promoting health II

Question 1

what are frequent attenders called?

Answer 1

high volume service users

Question 2

why might someone stop attending?

Answer 2

prison sentence or death

Question 3

what was the study carried out by Felicte et al focusing on?

Answer 3

5 question around violence and neglect and 5 on environment to identify adverse childhood experience

Question 4

what were the results of the study by felicte et al?

Answer 4

4 or more ACEs were related to worse outcomes

Question 5

what is the mitigating factor for ACEs?

Answer 5

positive adult relationships

Question 6

why do ACEs affect outcome?

Answer 6

chronic stress causes anatomical changes in the brain - underdevelopment of the limbic system which controls emotion and consciousness and therefore impulsivity, anger management, thinking and behavioural control

Question 7

what is the need in justice system?

Answer 7

to prevent the intergenerational cycle of violence

Question 8

what are vulnerabilities?

Answer 8

they are symptoms of childhood trauma

Question 9

what do new projects look at?

Answer 9

diversion - the link between mental health and diversion to court - causes a 15% reduction in reoffending

Question 10

what are the five divisions of direct harm to children?

Answer 10

physical, verbal and sexual abuse to child, emotional and physical neglect

Question 11

what are the environmental factors of ACEs?

Answer 11

parental separation, metal ill health, drug or alcohol abuse, incarceration, domestic violence

Question 12

what has more of an impact to adult outcomes, witnessing violence or being abused?

Answer 12

witnessing domestic abuse

Question 13

what are the effects of ACEss?

Answer 13

increase in high risk drinking by 4x, 14x more likely to be a victim of violence in last 12 months, 15x more likely to have committed violence to others in last 12 months, 16x more likely to have used crack cocaine or heroin and 20x more likely to have been incarcerated

Question 14

`what do ACEs result in?

Answer 14

mental health, medication self diagnosed or clinically diagnosed and violence offences

Question 15

what is the first priority for the wellbeing of an offender?

Answer 15

housing - don’t have capacity, funds or accounts

Question 16

what is important in the wellbeing of an offender?

Answer 16

addiction services, mental and physical health, violence, learning disabilities, money and relationships

Question 17

what learning disability is found in 25% of the prison population?

Answer 17

ADHD

Question 18

what is the triad found by probation figures?

Answer 18

mental health, reoffending and employement

Question 19

what are wider determinants of crime?

Answer 19

wider determinants of wellbeing

Question 20

what can be done to help reoffenders?

Answer 20

societal improvements, identification of those in need, community orders and support, recognition that crime and health are related

Question 21

what are the main issues within prisons?

Answer 21

they are not well run - outdated IT systems with duplication and poor capacity, many sectors working on their own, NHS and other sectors aiming to help prison offenders but individuals are not always willing to accept help

Question 22

what are the three key domains of public health?

Answer 22

health improvement, protection and services

Question 23

what is health protection?

Answer 23

it is a set of activities in public health that are protecting individuals and groups from single cases of infectious disease, incidents, outbreaks and non infectious hazards such as radiation and chemicals - also environmental control such as in flooding

Question 24

what is the role of health protection teams on notification of communicable disease?

Answer 24

they will help to minimise spread, reduce population burden and provide advice to HCPs

Question 25

what is the point of HPTs?

Answer 25

local disease surveillance, national and local plans for disease, investigating and managing incidents and risk to health, asking for wider cases and interviewing families, alerting clinicians, control measure to stop secondary spread and sending organisms for specialist typing

Question 26

where are HPTs found?

Answer 26

they are found in PHE across 15 regions of the UK

Question 27

what are examples of notifiable disease?

Answer 27

acute encephalitis, SARS, TB, diptheria, IGAS and mumps

Question 28

how do HPTs work?

Answer 28

they clarify the problem and the diagnosis, decide if it is an outbreak, call outbreak control meeting and get help from microbiologists and clinicians, identify cause and initiate control measures

Question 29

what classifies as an outbreak?

Answer 29

2 or more related cases

Question 30

what is health protection for?

Answer 30

infectious disease, radiation, chemicals and other poisons, emergency response or major incidents, environmental health hazards

Question 31

what are the three definitions of coronavirus?

Answer 31

1. acute respiratory infection (severe) requiring hospital admission with evidence of pneumonia or acute respiratory distress syndrome
2. acute respiratory infection of any severity with at least one of SOB or cough
3. fever with no symptoms

Question 32

what should a clinician do if suspect coronavirus?

Answer 32

isolate, do not examine, leave room and wash hands, patient call 111

Question 33

what is the management of coronavirus?

Answer 33

respiratory isolation, specialist care and PPE - only positive tests are dealt with, contact all people have been in contact with

Question 34

what will public health do?

Answer 34

maximise population health drivers

Question 35

how much does health care use increase per year?

Answer 35

by 4%

Question 36

what is the epidemiology of multimorbidity?

Answer 36

increases with ageing - is a common condition dealt with in the NHS - 1/3 conditions - 7/10 of total costs and there is a 6 fold increase in ED attendance for those with these conditions

Question 37

what is a common cause of multimorbidity?

Answer 37

inequitability - most are in the least deprived areas

Question 38

what is the assessment for multimorbidity?

Answer 38

data integration and extraction, data analysis, practice based discussion of data, evidence and system mapping, experts by experience input, patient engagement and dissemination

Question 39

what are the systems that encompasses multimorbidity ?

Answer 39

medical, social, coordination of care and prevention systems