VLE and SocPop

Question 1

Describe the paternalistic patient doctor relationship

Answer 1

Doctor-led

Question 2

Describe the shared patient doctor relationship

Answer 2

Partnership

Question 3

Describe the informed patient doctor relationship

Answer 3

Patient led

Question 4

What ethical principle underlines the paternalistic model of Dr-patient relationships?

Answer 4

Beneficence

Question 5

What ethical principle underlines the informed model of Dr-patient relationships?

Answer 5

Autonomy

Question 6

What tool can Drs use to stimulate a shared decision making environment?

Answer 6

ICE

Question 7

Define sex

Answer 7

Biological and physiological characteristics that are used to categorise people as male or female

Question 8

Define gender

Answer 8

Socially constructed roles, behaviours, activities, and attributes that a given society considers appropriate for males and females

Question 9

Define gender identity

Answer 9

Internal sense of one’s own gender

Question 10

What is confidentiality?

Answer 10

A duty of confidence arises when one person discloses information to another in circumstances where it is reasonable to expect the information will be held in confidence

Question 11

What areas of law cover the use and disclosure of confidential information?

Answer 11

Common Law of Confidentiality
Data Protection Act 2018
Human Rights Act 1998
Administrative Law

Question 12

What ethical concepts underpin confidentiality?

Answer 12

Autonomy
Privacy
Identity
Promise keeping/trust

Question 13

When is it justifiable to breach confidentiality?

Answer 13

The patient consents
It is required by law
It is justified in the public interest

Question 14

What is the epidemiological transition?

Answer 14

A change in a state of birth and death rates - as social and economic development improves, these rates go down leading to an increase in total population.

Deaths from acute infection decline, deaths from chronic and non-communicable diseases increase

Question 15

Why is infant mortality a concern in public health?

Answer 15

Particularly good indicator of nations health status - linked with a nation’s living conditions

Question 16

Comment on child (1-15)mortality in the UK

Answer 16

Higher rates compared to other EU countries

Under 5 mortality is 50% higher than Sweden

Question 17

What is life expectancy?

Answer 17

Average years a newborn baby could be expected to live if the mortality patterns at time of birth stayed constant.

Question 18

What is healthy life expectancy?

Answer 18

Is the average number of years in a particular year can expect to live in a state of general ‘good’ health.

Women tend to live longer than men but men spend a greater proportion of their life in ‘good health’. This is self-defined measure from questionnaires, could be subjective? However corresponds with objective measures

Question 19

What are the leading causes of death in England and Wales in order?

Answer 19

Dementia and Alzheimer's
IHD
Cerebrovascular disease
Chronic lower respiratory disease 
Lung cancer

Question 20

What are the leading causes of death in men and women?

Answer 20

Women - dementia

Men - IHD

Question 21

Which cancer is the main cause of cancer deaths in both men and women?

Answer 21

Lung cancer

Question 22

What is used to classify socio-economic class?

Answer 22

Registrar General’s socio-economic classification

Question 23

Which socio-economic class has the highest rate of mortality and morbidity?

Answer 23

Routine and manual jobs (lower socio-economic status).

Also evident in child and infant mortality

Question 24

What geographical locations have high morbidity and mortality rates?

Answer 24

North, West, and urban areas

Question 25

What are the 2 explanatory models for health inequality?

Answer 25

Behavioural and cultural model Social inequality: - material and neo-materialist model - psychosocial model

Question 26

What does the Marmot review say about social inequality and health behaviour?`

Answer 26

People with low incomes have high cognitive load and find it difficult to make decisions about the future. Would rather feed children something that they can afford than nothing at all

Question 27

Summarise the materialist explanation to health inequality

Answer 27

Low socio-economic status is associated with poorer access to material health resources e.g. food, fuel, heating, exercise etc.

Question 28

Summarise the psychosocial explanation to health inequality

Answer 28

Psychosocial stress can lead us to make poorer health style choices e.g. drink, drugs. The stress of a low income can exacerbate these processes leading to the social gradient of health outcomes. The greater the inequality, the more lower-income people can feel like they're worse off e.g. holidays, designer clothes. Can lead to more stress. Poor health outcomes are associated with lower social control over life

Question 29

Define prevention

Answer 29

Actions aimed at eradicating, eliminating, or minimising the impact of disease and disability, or if none of these is feasible, retarding the progress of disease and disability.

Question 30

Define health promotion

Answer 30

the process of enabling people to increase control over their health and its determinants, and thereby improve their health

Question 31

What is primary prevention?

Answer 31

Pre-disease, avoid a disease starting in the first place e.g. immunisations

Question 32

What is secondary prevention?

Answer 32

Latent or early stage of disease, early detection e.g. smear tests

Question 33

What is tertiary prevention?

Answer 33

Symptomatic disease, limit the damage of the disease to maximise QOL e.g. rehab programmes, palliative care, pain management

Question 34

What is the high risk strategy of health prevention?

Answer 34

To bring preventative care to high risk individuals. | Requires detection and follow up.

Question 35

What is the population strategy of health prevention?

Answer 35

Directed at the whole population irrelevant of those at risk. This approach is directed towards socio-economic factors. Policies intervene at this point e.g. sugar tax, vaccinations

Question 36

What are Ewles and Simnett's 5 approaches to health promotion?

Answer 36

``` Medical Behaviour change Educational Client centred Societal change ```

Question 37

Summarise Beattie's Model of health promotion

Answer 37

4 quadrants: Authoritative --> negotiated Individual --> collective. Makes a cross. Different ideologies fit into the 4 quadrants

Question 38

What is health inequality?

Answer 38

The unjust and avoidable differences in people’s health across the population and between specific population groups.

Question 39

What are the 4 recommendations from the Marmot review?

Answer 39

Reduce the social gradient Progressive universalism Action across all social determinants Action across all sectors Participatory decision making at local level

Question 40

What is progressive/proportionate universalism?

Answer 40

Improvements of health in all groups , but the rate of improvement increases at each step downwards on the socio-economic scale. Delivery of resources at a scale and intensity proportionate to need