Public Health week 1 Flashcards

1
Q

Domestic abuse (DA) definition.

a) An ______ or a pattern of ______
b) C_____, c_____ or t______ behaviour, violence or abuse
c) Between those aged over ____ years, (if younger, this is a ____ _____ issue) who are or have been ____ partners or ____ _____
d) Regardless of g______ or s_______
e) Can encompass what 5 forms of DA

A

a) Incident
b) Controlling, coercive or threatening
c) 16; child protection; intimate partners or family members
d) gender or sexuality
e) physical, psychological, emotional, financial, sexual

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2
Q

DA: health impacts.

a) Physical
b) Somatic/chronic illness - types (neuro, GI, gynae, obstetric)
c) P______ - 5 common
d) If children involved, consider…?

A

a) injury
b) headaches, pelvic bleeds/pain, IBS, LBW and prem delivery
c) PTSD, depression, anxiety, substance misuse, eating disorders
d) safeguarding; risk of child abuse

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3
Q

What is the toxic triangle for child abuse?

A

DA, mental health issues, substance misuse

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4
Q

Risk factors for DA.

a) Toxic _____
b) Patient is iso____.
c) Gender

A

triangle; isolated; female

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5
Q

Risk levels for DA.

a) Standard
b) Medium
c) High

A

a) Current evidence suggests low likelihood of causing serious harm
b) Identifiable indicators of serious harm risk, but current evidence suggests current harm unlikely unless a change of circumstances (e.g. baby arrival)
c) Identifiable indicators of imminent serious harm risk

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6
Q

Tool to assess risk

  • Name
  • Three components of dynamic risk assessment
A

DASH

Victim: children/pregnant, isolated, frightened, depression/suicidal

Perpetrator: violent/criminal history, weapons, drugs/alcohol/mental health, suicidal, accomplices

Interaction: stalking, death threats, sexual abuse, strangling/drowning, escalation (freq/severity)

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7
Q

MARAC

  • stands for…
  • Who is involved?
  • What do they do?
A

Multi-Agency Risk Assessment Conference

Police, social work, housing, health visitor, etc.

Priorities for each individual to action

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8
Q

IDVAS

  • stands for…
  • what do they do?
A

Independent Domestic Violence Advice Service

Help those at highest risk of harm from DA

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9
Q

Interventions for DA.

a) First contact (posters)
b) Ask ____ questions (not in front of who?)
c) Acknowledge that DA is ______.
d) High risk: refer to _____ or _____

A

a) Helpline
b) Direct; children, relatives
c) Serious
d) MARAC or IDVAS

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10
Q

Health psychology.

a) What is it?
b) What is its aim?

A

a) Emphasis on psychological factors in the cause, progression and consequences of health and illness
b) To promote healthy behaviours to avoid illness

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11
Q

Health behaviours.

a) Health behaviour - example
b) Illness behaviour - example
c) Sick role behaviour - example
d) Two conflicting types of health behaviour (good/bad)

A

a) Eating healthily
b) Seeking medical help
c) Active process - taking medications
d) Health-promoting and health-damaging

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12
Q

Why do people engage in health-damaging behaviours?

a) Main phenomenon (1 mark)
b) Explain this (2 marks)
c) 4 examples of this.
d) 5 other reasons for engaging in health damaging behaviours

A

a) Unrealistic optimism
b) Due to inaccurate perceptions of risk and susceptibility
c) Lack of personal experience of problem; believe that it’s preventable through personal action; believe that if its not happened now it won’t happen; believe that problem is infrequent
d) Age (teenage), pleasure, health beliefs, socioeconomics, stress, cultural variability, situational rationality

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13
Q

Behaviour and burnout in medical students.

a) 3 phenomena
b) 3 protective factors

A

a) Depersonalisation, emotional exhaustion, lack of personal achievement
b) diet, sleep, exercise

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14
Q

Reasons for non-compliance - give 4

A

SEs, socioeconomics, perceive no benefit, practical issues

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15
Q

Health behaviour interventions.
a) 2 approaches
b Give 3 examples of health promotion
c) On what 3 levels can/do these interventions act?
d) Describe how campaign to reduce alcohol consumption would impact on these three levels

A

a) Population; patient-centred
b) Screening, campaigns (5 a day, drinkaware, Stoptober), immunisation
c) Individual, community, population
d) Ind - reduce alcohol, reduce DA, Comm - reduce A&E numbers, reduce crime; Pop - reduced tax levied, increase pop health and productivity and so increased GDP

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16
Q

NICE guidance on health behaviours: 8 steps

  1. ____ intervention
  2. Assess _____ context
  3. E______ and t______
  4. I____-level interventions
  5. ______-level interventions
  6. ______-level interventions
  7. Evaluate e______
  8. Evaluate c___-e_______
A
Plan
Social
Education, training
Individual
Comm
Pop
Effectiveness
Cost-effectiveness
17
Q

Health needs assessment.

a) A _____ method for reviewing health issues facing a population, leading to agreed ______ and ______allocation to improve _____ and reduce ______
b) 3 approaches

A

a) Systematic, priorities, resource, health, inequality

b) epidemiological, comparative and corporate

18
Q

Define:

a) Health care need
b) Demand
c) Supply

A

a) Ability to benefit from an intervention
b) What people ask for
c) What is provided

19
Q

Sociological ‘needs’

a) Felt need
b) Expressed need
c) Normative need
d) Comparative need

A

a) Individual perception
b) Seek help (demand)
c) Professionals define the ability to benefit (healthcare need)
d) Comparing different groups

20
Q

HNA: epidemiological approach.
a) Stages: 1. Define the _____ (statistically, using incidence/prevalence etc.)
Stage 2. Identify potentially available ______.
Stage 3. Assess the _____ ____ (effectiveness and ___-effectiveness).
Stage 4. Look at existing ____ of care.
Stage 5. Look at existing ______ (for an ____ need, or a service not needed).
Stage 6. Make ________.
b) Problems

A

a) Problem, services, evidence base, cost, models, services, unmet, recommendations
b) Poor quality data, doesn’t look at felt needs (qual)

21
Q

HNA: comparative approach

a) Explain
b) Problems

A

a) Comparing different groups

b) all relative (no absolute standard), difficulty in finding comparable population

22
Q

HNA: corporate approach

a) Takes into account…
b) Problems

A

a) Views of opinion leaders, professionals, providers, politicians, press
b) Vested interests, lobbying, Big Pharma, difficult to distinguish need from demand

23
Q

Smoking cessation.

a) 4 economic costs of smoking
b) NCSCT - i) who are they? ii) what 3 functions do they have?
c) Success: i) 2 best interventions? ii) Better than _____ alone. iii) 1-year success rates?

A

a) Absenteeism, healthcare costs, cigarette butt cleaning, smoking breaks
b) National centre for smoking cessation training; deliver training, provide support services, deliver research
c) NHS behavioural support plus medication (Group and individual), better than medication alone, 15-30%

24
Q

Health determinants.

a) Two main groups - examples

A

Genes - gender, FHx
Environment - drugs, employment, lifestyle,
epigenetics

25
Q

Equality = ?
Equity = ?
Diagram

A

Equal shares

Fair and just (proportionate)

26
Q

a) Horizontal equity = ? Example
b) Vertical equity = ? Example
c) Types of things that may be inequitable
d) Non-healthcare factors contributing to inequity

A

a) Equal treatment for equal need (e.g. all those with MI treated equally)
b) Unequal treatment for unequal need (e.g. areas with poorer health may need greater expenditure on health services)
c) Expenditure, access, utilisation, health care outcome, health status
d) Education, housing

27
Q

Three domains of Public Health- examples for each

A

Improvement - Socioeconomics: inequalities, education, housing, employment
Protection - IDs, chemicals, radiation, environmental hazard
Services - Clinical effectiveness, audit and evaluation, clinical governance, service planning, efficiency

28
Q

a) Explain the difference between secondary and tertiary prevention
b) Explain the difference between horizontal and vertical equity
c) Explain the difference between interventions delivered at an individual or ecological level and give and example

A

a) Secondary - early-stage/subclinical (e.g. cervical screening, HTN screen), Tertiary - established disease (e.g. post-MI)

b) Horizontal: Equal treatment for equal need (e.g. all those with MI treated equally)
Vertical: Unequal treatment for unequal need (e.g. areas with poorer health may need greater expenditure on health services)

29
Q

Give an example of something that is:

a) Supplied but not needed or demanded
b) Demanded but not needed or supplied
c) Needed and demanded but not supplied
d) Supplied and needed but not demanded

A

a) Prescribing cascade - medications not wanted and causing unnecessary SEs as not been reviewed
b) Homeopathy
c) Dental treatment, eye tests, travel vaccinations (not on the NHS)
d) Contact tracing for STIs