PUBLIC HEALTH Flashcards
What is Mental Health as a Definition?
“a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”.
What are some Specific mental health problems in doctors?
Increased suicide rates
Increased marital dysfunction and divorce
Increased drug and alcohol problems
What are the symptoms of burnout?
o Diminished personal contact
o Work avoidance
o Increased minor illness
o Feelings of fatigue
What categories can influence health?
o Biological
o Personal lifestyle
o Health services
o The Physical and Social Environment
What is the Black Report 1980?
o Confirmed that social class health inequalities had a big part in overall mortality
o Confirmed health inequalities are widening
o Mechanisms to explain why:
▪ Artefact, social selection, behaviour, material circumstance
What is the Acheson Report 1988?
o Mortality has decreased in the last 50 years but inequalities remained or widened
o Recommendations:
▪ Evaluate all policies likely to affect health in terms of the impact on inequality
▪ Prioritise health of families with children
▪ Government should reduce income inequalities and improve living
conditions in poor households
What is the prevention paradox
Outlines that large numbers of people must participate in a preventive strategy for direct benefit to relatively few.
eg everyone wears seatblets, but only gonaa actually beenfit the small number of people that get in car crashes
What are the 3 doman of publinc health
health improvement - (tackling inequalities)
Health protection (controlling infectious diseases)
Improving services (eg Audits)
What are the Theories of Causation?
Lifecourse
Psychosocial
Materialist
What are some Theories of Causation?
- Lifecourse:
▪ Critical periods have a greater impact in the life course e.g. measles in pregnancy
▪ Accumulation: hazards and their impacts add up e.g. hard blue-collar work
▪ Interactions and pathways - Psychosocial
▪ Social inequality may affect how people feel which in turn can affect body
chemistry, focuses on the individual - Materialist
▪ Poverty exposes people to more health hazards
▪ Disadvantaged people are more likely to live in areas exposed to harm e.g.
damp and pollution
What must consent be?
Consent must be:
o Voluntary
o Informed
o Made by someone with capacity
When is a patient unable to make a decision?
If the Px cannot:
o Understand the relevant information
o Retain it
o Use or weight it to make a decision
o Communicate the decision
What are some Risk factors for CHD?
o Unmodifiable = age, sex, ethnicity, genetics
o Lifestyle: smoking, diet, physical inactivity
o Clinical RF: hypertension, lipids, DM
o Psychosocial: behaviour trait, depression/anxiety, work, social support
What are Coronary Prone behaviours and who described them?
Friedman and Rosenman 1959:
o Competitive, hostile, impatient
o Type A behaviour
o Assess type A behaviour with MMPI
What do the Whitehall Studies show?
o Whitehall I:
▪ Male british civil servants over 10yr period
▪ Men in lowest grade had higher mortality than men in highest grade
▪ 3x mortality rate from all causes
o Whitehall II:
▪ 10,000 civil servants
▪ Employment grade was strongly associated with work control and demands
What is required to verify death?
o No heart sounds or carotid pulse for one minute
o No breath sounds or respiratory effort for one minute
o No response to painful stimuli
o Pupils are fixed and dilated
Define Palliative Care?
Improves QOL of patients and families who face life threatening
illness.
Provides pain and symptom relief and spiritual and psychological support from diagnosis to the end of life and bereavement
Who are some providers of Palliative Care?
o Consultants in palliative medicine
o Clinical nurse specialists e.g. Macmillan nurses
o Social workers
o Chaplains
o Physiotherapists
o Dieticians
What are the building blocks of Palliative Care?
o Holistic
o Individualised
o Patient and family centred
o Multidisciplinary approach
What are the aims of Palliative Care?
o Promote QOL
o Promote dignity and autonomy
o Control disease symptoms
How can you keep alcohol related harm risks low?
o Do not regularly drink >14 units / week
o If you do drink 14 units spread them evenly over 3+ days
o It’s a good idea to have several alcohol-free days each week
What are factors that suggest substance misuse?
o Results in failure to fulfil role obligations e.g. work, school, home life
o May be physically hazardous e.g. driving or operating machinery
o Continued misuse despite persistent or recurrent social or interpersonal problems
How do you calculate the number of alcoholic units in a drink?
- Number of units in a drink = (%ABV x volume in ml)/1000
8g of pure alcohol or 10ml
Define what 1 pack year is
How many straights is in a standard pack of cigarettes?
1 pack year =
1 pack, every day, for a year
its a way of gauging how much someone has smoked over their life
There are 20 cigarettes are in a standard pack of cigarrarettes