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Phase 1 Med (Liv) > Public Health (summary sheets) > Flashcards

Public Health (summary sheets) Flashcards

1
Q

What is the main determinant of population health?

A

The extent of income division

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2
Q

What is the Gini coefficient?

A

A statistical representation of nation’s income distribution
amongs its residents - the lower the coefficient, the greater the equality amongst people. UK has a rather high inequality coefficient compared to some

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3
Q

What is the most powerful predictor of health experience?

A

Socio-economic model of health

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4
Q

What are 3 responses to health inequalities?

A
  • The Black report
  • The Acheson report
  • Proportionate Universalism
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5
Q

What was mentioned in the Black report?

A
  • Material (environmental causes, might be mediated by behaviour)
  • Artefact (an apparent product of how the inequality is measured)
  • Cultural/behavioural (poorer people behave in unhealthy ways)
  • Selection (sick people sink socially and economically)
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6
Q

What was mentioned in the Acheson report?

A
  • Income inequality should be reduced

- Give high priority to the health of families with children

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7
Q

What was mentioned within Proportionate Universalism?

A
  • Focusing on the disadvantaged only will not help to reduce the inequality
  • Action must be universal but with a scale and intensity proportional to the
    disadvantage (hence the name)
  • Fair distribution of wealth is important
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8
Q

What are the 3 broad topics within the theories of causation?

A

Psychosocial, neo-material and life-course

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9
Q

What is the psychosocial theory of causation?

A
  • Stress results in inability to respond efficiently to body’s demands
  • Impact on blood pressure, cortisol levels and on inflammatory and neuro-
    endocrine responses
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10
Q

What is the Neo-material theory of causation?

A
  • More hierarchal societies are less willing to invest into the provision of public goods
  • Poorer people have less material goods, quality of which is generally lower
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11
Q

What is the life-course theory of causation?

A
  • A combination of both Psychosocial and Neo-material explanations
  • Critical periods - possess greater impact at certain points in the life course
    (childhood)
  • Accumulation - hazards and their impacts add up -> hard work leads to injuries
    resulting in disabilities that may lead to more injuries
  • Interactions and pathways - sexual abuse in childhood leads to poor partner choice in adulthood
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12
Q

What are the 4 domains of public health?

A
  • Health protection
  • Improving services
  • Health improvement
  • Addressing the wider determinants of health
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13
Q

What is health protection?

A

Infectious diseases, chemicals and poisons, pollution, radiation,
emergency response

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14
Q

What is health improvement?

A

Lifestyles, family & community, education, employment,

housing, surveillance and monitoring

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15
Q

What is meta-ethics?

A

Exploring fundamental questions - right/wrong/defining the good life

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16
Q

What is ethical theory?

A

Philosophical attempts to create ethical theories

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17
Q

What are applied ethics?

A

A recent emergence of ethical investigation in specific areas

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18
Q

What are the 5 structural determinants of health?

A
  • Social class
  • Material deprivation/poverty
  • Unemployment
  • Discrimination/racism
  • Gender and health
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19
Q

What is the biomedical model?

A
  • Mind and body are treated separately
  • Body, like a machine, can be repaired
  • This privileges use of technological interventions
  • It neglects social and psychological dimensions of disease
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20
Q

When is confidentiality allowed to be broke?

A
  • When required by law (notifiable disease, regulatory bodies, ordered by judge or police)
  • Patient consent
  • Public interest (serious communicable disease, serious crime, research, education)
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21
Q

What are the criteria for disclosure of confidentiality?

A
  • Anonymous if practicable
  • Patient’s consent
  • Kept to a necessary minimum
  • Meets current law (data protection)
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22
Q

What are the three main notifiable diseases (reported by WHO)?

A
  • Cholera
  • Yellow fever
  • Plague
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23
Q

What is health behaviour?

A

Aimed to prevent disease (eating healthily)

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24
Q

What is illness behaviour?

A

Aimed to seek remedy (going to doctor)

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25
Q

What is sick role behaviour?

A

Aimed to getting well (compliance, resting)

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26
Q

What are 5 lifestyle factors which promote mortality?

A
  • Smoking
  • Obesity
  • Sedentary life
  • Excess alcohol
  • Poor diet
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27
Q

What is the health belief model of behavioural change (Becker 1974)?

A
  • Individuals must believe they are susceptible to the condition
  • Individuals must believe it has serious consequences
  • Individuals must believe that taking action reduces their risks
  • Individuals must believe that the benefits of taking action outweigh the costs
28
Q

What is the transtheoretical model of behavioural change?

A
  • Pre-contemplation (no intention giving up smoking)
  • Contemplation (considering quitting)
  • Preparation (getting ready to quit in the near future)
  • Action (engaged in giving up smoking)
  • Maintenance (steady non-smoker)
  • Relapse?
29
Q

What is utilitarian/consequentialism?

A
  • An act is evaluated solely in term of its consequences

- Maximising good and minimising harm

30
Q

What is Kantianism?

A
  • Features of the act themselves determine worthiness (goodness) of that act
  • Following natural law and rights
31
Q

What is virtue ethics?

A
  • Focus is on the kind of person who is acting, deemphasises rules
  • Integration of reason and emotion
32
Q

What are the 5 focal virtues?

A
  • Compassion
  • Discernment
  • Trustworthiness
  • Integrity
  • Conscientiousness
33
Q

What are the 4 principles (Prima Facie)?

A
  • Autonomy
  • Benevolence
  • Non-maleficence
  • Justice
34
Q

What does autonomy consist of?

A
  • The decision is intentional
  • The decision is done with understanding
  • There are no major controlling influences over the decision
35
Q

What is included in the Katz ADL scale?

A
  • Bathing
  • Dressing
  • Toilet use
  • Transferring (in/out of bed or chair)
  • Urine and bowel continence
  • Eating
36
Q

What does the mini mental state examination (MMSE) test?

A
  • Orientation, immediate memory
  • Short-term memory
  • Language functioning
37
Q

What is acute illness?

A

A disease of short duration that starts quickly and has severe symptoms (often can be cured)

38
Q

What is chronic illness?

A

A persistent or recurring condition, which may or may not be severe, often starting gradually with slow changes (can’t be cured but can be treated)

39
Q

What is polypharmacy?

A

The use of multiple medications or administration of more medications than are clinically indicated

40
Q

What are the key challenges of an ageing population?

A
  • Strains on pension and social security systems
  • Increasing demand for health care
  • Bigger need for trained health workforce
  • Increasing demand for long-term care
  • Pervasive ageism (denying older people the rights and opportunities available for other
    adults)
41
Q

What are the causes of ageing population?

A
  • Improvements in sanitation, housing, nutrition & medical interventions
  • Life expectancy is rising around the globe
  • Substantial falls in fertility (higher age of first pregnancy?)
  • Decline in premature mortality
  • More people reaching older age while fewer children are born
42
Q

What is intrinsic ageing?

A

Natural, universal, inevitable

43
Q

What is extrinsic ageing?

A

Dependent on external factors (UV ray exposure, smoking, air pollution, etc.)

44
Q

What are the causes of gender bias at an older age?

A
  • Women tend to live to older ages
  • 20% biological - premenopausal women are protected from heart disease by hormones
  • 80% environmental - men take more lifestyle risks
45
Q

What are the consequences of higher lifestyle expectancy?

A
  • Pensions will have higher pay outs than those currently planned
  • Chronic and co-morbid conditions will prevail
  • Rising inequalities as more affluent groups will use health services for longer
46
Q

What is the Glaser & Strauss (1965) awareness of dying?

A
  • Observational study of interactions between dying people, relatives and staff in USA Hospitals
  • Identified 4 awareness contexts:
  • Closed awareness
  • Suspicion awareness
  • Mutual Pretence
  • Open awareness
47
Q

What is social death?

A

When people die in social and interpersonal terms before their actual
biological death - lonely, impersonal death

48
Q

What is the chain of infection?

A
  • Susceptible host - low immunity, low white cell count, imbalance in normal flora, invasive
    procedures
  • Causative micro-organism - increase number in hospital, resistant strains
  • Reservoir - patients, visitors, stuff, fomites -> where the spread originates
  • Portal of entry/exit - respiratory tract, GI tract, GeUri tract, broken skin
  • Mode of transmission:
  • exogenous spread (direct/indirect contact, vector spread, airborne)
  • endogenous spread (self spread)
49
Q

What are the physiological effects of nicotine?

A
  • Activation of nicotinic ACh receptors in the brain
  • Causing dopamine release in the NAcc (nucleus accumbens)
  • Stimulant, tolerance and withdrawal
50
Q

What are the health problems connected with smoking?

A
  • Cardiovascular problems (strokes, heart attacks, DVTs)
  • Other cancers (stomach, kidney, pancreas, bladder, mouth, throat,…)
  • Stomach ulcers
  • Impotence
  • Diabetes
  • Oral health (gum disease)
  • Cataracts
51
Q

What are the methods used for smoking cessation?

A
  • NRT (Nicotine Replacement Therapy):
  • Patches, gums, nasal spray, microtab, inhalator
  • Non-nicotine pharmacotherapy:
  • Varenicline (Champix)
  • Bupropion (Zyban)
52
Q

What is the patient approach (3 A’s)?

A

Ask, advise, assist

53
Q

What are the three leading causes of death in children in developing world?

A
  • Pneumonia
  • Diarrhoea
  • Malaria
54
Q

How can a migrant be defined?

A
  • Country of birth
  • Country of nationality
  • Duration of stay
55
Q

What are the two broad types of migrant?

A
  • Asylum seekers

- Economic migrants

56
Q

What are some vulnerability causes in migrants?

A
  • Persecution, war, political and social unrest
  • Exploitation, torture, rape, bereavement
  • Burden of disease and socio-economic status
57
Q

What are some of the NHS goals?

A
  • Equity of access
  • Reducing gap in health inequalities
  • Providing services for the vulnerable
  • Ensuring the services are appropriate and accessible
58
Q

What is screening?

A

A process which sorts out apparently well people who probably have a disease
from those who probably do not

59
Q

What is primary prevention?

A

To prevent a disease from occurring

60
Q

What is secondary prevention?

A

Detection of early disease in order to alter the course of the disease and maximise the chances of a complete recovery

61
Q

What is tertiary prevention?

A

Trying to slow down the progression of the disease

62
Q

What is sensitivity?

A

a/a+c: the proportion of people with the disease who are correctly identified by the screening test

63
Q

What is specificity?

A

d/b+d: the proportion of people without the disease who are correctly excluded by the screening test

64
Q

What is PPV (positive predictive value)?

A

a/a+b: the proportion of people with a positive test result who actually have the disease

65
Q

What is NPV (negative predictive value)?

A

d/c+d: the proportion of people with a negative test result who do not have the disease

66
Q

What is prevalence?

A

The proportion of a population found to have the disease

67
Q

What is incidence?

A

The number of new cases within a specified time period divided by the size of the population initially as risk

Phase 1 Med (Liv) (13 decks)

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