KINE 1020 lecture notes PDF

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KINE 1020:Lecture 2: 09/10/ - “what is it about your families lifestyle impact your health” - A healthy lifestyle is exercise regularly, eating healthy, reduce stress, drink plenty of water, being socially interactive - Susruta of India, (600 BCE before common era) was the first doctor prescribe dai...

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KINE 1020: Lecture 2: 09/10/20 - “what is it about your families lifestyle impact your health” - A healthy lifestyle is exercise regularly, eating healthy, reduce stress, drink plenty of water, being socially interactive - Susruta of India, (600 BCE before common era) was the first doctor prescribe daily exercise as medicine for his patients  He advocated exercise because it made the body strong, firm, compact, and light, which seemed to enhance the growth of the limbs.  He noticed it reduced laziness and senility (means reduce forgetfulness) - Hippocrates is a Greek scholar  (4060-370 B.C)  Believed in the science in exercise  Was the first to say if you have the right diet and exercise we would have found the safest way to health - Aristotle:  The father of Kinesiology  The exercise of walking is said to produce better health, or does possession of better health produce the ability to walk?”  He thought if you break the vicious cycle of not exercising, it will lead to better health - Edward Stanley:  British statesman  “those who think they have not time for bodily exercise will sooner or later have to find time for illness.” - Exercise is medicine - Lifestyle factors in health  Relationships b/w lifestyles and health is not so simple  People who exercise regularly tend to eat better  People who exercise regularly tend to be leaner have less chronic diseases. but too often limits the ability to move  People who smoke are less likely to engage in physical activity in their leisure time (because of respiratory issues)  Yet people who increase their physical activity do not stop smoking (except those interested in being highly trained)  No clear relationship exists between physical activity and alcohol consumption  The link between physical activity and obesity is complex and is possible to be fat and fit - Firsts’ in exercise physiology  1737 – Luigi Galvani discovers that electricity stimulates contraction  1847 – Carl Ludwig measures human BP  1887 – Augustus Desiré Waller records the electrical activity of the human heart using the first EKG  1920 – Archibald V. Hill describes maximal oxygen uptake (VO2 MAX) during exercise in humans  1957 – A.F Huxley theorizes about muscle cross-bridges in contraction

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 (does not test dates but concepts, A.V Hill is profs hero!!) Physical Fitness Definitions  The capacity to live an optimal life  A functional quality of well-being that is influenced by and associated with participation in physical activity  *The ability to perform muscular work satisfactorily. It is determined by level of several attributes which are influenced by activity such as cardiovascular – respiratory endurance, muscular strength, muscular endurance, flexibility and body composition* memorize bc it is the most accurate Health related fitness:  Those components of fitness that allow you to do activities of daily living Performance related fitness:  Those components of fitness that enable optimal work or sport performance Is it…? Health or performance related  Walking your dog  health  Carrying a hose up a flight of stairs  performance  Doing cartwheels on a balance beam  performance  Having a normal body weight  health  Being able to touch your toes  Both health and performance  Questions like this will be on the exam What is health? *  The Health Continuum: your health is set on a continuum and can change overtime

Many of us are sitting somewhere on the continuum And it can shift very quickly Can you change your behaviours? Can you be healthier?

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Read chapters 1 & 2

Lecture 3: 09/14/20 - Investment: the act of putting money, effort, time and dedication to make a profit or get an advantage, or the money, effort, time, etc. - Health defined:  WHO: a state of complete physical, mental, and social well-being, not merely the absence of disease  Are functioning properly in a social setting - What impacts our health:  Genetics: diabetes cancer, high BP, mental health etc  Behaviours: alcoholism, not exercising regularly, practicing safe sex etc.  Community & society: people follow with society, the people you are surrounded with  Environment: where you live, how you live. Ect. COVID cases in your region - What is being Healthy?  A connection between body, mind, and spirit

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Lalonde was a Health care minister and made this frame work! Study for the midterm Played a key role in a healthy justice society Was the first one to realize that environment and lifestyle were connected Healthcare systems:  Canada has government – sponsored public plan available to all citizens that covers almost all elements of healthcare (but may not cover all the medications)  The United States offers some government – sponsored programs, but the majority buy private healthcare through their employer  ACA ( affordable care act) Obama care  Trump wants to cut this program Health care costs:  253.5 Billion is the cost of our Canadian health care  264 billion dollars in 2019, increasing rapidly since the 1970  About $7,068 per person per year in 2019  11.6% of Gross domestic product (GDP)  4.2% increase per year (inflation about 2%) Slide 14-15 don’t have to memorize Canada’s health care system:  Universal coverage for medically necessary health care services provided on the basis of need, rather than the ability to pay  The termed Medicare – a publicly funded health care system  Interlocking set of ten providers and three territorial health insurance plans

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Ontario residents are eligible for provincially funded health coverage (OHIP, Ontario Health Insurance Plan) Need to be a permeant residence in Ontario Need to be physically present in Ontario for 153 days in any 12 month period and make your primary place of residence in Ontario Can use it in other provinces Canada V.S. United States health care  In contrast to the United States, where Medicare is restricted to the elderly, the Canadian program provides universal coverage for all citizens and permanent residents, enabling them to access services throughout the country when they travel or move from province to province  Whereas the US the more money you have, the better and more health care service you get

Lecture 4: 09/16.20

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The healthcare is both provincial and federal The federal government and take taxes and use the tax money towards the healthcare system Medicare is paid for by the government, which pay for hospitals, diagnosis tools, which is paid for from taxes Layer 2 is a good thing to have because you have additional health care, which is OHIP, and additional insurance coverage Layer 3, almost all private funding, never pay out of pocket, and complimentary medicine, covers physiotherapy, chiropractor, it’s private insurance which covers those things. Also similar to the US healthcare system This model outlines different aspects of the Canadian healthcare system When you turn 25 and older, loose the health care coverage they might have had Ontario health Insurance Plan (OHIP)  Gives access to level one health care, which is access to doctors, tests, etc.  Must be a Canadian citizen  OHIP all necessary hospital and medical or primary care services and wide range of other health care services  A variety of community services, such as home care and other support services that help people manage chronic illnesses and live independently  Community mental health services for people with mental health problems  A portion of the cost of care provided by long-term care homes that provide residential care for people who are no longer able to live independently  Most cost of prescription drugs for seniors 65 and over on social assistance, and Ontario residents who face high drug costs

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The “National Health Service” medical model (UK and Canadian approach)  Health care (or healthcare) is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans  Level 1 Medical Doctor) Wide scope- first point of consultation, “family physician” or general practitioner- this person has a medical degree and has written board exams in Canada  Level 2) Focused scope- medical specialists,  typically in a hospital (cardiologist, urologist, oncologist, ophthalmologist, surgeon, etc.)- this medical graduate has done specialty fellowship(s)  3) Specialists in specialty hospital with advanced facilities for medical investigation (e.g. a hand surgeon, an oncologist in a specialized cancer hospital such as PMH, a pediatrician at SickKids) Ways in which the US may be considered superior to Canada  More doctors and advanced equipment per capita (less wait times)  If you can pay, you can get the highest quality of care very quickly  A variety of plans and options for care  Prescription drugs are typically covered by most insurance plans  Typically, doctors make more money in the USA… Physician Income  In Canada, doctors must bill their services to provincial health authorities at standardized rates. The different medical specializations earn different salaries each year depending on the number of patients that they see and the average cost of each procedure.  Instead of billing a government authority, American healthcare providers bill health insurance companies for the procedures they perform with any remaining costs covered by the patient. This leads to differences in the amount billed for each procedure. For example, a surgeon doing a hip replacement in Canada can bill the government for around $650. The average cost of the same procedure in the US is $1634. (none of these numbers are on the exam) Medical problems caused 2/3rds of all personal bankruptcies in the U.S. Most of those who filed bankruptcy had medical insurance at the start of their illness, including 60% who had private coverage (i.e. not Medicare or Medicaid). Highest costs were associated with complications from diabetes. 2/3rds pf US citizens because they cant afford their medical bills “Unless you're very very wealthy in the US, your family is just one serious illness away from bankruptcy” Ways in which Canada’s health care model may be considered superior over USA’s model  In Canada, everyone regardless of wealth gets similar high-quality care  Access to doctors and equipment is guaranteed (eventually)  Less spending on healthcare and more satisfaction with quality  Canadian’s have a longer life expectancy  Doctors, not the insurance companies, decide who gets medical attention

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Canadian’s Current Health Care Status  Covid-19 is a major Health Crisis with infection rates on the rise again in Canada  Hospital resources could be depleted within 14–26 days without sustained physical distancing, and in the worst case scenario, 13,321 patients would die while waiting for needed resources.  Circulatory diseases, including heart disease and cancer are still the leading causes of death in Canada  In 2017, 1/3 of Canadian’s were obese and may require medical support to manage their disease  Obesity and obesity-related morbidities such as type 2 diabetes are a major public health concern. Obesity rates have risen markedly since the 1970s. Heart disease and stroke death rates remain high in Canada Main challenges to the Canadian system are related to:  Covid-19 mortality and morbidity  Economic downturn  ageing population  financing of long-term care services  financing of expensive new technologies and drugs  prevalence of avoidable diseases caused by poor health habits  shortage/ unbalanced geographic distribution of health care professionals

Lecture 5: 09/21/20 - Life expectancy:  Most basic measure of health  Life expectancy has risen steadily over time  It began to rise in the early 1900s  It began to rise because of penicillin was created and increased sanitization  Also the increase in technology  Different parts in the world have different life expectancies  It involves living conditions, health care systems, and access to te4chnology - Life expectancy in Canada:  Females have a greater life expectancy than males - Health promotion:  The Canadian health care system needs to focus on health promotion as well as caring for the sick - A Model Exists to assist health care planners:  The Precede-Proceed model:  Is a cost-benefit evaluation framework that helps health program planners, policy makers, and evaluations analyze the current health care situation and design new programs or approaches efficiently  Precede: outlines a diagnostic planning process while proceed guides the implementation and evaluation of the programs - Precede-Proceed Model:  The goals of this model:  Explain health-related behaviours and environments

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Help design and evaluate the interventions needed to influence both behaviours and the living conditions that influence them and their consequences  This model has been used, applies, tested, studied, extended, and verified in thousands of studies in a variety of settings (school, clinical, and workplace)  Originally developed in the 1970s by Green and colleagues at Johns Hopkins University  The acronym stands for Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation.  PRECEDE is based on the idea that, just as a medical diagnosis precedes (is before) a treatment plan, so should educational diagnosis precede an intervention plan. PRECEDE:  Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation  It involves assessing the following community factors:  Social assessment: Determine the social problems and needs of a given population and identify desired results.  Epidemiological assessment: Identify the health determinants of the identified problems and set priorities and goals.  Ecological assessment: Analyze behavioral and environmental determinants that predispose, reinforce, and enable the behaviors and lifestyles are identified.  Identify administrative and policy factors that influence implementation and match appropriate interventions that encourage desired and expected changes.  Implementation of interventions. PROCEED:  Stands for Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development.  involves the identification of desired outcomes and program implementation:  Implementation: Design intervention, assess availability of resources, and implement program.  Process Evaluation: Determine if program is reaching the targeted population and achieving desired goals.  Impact Evaluation: Evaluate the change in behavior.  Outcome Evaluation: Identify if there is a decrease in the incidence or prevalence of the identified negative behavior or an increase in identified positive behavior. Key Points:  Much of our health is dictated by voluntary behaviours-health promotion focuses on making good healthy choices  Health is more than physical well-being, or than the absence of disease, illness, or injury. It is a constellation of factors – economic, social, political, ecological, and physical – that add up to healthy, high-quality lives for individuals and communities.  Health is a community issue (our health is influenced by community attitudes, shaped by the community environment [physical, social, political, and economic], and colored by community history)

Lecture 6: 09/23/20 - Changing profile of health/disease  Up to the early 1900’s: most death were due to infectious diseases(tuberculosis, pneumonia, and influenza) - Early 1900’s to present:  Improved sanitation, antibiotics, vaccines and other medical advances  Life expectancy increased  more likely to develop, have to live with, and die from a chronic illness  Increasing role of lifestyle factors and health behaviours in the onset and course of chronic illness - What is killing Canadians?  Almost 60% of all deaths in Canada are from Cancer, Heart Disease, Stroke and Diabetes  Chronic diseases  Risk increases with age  All cases are treatable  Some are preventable  How can we reduce these? - Complementary and Alternative Medicine (CAM)  Defined as a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional (Western) medicine  According to one recent report by the Fraser Institute in 2016, about 80% of all Canadians surveyed used some form of CAM in their lifetime (e.g. acupuncture, supplements, chiropractic, etc.)  Usage is on the rise

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CAM  In 2016, massage was the most common type of therapy that Canadians used over their lifetime with 44 percent having tried it, followed by chiropractic care (42%), yoga (27%), relaxation techniques (25%), and acupuncture (22%).  The most rapidly expanding therapies over the past two decades (rate of change between 1997 and 2016) were massage, yoga, acupuncture, chiropractic care, osteopathy, and naturopathy.  High dose/mega vitamins, herbal therapies, and folk remedies appear to be in declining use over that same time period.  The majority of Canadians choosing to use complementary and alternative therapies in the 12 months preceding the 2016 survey continued to do so for “wellness”—to prevent future illness from occurring or to maintain health and vitality.  Canadians spent an estimated $8.8 billion on CAM in the latter half of 2015 and first half of 2016. Types of CAM  Grouped into broad categories, such as natural products, mind and body medicine (e.g. yoga, meditation) and manipulative and body-based practices (chiropractic's, acupuncture).  Natural products  Dietary supplements that are nonvitamin, nonmineral (such as Echinacea and fish oils), probiotics, herbal and botanical “medicines” The snake oil sales-man, was make claims and said that using this can reduce inflammation and have a longevity for life spans. Shows us that the claims are false he would mix other oils in the snake oil which doesn’t make it 100% CAM- Issues of Safety and effectiveness  Generally unregulated in Canada  Some may be covered by private health insurance plans but most are NOT covered by Medicare (level 1 coverage)  Select CAM practitioners with care. Find out about the practitioner's training and experience.  Be aware that some dietary supplements may interact with medications or other supplements, may have side effects of their own, or may contain potentially harmful ingredients not listed on the label. Also keep in mind that most supplements have not been tested in pregnant women, nursing mothers, or children.  Tell your health care providers about any complementary and alternative practices you use.  Needs to be health Canada approved Evidence Based Medicine (EBM)  EBM is the use of current “best evidence” in making decisions about the care of individual patients  Evidence comes from peer reviewed original published manuscripts/journals  Evidence-based medicine (EBM) is the process of systematically reviewing, appraising and using clinical research findings to aid the delivery of optimum clinical care to patients  Used to determine the “strength” or “weight” of the scientific evidence for a type of care (medicinal and non medicinal)

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 Clinically effective  Cost effective? Evidence based recommendations  Based on “quality of evidence” and thus study design  Level I: Evidence obtained from at least one properly designed randomized controlled trial.  Level IIa: Evidence obtained from well-designed controlled trials but without randomization.  Level IIb: Evidence obtained from well-designed cohort or case-control analytic studies, preferably from more than one center or research group.  Level III: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.

Lecture 7: 09/25/20 - Motivation and Locus of Control:  Motivation  Triggered by internal and external factors...