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1

Dangers of overprescribing antibiotics

Unecessary side effects
Medicalise self limiting conditions
Antibiotic resistance

2

Purposes of primary care

Managing illness and clinical illness over time
Finding the best available clinical solutions to clinical problems
Preventing illness
Promoting health

3

Epigenetics

Expression of the genome depends on the environment

4

Allostasis

Stability through change

5

What is allostatic load

Long term overtaxation of our physiological systems leads to impaired health (the pathophysiology of stress)

6

Salutogenesis

Favourable physiological changes secondary to experiences which promote healing and health

7

Define domestic abuse

Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality

8

Give some types of domestic abuse

Pscyhological
Physical
Sexual
Financial
Emotional

9

How does domestic abuse affect health

Traumatic injuries following assault
Somatic problems or chronic illness
Psychological or psychosocial problems

10

Standard domestic abuse risk

Current evidence does not indicate likelihood of causing serious harm

11

Medium domestic abuse risk

Idenitifiable indicators of risk of serious harm

12

High domestic abuse risk

Identifiable indicators of imminent risk of serious harm

13

How to deal with domestic and sexual abuse as a GP

Display posters
Focus on safety
Ask direct questions
Be clear that behaviour is not ok
Give info
Be part of the process

14

Practical advice to domestic abuse patients

Phone a helpline

15

Domestic abuse MARAC

Single meeting about the abuse

16

IDVA

Service that works with high risk women

17

DHR

Review of circumstances surrounding domestic abuse deaths

18

Determinants of health

Genes
Environment
Lifestyle
Health Care

19

Horizontal equity

Equal treatment for equal need

20

Vertical equity

Unequal treatment for unequal need

21

Examining health equity

Supply of healthcare
Access to health care
Utilisation of health care
Health care outcomes
Health status
Resource allocation
Wider determinants of health

22

Three domains of public health

Health improvement
Health protection
Improving services

23

Health needs assessment definition

Systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities

24

Define felt need

Individual perceptions of variation from normal health

25

Define expressed need

Individual seeks help to overcome variation in normal health

26

Define normative need

Professional defines intervention appropriate for the expressed need

27

Define comparative need

Comparison between severity, range of interventions and cost

28

Public health approach to health needs assessment

Epidemiological
Comparative
Corporate

29

Epidemiological approach to health needs assessment

Define problem
Size of problem
Services available
Evidence base
Models of care
Existing services
Reccomendations

30

Comparative approach to health needs assessment

Compares the services received by a population with others