Lectures Flashcards
What is interesting about the definition of health?
That most scientists cannot agree on a definition of health so there are multiple.
What are some common factors that affect health?
Biology, the environment, social economic & cultural factors and lifestyle & behaviour.
What is DALY and what does it stand for?
DALY stands for “Disability Adjusted Life Lost” and it is the total sum of the time (life) lost for those with a disability. Disability being any form of illness or disease, it may be a mental illness or a chronic disease for example.
What is YLL and what does it stand for?
YLL stands for “Years of Life Lost (due to death)” and it is how many years of life lost to death. For example if someone past away at 12 but they should have on average lived to around 70 they would have lost 58 years due to death.
What is YLD and what does it stand for?
YLD stands for “Years lived with a disability” and it means how long someone dealt with a disability before either 1. passing away or 2. Losing that disability.
When looking at health as a New Zealander, why should we care about health globally?
Because health in other countries can either impact, change or help our health in NZ. Examples include: Human rights laws and public goods, the spread of illness, globalization and development and security and diplomacy.
What are the 3 Lay (Layers of answers) of health?
- Health is not being ill or having disease
- Health is having the capacity to meet life’s obligations
- Health is a sense of well-being expressed in physical and mental terms.
What is the McKeown thesis?
“In a body of research published from the 1950s
to the 1980s, the physician and demographic
historian Thomas McKeown put forth the view
that the growth in population in the industrialized
world from the late 1700s to the present was due
not to life-saving advancements in the field of
medicine or public health, but instead to
improvements in overall standards of living,
especially diet and nutritional status, resulting from
better economic conditions.”
What are proximal causes of disease?
Proximal causes represent an immediate vulnerability for a particular condition or event. Some examples of proximal risk factors are ongoing abuse, having difficulties because of a physical impairment or injury, poor academic or work performance, and stressful life events
What are the distal causes of disease?
Distal causes are causes that represents an underlying vulnerability for a particular condition or event. This does not predict that the condition or event will definitely happen or that it will happen any time soon, but rather that a person may be at risk for the condition at some time in the future. Such as a a risk of heart disease in a person.
At what levels can we intervene in health?
Downstream, Midstream, and Upstream.
What is the Lalonde report?
The four key aspects to health which as the following: Biology, environment, health care, and lifestyle.
What does ‘Downstream’ mean?
It is a downstream intervention of health. This means we are working to change or diminish the effects of the causes. Such as providing rehab for someone with a drug addiction.
What does ‘Midstream’ mean?
It is a midstream intervention of health, this means we are working to change the causes. For example provide educational resources about drug addiction to prevent the amount of people having drug addictions.
What does the ‘Upstream’ mean?
It is a upstream intervention of health, this means we are working to diminish the causes of the causes. For example drug addiction could be a consequence of lack of jobs or increase in poverty, therefore upstream intervention would be increasing jobs and making law changes to help decrease poverty.
Why is it hard to study and investigate how changes in health impact populations?
Because people lie about their situations and the study may be hard to back up with true evidence.
What are conservative strategies?
Encouraging people to take individual responsibility of their health.
What are radical strategies?
Challenging the state and advocating major social change in health.
What is the Ottawa charter for health promotion?
The Ottawa Charter is a global health milestone, and remains a vital reference for health promotion. The Charter identifies five components of health promotion action and prerequisites for health, including peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice and equity
What are the ‘Social determinants of health’?
The social determinants of health (SDH) are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems
include economic policies and systems, development agendas, social norms, social policies and political systems.
What are some examples of Social Determinants of Health (SDH)?
Childhood experiences, Housing, Education, Social support, Family income, Employment, Communities, Access to health services.
What is the stress response in health?
The stress response, or “fight or flight” response is the emergency reaction system of the body. It is there to keep you safe in emergencies. The stress response includes physical and thought responses to your perception of various situations.
What is the difference between acute or chronic stress?
Acute stress is short-term stress. Chronic stress is long-term stress.
What is the difference between Direct and Indirect relationships?
Direct is when your human physiology impacts your health. And Indirect is when your coping mechanisms and what you prioritise impacts your health.
What is the ‘Allostatic’ load?
Allostatic load is “the wear and tear on the body” which accumulates as an individual is exposed to repeated or chronic stress.
True or False? The relationship between social determinants and health status is often multidirectional.
True for example poor financial status will cause stress which causes poor mental health. But poor mental health will lead to less productivity which leads to a poor financial status.
Explain the factors for how housing is a social determinant of health.
A house which is hard to heat can cause asthma. A house which has bad air pollution can cause respiratory problems. A house which is overcrowded can cause mental health issues. A house which has financial difficulties can cause mental health issues.
What is energy poverty?
Energy poverty is lack of access to modern energy services. According to the Energy Poverty Action initiative of the World Economic Forum, “Access to energy is fundamental to improving quality of life and is a key imperative for economic development.
What is Health Psychology?
Health psychology is the study of psychological and behavioural processes in health, illness, and healthcare.
What are the 3 aspects of health psychology that are studied?
- How do people stay healthy, 2. Why do people become Ill, 3. How do people respond when they get ill
Why is place/location important for understanding health?
As the environment and exposures of a place/location can impact an individuals health such as living is a polluted city may increase an individual’s chances of developing asthma.
What are some physical environmental influences on health and illness?
Air & Water quality, green/blue space, and exposure.
What are some social environmental influences to do with location on health and illness?
Social and cultural norms around health related behaviours (diet/drinking), Peer pressure and social learning, access to resources.
What are 2 of the things health geography address?
The difference in air pollution between areas and the accessibility of health services in different locations.
What is the lancet?
The Lancet is a weekly peer-reviewed general medical journal. It is among the world’s oldest, most prestigious, and best known general medical journals.
When talking about health geography what does composition mean?
Characteristics of people in particular places that influence health.
When talking about health geography what does context mean?
Characteristics of places that have independent influences on health incomes
Out of composition and context what best fits this statement: An area that has a younger population tends to be a healthier area
Composition
Out of composition and context what best fits this statement: An area with higher rates of pollution tends to be an unhealthier area
Context
What is the map by John Snow?
John Snow is viewed by many as a pioneer in disease mapping. For the 1854 cholera outbreak in London’s Broad Street region, he presented two maps. After careful investigation, including plotting cases of cholera on a map of the area, Snow was able to identify a water pump in Broad (now Broadwick) Street as the source of the disease.
How do we measure exposure?
By distance, exposure (location), and time (for example pollution in a certain area over time).
True or False, It is very easy to map social exposure.
False, It is very hard.
What are the ‘3 biggest challenges in life’?
Nature, other people, and self.
What is tikanga maori?
Tikanga is a Māori concept with a wide range of meanings — culture, custom, ethic, etiquette, fashion, formality, lore, manner, meaning, mechanism, method, protocol, style. Generally taken to mean “the Māori way of doing things”
What is Enculturation?
the process whereby individuals learn their group’s culture, through experience, observation, and instruction.
What is ethnocentrism?
Ethnocentrism is used in social sciences and anthropology to describe the act of judging another culture and believing that the values and standards of one’s own culture are superior
What is acculturation?
Acculturation is a process in which an individual adopts, acquires and adjusts to a new cultural environment.
What are comorbid conditions?
Having multiple conditions that usually relate or cause others.
What does comorbidity mean?
Comorbidity refers to one or more diseases or conditions that occur along with another condition in the same person at the same time. 1 Conditions considered comorbidities are often long-term or chronic conditions.
What are SES groups?
Groups of social economic status
What are the potential errors when dealing with patient symptoms?
- Deciding a symptom is not important when it is or 2. Deciding a symptom is important when its not.
What is the 3 stage process of dealing with symptoms?
- Becoming aware of sensations. 2. Interpreting sensations 3. Planning and action.
What can change the nature of a symptom between individuals?
- Their focus of attention, 2. Individual differences such as gender and coping styles, 3. Mood, and 4. Stress
True or False? Positive and negative moods can have an effect on how you process symptoms.
True
True or False? Stress aggravates the experience of symptoms.
True
What is medical students disease?
a condition frequently reported in medical students, who perceive themselves to be experiencing the symptoms of a disease that they are studying. The condition is associated with the fear of contracting the disease in question.
What is health psychology?
Health psychology is the study of psychological and behavioral processes in health, illness, and healthcare. It is concerned with understanding how psychological, behavioral, and cultural factors contribute to physical health and illness.
What is mass psychological illness?
Mass psychogenic illness is when people in a group start feeling sick at the same time even though there is no physical or environmental reason for them to be sick. They could think they’ve been exposed to something dangerous, like a germ or a toxin (poison)
True or False? People tend to have organised conceptions of individual illnesses.
True.
What are the 5 components of illness perception?
- Identify (What you think it is). 2. Timeline (How long do you think it will last). 3. Consequences (How serious do you think it is). 4. Cause (How you think it was caused). 5. Belief (What you think may cure it)
What can go wrong with someones illness perception?
Their beliefs about their symptoms may lead to incorrect illness representations and may lead people to not seek medical treatment. Illness perception may also lead people to think they don’t need to engage in advised self-care behaviour.
What is the microbiota?
Microbiota are “ecological communities of commensal, symbiotic and pathogenic microorganisms” found in and on all multicellular organisms studied to date from plants to animals. Microbiota includes bacteria, archaea, protists, fungi and viruses.
What are microbes?
A microorganism, or microbe, is a microscopic organism, which may exist in its single-celled form or in a colony of cells as bacteria, viruses, fungi, algae and protozoa.
What are microorganisms?
A microorganism, or microbe, is a microscopic organism, which may exist in its single-celled form or in a colony of cells as bacteria, viruses, fungi, algae and protozoa.
How many microbes are transferred if you shake dry hands with someone briefly?
655 Microbes.
How many microbes are transferred if you shake wet hands with someone briefly?
68,000 Microbes
How many cells does the human body have?
Estimated at about around 37.2 trillion cells or between 10 and 100 trillion cells.
How many microorganisms inhabit the human body?
10-1000 trillion microorganisms
Why are microbes important parts of your immune system?
The human body is teeming with bacteria. … These beneficial bugs are called commensal bacteria. One of the most important functions of commensal bacteria is boosting the immune system.
What are bacteroides?
Bacteroides is a genus of Gram-negative, obligate anaerobic bacteria. Bacteroides species are normally mutualistic, making up the most substantial portion of the mammalian gastrointestinal microbiota, where they play process complex molecules to simpler ones in the host intestine.
What are ecosystem scales?
The geographical area that is considered an ecosystem, depending on the purpose of the analysis.
Why does the mitochondria have its own DNA?
Mitochondria has its own DNA because it is believed that mitochondria have originated from primitive bacteria which was engulfed by the Eukaryotic cell. The theory suggests that the bacteria remained inside the pro-eukaryotic cell as Symbiont.
Where does the most essential DNA sit in your body?
In the mitochondria
Which parent do you get your mitochondria from?
Your mum
True or False, Bacteria is free roaming in the human body.
False, different bacteria in the human body have different places in which they roam.
What may effect the development of a child’s microbiota?
Maternal exposures such as food and drinks and soaps and creams.
What increases you chances of having greater bacteria diversity?
Having more fibre.
If someone has extremely low bacteria diversity what would you do to fix this?
Poo transplant.
How many species are there estimated to be?
We know of 8.7 million species so far but some scientists estimate the global number of species to be around 1 billion.
What is a phage?
a virus that infects and replicates within bacteria and archaea.
What is biomass?
Biomass is plant or animal material used for energy production (electricity or heat), or in various industrial processes as raw substance for a range of products.
True or False, life on earth is very dense.
True, extremely dense, most of the molecules for example phage in the human body could be unraveled and spread all around space.
True or False, phage genetically represents earths gene pool.
True.
How many unique genes do phage hold?
2.5 billion unique genes therefore this genome is over 1 million times larger than the human genome.
What is the source of infectious diseases?
Microorganisms
True or False, all microorganisms can either hurt or live mutually with us.
False, there are some which can do both, there are some which benefit us, and there are some which can only live by harming us.
What are opportunistic pathogens?
An infectious microorganism that is normally a commensal or does not harm its host but can cause disease when the host’s resistance is low. For example some microorganisms may thrive in burn environments, so if you were to get a burn you would get an infection in that area due to that microorganism.
Has there been anything done to stop antibiotic resistance?
No.
What are the impacts of antibiotic resistance?
Increased suffering, mortality & morbidity, cost of care, cost of drugs, and infectious time.
Why are antibiotic effective?
They are not benign
What does benign mean?
(of a disease) not harmful in effect.
What are some of the issues associated with ciprofloxacin?
Ciprofloxacin can cause serious side effects, including tendon problems, side effects on your nerves (which may cause permanent nerve damage), serious mood or behavior changes (after just one dose), or low blood sugar (which can lead to coma).
What kind of life long effects can antibiotic have?
effects such as disrupt to digestion, cause diarrhoea and ulcerative colitis, but new research is also linking it to immune function, obesity, food absorption, depression, sepsis, asthma and allergies.
What is the percentage of NZ chickens that carry Vancomycin resistant enterococci?
50%
What is a ‘super bug’?
A superbug is usually defined as a microorganism that is resistant to commonly used antibiotics – but not all superbugs are created equal. The number of different antibiotics to which it can be resistant determines the degree of the superbug.
What are the side effects of Vancomycin?
serious allergic reactions (anaphylactoid reactions), including low blood pressure, wheezing, indigestion, hives, or. itching. Rapid infusion of Vancomycin may also cause flushing of the upper body (called “red neck” or “red man syndrome”), dizziness,
Can there be antibiotics in the air?
Yes, especially from modern farming environments.
Are we exposed to bacteria in the food that we eat?
yes especially when we eat vegetables due to dirt bacteria
True or False? We are naturally surrounded by bacteria.
True
What makes us more vulnerable to bacteria?
Changes to our environment.
What are some ‘bacteria’ risk behaviours?
Using places such as public toilets.
What kind of surfaces do fecal bacteria like?
They thrive in wet surfaces.
Why are are bathrooms designed the way they are in terms of bacteria?
They are designed with hard-dry surfaces so that bacteria cannot thrive in these places.
How many seconds should you wash your hand (minimum)?
8 seconds
What is more important to wash or to dry your hands?
It is argued that it is more important to dry your hands although you should ALWAYS do both.
Is antibacterial soap safe or bad to use?
You should not use antibacterial soap unless you are a trained professional as the way that we wash our hands would mean that the soap could actually increase our chances of getting bacterial infections.
What do antibacterial soaps do to our bodies?
our bodies absorb antibacterial soaps and can be found in our pee, they are also toxic to our microbiota and can change our internal ecology.
What are pesticides?
Pesticides are substances that are meant to control pests, including weeds.
How many pesticides are there in the US that are not regulated?
Over 200
Who uses more chemical pesticides on lawns, farmers or homeowners?
Homeowners use up to 10x more chemical pesticides
What are the side effects of being on antibiotics?
nausea, indigestion, vomiting, diarrhoea, bloating, feeling of fullness, loss of appetite, stomach cramping or pain.
What is the CHDS cohort study?
The CHDS is a longitudinal study of a birth cohort of 1265 children born in the Christchurch (New Zealand) urban region during mid 1977.
How common was it (within the CHDS study) to report drinking before the age 11?
Very common with most reporting this.
What is the lethal dose of alcohol?
23 Standard drinks although this depends on the factors of an individual.
How many NZ drinkers are heavy drinkers?
25%
What percentage of police arrests involve alcohol?
1/3
What alcoholic beverage is most sensitive to price?
Beer
What beverage preference do we have in NZ?
Beer
How many serious violent crimes in NZ relate to alcohol?
Half
How many children are born with FASD per year in NZ?
Up to 3000 children
How many alcohol related physical and sexual assaults are there per year in NZ?
70,000
Should we have an excessive free market, effective regulation, or prohibition of alcohol?
Effective regulation for the best way of preventing alcohol related issues.
What is the 5+ solution alcohol action in NZ?
To raise the price of alcohol, lower the purchase age, reduce accessibility, reduce alcohol advertising and sponsorship, and increase drink-driving counter measures. This solution is backed up by MANY other studies.
Do the public support the ideas of the 5+ solution alcohol action in NZ?
In majority YES!
Why has the government not made a change to alcohol laws?
Likely due to being strongly influenced by private vested interests (Alcohol Industry) and engaged in tinkering, delay and obfuscation.
What does the CHDS study aim to study in regards to cannabis use?
- Population patterns of substance use.
2. Possible causality due to earlier experiences and characteristics
By the age 35 how many people on average have tried cannabis?
80%
Who tends to have regular use and high dependance of cannabis?
Males
What does early involvement of cannabis do?
It impacts educational achievement and unemployment rates.
What is the ‘gateway’ drug argument with marijuana?
That if you take marijuana you are more likely to take other drugs.
What are the criteria or evidence required for a drug to be a gateway drug?
It must: Have temporal ordering, dose/response, resistance to confounding by other factors, and specificity of association.
What is the lethal dose of cannabis?
So far there is no known lethal dose of cannabis.
Do police make arrests for possession of cannabis?
Not usually
If police make arrests for possession of cannabis what race is more likely to get in trouble?
The black race
Did the legalisation of cannabis in other countries cause an increase in cannabis use in those countries?
No
What is the difference between a child and an adult?
The brain development and puberty.
When is puberty?
between the ages 8 and 16 and it can last for between 2-5 years.
What is the cortical region of the brain?
Cortical areas that are neither motor or sensory but are thought to be involved in higher processing of information. Such as processing empathy, emotions and literacy.
What is the limbic region of the brain?
The limbic system is the portion of the brain that deals with three key functions: emotions, memories and arousal (or stimulation). Concerned with emotional response.
What is grey matter in the brain?
Grey matter contains most of the brain’s neuronal cell bodies. The grey matter includes regions of the brain involved in muscle control, and sensory perception such as seeing and hearing, memory, emotions, speech, decision making, and self-control
What is ACE?
An adverse childhood experience (ACE) describes a traumatic experience in a person’s life occurring before the age of 18 that the person remembers as an adult.
What is GABA?
GABA is a chemical messenger that is widely distributed in the brain. GABA’s natural function is to reduce the activity of the neurons to which it binds. Some researchers believe that one of the purposes that GABA serves is to control the fear or anxiety experienced when neurons are overexcited.
What can stress lead to?
Diseases due to adrenaline noradrenaline cortisol.
What is the most important thing for adolescents and young people?
Connection, especially in friendships.
What do adverse childhood experiences cause?
Disrupted neurodevelopment, social emotional and cognitive impairment, adoption of health-risk behaviours, disease, disability, social problems and death.
What is the HEADSS assessment?
HEADSS is an acronym for the topics that the physician wants to be sure to cover: home, education (ie, school), activities/employment, drugs, suicidality, and sex.
What builds resistance?
Competence, connection, character, confidence, control, and coping mechanisms.
