Environmental impact on health Flashcards
in utero impacts on health
fetal infection matrenal nutrition maternal illness maternal stress maternal medication environmental exposures e/g pesticides
influences on long term health social/environmental
environment family, neighbourhood school nutrition - maternal/foetal and child social - behaviours seen/substance use/caregiver behaviour health provisions
influences on long term health biological
genetics
epigenetics
what is the barker hypothesis/developmental origins of health and disease (DOHaD)
risk of coronary events more strongly related to the rate of change of childhood BMI rather than actual BMI status
undernutrition in utero + overnutrition as a child = increased risk of metabolic syndrome, therefore increased risk of cardiovascular events
what is the mechanism of the barker hypothesis/ developmental origins of health and disease (DOHaD)
programming in utero - epigenetic changes which influence child development and physiology
e.g endocrinology changes, foetal bone, lean and fat mass, vascular loading, immune responses
what is epigenetics
heritable changes in DNA that do not change the nucleotide sequence but influence how genes are expressed
what are the associations with early environmental exposures (disease risks)
cardiovascular disease T2DM lung disease cancer risk neurological, special sense and intellectual development allergic and auto-immune diseases
prevention NHS programmes
NHS healthy child
aims of NHS healthy child programme
prevent disease
promote good health
reduce health inequalities
and provide universal advice
what comes under the NHS healthy child programme
health promotion suppporting care givers screening - pregnancy and after birth immunisation indentification of high risk families signposting - accident prevention, dental hygiene
what are the fundamentals of screening
disease should be able to be identified before a critical point
should be treatable
should prevent harm
screening itself should be accessible, easy to administer
cost effective
reproducible and accurate
examples of early childhood screening
newborn check
newborn hearing check
blood spot/heel prick test
what is done for pregnant women pree contraception?
commence folic acid
those with diabetes mellitus offered eye screening test
what maternal tests are done in the first trimester?
sickle cell and thalassemia at wk0-10
syphillis, hep B and HIV at any point
combined test - ultrasound + blood test - test for Downs, Edwards and Pataus syndrome (wk10-14)
what maternal tests are done in the 2nd and 3rd trimesters?
20wk ultrasound scan (detailed, structural abnormalities)
reoffer screenung for infectious disease
