Chronic diseases: Contributing behaviorAL and environmental factors Students in NC receive information on diabetes in 6th and 7th grades. They receive information on asthma in 6th grade. Both allergies and epilepsy are new to them this year. The focus of your discussion should be centered on how their behavior and environmental factors contribute to chronic diseases.

What is a chronic disease? Persistent or long-lasting, opposite of acute Leading cause of mortality worldwide Nearly one in two Americans has a chronic medical condition Most common: high blood pressure, arthritis, respiratory diseases and high blood pressure Many young people experience chronic conditions: Diabetes Allergies Asthma Epilepsy Source – Wikipedia. The most common chronic conditions are included here, but typically apply to adults. The four chronic diseases discussed here (epilepsy, diabetes, allergies, asthma) are part of the NC Standard Course of Study.

Epilepsy A condition of the nervous system – affects 2.5 million Americans. People with epilepsy have seizures that are a bit like an electrical brainstorm. A seizure prevents the brain from processing incoming sensory signals and from controlling muscles. That is why people with epilepsy may fall down and twitch. Fairly common – occurs in about 1 in every 100 – 200 people. Sources: http://kisdhealth.org 12/13/2011 http://faculty.washington.edu/chudler/epi.html 12/13/2011 www.nichcy.org – Epilepsy, June 2010 Fact Sheet #6 You may want to elaborate further on the fact that there are numerous types of epilepsy. You may wish to discuss what happens when an individual has a seizure, and that there are a series of appropriate first aid responses to an individual during a seizure. Anti-epileptic medication is the most common treatment for epilepsy. It’s effective in stopping sezures in 70% of patients.

Epilepsy continued Can epilepsy be prevented? Yes and No. Head injuries that result from sports or other accidents can cause epilepsy, but they are often preventable. How? Helmets Safety belts Hard hats Safety measures – common sense Epilepsy can also occur without injury or can be hereditary. Researchers are still exploring the reasons why some people have epilepsy. At least half of those with epilepsy never experienced a head injury Source: http://www.epilepsyadvocate.com 12/12/11 www.nichcy.org – Epilepsy, June 2010 Fact Sheet #6 About three million Americans have epilepsy. Of the 200,000 new cases diagnosed each year, nearly 45,000 are children and adolescents. Epilepsy affects people in all nations and of all races. Its incidence is greater in African American and socially disadvantaged populations. Epilepsy continued

Epilepsy continued Other causes of Epilepsy: Brain tumor Stroke Arteriosclerosis Infection (meningitis or encephalitis) What can I do to reduce the risk of seizures: Take prescribed medication Get enough sleep Avoid unusual stress Eat a well-balanced diet Maintain correct weight See your doctor Keep immunizations up to date. Sources: http://www.epilepsyadvocate.com 12/12/11 http://faculty.washington.edu/chudler/epi/html 12/13/11 Behavior Risks: Eating right and exercising will help maintain an ideal weight which will help control blood pressure which reduces the chance of stroke and reduces the chance of epileptic seizures. Epilepsy continued

Famous People with Epilepsy Julius Caesar George Frederick Handel Peter the Great Napoleon Bonaparte Vincent van Gogh Lord Byron Source: http://faculty.washington.edu/chudler/epi/html 12/13/11 It is easy for young people to believe that with a serious chronic condition, you are completely disabled. Pointing out that famous people have had the diseases puts it back into perspective. Also: Susan Boyle and Prince

Effects of an Allergic Response Most of the time your immune system fights germs and bacteria to help you stay healthy. If you have allergies, the immune system treats allergens (such as pollen) as if they are invading the body. Source: http://ncbi.nlm.nih.gov/pubmedhealth/PMH0001815/?report=printable 12/14/2011 http://kidshealth.org/kid/asthma_basics/triggers/allergies_asthma.html 12/12/2011 Allergies have not been covered in the NC Standard Course of Study until students are in 8th grade, with this lesson.

What Causes Allergies? Common allergens: drugs dust food insect bites mold pet dander pollen

What are Symptoms of Allergies? Breathing problems (coughing, shortness of breath) Burning, tearing, or itchy eyes Headache Hives Runny nose Wheezing Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001815/?report=printable There are more allergy symptoms. Ask the class if anyone has an allergy and if they react in a way not listed here. Other reactions are – diarrhea, itching of the nose, mouth, throat, or skin, skin rashes, stomach cramps, nausea, vomiting.

How a Person is Tested for Allergies Skin testing is the most common method of allergy testing. One type of skin testing is the prick test. Skin is pricked with a small amount of the suspected allergen. The site is closely monitored to see if a reaction occurs. Blood tests are also used to measure levels of allergy-related substances.

Allergies Treatment Medications used to treat allergies: Antihistamines Corticosteroids Decongestants Allergy shots are sometimes recommended if you cannot avoid the allergen and your symptoms are hard to control.

Prevention of Allergies Breastfeeding children for at least 4 months or more may help prevent a cow’s milk allergy and wheezing in early childhood. Once allergies have developed, treating the allergies and carefully avoiding allergy triggers can prevent reactions in the future. There is also evidence that infants who are exposed to certain allergens in the air (such as dust mites and cat dander) may be less likely to develop allergies. This is called the “hygiene hypothesis”. It came from the observation that infants on farms tend to have fewer allergies than those who grow up in more sterile environments.

Asthma and Allergies People who have certain kinds of allergies are more likely to have asthma. Allergies that affect the nose and eyes – typically pollen or dust – can also trigger asthma symptoms. Not everyone who has allergies gets asthma. Not all asthma happens because of allergies. About 3 of 4 kids have asthma symptoms triggered by an allergy. It is important to present the concept of how allergies and asthma are related.

Asthma (continued) People with asthma experience problems with their airways – the breathing tubes in their lungs. Airways become swollen and full of mucus. Asthma is the nation’s fastest-growing chronic disease. Rates among children under four have more than doubled in the last 20 years. African-American children are five times more likely to die from asthma than Caucasians. Asthma = one of the leading causes of school absenteeism Sources: EDF – Environmental Defense Fund – Asthma and air pollution.

Asthma Triggers Triggers do not cause asthma, but lead to flare-ups. People with asthma experience different triggers What are common triggers? Air pollution Smoke (first, second and third-hand smoke) Exercise Allergens cause allergic reactions. Examples: mold, dust mites, cockroaches, pollen, animal dander, feathers Cold/flu Weather (wind stirring up mold and pollen) Source: http://kidshealth.org/kid/asthma_BASICS/TRIGGERS/ASTHMA_TRIGGERS.HTM 12/12/11L http://www.youtube.com/watch?v=vlZ7R07OrR4&feature=related I – an excellent U-tube of less than 3 minutes that explains what happens in an asthma attack. Second hand smoke – someone else’s smoking / you are breathing it. Third hand smoke – individual who has been exposed to second hand smoke (klinging to clothes, skin, etc) then transferred to others. Example: If parent smokes outside and comes in to the child, some of the residue is still passed to the child. Sources: EDF – Environmental Defense Fund – Asthma and air pollution. “A strong case for the importance of ozone in triggering summertime asthma attacks comes from a study of Atlanta during the 1996 Summer Olympics. To reduce traffic congestion downtown during the 17 days the games were being held, the city enhanced public transit, closed downtown to private cars and encouraged businesses to promote telecommuting and alternative work hours. The study found that daily peak ozone levels dropped 28% and hospitalizations for asthma fell by almost 20% during that time. The Atlanta case demonstrates a link between air quality and the prevalence of asthma attacks, and offers evidence that reducing air pollution is a powerful means of combating this medical scourge.”

Asthma How can asthma be controlled? Become an advocate for clean air Reduce exposure to air pollution Watch for the weather reports Keep your room clean and free of dust Wash your sheets weekly in hot water Keep any pets out of your room Stay away from freshly cut grass and leaf piles Keep your medication with you at all times Sources: http://kidshealth.org/kid/asthma_basics/triggers/weather_asthma.html 12/12/11 EDF – Environmental Defense Fund – Asthma and air pollution.

Diabetes Disease in which there are high levels of sugar in the blood. Type I diabetes can occur at any age; most often diagnosed in children, teens young adults. In this disease, the body makes little or no insulin Daily injections of insulin are required The exact cause is unknown Source: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001356/?report=printable 12/14/2011 Type I diabetes is often called Juvenile onset diabetes

Diabetes Type 2 diabetes makes up most of the diabetes cases. Occurs mostly in adulthood, but teens/young adults are being diagnosed with it because of high obesity rates. Many people with Type 2 diabetes do not know they have it. Type 2 diabetes is often called Adult-onset diabetes

Diabetes Symptoms Blurry vision Excessive thirst Fatigue Frequent urination Hunger Weight loss

Diabetes Prognosis Better control of Helps reduce the risk of blood sugar cholesterol blood pressure levels Helps reduce the risk of kidney disease eye disease nervous system disease heart attack stroke

Diabetes Complications Heart disease and stroke High blood pressure Blindness Kidney disease Nervous system disease Amputation More than 60% of non-traumatic lower-limb amputations occur in people with diabetes. Source: American Diabetes Association; http://www.diabetes.org/diabetes-basics/diabetes-statistics/ 12/15/2011.

Diabetes There is no way to prevent Type 1. Prevention of the onset of Type 2: Keep an ideal body weight Exercise Source: Most diabetes info from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/?report=printable 12/14/11

Keeping an Ideal Body Weight Who is responsible for your weight? Some interesting statistics: Each day, 1 in 4 Americans visit a fast food restaurant. You would have to walk for seven hours to burn off a Super-Sized Coke, fries and Big Mac 60 percent of all adult Americans are either overweight or obese Source: Fast Food Facts from the Super Size Me Web site. Teachers: The journal article, The Effect of Fast Food Restaurants on Obesity (Jan 2009) is available on-line. Authors found that among 9th grade children, a fast food restaurant within a tenth of a mile of a school was associated with at least a 5.2 percent increase in obesity rates.

Chronic diseases When you compare the different diseases we have discussed today, what are the most common steps to prevention? This question will be the kick off for discussion in your classroom. Do not read the listed suggested answers below. Some suggested answers: weight control, diet, exercise, seeing your doctor regularly, taking care of yourself before something goes wrong. Political involvement. Voting. Staying educated about current events.