2017/2018

Public Health Phase 3a Revision Session Anna Kirkwood and Jess Hartley 09/10/17 The Peer Teaching Society is not liable for false or misleading information…

Contents Health belief models Communicable Disease Control The Peer Teaching Society is not liable for false or misleading information…

Health belief model Perceived susceptibility to ill health Perceived severity of ill health Likelihood of engaging in health-promoting behaviour Perceived benefits of behaviour change HBM proposes individuals conduct internal assessments comprising four components when deciding whether or not to change their behaviour Any suggestions as to the four components? Perceived barriers to taking action The Peer Teaching Society is not liable for false or misleading information…

Stages of change/trans-theoretical model Pre-contemplation Contemplation Preparation Roger, 74 years old- smoked 20/day since he was 16 Action A widely applied behaviour change model. It suggests that the process of health behaviour change involves progression though six stages of change that represent the levels of motivational readiness Does anyone know the stages? If you apply this to a GP setting, where you are trying to get patients to change their health behaviours for the better. Roger has smoked all his life, it’s a natural habit for him and he has never thought of quitting- where is he on the scale? (Pre-contemplation) It would be a big ask if he came into a consultation to tell him to stop, prescribe champix and tell him when he gets home to throw all his cigarettes out. Use the health belief model to bring up and discuss the prospect of quitting smoking (perceived susceptibility to ill health, severity of ill health, benefits of behaviour change, barriers to taking action). Roger will now leave in contemplation When Roger returns, he is ready to quit smoking- DISCUSS setting a quit date, throwing out extra cigarettes, lighters and ashtrays, and stopping buying extra cigarettes. Prescribe champix (Preparation) Roger quits smoking according to the plan (ACTION) Roger returns, he has not smoked for 3 months (MAINTENANCE)- you remind him of the importance of avoiding triggers, back up the benefits he is starting to feel (health belief model) Roger comes back in another month- he has had a family crisis and had a cigarette to calm his nerves (RELAPSE). Reassured that this is not failure- he is not back at the contemplation stage and will need to prepare to quit again. Maintenance Relapse The Peer Teaching Society is not liable for false or misleading information…

Perceived behavioural control Theory of planned behaviour Attitudes Subjective norm Intention Behaviour The central factor is the individuals intention to perform a given behaviour The stronger the intention to engage in a behaviour, the more likely the completion of behaviour change Intentions are influenced by three things…..attitudes towards the behaviour, the subjective norm, the perceived behavioural control Perceived behavioural control The Peer Teaching Society is not liable for false or misleading information…

Communicable disease control SURVEILLANCE, PREVENTION, CONTROL The Peer Teaching Society is not liable for false or misleading information…

Which communicable diseases do public health care about? High mortality High morbidity Highly contagious Expensive to treat Effective interventions The Peer Teaching Society is not liable for false or misleading information…

WHO? Registered Medical Practitioners Laboratories Notifiable diseases The Peer Teaching Society is not liable for false or misleading information…

WHEN? Notifiable diseases Individual cases of notifiable diseases Other infection/ contamination which could be a significant risk to human health On CLINICAL SUSPICION DON’T wait for lab confirmation The Peer Teaching Society is not liable for false or misleading information…

WHAT? Notifiable diseases Index case details: name, NHS no., DOB, contact details Disease/ contamination details: what, onset, diagnosis, samples, hospitalised?, died? The Peer Teaching Society is not liable for false or misleading information…

HOW? Notifiable diseases Contact your local health protection authority Written notification or if urgent, telephone followed by written The Peer Teaching Society is not liable for false or misleading information…

Notifiable diseases There’s a long list! Worth going over, easy marks to be had Acute encephalitis Acute infectious hepatitis Acute meningitis Acute poliomyelitis Anthrax Botulism Brucellosis Cholera Diphtheria Enteric fever (typhoid or paratyphoid fever) Food poisoning Haemolytic uraemic syndrome (HUS) Infectious bloody diarrhoea Invasive group A streptococcal disease Legionnaires’ disease Leprosy Malaria Measles Meningococcal septicaemia Mumps Plague Rabies Rubella Severe Acute Respiratory Syndrome (SARS) Scarlet fever Smallpox Tetanus Tuberculosis Typhus Viral haemorrhagic fever (VHF) Whooping cough Yellow fever The Peer Teaching Society is not liable for false or misleading information…

Other notifications Other infection/ contamination which could be a significant risk to human health Known chicken pox in a healthcare worker Emerging infectious disease (something like SARS) Radiological hazard Other chemicals e.g. carbon monoxide Voluntary notification of suspected outbreaks/ clusters E.g. scabies in a care home The Peer Teaching Society is not liable for false or misleading information…

An aggregation of cases which may or may not be linked Outbreak control: definitions CLUSTER An aggregation of cases which may or may not be linked The Peer Teaching Society is not liable for false or misleading information…

SUSPECTED OUTBREAK Definitions Occurrence of more cases than normally expected within a specific place/ group over a given period of time 2+ cases linked through common exposure/ characteristic/ time/ location SINGLE case of rare/ serious disease The Peer Teaching Society is not liable for false or misleading information…

Link confirmed through epidemiological/ microbiological investigation Definitions CONFIRMED OUTBREAK Link confirmed through epidemiological/ microbiological investigation The Peer Teaching Society is not liable for false or misleading information…

Definitions EPIDEMIC Occurrence within an area in excess of what is expected for a given time period The Peer Teaching Society is not liable for false or misleading information…

PANDEMIC Epidemic widespread over several countries Definitions The Peer Teaching Society is not liable for false or misleading information…

ENDEMIC HYPER-ENDEMIC Definitions Persistent level of disease occurrence HYPER-ENDEMIC Persistently high level of disease occurrence The Peer Teaching Society is not liable for false or misleading information…

SBA GP sees a patient with 2 day history of vomiting and diarrhoea following a meal at a local takeaway. This is the 3rd patient this week with a similar presentation No need to notify Written notification to arrive within 3 days Call the communicable disease consultant Call the laboratory The Peer Teaching Society is not liable for false or misleading information…

SBA 20 year old medical student presents with unilateral swelling of the parotid gland, fever, headache and malaise. No need to notify Written notification to arrive within 3 days Call the communicable disease consultant Call the laboratory The Peer Teaching Society is not liable for false or misleading information…

SBA Patient presents with flu like illness, headache, muscle pains and cyclical shivering/fevers. Their temperature is 38oC and they are sweating profusely. They returned from holiday in Madagascar 5 days ago. No need to notify Written notification to arrive within 3 days Call the communicable disease consultant Call the laboratory The Peer Teaching Society is not liable for false or misleading information…

SBA 22 year old man presents with purulent urethral discharge and dysuria No need to notify Written notification to arrive within 3 days Call the communicable disease consultant Call the laboratory The Peer Teaching Society is not liable for false or misleading information…

Any Questions? The Peer Teaching Society is not liable for false or misleading information…

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