Public Health Flashcards
What are the two classifications of the determinants of health?
Lalonde report, 1974: genes, environment, lifestyle and health care
Dahlgren and whitehead,1991: semi circle of health
what is primary , secondary and tertiary prevention
bonus exam style: Explain the difference between secondary and tertiary
prevention
- stop disease starting first place
- identify and find intervention to alter disease cause
- prevent consequences of disease
types of equity and meaning
bonus exam style: Explain the difference between horizontal and vertical equity in
relation to health care
horizontal: equal treatment for equal need
vertical: unequal treatment for unequal need
what are the classifications of dimensions of health equity
spatial (i.e geographical)
social (class, gender, ethnicity)
what are the three domains of public health practice?
- health improvement
(societal interventions aimed at preventing disease, inequalities, education,housing) - health protection
(infectious diseases,chemicals,radiation) - health care
(service planning, audit and evaluation and efficiency)
what are the three levels of interventions and examples
bonus exam styles: Explain the difference between public health interventions
delivered at the population (ecological) and individual levels,
using one example for each to illustrate your answer.
- individual level: childhood immunisation
- community level: playground set up for local community
- ecological level: ban smoking in enclosed public spaces (e.g. general intervention not delivered and individual level)
what is the difference between health behaviour and illness behaviour and sick role behaviour
health - aimed to prevent disease
illness - aimed to seek remedy
sick role - aim of getting well (e.g. taking prescribed meds and resting)
give an example of interventions on population and individual level
population:
- health promotion
individual: patient centred approach, care responsive to individual needs
2 examples of health promotions/awareness campaigns
“Healthier you” Diabetes prevention
• Change 4 Life Campaign, “5 a day”
• Every mind matters
why do patients practise health damaging behaviour
inaccurate perceptions of risk and susceptibility
what are perceptions of risk influenced by (4)
Perceptions of risk influenced by:
- Lack of personal experience with problem
- Belief that preventable by personal action
- Belief that if not happened by now, it’s not likely to
- Belief that problem infrequent
definition of domestic abuse
- rough definition
incident or pattern of incidents of controlling coercing or threatening behaviour, violence or abuse between tose 16+ who are or have been intimate partners or family members reguardless of gender or sexuality.
- psych
- physical
- sexual
- financial
- emotional
indicator for suspicion for domestic abuse>
accident reported as unwitnessed by anyone else
give two beliefs of the health belief model
individuals will change if they:
- believe they are susceptible to condition in question
- believe of serious consequences
- belief taking action reduces sucsceptibility
- believe that benefits of taking action outweight costs
list two cues to action (internal and external)
internal - exacerbations of symptoms
external - advice from others (e.g GP)
what is the theory of planned behaviour?
proposes the best predictor of behaviour is intention
what are the three determining factors of intention
theory of planned behaviour
- attitude to behaviour
- subjective norm
- perceived behavioural control
critiques of planned behaviour (2)
lack of temporal element and lack of direction or casuality
- assumes that attitudes, subjective norms and PBC can be measured
- relies of self-reported behaviour
1.
There are three main behaviours related to health:
Specify the three types of health related behaviours and
provide an example of each: (6 marks
Health Behaviour: a behaviour aimed to prevent
disease (e.g. eating healthily)
•
Illness Behaviour: a behaviour aimed to seek remedy
(e.g. going to the doctor)
•
Sick role Behaviour: any activity aimed at getting well
(e.g. taking prescribed medications; resting)
heory of planned behaviour (Ajzen, 1988)
suggests that behaviours are governed by our
intentions to carry out target behaviours.
Specify the three factors that influence our
intentions and give an example of each with
reference to smoking cessation (6 marks
attitude to behaviour
- subjective norm
- perceived behavioural control
Transtheoretical model, or stages of change
model (Prochaska & DiClemente, 1984)
specifies five sequential stages that an
individual will pass through in order for
behaviour change to occur. Which of the below
is the third stage?
a) maintenance
b) Preparation
c) contemplation
d) action
e) Precontemplation
preparation
onsidering the NICE guidelines on behaviour change -
Interventions to change health related behaviour should
work in partnership with individuals, communities,
organisations and populations. Identify three typical
transition points whereby interventions are likely to be
more effective: (3 marks
- leaving school, • entering the workforce • becoming a parent • becoming unemployed • retirement and bereavement
define malnutrition
deficiencies, excess or imbalance in a persons intake of energy and/or nutrients.
- undernutrition and overweight
list two early influences on feeding/eating behaviour
- maternal diet and taste preference development
- breastfeeding
- parenting practices
- age of intro to solid food
what is amniotic fluid influenced by?
maternal diet
in utero environment influences taste exposure
in what groups is breast-feeding prevalence particularly low?
- very young mothers, disadvantaged socio-economic groups
what are the three types of milk making up the composition of breast milk
- colostrum
- foremilk
- hindmilk
how is breast feeding suggested to affect food preferences of infant?
- acceptance of novel food during weaning- breastfed children less picky eaters in childhood
- diet richer in fruit and vegetables >3m
at what period of life is a person sensitive to the development of flavour and food preferences?
first two years
what is the concept of chemical continuity?
transmission of flavours from maternal diet via amniotic fluid and then breast milk
difference between eating disorder and disordered eating?
- ED: clinically meaningful behaviour or psych pattern to do with eating/weight associated with distress, disability or increase in morbidity/mortality
- DE: restraint/strict diet/emotional eating/night eating/weight and shape concerns - not warranted clinical diagnosis
what is the prevelance of obesity for the population?
over 50%
where is the prevelance of obesity highest
areas of high deprivation
why can dieting be challenging for patients susceptible to obesity?
- unrepsonsive to internal cues signalling satiety and hunger
- dietary restraint
- vulnerable to external cues that signal availability of food
multimorbidity definition
2 or more long term(chronic) health conditions with long term management.
polypharmacy definition
pt regular use of at least five medications - increases risk of adverse outcomes.
negative of polypharmacy
increase risk of adverse SE
what are the types of polypharmacy
- appropriate polypharmacy
- problematic polypharmacy
how many unhealthy lifestyle factors increase your risk of multi-morbidity?
5
atorvastatin SE?
myalgia
bisoprolol SE?
cool peripheries
co-codamol SE?
constipation
cyproterone SE? (hormon p. cancer)
increased risk meningioma
digoxin used for?
rate control (AF)
sign of digoxin toxicity?
easily overlooked - blurred vision, fatigued
doxazosin drug type?
alpha blocker
what type of drug is furosemide - worry with drug?
loop diuretic
can cause hyponatraemia
Rivaroxaban drug type
DOAC
headache red flags (4)
- worse on leaning forward/coughing/sneezing
- seizures
- worse in morning/waking up at night
- change in vision
ramipril electrolyte disturbance
hyperkalaemia
causes of haematuria? (4)
- warfarin - raised INR
- ca of urinary tract
- stones
- uti
what are the two ways to do an INR
- finger prick
- urinalysis
alendronic acid drug type and what rules are given when prescribing this med?
bisphosponate (taken upright full glass of water. no meds for at least an hour)
what drug type is amitriptyline?
tri-cyclic antidepressant
side effect of tri-cyclic antidepressant
dry mouth, drowsy
citalopram drug type
ssri - can cause hyponatraemia
donepezil is used to treat what condition?
dementia
what is hyoscine butylbromide commonly known as?
buscopan
what type of drug is mebeverine?
anti-spasmodic
what is solifenacin
used to treat irritable bladder - anti-cholinergic effect
list some anticholinergic SE (6)
- blurred vision dry eyes - constipation - urinary retention - increased HR - increased sweating
what is the definition for “need” according to nice?
- ability to benefit from an intervention
what is health needs assessment?
systematic method for reviewing health issues facing a population, leading to agreed priorities
difference between health need vs health care need
health need - need for health , general
- need for health care - more specific, ability to benefit from health care
what may a health needs assessment be carried out for?
- a population or sub-group
- a condition
- an intervention
what are the bradshaw properties for a sociological perspective (4)
- felt need (individual perspective)
- expressed need (demand)
- normative need (professionals)
- comparative need (compare severity/range of intervention and costs)
what is considered in a health needs assessment (3)
- epidemiological
- comparative
- corporate
what is maxwells dimension of quality (3as, 3es)
- acceptibility accessibility - appropriateness - effectiveness - efficiency - equity
define the three types of consequentialism
- utilitarianism (best course promotes most happiness and absence of pain for all)
- egoism ( best course for you!)
- altruism (best course is whats best for others wellbeing)
