Detreminants of Chronic Disease

Question 1

What are the three main risk factors of FOAD?

Answer 1

Antenatal programing

Behavioral or lifestyle risk factors

Psychological risk factors

Question 2

what are some fetal stressors that can influence FOAD?

Answer 2

Maternal psychological stress

Maternal malnutrition

Smoking during pregnancy

Alcohol during pregnancy ( influence later on FOAD or gets FASD (teratogenic)

Placental factors

Question 3

What are the two overall consequences of fetal stressors during development?

EXAMPLE of each

Answer 3

Congenital abnormalities
- Vit D deficiency –> congenital rickets
-Alcohol exposure –> FASD

Diseases evident in adulthood/ FOAD
-Low birth weight –> increased risk of CHD

Question 4

What is the Baker/Thrififty phenotype hypothesis?

Answer 4

Fetal programming occurs when the fetus is exposed to a nutritionally poor in-utero environment = metabolism is prematurely alerted to a nutritionally poor environment (saves nutrients)

Question 5

How does baker/thriftfing phenotype hypothesis occur and what is the impact?

Answer 5

metabolic imprinting

allows infants to survive the predicted environment -. predisposed to adult diseases (obesity and HTN).

Question 6

What are the adaptions that predispose LBW offspring to CD:

Answer 6

Structural
Small kidneys and few nephrons

Metabolic
Altered settings for metabolism/hormonal feedback

More vulnerable to adverse influence later in life

Question 7

What biopsychosocial factors influence stress predisposition

Answer 7

Age, work, culture

Question 8

Physiology of chronic stress

Answer 8

Amygdala –> hypothalamus

Short term = sympathetic –> adrenal glands

Long term = hormonal –> adrenal glands

Question 9

Broken Heart Syndrome

Answer 9

Symptoms alike a heart attack

Induced by a stress event

Question 10

What was the overall conclusion of the Whitehall study?

Answer 10

Stress = chronic disease INDEPENDENT of biomedical factors

Question 11

What is the impact of social support on stress?

Answer 11

Alleviates stress

Cardioprotective

promotes Oxytocin release

Question 12

How does the release of Oxytocin improve stress?

Answer 12

Social support promotes O release

O inhibits HPA

O positive feedback on seeking social support

Question 13

What tools do you use to identify a patient that is at risk of stress?

Answer 13

social history
HEADASS

If stressed:
Health Belief model
Transtheroetical modle

Question 14

What is a Community Health Needs Assesment?

Answer 14

Systematic process for identifying health issues facing a community = agreed-upon strategies to improve health

Question 15

Why are Community Health Needs Assessments undertaken?

Answer 15

Helps community identify unmet health needs

Helps community examine root causes

Identifies where and how changes need to be made

Question 16

Steps in creating a Community Health Needs Assessment

Answer 16

Root cause analysis (stakeholders brainstorm underlying causes)

Prioritization of root causes

Development of activities and strategies

Question 17

Contributing factors vs Risk Factors

Answer 17

C= enable/ reinforce risk factor

R= directly causes the problem

Question 18

What does the Prioritisation criteria typically include?

Answer 18

Importance
(is the contributing factor the most important cause)

Timeline
(is the contributing factor changeable in 1-2 yrs)

Costs
(it is changeable within a appropriate budget for a community level health intervention)

Question 19

what types of behaviours are secondary risk factors often?

Answer 19

At-risk health behavious