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Phase 1 Notes > Public Health > Flashcards

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
Q

What is ICD-10

A

Range of codes used by computer to record causes of death.

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26
Q

Some official sources of mortality data

A

WHO
ONS
NHS Digital
Public Health England

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27
Q

How do we assess data quality?
(CART)

A

Completeness - legally required
Accuracy - well defined
Relevancy - Difficult to ascribe
Timeliness - Inaccurate information

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28
Q

How is morbidity more subjective?

A

Degree or severity of disease
Incidence (number of new cases)
Prevelance (total cases at a time)

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29
Q

How to measure Incidence?

A

Incidence rate = Number of new cases/ Population at risk

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30
Q

How to measure prevelance?

A

Prevelance = number of cases at a point in time/ total population

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31
Q

Why is morbidity subjective?

A

Few deaths from many illnesses
No single source of routine data
Wide diversity of data about illness
No clear level of disease

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32
Q

Routine sources of morbidity information

A

Cancer registrations
Primary care
Surveys
Hospital inpatients data

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33
Q

What do cancer registrations collect?

A

Patient details
Details of tumour
Date of death

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34
Q

What is quality and outcomes framework?

A

Voluntary incentive payment scheme for GPs that record common chronic diseases e.g. asthma and diabetes, major public health concerns.g. Smoking and obesity

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35
Q

What is the iceberg concept of disease?

A

Number of cases discovered is a lot less than misdiagnosed and undiscovered.

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36
Q

What is the health survey for England?

A

Annual surveys cover general health, education, housing, etc and vary yearly

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37
Q

Which mechanisms of green space provide health and well-being benefits?

A
  1. Mitigation of harm
  2. Restoration of depleted capacities
  3. Building new capacities
  4. Microbial diversity
38
Q

Describe mitigation of harm (green space)

A

Reduce air pollution
Noise reduction
Temperature regulation

39
Q

Describe restoration of depleted capacities (green space)

A

Reduction of stress
Increase in positive emotions
Recovery from attentional fatigue

40
Q

Describe building new capacities (green spaces)

A

Community and social cohesion
Physical exercise

41
Q

Define public health

A

Science (epidemiology) and art (influence, leadership) of preventing disease, prolonging life and promoting health through the organised efforts of society.

42
Q

Clinical medicine vs public health

A

Individuals / population
Treat sick / Prevent I’ll-health
Work alone / Work with organisationss
Short timescale / long

43
Q

Define stigma

A

The process by which the actions of others spoil normal identity

44
Q

Common diseases in high income countries

A

Heart + circulatory diseases
Cancer
Respiratory disorders

45
Q

Common diseases in low income countries

A

Lower respiratory diseases
HIV / AIDS
Diarrhoeal diseas
Malaria
Tuberculosis

46
Q

Define global health

A

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
Q

Name 4 domains of a doctor

A
  1. Knowledge and skills
  2. Safety and Quakity
  3. Communication and partnership
  4. Maintaining trust
48
Q

Define sexual and reproductive health

A

Complete physical, mental, and social well-being not merely the absence of disease, but all matters relating to reproductive system.

49
Q

Name some SRH issues

A

Maternal mortality, morbidity
STI
Miscarriage
Infertility
Sexual abuse
Female Genital Mutilation
Cervical cancer

50
Q

How many people in the UK have had a sexual health condition?

A

1/6

51
Q

What are some current SRH priorities?

A

Fall in unwanted pregnancies
More HIV testing
Access to free condoms
Protecting children from SA
Improve service and knowledge

52
Q

Name some common STIs

A

Gonnorhea
Chlamydia
Syphilis
HIV
Hepatitis A, B, C
HPV

53
Q

Name some primary secondary and tertiary preventions of STIs

A

P - counselling , sex education
S - Screening and testing
T - Cure + prevent transmission

54
Q

What BMI is classes as obese?

A

Overweight: BMI 25-30
Obese: BMI 30<
Morbid kObesity: BMI 40<

55
Q

What % of people aged 45-74 in England are obese?

A

Almost 75%

56
Q

What influences weight status?

A

Deprivation
Place
Disability
Ethnicity
Qualifications
Age

57
Q

Is obesity simple?

A

No - it’s no longer calories in and out.

58
Q

Define food security

A

All people at all times have physical, social and economic access to sufficient, safe and nutritious food

59
Q

Define food insecurity

A

Smaller meals, skipping meals, being hungry and not eating, not eating for a whole day.

60
Q

Define ageing

A

Progressive physiological changes in an organism or a decline in biological functions and he organisms ability to adapt to metabolic stress

61
Q

Multimorbidity vs frailty

A

M - multiple disease at the same time
F- diminished strength, endurance increasing vulnerability and death

62
Q

How do we age?

A

Normally damaged mitochondria and proteins are autophagic cleared. However in ageing, this decreases so toxic substances build up

63
Q

What is a key driver of senescence and ageing in humans?

A

Telomere shortening

64
Q

Why do senescent cells accumulate with ageing?

A

Most cells enter senescence
Inefficient clearance by the immune system
Evasion of immune surveillance
Inflammation driven by paracrine senescence

65
Q

What is opportunity cost?

A

To spend resources on one activity means a sacrifice in terms of a lost opportunity cost elsewhere

66
Q

What is economic efficiency?

A

Resources are allocated in a way that maximises benefit

67
Q

Define economic evaluation

A

A comparative study of the costs and benefits of alternative health care interventions for some given disease

68
Q

How are health benefits measured?

A
  1. Natural units - pain score, bp
  2. QALY - quality vs length of life
  3. Monetary value - willingness to pay costs
69
Q

What is cost-minimisation analysis

A

If two treatments are the same, choose the minimal cost

70
Q

What is cost-consequence analysis

A

Reports differences in costs and consequences without bringing them together

71
Q

Health damage vs promoting behaviour

A

D - smoking, drinking, sun, driving withou a seatbelt
P - exercise, healthy diet, vaccines, compliance

72
Q

3 levels of disease prevention

A

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
Q

Effects of interventions on levels

A

Interventions at a population/local affect individuals and vice versa

74
Q

Practicing health damaging behaviour is influenced by

A

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
Q

3 model and theories of behavioural change

A
  1. Health belief model
  2. Theory of planned behaviour
  3. Stages of change model
76
Q

Describe health belief model

A

Individuals will change if they BELIEVE:
They are susceptible to condition and has serious consequences. Taking action reduces susceptibility and out weights cost

77
Q

Internal and external cues to action

A

I - pain
E - letter, leaflets

78
Q

Describe theory of planned behaviour

A

The best predictor of behaviour change is intention.
Intention is determined by:
- attitude
- subjective norm
- perceived behavioural control

79
Q

What are the 5 stages of stage model/ trans theoretical model of health behaviour?

A

Precontemplation
Contemplation
Preparation (30 days)
Action (3-6 months)
Maintenance (>6months)
(Progress forward and relapse backwards)

80
Q

Other factors to consider about health behavioural change

A

Personality traits
Impact of past behaviour/past
Predictors of maintenance

81
Q

Define cardio respiratory fitness

A

The ability of the circulatory and respiratory systems to supply oxygen to skeletal muscles during sustained physical activity

82
Q

Define fitness

A

Condition of being physically fit and healthy

83
Q

Define physical activity

A

Any bodily movement by skeletal muscles that require energy expenditure e.g. gardening, walking

84
Q

Ways to measure physical activity

A

Surveys
Accelerometers
Cardio pulmonary exercise test

85
Q

Fitness/ Inactivty is a risk factor for

A

Death
Cardiovascular disease
Hypertension
Stroke
Osteoarthritis
Etc

86
Q

Should older adults exercise?

A

Yes!
Reduces hip fractures etc

87
Q

Are fitness, activity and exercise the same?

A

No!
You can be slim and unfit
(Obese and fit have a low risk)

88
Q

Sedentary behaviours is an independent risk factor to

A

Obesit
Type 2 diabetes
Cancer
CVD
Mortality

89
Q

Barriers for sedentary behaviour

A

Occupation
Travel
Social

90
Q

Guidelines on physical activity for adults per week

A

150 mins of moderate intense
75 minsof vigorous
Muscle strengthening 2 days

Phase 1 Notes (9 decks)

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