Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

YR1 Epidemiology in Practice > Lectures 7&8 - Disease prevention part 1 > Flashcards

Lectures 7&8 - Disease prevention part 1 Flashcards

1
Q

what is the WHO definition of health?

A

a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the definition of public health?

A

the science and art of preventing disease, prolonging life and promoting health through organised efforts of society

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the 3 main domains of public health?

A

1) health improvement/promotion
2) health protection - focused on infectious diseases and emerging hazards
3) health services/health care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

life expectancy is an indicator of health. what factors effect life expectancy?

A
  • geopolitics
  • health care provision
  • innovation
  • economic development
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what factors effect likelihood of smoking?

A
  • deprivation
  • education
  • ethnicity
  • obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what factors effect likelihood of drinking?

A
  • age - young people are less likely to consume the same amount of alcohol in a week than older people, but are more likely to exceed the weekly recommended limit in a day
  • as household income increases the amount of alcohol consumed is likely to increase
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the differences between upstream determinants and downstream determinants?

A
  • upstream determinants involve life circumstances on a macro level (e.g. housing, education)
  • downstream determinants involve risk factors on a micro level (e.g. ethnicity, gender, alcohol consumption, genetics, obesity, stress)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the 3 causes of health inequalities?

A
  • upstream determinants - financial status, employment, work environment, education, housing
  • lifestyle factors - smoking, BP, alcohol, cholesterol, BMI
  • health services - primary and secondary care, preventative care, community services
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is health promotion?

A

the process of enabling people to increase control over, and to improve their health. it involves changing actions towards social, economic and environmental conditions to alleviate their impact on public and individual health.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what does health promotion involve?

A
  • clinical intervention - biomedical screening/ immunisation
  • health education - smoking cessation, healthy eating, exercise promotion
  • healthy public policy - legal, fiscal and social measures to make healthy choices easier (e.g. sugar tax), sustainable policies and opportunities that enable equality for health and well-being
  • community development - groups with their own agendas, partnerships with public, private, non-governmental and international organisations
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does the Health Promotion Tannahill Model involve?

A

overlap of protection (legal, fiscal, social measures), prevention (medical interventions) and education methods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are the 4 levels of prevention?

A

1) primordial prevention
2) primary prevention
3) secondary prevention
4) tertiary prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is primordial prevention?

A

prevention of factors promoting the emergence of lifestyles, behaviours and exposure patterns which contribute to increased risk of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is primary prevention?

A

actions to prevent the onset of disease, by limiting exposures to risk factors by individual/communal behaviour change (E.g. vaccination)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is secondary prevention?

A

halting the progression of an illness once it has already established. early detection followed by prompt, effective treatment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is tertiary prevention?

A

rehabilitation of people with established disease to minimise residual disability and complications. aims to improve quality of life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the 2 main approaches to disease prevention?

A

1) high risk - identifying those in special need, then controlling exposure or providing protection against effect of exposure
2) population - recognition that the occurrence of common diseases and exposures reflects the behaviour and circumstances of society as a whole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the prevention paradox?

A

many people exposed to a small risk may generate more disease than a few people exposed to a large risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the strengths of a high risk approach?

A
  • effective due to high motivation of individual and clinician
  • efficient
  • benefit:risk ratio is favourable
  • appropriate to individual
  • easy to evaluate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the weaknesses of a high risk approach?

A
  • palliative and temporary (misses a large amount of disease)
  • risk prediction may not be accurate
  • limited potential
  • hard to change individual’s behaviour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the strengths of the population approach?

A
  • equitable (overall risk may be high if many are exposed to low risk)
  • radical
  • large potential for population
  • behaviourally appropriate
22
Q

what are the weaknesses of the population approach??

A
  • small advantage to individual
  • poor motivation of individual and clinician
  • benefit:risk ratio is worse
23
Q

at what levels can health promotion have an impact?

A
  • population - internationally/nationally (gov’t, ads, media)
  • community - locally (GP, hospitals, schools)
  • individual (support group)
24
Q

give an example of a Health Promotion role where doctors have worked with individuals

A

Smoking Cessation:

  • smoking cessation guidelines (NICE)
  • motivational interview
  • support for stopping
  • prescription of nicotine replacement therapy
  • referral to specialist services
25
Q

describe the Wanless Report for Health Promotion

A 
involves the need to focus on prevention and the wider determinants of health 
3 reports:
1) on NHS
2) on social care
3) on public health
26
Q

what 6 areas were identified to target by the gov’t (Gov’t White paper - Choosing Health) after the Wanless report?

A
  • smoking
  • alcohol
  • obesity
  • sexual health
  • teenage pregnancy - mental health
  • diet
27
Q

describe the Commission on Social Determinants of Health

A
  • improve conditions of daily life
  • tackle inequitable distribution of power, money and resources
  • develop a workforce that is trained in the social determinants of heath
  • raise public awareness about social determinants
28
Q

what is The Marmot Review?

A

UK’s response to Commission on Social determinants of heath

29
Q

what are the 6 main objectives of The Marmot Review?

A

1) give every child the best start in life
2) enable everyone to maximise their capabilities and have control over their lives
3) fair employment and good work for all
4) healthy standard of living for all
5) healthy and sustainable places and communities
6) strengthen the role and impact of ill health prevention

30
Q

what are the key public health initiatives in the UK?

A
  • smoking cessation (and clinics/nicotine replacement therapy/group sessions)
  • policy
  • legislation
  • taxation
  • media campaigns
  • school activities
  • healthy workplaces
  • 1-to-1 support
31
Q

what strategies are involved in reducing alcohol consumption?

A
  • ban on selling alcohol below the price of duty and VAT so stop sale of cheap alcohol
  • challenge alcohol industry to support local partnerships, reduce availability of high-strength products, promote and display alcohol responsibility and improve education
  • provide action at local level to strengthen partnerships
  • improve the licensing system
32
Q

what strategies are involved in reducing STIs and Chlamydia infections?

A

as chlamydia is the most common STI, national screening programme is offered especially to young people

33
Q

what strategies are involved in reducing teenage/under-age pregnancy?

A
  • information, advice and support from parents, schools and professionals
  • approachable sexual and reproductive health services
  • Sex. Worth talking about campaign
  • mandatory sex and relationships education
  • improved access to contraceptives
  • early intervention for high risk individuals
34
Q

what vaccines are involved in improving immunisations?

A
  • Men ACYW vaccine
  • MMR
  • tetanus and polio
35
Q

describe descriptive studies

A

describe the distribution of factors/disease in relation to the person, place or time

36
Q

what types of data are used in descriptive studies?

A
  • routine (e.g. births, deaths)
  • survey (e.g. Health Survey for England)
  • performance management: quality and outcomes framework for GPs
37
Q

what is routine data?

A

“data that is routinely collected and recorded in an ongoing, systematic way, often for administrative or statutory purposes and without any specific research question in mind at the time of collection”

38
Q

what are the most important types of routine data used in the UK?

A
  • health outcome data - e.g. deaths, hospital admissions, primary care consultations or prescriptions
  • exposures and health determinant data (e.g. smoking)
  • demographic data - e.g. census population counts
  • geographical data - e.g. location of GP practices
39
Q

what are the advantages of routine data?

A
  • cheap
  • already collected and available
  • standardised collection procedures
  • comprehensive
  • wide range of records
  • available for past years
  • experience in use and interpretation
40
Q

what are the disadvantages of routine data?

A
  • may not answer question
  • not every case captured
  • variable quality
  • variable validity
  • disease labelling may vary by time/area
  • coding changes
  • requires careful interpretation
41
Q

what does health outcome data involve?

A
  • mortality
  • cancer
  • infectious diseases
  • pregnancy terminations
  • congenital anomalies
  • GP data
42
Q

how is the census recorded?

A
  • questionnaire beginning 1801 and occurring every 10 years
  • population estimates
  • health questions
  • compulsory registration of births and deaths
43
Q

how is mortality recorded?

A
  • death certificates:
  • local registrars of births/deaths
  • ONS for coding and processing
44
Q

how are cancer registrations recorded?

A
  • voluntary notification to local cancer registry

- also from death certificates

45
Q

how are infectious disease notifications recorded?

A
  • reported by doctors

- incidence of disease

46
Q

what is the quality and outcomes framework?

A
  • a component of the new General Medical Services contract for GPs
  • rewards practices for the provision of quality care, and helps to fund further improvements in the delivery of clinical care
47
Q

how are controls in case-control studies selected?

A
  • subjects must be free of the disease/outcome during the same period of time in which the cases were identified
  • subjects should be representative of the population
48
Q

what may act as sources of controls for case-control studies?

A
  • neighbourhood
  • friends/relatives
  • hospitals
49
Q

what are the advantages of cohort studies?

A
  • can look at multiple outcomes
  • can follow through the natural history of disease
  • can look at risks relative to rare exposures
  • can calculate incidence
  • can minimise bias if prospective
50
Q

what are the disadvantages of cohort studies?

A
  • poor for studying rare diseases
  • expensive and time-consuming if prospective
  • loss of following-up may introduce bias
  • healthy worker/volunteer effect may effect representation (bias)
51
Q

describe the standardised mortality ratio?

A

used for comparing death rates in one area with a “standard population”, adjusting for age and often sex

52
Q

what do you calculate standardised mortality ratio?

A

SMR = number of Observed deaths (O) / number of Expected deaths if the same age-specific rates as the standard population were experienced (E)

SMR = O/E

YR1 Epidemiology in Practice (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions