Adult and Men's health Flashcards
What is a positive stress response?
normal and essential part of healthy development, characterized by brief increases in heart rate and mild elevations in hormone levels
What situations could trigger a positive stress response?
- first day with a new caregiver
2. receiving an injected immunization
What is a tolerable stress response?
activates the body’s alert systems to a greater degree as a result of more severe, longer-lasting difficulties, such as the loss of a loved one, a natural disaster, or a frightening injury
Does a tolerable stress lead to life long effects?
- If the activation is time-limited and buffered by relationships with adults who help the child adapt
- the brain and other organs recover from what might otherwise be damaging effects
What is a toxic stress response?
can occur when a child experiences strong, frequent, and/or prolonged adversity—such as physical or emotional abuse, chronic neglect, caregiver substance abuse or mental illness, exposure to violence, and/or the accumulated burdens of family economic hardship—without adequate adult support
How can a toxic stress response affect development?
kind of prolonged activation of the stress response systems can disrupt the development of brain architecture and other organ systems, and increase the risk for stress-related disease and cognitive impairment, well into the adult years
What happens if this toxic stress response occurs continually or is triggered by multiple sources?
it can have a cumulative toll on an individual’s physical and mental health—for a lifetime
How do ACEs affect development?
- more adverse experiences in childhood, the greater the likelihood of developmental delays and later health problems
- including heart disease, diabetes, substance abuse, and depression.
What can prevent or reverse the damaging effects of toxic stress response?
supportive, responsive relationshipswith caring adults as early in life as possible
Do males live longer than females?
- Live shorter lives
- Suffer life-limiting disease sooner
- The gap between make and female life expectancy is greater in higher income countries
On average how much earlier to men die?
5 years
How does male lifestyle affect their increased mortality?
- Men take more risks and are involved in more accidents - more men drive than women around the world
- construction and agriculture are inherently riskier occupations
How soon do men present to their GP?
Men are less likely to seek help when they need it (reduced health literacy), less likely to see GP - so tend to present in more progressed stage of disease
Although road injuries are a big cause of death amongst males what is another major reason?
- Mental health
- stigmatises and less social than women more prone to alcohol misuse and homelessness
- 3/4 suicides occur by men and more likely to be violent and completed - depression relates as more irritability
How can you change these death rates?
- change in culture and improve health literacy
- Workplaces: flexible, healthier canteens
- Social prescribing
What are the 7 pillars of self-care framework?
- Knowledge and health literacy
- Mental wellbeing
- Physical acitivty
- Healthy eating
- Risk avoidance
- Good hygiene
- Rational use of products and services
What is self care?
what people do for themselves to establish and maintain health, and to prevent and deal with illness
What are aspects of self care?
- empowerment
- self-management
- self-monitoring
- self-treatment
- self-efficacy
- patient activation
- self-help
What is the self-care continuum?
slide along it during life-course
What are social cultural and political factors that are the main causes of chronic disease?
- Globalisation
- Urbanisation
- Ageing population
What are personal risk factors that are the main causes of chronic disease?
- unhealthy diet
- physical inactivity
- tobacco use
- excess alcohol
- age and genes
- risk factors are modifiable (with self-care)!
What are intermediate risk factors that are the main causes of chronic disease?
- Raised BP
- Raised blood glucose
- Abnormal blood lipids
- Overweight/ obesity
- risk factors are modifiable (with self-care)!
What are examples of self care in communicable disease?
- Risk avoidance: school closures, lockdown measures, social distancing
- Good hygiene: hand washing, sanitiser gel, contract tracing app
- Awareness and literacy: health literacy, public health messaging, shielding high risk groups
What are examples of risk management?
- regular hand washing
- taking up vaccinations
- practising safe sex
How are self-car behaviours included?
- Activation
- Incentivisation
- Nudges
- Gamification
- Personalisation
How do these behaviours manifest?
- Lifestyle medicine
- Lifestyle over drugs
- Person-centred medicine
- Doctors as coaches
- The democratisation of self-care
- Health in all policy (HiAP) approach
How do the 300,000+ health apps help in self-care technology (enablers)?
- eHealth and mHealth
- Internet of things
- Diagnostics
- Fitness trackers
- Internet pharmacies
- Social media platforms
- Decision support tools
- AI
How do the 1000+ health apps help in self-care technology (enablers)?
- Blood pressure monitor
- Sleep apnoea monitor
- Glucometer
- Breath-analysis
- Heart rate
- Pedometer
- Mood assessment
- Movement / fall sensor
- Cognitive performance
What is the paradigm shift?
- Passive individual poor self care, downstream interventions
- Self-care can help bridge the gap between health and social acre
- Prevention agenda - Activated individual, good self-care, upstream measures of prevention
What are policy terms?
- Inequalities
- Homelessness
- Alcohol dependency
- Suicide
- Social Isolation
- Loneliness
What is self care community of practice (COP)?
It can play a vital role in helping tackle these problems by focusing more on upstream measure of prevention
‘Social prescribing’
Why is self-care important?
Self care from cradle to grave: from 5 to 105 years
- self-care plays a key role in promoting vitality in a ageing
- directly relevant to lifestyle medicine and workplace health
- Self care behaviours are a huge area of focus today
What are some complications of drugs that are injected?
- Blood clot
2. Infectious disease (e.g. Hep C, HIV)
What is the definition of alcohol misuse?
More than 14 units/week or >8 units/session for men or >6 units/session for women
When is the peak of alcohol mis use?
Peak 55-64
What is the alcohol harm paradox?
- Inverse relationship between SES: social economic status and alcohol misuse : increase quantity of alcohol as affluence increases
- However deprived communities experience more harm from alcohol
- Could be due to multiplier effect where alcohol interacts with other factors e.g. less savings and less social support may be less able to cope with effects of alcohol misuse
- Lower SES users may consume higher amounts in less frequent episodes
What is the relationship between alcohol use and mental health?
- Maladaptive coping strategy
- Increased alcohol consumption
- Depressant effects of alcohol
What are the wider social impact of alcohol misuse?
- Relationship
- Domestic abuse
- Child abuse
- Crime
- Road traffic accidents
- So alcohol may be underlying cause as to why people present to healthcare services
What is the screening for drinking at hazardous or harmful levels?
- Audit
2. Audit C
What is the treatment for alcohol cessation?
-Brief advice
-Self help resources
-Follow up appointment
-If unsuccessful:
Extended brief intervention and/or CBT
What are the symptoms of acute alcohol withdrawal?
- Hypertension
- Tachycardia
- Sweating
- Tremor
- Agitation
What happens in severe cases of alcohol withdrawal?
- In severe cases (delirium tremens);
- confusion
- Seizures
- hallucinations
- hyperthermia
What happens if alcohol withdrawal is suspected?
admit to hospital
When are you at risk of having Wenicke’s encephalopathy?
when consume large amounts of alcohol
- Caused by vitamin B1 (thiamine) deficiency
- Neurological emergency
What are the symptoms of Wernicke’s encephalopathy?
- Symptoms include:
- gait and balance disturbance
- altered consciousness
- eye movement abnormalities - Patients are likely to require IV thiamine (to avoid neurological injury)
What do you need to do prior to starting planned withdrawal?
- Advise not to stop drinking suddenly
- Inform DVLA and stop driving
- Assessed for alcohol-related co-rmorbidities requiring specialist care:
- Mental illness
- Liver disease
- Pancreatitis - Patients are likely to require oral thiamine
Where does supervised withdrawal occur?
- Primary care (only if):
- patient is at reduced risk of adverse outcomes
- under supervision of a GP with a special interest in substance misuse - Otherwise take place in specialist services
How long is alcohol withdrawl?
1-2 weeks w/ chlordiazepoxide
How is abstinence maintained?
use acamprosate (reduces urge to drink and works best with talking therapy)
How does acamprosate work?
influences gama aminobutyric acid (GABA) (thought to be partially responsible for alcohol cravings)
What does after care for alcohol cessation involve?
After care is important as high risk of relapse e.g:
- One to one
- Group support
- or residential rehabilitation
What are the treatment options for smoking cessation?
- Bupropion
- NRT
- Varenicline
What is bupropion?
- tablet 1-2 weeks before quit (1 tablet a day for 6 day) then 2 tablets a day 8 hours apart not near bed - 10 days
- Nausea, sleep, dry mouth
- Take 9 weeks
What is NRT?
- Skin patch,
- Quit on Sunday, put patch on Sunday morning dry hairless seater 24 hour another place and inhalator on Sunday
What is varenicline?
- Start taking 1-2 weeks before
- Reduce unpleasant
- Nausea
- 12 weeks
- One 1 tablet first 3 days
- 2 next 4 days (morning and evening)
- 1 blue tablet morning and evening
