Public Health Flashcards
Define mental health
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
What can affect mental health?
Gender
Race
Religion
Social class
etc
What are some specific mental health problems in doctors?
↑ Suicide rates
↑ Marital dysfunction and divorce
↑ Drug and alcohol problems
State some symptoms of burnout
Diminished personal contact
Work avoidance
Increased minor illness
Fatigue
State 4 general categories of health influences
Biological
Personal lifestyle
Health services
The physical and social environment
What does the Black Report 1980 show?
Confirms social class health inequalities in overall mortality
Also confirms health inequalities are widening
What mechanisms explain the Black Report 1980?
Artefact
Social selection
Behaviour
Material circumstance
What does Friedman and Rosenman 1959 describe?
Coronary prone behaviours
What does the Acheson Report 1988 show?
That mortality has decreased in the last 50 years but inequalities remain or have widened
Describe lifecourse theory of causation
Give examples
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
Name the 3 theories of causation
- Lifecourse
- Psychosocial
- Materialist
Recommendations after the Acheson Report 1988
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
Describe psychosocial theory of causation
Social inequality may affect how people feel
In turn, affects body chemistry
Focuses on the individual
Describe materialist theory of causation
Poverty exposes people to more health hazards
Disadvantaged people are more likely to live in areas exposed to harm e.g. damp, pollution
If you are acting in the patient’s best interests (bc they are incompetent), what do you need to consider?
Whether Px may soon regain capacity
Patient’s past/present wishes
Patient’s beliefs and values
Consult with anyone applicable
What’s a consequence of improperly informed consent?
Potential negligence claim
What do you do if a patient if incompetent and ∴ cannot consent?
Check whether there is someone else that can make a decision
Act in the Px best interests
Describe the conditions of consent
Voluntary
Informed
Made by someone w capacity
Describe a patient that does not have capacity to consent
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
Dive examples of psychosocial RFs for CHD
Behaviour trait
Depression/anxiety
Work
Social support
Give examples of clinical RFs for CHD
HTN
Lipids
DM
Describe Coronary prone behaviours
Competitive, hostile, impatient
Type A behaviour
How would you assess Type A behaviour?
with MMPI
How do you verify death?
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
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
What did Whitehall II study investigate?
10 000 civil servants
Employment grade was strongly assoc with work control and demands
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
Describe absolutist explanations for psychosocial influences on CHD
About poverty
Absolute measures of socioeconomic deprivation
Describe relativist explanations for psychosocial influences on CHD
About relative differences
Larger relative difference means poorer outcomes for those worse off
What % of people die in hospital?
~ 60%
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
Name some providers of specialist palliative care
Palliative med consultants
Clinical nurse specialist (e.g. Macmillan nurses)
Social workers
Chaplains
Physios
Dieticians
What are the aims of palliative care?
Promote QoL, dignity and autonomy
Control disease symptoms
Units in a drink =
( % ABV x vol ml) / 1000
