promoting health II Flashcards
what are frequent attenders called?
high volume service users
why might someone stop attending?
prison sentence or death
what was the study carried out by Felicte et al focusing on?
5 question around violence and neglect and 5 on environment to identify adverse childhood experience
what were the results of the study by felicte et al?
4 or more ACEs were related to worse outcomes
what is the mitigating factor for ACEs?
positive adult relationships
why do ACEs affect outcome?
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
what is the need in justice system?
to prevent the intergenerational cycle of violence
what are vulnerabilities?
they are symptoms of childhood trauma
what do new projects look at?
diversion - the link between mental health and diversion to court - causes a 15% reduction in reoffending
what are the five divisions of direct harm to children?
physical, verbal and sexual abuse to child, emotional and physical neglect
what are the environmental factors of ACEs?
parental separation, metal ill health, drug or alcohol abuse, incarceration, domestic violence
what has more of an impact to adult outcomes, witnessing violence or being abused?
witnessing domestic abuse
what are the effects of ACEss?
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
`what do ACEs result in?
mental health, medication self diagnosed or clinically diagnosed and violence offences
what is the first priority for the wellbeing of an offender?
housing - don’t have capacity, funds or accounts
what is important in the wellbeing of an offender?
addiction services, mental and physical health, violence, learning disabilities, money and relationships
what learning disability is found in 25% of the prison population?
ADHD
what is the triad found by probation figures?
mental health, reoffending and employement
what are wider determinants of crime?
wider determinants of wellbeing
what can be done to help reoffenders?
societal improvements, identification of those in need, community orders and support, recognition that crime and health are related
what are the main issues within prisons?
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
what are the three key domains of public health?
health improvement, protection and services
what is health protection?
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
what is the role of health protection teams on notification of communicable disease?
they will help to minimise spread, reduce population burden and provide advice to HCPs
what is the point of HPTs?
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
where are HPTs found?
they are found in PHE across 15 regions of the UK
what are examples of notifiable disease?
acute encephalitis, SARS, TB, diptheria, IGAS and mumps
how do HPTs work?
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
what classifies as an outbreak?
2 or more related cases
what is health protection for?
infectious disease, radiation, chemicals and other poisons, emergency response or major incidents, environmental health hazards
what are the three definitions of coronavirus?
- acute respiratory infection (severe) requiring hospital admission with evidence of pneumonia or acute respiratory distress syndrome
- acute respiratory infection of any severity with at least one of SOB or cough
- fever with no symptoms
what should a clinician do if suspect coronavirus?
isolate, do not examine, leave room and wash hands, patient call 111
what is the management of coronavirus?
respiratory isolation, specialist care and PPE - only positive tests are dealt with, contact all people have been in contact with
what will public health do?
maximise population health drivers
how much does health care use increase per year?
by 4%
what is the epidemiology of multimorbidity?
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
what is a common cause of multimorbidity?
inequitability - most are in the least deprived areas
what is the assessment for multimorbidity?
data integration and extraction, data analysis, practice based discussion of data, evidence and system mapping, experts by experience input, patient engagement and dissemination
what are the systems that encompasses multimorbidity ?
medical, social, coordination of care and prevention systems
