Public Health Flashcards

1
Q

Define mental health

A

A state of well-being in which every individual realises his or her own potential, can cope w normal stresses of life, can work productively and is able to make a contribution to community

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2
Q

What can affect mental health?

A

Gender
Race
Religion
Social class
etc

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3
Q

What are some specific mental health problems in doctors?

A

↑ Suicide rates
↑ Marital dysfunction and divorce
↑ Drug and alcohol problems

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4
Q

State some symptoms of burnout

A

Diminished personal contact
Work avoidance
Increased minor illness
Fatigue

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5
Q

State 4 general categories of health influences

A

Biological
Personal lifestyle
Health services
The physical and social environment

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6
Q

What does the Black Report 1980 show?

A

Confirms social class health inequalities in overall mortality
Also confirms health inequalities are widening

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7
Q

What mechanisms explain the Black Report 1980?

A

Artefact
Social selection
Behaviour
Material circumstance

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8
Q

What does Friedman and Rosenman 1959 describe?

A

Coronary prone behaviours

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9
Q

What does the Acheson Report 1988 show?

A

That mortality has decreased in the last 50 years but inequalities remain or have widened

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10
Q

Describe lifecourse theory of causation
Give examples

A

Critical periods have bigger impact in life course e.g. measles during pregnancy

Accumulation - hazards and impacts add up e.g. hard blue-collar work

Interactions and pathways

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10
Q

Name the 3 theories of causation

A
  1. Lifecourse
  2. Psychosocial
  3. Materialist
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10
Q

Recommendations after the Acheson Report 1988

A

Evaluate all policies likely to affect health (in terms of impact on inequality)
Prioritise health of families w/ children
Gov should ↓ income inequalities and improve living condition in poorer households

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11
Q

Describe psychosocial theory of causation

A

Social inequality may affect how people feel
In turn, affects body chemistry
Focuses on the individual

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11
Q

Describe materialist theory of causation

A

Poverty exposes people to more health hazards
Disadvantaged people are more likely to live in areas exposed to harm e.g. damp, pollution

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12
Q

If you are acting in the patient’s best interests (bc they are incompetent), what do you need to consider?

A

Whether Px may soon regain capacity
Patient’s past/present wishes
Patient’s beliefs and values
Consult with anyone applicable

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12
Q

What’s a consequence of improperly informed consent?

A

Potential negligence claim

12
Q

What do you do if a patient if incompetent and ∴ cannot consent?

A

Check whether there is someone else that can make a decision
Act in the Px best interests

12
Q

Describe the conditions of consent

A

Voluntary
Informed
Made by someone w capacity

12
Q

Describe a patient that does not have capacity to consent

A

Does not understand the relevant information
Cannot retain the info
Can’t use/weight the info to make a decision
Can’t communicate the decision

12
Q

Dive examples of psychosocial RFs for CHD

A

Behaviour trait
Depression/anxiety
Work
Social support

12
Q

Give examples of clinical RFs for CHD

A

HTN
Lipids
DM

13
Q

Describe Coronary prone behaviours

A

Competitive, hostile, impatient
Type A behaviour

14
Q

How would you assess Type A behaviour?

15
Q

How do you verify death?

A

No heart sounds or carotid pulse for 1 min
No breath sounds or resp effort for 1 min
No response to painful stimuli
Pupils are fixed and dilated

16
What did Whitehall I study investigate?
Male british civil servants over 10 year period Men in lowest grade higher mortality than in highest grade 3x mortality rate from ALL causes
17
What did Whitehall II study investigate?
10 000 civil servants Employment grade was strongly assoc with work control and demands
18
What can doctors do to reduce negative influences on CHD?
Observe behaviour patterns Identify signs of depression/anxiety Ask Pxs Qs from assessment tools, about job and support Liaise w relevant services
19
Describe absolutist explanations for psychosocial influences on CHD
About poverty Absolute measures of socioeconomic deprivation
20
Describe relativist explanations for psychosocial influences on CHD
About relative differences Larger relative difference means poorer outcomes for those worse off
21
What % of people die in hospital?
~ 60%
22
Define palliative care
Improves QoL of patients & family who face life-threatening illness. Provides pain and symptom relief, spiritual and psychological support from diagnosis Till end of life and bereavement
23
Name some providers of specialist palliative care
Palliative med consultants Clinical nurse specialist (e.g. Macmillan nurses) Social workers Chaplains Physios Dieticians
24
What are the aims of palliative care?
Promote QoL, dignity and autonomy Control disease symptoms
25
Units in a drink =
( % ABV x vol ml) / 1000