Public Health Flashcards
What is the definition of a health inequality?
Unjust and avoidable differences in people’s health across the population and between specific population groups. They are socially determined by circumstances largely beyond an individual’s control
What are ACEs?
- potentially traumatic events that can have negative, lasting effects on health and well-being.
- These experiences range from physical, emotional or sexual abuse to parental divorce or the incarceration of a parent or guardian.
How can ACEs be categorised?
Abuse
Neglect
Adveristy
What are the 10 screened for ACEs?
- physical abuse
- sexual abuse
- emotional abuse
- physical neglect
- emotional neglect
- Mother treated violently
- Household substance misuse
- Household mental illness
- Parents Separation or divorce
- Incarcerated family member
What is toxic stress?
The term toxic stress is prolonged activation of stress response systems in the absence of protective relationships
How does toxic stress affect a child’s body?
Chronic traumatic stress in early life alters how a child’s brain develops it fundamentally alters:
- nervous
- hormonal
- immunological system development
How can toxic stress present in a child at school?
It can present in school as an anxious, disengaged poor learner.
What are the primary components of GIRFEC?
- Is the child focused - it ensures the child or young person - and their family is at the centre of decision-making and the support available to them
- Is based on an understanding of the wellbeing of a child in their current situation
- is based on tackling needs early
- requires joined-up working
What are actions that can be taken to reduce health inequalities?
- Introduce a minimum income for healthy living
- Ensure the welfare system provides sufficient income for healthy living and reduces stigma for recipients through universal provision in proportion to need
- A more progressive individual and corporate taxation
- The creation of a vibrant democracy, a greater and more equitable participation in elections and local public service decision making
- Active labour market policies and holistic support to create good jobs and help people get and sustain work.
What are primary preventions for ACEs?
- Addressing wider determinants of health
- Nurse family partnership
- Parenting programmes
- Social care to prevent intergenerational transmission
- Trauma and adversity informed care e.g., national trauma training programmes
- Importance of relationships
What are secondary preventions for ACEs?
- Trauma and adversity informed care
- Substance misuse support
- Support fir families where a parent has been incarcerated
- Support for families with parent with mental health illness
- Looked after children support including health assessments and corporate parents
- Community ACE hubs
What are tertiary preventions for ACEs?
- health services
- social services
- justice
- multiagency working
What are the aims of immunisations?
Prevent onset of disease through primary prevention - pre-exposure in most circumstances e.g., childhood immunisation schedules, travel vaccines, occupational vaccines
Interrupt transmission
ALter course of infection/disease to prevent or limit consequences - immunoglobulin e.g., Hep B, Rabies, VZV
What is active immunity?
- protection that is produced by an individual’s own immune system via B and T cells
- Usually long lasting
What is natural passive immunity?
- Natural passive immunity → mother to unborn baby via placenta
- Last up to 1 year
- Some antigens (e.g., measles) but not others (e.g., pertussis, as CM immunity important)
What is artificial passive immunity?
- Artificial passive immunity → from another person or animal e.g., human IgG for Hep B, anti-toxin for diphtheria
- Antibodies from blood donors
- Human normal Ig
- Specific Ig
What are the advantages of artificial passive immunity?
- Rapid action
- Post-exposure
- Can attenuate illness
- Outbreak control
- Can be used if contraindication to active vaccination
What are the disadvantages of artificial passive immunity?
- short-term protection
- Short time window
- Blood derived
- Hypersensitivity reaction
- Expensive
How do vaccines work?
vaccines teach the immune system to recognise bacteria and viruses before the individual encounters them as potential pathogens, so allowing the body to fight against the pathogens - active immunity
What are live virus vaccines?
Attenuated organism, replicates in host e.g., OPV, MMR, rotavirus
What are inactivated vaccines?
- Suspensions of killed organisms e.g., whole-cell pertussis (whooping cough), whole-cell typhoid
- Subunit vaccines
- Toxoids e.g., diphtheria toxoid, tetanus toxoid, pertussis toxoid
- Polysaccharides e.g., pneumococcal, typhoid (Vi)
- Conjugate vaccines - polysaccharide attached to immunogenic proteins e.g., Hib, MenC
What are contraindications of vaccines?
- Confirmed anaphylaxis reaction to a previous dose of same antigen or vaccine component
- Live vaccines:
- Immunosuppression (primary, radiotherapy, high-dose steroids/other drugs, HIV)
- Pregnancy
- Egg allergy (yellow fever, flu)
- Severe latex allergy
- Acute or evolving illness - defer till resolved/stabilised
What is herd immunity?
- protect unvaccinated individuals, by having a sufficiently large proportion of the population vaccinated
- Vaccinated individuals stop transmission of organism
- Proportion required to be immune derived mathematically, dependent on R0 which is based on:
- Transmissibility and infectiousness of organism
- Social mixing in population
What are the phases for new vaccines investigations?
- Phase I: is it safe, is it immunogenic
- Phase II: how reactogenic is it, dosage, how it compares with current vaccines
- Phase III: efficacy, any rarer reactions/safety issues
- Phase IV: post-marketing surveillance - yellow card scheme (passive reporting, suspected adverse drug reactions)
