Public health concerns

Question 1

Has the number of people smoking increased or decreased since 1970s?

Answer 1

Decreased

Question 2

Is tobacco a stimulant or depressant?

Answer 2

stimulant - some wrongly believe it is a relaxant but this is because it removes the withdrawal symptoms (cravings, irritability)

Question 3

What is the single biggest cause of illness and premature death in the UK?

Answer 3

Smoking tobacco

Question 4

What are some health problems associated with smoking? (7)

Answer 4

CVD
Cancers
Stomach ulcers
Impotence
Diabetes
Oral health (gum disease)
Cataracts

Question 5

What are some pharmacological interventions to stop smoking?

Answer 5

Nicotine replacement therapy (NRT) - patches, gum, nasal spray, micro tab, lozenges, inhaler
Nicotine pharmacotherapy: bupropion and varenicline

Question 6

What is the difference between primary, secondary and tertiary prevention in terms of public health?

Answer 6

Primary Prevention - Public health intervention in healthy people to prevent disease

Secondary Prevention - Screening - early stage disease but intervening early or providing information to stop it developing further

Tertiary Prevention - When we know they have the disease and we intervene to try and stop further complications

Question 7

What is the difference between:
sensitivity
specificity
positive predictive value
negative predictive value

Answer 7

sensitivity: the proportion of people with the disease who are correctly identified by the screening test
(true positive / true positive + false negative)

specificity: proportion of people without the disease who are correctly excluded by the screening test
(true neg/ false pos + true neg)

positive predictive value: proportion of people with a positive result who actually have the disease
(true pos / true pos + false pos)

negative predictive value: proportion of people with a negative result who do not have the disease
(true neg / false neg + true neg)

Question 8

What are the 10 Wilson and Jungner criteria

Answer 8

1. The condition sought should be an important health problem
2. The natural history of the condition and development should be well understood
3. There should be a detectable early stage
4. There should be an accepted treatment for patients with recognised disease
5. Adequate health service provision should be made for the extra clinical workload resulting from screening
6. A suitable test should be devised for the early stage
7. The test should be acceptable to the population
8. Intervals for repeating the test should be determined (every 2,5,10 years?)
9. There should be an agreed policy on whom to treat
10. The costs should be balanced against the benefits and the risks (physical and psychological) should be less than the benefits

Question 9

What is the different screening programmes in the UK throughout life?

Answer 9

Screening in pregnancy - antenatal screening
Newborn screening - within 3 days of birth and then at 6 weeks
Diabetic eye screening - over 12 every year for diabetics
Cervical screening - women aged 25-49
Breast cancer screening - women 50-71
Bowel cancer screening - men and women 60-74 every 2 years
AAA screening - men after 65

Question 10

In England, what percentage of adults are obese and what percentage are overweight?

Answer 10

30% obese

further 35% overweight

Question 11

Differences between disability, impairment and handicap?

Answer 11

Disability

• ‘substantial’ is more than minor or trivial, eg it takes much longer than it usually would to complete a daily task like getting dressed
• ‘long-term’ means 12 months or more, eg a breathing condition that develops as a result of a lung infection

Impairment
- Loss or abnormality of psychological, physiological or anatomical structure or function

Handicap
- Social disadvantage for a given individual that limits or prevents the fulfilment of a role

Question 12

What is a learning disability?

Answer 12

Significant impairment of general cognitive functioning acquired in childhood that is life long and leads to difficulty with everyday tasks

Question 13

Examples of additional physical disorder in those with learning disabilities?

Answer 13

• more likely to have GI cancer death
• coronary HD
• respiratory disease
• vision impairment
• hearing impairment
• MSK impairment 14x more likely
• poor oral hygiene
• constipation is one of the leading causes of death as doctors do not known what is wrong so they give them analgesics which causes constipation and can lead to death