) Not a cardiovascular disease; an acute condition related to the vascular system in the brain

b) Symptoms are usually sudden – loss of consciousness or death (major cause of death to people over 50)

c) Other symptoms – difficulty speaking, difficulty walking, and paralysis of one side or the other; these depend on the side of the brain that had to stroke

1) For example, paralysis that affects the right side of the body is caused by the left side of brain.

d) Some people only have minor symptoms and recover with little or no permanent problems.

5. Those who recover with permanent damage may either learn to function with the disability or need to be placed somewhere where they can receive daily assistance. Treatment modalities for cardiovascular diseases.

a) The traditional approach is medication and surgery

b) Cardiac Bypass surgery – procedure that corrects obstructed blood flow to the heart muscle by unblocking arteries.

c) Coronary angioplasty (stint)

6. Medical options and precautions

a) Cardiokymography (CKG) together with Electrocardiograms (ECGs) may help to detect what is often referred to as silent heart disease

7. Medications to treat the disease or the symptoms (examples)

a) Drugs to help control cholesterol

b) Drugs to reduce hypertension

c) Drugs to regulate heart beat

8. Alternative approach

a) Diet and supplements can help the body to heal damages to the cardiovascular system.

b) Cardiovascular disease treatments

1) Flaxseed

2) Vitamin E

3) Omega-3 fatty acids

4) Garlic

5) Routine Vitamin Supplements

2. Discuss the effects of cultural beliefs and practices on disease manifestation and management.

a. Depending on one’s culture, cardiovascular disease and treatment thereof might be exasperated and/or managed differently based on several variables.

1. Varied religious and cultural beliefs

2. Values

3. Traditions

4. Societal norms

5. Class; Social status or position in societal hierarchy or archetypes

6. Cultural barriers include multiplicity of languages

7. Economic barriers include poverty

8. Education

9. Health risks

10. Dietary habits

11. Compliancy based on cultural views/expectations

12. Cultural Differences in Symptom Management

a) Pain – Management of pain is generally undertreated in most cultures. Example: American Indians may complain of pain in general terms not any specific issues. In many cultures patients may only complain of pain to family members.

b) Physical illness – This varies in many cultures. Western medicine is traditional. Navajo’s practice is holistic and based in natural practices and beliefs through the generations. They relate to physical illness to violations in social proscriptive behaviors.

c) Sick Role – Many cultures believe a person should be quiet and stoic when sick

d) Home and Folk remedies – Roots and herbs are used for common maladies (coughs, aches, etc.) Some tribes will use sweat lodges to purify the system of illness.

3. Identify community health promotion and wellness strategies.

a. A focus on prevention

1. Media

2. Public service announcements

b. Lifestyle factors that reduce the risk of forming atherosclerosis and developing cardiovascular diseases

1. Not smoking, variations thereof

2. Choosing healthy foods

3. Low salt intake

4. Regular physical activity

5. Reducing weight and waist size

6. Drinking alcohol in moderation

7. Maintaining normal blood pressure and cholesterol levels

8. A daily, low-dose of aspirin

4. Identify the impact of cardiovascular diseases on health care resources.

a. Impact on Patient

1. Physical limitations

2. Psychological problems

a) Embarrassment from scar

b) Stigma from having heart issues.

3. Social problems

a) Treated differently

b) Unwanted attention

b. Impact on Caregivers

1. Financial strain

2. Emotional distress

c. Statistics ()

1. Heart disease and stroke, the first and third leading causes of death for men and women.

2. Cardiovascular diseases, including heart disease and stroke, account for more than one-third (33.6%) of all U.S. deaths.

3. Americans who died of cardiovascular diseases, 150,000 were younger than age 65 (Y2007).

d. Cost Estimates ()

1. In 2010, the total costs of cardiovascular diseases in the United States were estimated to be $444 billion.

a) Treatment of these diseases accounts for about $1 of every $6 spent on health care

b) Economic impact of heart disease to increase with aging of population.

Discussion Starters:

• What role and how does culture influence the rate of cardiac disease? How might knowledge of these differences assist in addressing risk factors?

• How does diet impact cardiovascular disease occurrence? How do demographics and economics impact cardiovascular disease occurrence?

• Explain why, as a nation, we have changed our focus on heart disease over the years; including discussion on the following:

o Preventative treatment changes (diet, exercise, etc)

o The future focus on treatment (technology, genetic engineering, etc.)

Learning Activity Notes (optional)

For general activities and resources, please refer to Faculty Resource Guide at

Week Four Faculty Notes

Endocrine Diseases

• Examine common endocrine diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of endocrine diseases on health care resources.

COURSE CURRICULUM DESIGN NOTES

THIS WEEK’S CONTENT FOCUSES ON THE IMPACT OF DIABETES MELLITUS ON SOCIETY’S RESOURCES, CULTURAL BELIEFS AND PRACTICES, AND THE COMMUNITY HEALTH PROMOTION AND WELLNESS STRATEGIES DESIGNED THAT ADDRESS THIS GROUP OF DISEASES. ASSESSMENTS WERE CREATED AND RESOURCES ADDED TO SPECIFICALLY COVER THESE TOPICS.

Content outline

ENDOCRINE DISEASES

Note. Only common diseases will be mentioned; there is no intent to be all-inclusive.

1. Examine common endocrine diseases and their treatment modalities.

d. Basic anatomy and physiology of endocrine system

1) Thyroid

2) Thymus

3) Hypothalamus

4) Pituitary

5) Penial

6) Parathyroids

7) Adrenal

8) Pancreas

9) Ovaries

10) Testicles

11) Placenta

e. Endocrine disease as it relates to diabetes and the health system as a whole

1) Diabetes

a) Approximately 14 million people in the US have diabetes and number is growing

b) Diabetes occurs because of the response or production of insulin in the body (insulin- a pancreas produced hormone that regulates carbohydrate and fat metabolism)

c) When this occurs almost every part of the body can be affected

2) Define the types of diabetes

a) Type I

1) Signs and symptoms

2) Indicates that the person does not produce the hormone insulin

3) Usually diagnosed in children and adolescents

b) Type II

1) Signs and symptoms

2) Indicates that the pancreas in not producing enough insulin and had been predominantly seen individuals over the age of 45

3) With the increase of obesity in the population there has been an increase of type 2 diabetes in many younger people. This type can also go undiagnosed for many years which then increase the potential for complications.

4) Before the development of insulin injections, the disease was fatal, but now with medications and diet this chronic disease can be managed.

5) The disease still has significant issues that can cause complications leading to death.

c) Gestational

1) Signs and symptoms

d) Risk factors

1) Some minority groups have higher risk factors ( African American, Native American, and Latinos)

2) Other factors – obesity, lack of exercise, unhealthy food choices, and genetics

3) Common diabetes treatments

a) Constant monitoring

b) Insulin injections

c) Implantable insulin pump

d) Diet

4) Alternative approach

a) Diet and exercise (Type II)

b) Islet cell transplants

c) Herbs

4. Discuss the effects of cultural beliefs and practices on disease manifestation and management.

e. Varied religious and cultural beliefs

f. Values

g. Traditions – how lessons and lifestyles are passed down through generations

h. Societal norms

i. Class – social status/position in societal hierarchy/ archetypes

j. Cultural barriers include multiplicity of languages

k. Economic barriers include poverty

l. Education – best treatment option depending on lifestyle; education about the disease, the loss of feeling in extremities, loss of sensation, how to recognize when sustaining injuries if you cannot feel them

m. Health risks – heredity and family lineage a contributing factor

n. Dietary habits

o. Compliancy based on cultural views and expectations – treatment regimen

p. Cultural differences in symptom management (particularly across age groups)

5. Identify community health promotion and wellness strategies.

a. Disease management technology

1) New and different ways to assess current sugar levels

b. Awareness of disease

c. Information technology

1) Efficient means of receiving disease testing supplies

2) Internet

3) Palm sized devices

4) Apps

5) Electronic health records

6) Continuous speech recognition

7) Wireless computing

d. Fundraising

1) Global recognition of diabetes effects

2) Community efforts

3) Schools’ attention

a) Meals/vending

b) Physical education/activity

c) Community gardens

d) Education

1.

2.

3. Identify the impact of endocrine diseases on health care resources.

a. Impact on Patient

1) Stress

2) Frustration

3) Depression (sadness)

b. Impact on Caregivers

1) Many caregivers will feel the same as the patient: stress, frustration, distress

c. Statistics

1) Diabetes statistics from American Diabetes Association ()

a) In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes.

b) In 2010 the figures were 25.8 million and 8.3%.

2) Osteoporosis

a) Osteoporosis affects 40 million people in the U.S.

3) Hypothyroidism

a) Affects nearly 5% of the U.S. population over age 12.

d. Cost

1) Diabetes

a) Annual cost of $245 billion in the US.

2) Osteoporosis

a) Treatment costs of $19 billion

3) Hypothyroidism (Underactive Thyroid)

a) Treatment for women (18 years and older) totaled $4.3 billion in 2008.

Discussion Starters:

• Diabetes is the most common endocrine disease in the United States. What groups are most affected by diabetes? What statistics are available to describe the incidence and trends of diabetes? How might incidence statistics assist the healthcare manager in planning resource acquisition and utilization?

• Identify four other body systems directly affected by diabetes. In what ways can diabetes impact these systems? What does this tell you about how one organ system can directly or indirectly impact another? What does this say about comprehensive health care?

Learning Activity Notes (optional)

Week Five Faculty Notes

Respiratory Diseases

• Examine common respiratory diseases and their treatment modalities.

• Discuss the effects of cultural beliefs and practices on disease manifestation and management.

• Identify community health promotion and wellness strategies.

• Identify the impact of respiratory diseases on health care resources.

COURSE Curriculum Design Notes

THIS WEEK’S CONTENT FOCUSES ON THE IMPACT OF COMMON RESPIRATORY DISEASES ON SOCIETY’S RESOURCES, CULTURAL BELIEFS AND PRACTICES, AND THE COMMUNITY HEALTH PROMOTION AND WELLNESS STRATEGIES DESIGNED THAT ADDRESS SUCH AFFLICTIONS. ASSESSMENTS WERE CREATED AND RESOURCES ADDED TO SPECIFICALLY COVER THESE TOPICS.

Faculty should also focus on the cultures that are most important to the geographical area. For example: Native American, African American, Korean, Hispanic, Homosexual, Poor, Wealthy, etc.

Content outline

RESPIRATORY DISEASES

1. Examine common respiratory diseases and their treatments

Note. Only common diseases will be mentioned - there is no intent to be all-inclusive.

a. Review basic anatomy and physiology

a. Lobes of the right lung

b. Lobes of the left lung

c. Sternum and ribs

d. Diaphragm

e. Upper respiratory system

1. Nose, mouth, pharynx, epiglottis, larynx

f. Lower respiratory system

1. Trachea, bronchi, bronchioles, alveoli

b. Common signs and symptoms of respiratory disease

a. Difficulty breathing (shortness of breath)

b. Coughing and sneezing

c. Wheezing

d. Elevated temperature

e. Nasal discharge (runny nose)

f. Cyanosis (not usually seen, but the person has a very low oxygen level and their lips will appear bluish)

c. Causes of Respiratory Diseases

a. Bacteria or Viruses or fungus

b. Smoking

c. Allergies

d. Trauma – chest injuries, stabbing

d. Common Acute Respiratory Diseases

a. Common cold – caused by a viral infection

b. Sinusitis – can be caused by spread of the cold virus to the sinus, air pollution and allergies can also be a cause

c. Influenza – highly contagious viral infection; many strains of the flu viruses

d. Laryngitis – inflammation of the throat in vocal cords; can be caused by bacterial or viral infections, smoke, chemical fumes or over use of the voice (singers are often at risk)

e. Bronchitis – inflammation of the lining of the bronchus; usually follows a cold or inhaling fumes

f. Pneumonia – inflammation of the pulmonary lobes of the lungs; caused by an infection

g. SARS (Sudden Acute Respiratory Syndrome) – A relatively new disease that spreads easily to those people having close contact with the infected person; examples of this are kissing, hugging, and sharing a drink or utensils

1. Spread by coughing or sneezing; droplets go into the air. Caused by a new virus which has been contained but could break out again

e. Common Chronic Respiratory Diseases

a. Asthma – this disease is a hypersensitivity to an allergy factor which causes the constriction making it difficult to breath; the person often sounds like they are wheezing and trying to get air in the lungs

1. Leading cause of chronic illness in children

2. Pollen, dust, smoke, or even stress, are examples of things that can trigger an attack.

b. Allergies – the body’s reaction to foreign items such as pollen, food, flowers, trees, pet hair, etc.

1. Most common respiratory symptoms are coughing, sneezing, runny nose, and itchy eyes.

c. Tuberculosis – a contagious bacterial disease that mainly affects the respiratory system but can also affect kidneys and brain

1. Initial symptoms are often vague – loss of weight, energy, and appetite

2. A chronic disease – untreated can lead to death

3. Not often seen in the United States but through globalization, the disease is reemerging in the country

4. A new form that is more resistant has been diagnosed.

d. Lung Cancer – Leading cause of cancer deaths

1. Most common cause of lung cancer related to smoking

2. Often, the patient has no symptoms until it has spread to other areas.

3. Treatment focuses on chemotherapy, radiation treatment. or sometimes surgery.

f. Common Respiratory Disease Treatments

1) Treatment depends on:

a) Particular disease being treated

b) Severity of disease

c) Age of the patient

2) Vaccination can prevent some respiratory diseases.

3) For acute respiratory diseases, prevention and isolation of the individual can decrease the spread of the disease.

a) Medications can be used to treat these diseases:

1) Antibiotics

2) Antihistamines

3) Cough syrups

4) Steroids – inhalers for asthma

5) Medications specific for tuberculosis

4) Alternative Therapies

a) Definitions:

1) Alternative medicine – Practice outside of conventional modern medicine. Includes healing philosophies and therapies. Typically not taught in medical schools. I.e. naturopathy, chiropractic, homeopathy and acupuncture.

2) Complementary Medicine – alternative medicine that is used in conjunction with conventional medicine. I.e. Use of acupuncture in place of anesthetics during surgery in Chinese hospitals. Use of sesame oil to treat cancer.

3) Holistic Medicine – treatment to both the physical body as well as mental, emotional, and spiritual aspects of health, I.e. hypnosis and visualization.

4) Natural Medicine – relies on the body's own healing powers. I.e. herbal remedies, diet and water therapies.

b) Treating respiratory diseases can include important factors like regular exercise and healthy nutrition.

c) Some people are sensitive to fungi and yeast, both of which thrive on sugar. Thus avoiding sugar is thought to improve the wellbeing of the individual with respiratory illness.

d) Diet rotation – strengthens immune system

e) Vitamin and herbal use of ionizers and filters, plus nasal irrigation and saline nasal sprays

2. Discuss the effects of cultural and health beliefs on disease manifestation and management

a. Economic barriers include poverty

b. Poor education leading to illiteracy

c. Lack of sanitation

d. Poor infrastructure of home ventilations

e. Varied religious and cultural beliefs

f. Cultural barriers include multiplicity of languages

g. Inaccessibility of healthcare facilities (distance, lack of facilities, or facilities not adequately staffed)

h. Disparities in the establishment and availability of healthcare facilities

i. Poor quality or not enough technical support as well as cultural beliefs may differ use of technology verses a spiritual cure

j. Lack qualified personnel, and no equivalence in training between the different countries

k. Trained personnel unlikely to stay in the same location

3. Identify community health promotion and wellness strategies

a. Smoking secession campaigns and laws

b. Environmental efforts for clean air

c. Influenza immunizations

d. Vitamin and herbal remedies for common colds

e. Hand washing education

f. Improving housing with poor ventilation

g. Decreasing indoor allergens

h. Monitoring for airborne chemical irritants

i. Improving the level of nutrition

j. Community education and the

k. Identifying and protecting workers in types of occupations with risks to respiratory diseases

l. Decreasing the socio-economic limits to preventable healthcare

4. Identify the impact of respiratory diseases on health care resources.

a. Impact on Patient

a. Restriction of physical activity

b. Depression

c. Anxiety

d. Feeling trapped by disease

b. Impact on Caregivers

a. Physical

b. Emotional

c. Financial

c. Statistics ()

a. Lung diseases, excluding lung cancer, caused an estimated 235,000 deaths in 2010.

b. From 2001 to 2010, death rates for asthma declined in both black and white males and females; death rates for COPD declined in both black and white males but rose in both black and white females.

c. In 2010, of the 10 leading causes of infant mortality, 4 were lung diseases or had a lung disease component

d. In 2010, approximately one in six deaths in children under 1 year of age was due to a lung disease.

d. Cost Estimates ()

a. Economic cost of asthma, COPD, and pneumonia was $106 billion in 2009

1. $81 billion in direct health expenditures

2. $25 billion in indirect cost of mortality.

Discussion Starters:

• What respiratory diseases are of concern for the elderly and infants and why?

• How does our society view smoking and how have our views changed over the years? Discuss the ethical concerns related to smoking and second hand smoke. Support your view with specific examples or references.

• What respiratory diseases are more prevalent in diverse populations? (e.g. Caucasians are more prone to die from COPD (American Lung Association, 2010). Provide an example of a respiratory disease common to a particular diverse or cultural group. How can this information assist the directing healthcare resources?

Learning Activity Notes (optional)

For general activities and resources, please refer to Faculty Resource Guide at

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