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Public Health Flashcards

1
Q

Homeostasis vs Allostasis

A

Homeo - Maintains internal environment for cell functions
Allo - Complex systems adapt in changing environments

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2
Q

Define allostatic load

A

Cumulative exposure to stressors leads to systems wearing out

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3
Q

Stress responses are mediated by 2 systems

A

Autonomic nervous system
Hypothalamus-pituitary axis

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4
Q

Which part of the brain is involved in stress

A

Amygdala - emotions
Hippocampus - memories and trauma

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5
Q

What are physical symptoms of chronic stress

A

Headache
Low energy
Chest pain
Sweating
Stomach ache
Cold hands + feet

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6
Q

What are behavioural responses to stress?

A

Easily startled
Change in appetite
Procrastinating
Use of alcohol, smoking + drugs
Sleep disturbances
Withdrawal

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7
Q

What are some cognitive responses to stress?

A

Constant worrying
Racing thoughts
Forgetfulness
Inability to focus
Poor judgement

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8
Q

What are some emotional responses to chronic stress

A

Depression
Mood swings
Aggression
Low self-esteem

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9
Q

Define natural selection

A

Differential survival and reproduction of individuals due to differences in phenotype

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10
Q

Define fitness

A

How successful a organism at reproducing

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11
Q

Describe Darwin’s theory

A

Variation
Selection
Retention (Reproduction)

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12
Q

What is evolutionary psychiatry?

A

Considers not an individual, but a species psychiatric vulnerability, symptoms and behaviour.

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13
Q

What does Evolutionary psychiatry propose?

A

Evolutionary theories to account for substance misuse, borderline states etc.

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14
Q

What are Tinbergen’s 4 questions?

A
  1. Mechanism - How does behaviour occur?
  2. Development - How does this behaviour arise in individual?
  3. Evolution - Hoe does this behaviour arise in species?
  4. Adaptive value - Why is this behaviour adaptive in species?
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15
Q

What are end products of the human brain?

A

Traits that have been shaped by evolution e.g. patterns, emotions and cognitions.

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16
Q

What is mismatch?

A

The environment currently Is different to the one humans evolved in e.g. culture, diet, alcohol

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17
Q

What are some Co-evolutionary considerations?

A

Pathogens evolve while we do
Microbes changed leading to autoimmune infections

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18
Q

What are some defences evolution has adapted?

A

Pain
Fever, fatigue
Nausea
Itching
Sneezing, vomiting, coughing

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19
Q

What is Dunbar number?

A

150
= max number of stable social relationships a person can maintain

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20
Q

What 3 types of emotion is regulated in compassion focused therapy?

A

Treat and protection
Drive and excitement
Contentment and soothing

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21
Q

What is routine health data

A

Collected, put together and disseminated data on a regular basis, about factors influencing health care.

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22
Q

Why collect routine health care?

A

.Monitor health of population
.Evaluate and assess performance
.Hypothesis causes of I’ll health
.Inform planning of services and policy

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23
Q

Types of health information

A

Mortality (death)
Morbidity (disease)
Quality of life
Individual lifestyle
Population demographics
Wider determinants e.g. Environmental, socio-cultural

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24
Q

How is mortality recorded?

A
  1. Doctor completes certificate
  2. Taken to local registration and registers death
  3. Copy sent to ONS where cause of death is coded
  4. ONS comple and publish mortality statistics
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25
What is ICD-10
Range of codes used by computer to record causes of death.
26
Some official sources of mortality data
WHO ONS NHS Digital Public Health England
27
How do we assess data quality? (CART)
Completeness - legally required Accuracy - well defined Relevancy - Difficult to ascribe Timeliness - Inaccurate information
28
How is morbidity more subjective?
Degree or severity of disease Incidence (number of new cases) Prevelance (total cases at a time)
29
How to measure Incidence?
Incidence rate = Number of new cases/ Population at risk
30
How to measure prevelance?
Prevelance = number of cases at a point in time/ total population
31
Why is morbidity subjective?
Few deaths from many illnesses No single source of routine data Wide diversity of data about illness No clear level of disease
32
Routine sources of morbidity information
Cancer registrations Primary care Surveys Hospital inpatients data
33
What do cancer registrations collect?
Patient details Details of tumour Date of death
34
What is quality and outcomes framework?
Voluntary incentive payment scheme for GPs that record common chronic diseases e.g. asthma and diabetes, major public health concerns.g. Smoking and obesity
35
What is the iceberg concept of disease?
Number of cases discovered is a lot less than misdiagnosed and undiscovered.
36
What is the health survey for England?
Annual surveys cover general health, education, housing, etc and vary yearly
37
Which mechanisms of green space provide health and well-being benefits?
1. Mitigation of harm 2. Restoration of depleted capacities 3. Building new capacities 4. Microbial diversity
38
Describe mitigation of harm (green space)
Reduce air pollution Noise reduction Temperature regulation
39
Describe restoration of depleted capacities (green space)
Reduction of stress Increase in positive emotions Recovery from attentional fatigue
40
Describe building new capacities (green spaces)
Community and social cohesion Physical exercise
41
Define public health
Science (epidemiology) and art (influence, leadership) of preventing disease, prolonging life and promoting health through the organised efforts of society.
42
Clinical medicine vs public health
Individuals / population Treat sick / Prevent I’ll-health Work alone / Work with organisationss Short timescale / long
43
Define stigma
The process by which the actions of others spoil normal identity
44
Common diseases in high income countries
Heart + circulatory diseases Cancer Respiratory disorders
45
Common diseases in low income countries
Lower respiratory diseases HIV / AIDS Diarrhoeal diseas Malaria Tuberculosis
46
Define global health
Health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions.
47
Name 4 domains of a doctor
1. Knowledge and skills 2. Safety and Quakity 3. Communication and partnership 4. Maintaining trust
48
Define sexual and reproductive health
Complete physical, mental, and social well-being not merely the absence of disease, but all matters relating to reproductive system.
49
Name some SRH issues
Maternal mortality, morbidity STI Miscarriage Infertility Sexual abuse Female Genital Mutilation Cervical cancer
50
How many people in the UK have had a sexual health condition?
1/6
51
What are some current SRH priorities?
Fall in unwanted pregnancies More HIV testing Access to free condoms Protecting children from SA Improve service and knowledge
52
Name some common STIs
Gonnorhea Chlamydia Syphilis HIV Hepatitis A, B, C HPV
53
Name some primary secondary and tertiary preventions of STIs
P - counselling , sex education S - Screening and testing T - Cure + prevent transmission
54
What BMI is classes as obese?
Overweight: BMI 25-30 Obese: BMI 30< Morbid kObesity: BMI 40<
55
What % of people aged 45-74 in England are obese?
Almost 75%
56
What influences weight status?
Deprivation Place Disability Ethnicity Qualifications Age
57
Is obesity simple?
No - it’s no longer calories in and out.
58
Define food security
All people at all times have physical, social and economic access to sufficient, safe and nutritious food
59
Define food insecurity
Smaller meals, skipping meals, being hungry and not eating, not eating for a whole day.
60
Define ageing
Progressive physiological changes in an organism or a decline in biological functions and he organisms ability to adapt to metabolic stress
61
Multimorbidity vs frailty
M - multiple disease at the same time F- diminished strength, endurance increasing vulnerability and death
62
How do we age?
Normally damaged mitochondria and proteins are autophagic cleared. However in ageing, this decreases so toxic substances build up
63
What is a key driver of senescence and ageing in humans?
Telomere shortening
64
Why do senescent cells accumulate with ageing?
Most cells enter senescence Inefficient clearance by the immune system Evasion of immune surveillance Inflammation driven by paracrine senescence
65
What is opportunity cost?
To spend resources on one activity means a sacrifice in terms of a lost opportunity cost elsewhere
66
What is economic efficiency?
Resources are allocated in a way that maximises benefit
67
Define economic evaluation
A comparative study of the costs and benefits of alternative health care interventions for some given disease
68
How are health benefits measured?
1. Natural units - pain score, bp 2. QALY - quality vs length of life 3. Monetary value - willingness to pay costs
69
What is cost-minimisation analysis
If two treatments are the same, choose the minimal cost
70
What is cost-consequence analysis
Reports differences in costs and consequences without bringing them together
71
Health damage vs promoting behaviour
D - smoking, drinking, sun, driving withou a seatbelt P - exercise, healthy diet, vaccines, compliance
72
3 levels of disease prevention
Primary Prevention—intervening before health effects occur Secondary Prevention—screening to identify diseases early Tertiary Prevention—managing disease post diagnosis to slow or stop.
73
Effects of interventions on levels
Interventions at a population/local affect individuals and vice versa
74
Practicing health damaging behaviour is influenced by
Unrealistic optimism = inaccurate perception of risk and susceptibility 1. Lack of personal experience with problem 2. Belief that preventable by personal action 3. Belief that if not happened by now, it’s not likely to 4. Belief that problem infrequent
75
3 model and theories of behavioural change
1. Health belief model 2. Theory of planned behaviour 3. Stages of change model
76
Describe health belief model
Individuals will change if they BELIEVE: They are susceptible to condition and has serious consequences. Taking action reduces susceptibility and out weights cost
77
Internal and external cues to action
I - pain E - letter, leaflets
78
Describe theory of planned behaviour
The best predictor of behaviour change is intention. Intention is determined by: - attitude - subjective norm - perceived behavioural control
79
What are the 5 stages of stage model/ trans theoretical model of health behaviour?
Precontemplation Contemplation Preparation (30 days) Action (3-6 months) Maintenance (>6months) (Progress forward and relapse backwards)
80
Other factors to consider about health behavioural change
Personality traits Impact of past behaviour/past Predictors of maintenance
81
Define cardio respiratory fitness
The ability of the circulatory and respiratory systems to supply oxygen to skeletal muscles during sustained physical activity
82
Define fitness
Condition of being physically fit and healthy
83
Define physical activity
Any bodily movement by skeletal muscles that require energy expenditure e.g. gardening, walking
84
Ways to measure physical activity
Surveys Accelerometers Cardio pulmonary exercise test
85
Fitness/ Inactivty is a risk factor for
Death Cardiovascular disease Hypertension Stroke Osteoarthritis Etc
86
Should older adults exercise?
Yes! Reduces hip fractures etc
87
Are fitness, activity and exercise the same?
No! You can be slim and unfit (Obese and fit have a low risk)
88
Sedentary behaviours is an independent risk factor to
Obesit Type 2 diabetes Cancer CVD Mortality
89
Barriers for sedentary behaviour
Occupation Travel Social
90
Guidelines on physical activity for adults per week
150 mins of moderate intense 75 minsof vigorous Muscle strengthening 2 days

Phase 1 Notes (9 decks)

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