Health Studies Level 3 cheat sheet

Three levels of prevention: primary (before disease onset, e.g. immunisation), secondary (early detection, e.g. screening), tertiary (limiting disability from established disease).

Ottawa Charter (1986) action areas: build healthy public policy, create supportive environments, strengthen community action, develop personal skills, reorient health services.

Three models of health behaviour: health belief model (perceived susceptibility, severity, benefits, barriers, cues to action), stages of change (precontemplation to maintenance), and social cognitive theory (self-efficacy, observational learning).

Screening programmes must satisfy Wilson-Jungner criteria, including an important health problem, accepted treatment, latent stage detectable by a suitable test, and cost-effective screening.

Herd immunity threshold formula: H = 1 − 1/R0; for measles R0 of 12–18 the threshold is roughly 92–95% of the population immune.

Incidence counts new cases per population at risk per unit time; prevalence counts all existing cases at a point or period; prevalence ≈ incidence × average duration.

The Dahlgren-Whitehead rainbow model layers influences on health: individual factors, lifestyle, social and community networks, living and working conditions, and general socioeconomic, cultural and environmental conditions.

Health inequalities are systematic, avoidable differences in health status between groups; the Marmot Review framed these as differences in the social determinants of health.

Anatomical position: standing upright, face forward, arms at sides with palms facing anteriorly, feet flat and directed forward; all directional terms are referenced to this position.

Directional pairs: anterior/posterior, superior/inferior, medial/lateral, proximal/distal, superficial/deep, ipsilateral/contralateral.

Planes: sagittal divides left and right; coronal (frontal) divides anterior and posterior; transverse (horizontal) divides superior and inferior.

Four tissue types: epithelial (covering and lining), connective (support and binding), muscle (contraction), nervous (conducting signals).

Skeletal system has 206 bones in the adult, divided into axial (skull, vertebral column, rib cage; 80 bones) and appendicular (limbs and girdles; 126 bones).

Bone remodelling involves osteoblasts (bone formation) and osteoclasts (bone resorption); calcium homeostasis is regulated by parathyroid hormone and calcitonin.

The heart has four chambers; the right side pumps deoxygenated blood to the lungs via the pulmonary artery and the left side pumps oxygenated blood to the body via the aorta.

The respiratory tract divides into upper (nose, pharynx, larynx) and lower (trachea, bronchi, bronchioles, alveoli); gas exchange occurs across alveolar membranes.

Homeostasis is maintenance of a stable internal environment via negative feedback loops (sensor, control centre, effector); positive feedback amplifies change (e.g. oxytocin in childbirth).

Normal adult resting values: heart rate 60–100 beats/min, respiratory rate 12–20 breaths/min, blood pressure around 120/80 mmHg, body temperature 36.1–37.2 °C, oxygen saturation 94–100%.

Cardiac output = heart rate × stroke volume; average resting output is roughly 5 L/min in adults.

Nephrons are the functional units of the kidney; they filter blood at the glomerulus and reabsorb water and solutes along the tubule under ADH and aldosterone control.

Piaget's stages: sensorimotor (0–2), preoperational (2–7), concrete operational (7–11), formal operational (11+).

Erikson's psychosocial stages include trust vs mistrust (infancy), autonomy vs shame (1–3), initiative vs guilt (3–6), industry vs inferiority (6–12), identity vs role confusion (adolescence), and integrity vs despair (late life).

Ageing changes include reduced cardiac output, decreased lung elasticity and vital capacity, reduced bone density, and slower reaction times, all affecting care planning.

Blood glucose regulation: insulin lowers blood glucose, glucagon raises it; normal fasting plasma glucose is roughly 3.9–5.5 mmol/L.

The care planning cycle: assess needs, plan goals, implement interventions, monitor and review, then revise; goals should be specific, measurable, achievable, relevant and time-bound.

Activities of daily living (ADLs) include washing, dressing, feeding, toileting and mobility; instrumental ADLs include shopping, cooking, managing finances and medication.

Person-centred care principles: treat people with dignity and respect, offer coordinated care, personalise care, enable choice and control, and support people to recognise their strengths.

Risk assessment in care settings covers falls, pressure ulcers, malnutrition, infection and safeguarding; tools include the Waterlow or Braden scale for pressure ulcers and MUST for nutrition.

Record-keeping standards: contemporaneous, accurate, legible, signed and dated, factual and free from opinion; records are legal documents and may be disclosed to courts.

Infection prevention: the WHO 'five moments for hand hygiene' and standard precautions (hand hygiene, PPE, safe sharps handling, safe waste disposal) apply to all service users.

Multi-disciplinary team working reduces duplication and improves outcomes; clear referral pathways and shared records support continuity of care.

Duty of care requires acting in the service user's best interests, not acting beyond competence, and reporting concerns promptly through the correct channel.

Macronutrients supply energy: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g, alcohol 7 kcal/g.

The Eatwell Guide proportions: fruit and vegetables about one third; starchy carbohydrates about one third; dairy and alternatives about 8%; beans, pulses, fish, eggs, meat about 12%; oils and spreads small amounts; fluids 6–8 glasses daily.

Reference intakes for adults: 2,000 kcal/day energy, 50 g total fat, 20 g saturated fat, 5 g salt, 30 g free sugars, 30 g fibre daily.

BMI = weight (kg) ÷ height (m)²; adult categories: under 18.5 underweight, 18.5–24.9 healthy, 25–29.9 overweight, 30+ obese.

Essential amino acids cannot be synthesised by the body (nine in adults) and must come from diet; complete proteins contain all essential amino acids in adequate amounts.

Fat-soluble vitamins A, D, E and K are stored in body fat and liver; water-soluble vitamins B and C are not stored and excess is excreted in urine.

In the UK, vitamin D supplementation of 10 micrograms daily is recommended for adults and children over one year, particularly in autumn and winter.

Physical activity guidelines for adults: 150 minutes of moderate-intensity activity or 75 minutes of vigorous activity per week, plus muscle-strengthening on two days.

The mental health continuum runs from healthy functioning through distress to diagnosable disorder; a person can move along it over time and circumstances.

The biopsychosocial model explains mental health as an interaction of biological, psychological and social factors, rather than a single cause.

Common anxiety and depressive symptoms: persistent low mood, loss of interest, sleep and appetite change, fatigue, worry, avoidance and impaired function for two weeks or more.

The stress-vulnerability model of psychosis states that symptoms arise when environmental stress exceeds a person's vulnerability threshold.

Recovery model principles: hope, identity, meaning, personal responsibility and a meaningful life; recovery is defined by the individual, not by symptom elimination.

Risk assessment in mental health covers risk to self (self-harm, suicide), risk to others, and vulnerability; protective factors include social support, employment and engagement with services.

The Mental Health Act 1983 (as amended 2007) in England and Wales allows detention for assessment or treatment when a person has a mental disorder of a nature or degree warranting detention and poses a risk.

Therapeutic communication techniques include open questions, active listening, reflection, paraphrasing and summarising; closed questions gather specific facts.

Categories of abuse: physical, emotional, sexual, financial, neglect, discriminatory, organisational, domestic, modern slavery and self-neglect.

The six safeguarding principles (Care Act 2014): empowerment, prevention, proportionality, protection, partnership, accountability.

Safeguarding children categories in England: physical abuse, emotional abuse, sexual abuse and neglect; significant harm is the legal threshold for intervention.

The Children Act 1989 establishes that the child's welfare is paramount and introduced the concept of parental responsibility.

The Mental Capacity Act 2005 presumes capacity, requires support to make decisions, permits unwise decisions, and requires best-interests decisions when capacity is absent.

The five statutory principles of the Mental Capacity Act: presumption of capacity, right to be supported, right to make unwise decisions, best interests, and least restrictive option.

Deprivation of Liberty Safeguards and Liberty Protection Safeguards apply when a person lacking capacity is deprived of liberty in a care setting; authorisation is required.

Whistleblowing (public interest disclosure) protects workers who report malpractice, and the Public Interest Disclosure Act 1998 provides protection from detriment or dismissal.

Hierarchy of evidence from highest to lowest: systematic reviews and meta-analyses, randomised controlled trials, cohort studies, case-control studies, cross-sectional studies, case reports, expert opinion.

Validity is the extent to which a tool measures what it intends; reliability is consistency of measurement over time or across raters.

Randomisation reduces selection bias; blinding reduces performance and detection bias; intention-to-treat analysis preserves randomisation benefits.

Sensitivity is the proportion of true positives correctly identified; specificity is the proportion of true negatives correctly identified.

Positive predictive value depends on prevalence as well as sensitivity and specificity, so it varies between populations.

Qualitative methods (interviews, focus groups, ethnography) explore meaning and experience; quantitative methods measure associations and effects numerically.

Ethical approval, informed consent, confidentiality and the right to withdraw are essential in all research involving human participants.

Critical appraisal asks whether the study is valid, what the results are, and whether they apply to the local population and setting.

Four ethical principles: autonomy (respect for self-determination), beneficence (doing good), non-maleficence (avoiding harm), justice (fairness and equity).

Informed consent requires capacity, sufficient information, understanding, voluntariness and the freedom to refuse.

Confidentiality is a professional duty but may be breached when there is a serious risk to the service user or others, or when required by law or court order.

Professional boundaries protect both service user and worker; crossing them (e.g. personal relationships, gifts, dual roles) should be discussed with a manager or supervisor.

The Nursing and Midwifery Council Code has four themes: prioritise people, practise effectively, preserve safety, and promote professionalism and trust.

Communication models include the sender-message-receiver model and the SBAR (situation, background, assessment, recommendation) handover structure.

Active listening involves attending, reflecting, clarifying and summarising; barriers include jargon, environment, hearing loss, anxiety and cultural differences.

Reflective practice models, such as Gibbs' reflective cycle (description, feelings, evaluation, analysis, conclusion, action plan), support learning from experience.

The NHS was established in 1948 under the National Health Service Act 1946, founded on principles of universal coverage, free at the point of use, and funded through taxation.

The NHS Long Term Plan (2019) sets priorities including integrated care systems, prevention, workforce, digital transformation and reducing health inequalities.

The Health and Social Care Act 2012 introduced clinical commissioning groups; the Health and Care Act 2022 replaced them with integrated care boards and placed integrated care systems on a statutory footing.

The Care Act 2014 sets out duties around wellbeing, prevention, market shaping, information and advice, and assessment and eligibility.

Public health responsibilities in England sit with local authorities following the transfer from the NHS in 2013; the UK Health Security Agency handles health protection.

Policy cycle stages: agenda setting, formulation, adoption, implementation, evaluation and revision.

The inverse care law states that availability of good medical care tends to vary inversely with need in the population served.

The NHS Constitution sets out seven principles and patient rights, including access to services within maximum waiting times and the right to be involved in decisions.

The Equality Act 2010 protects nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation.

Types of discrimination: direct, indirect, harassment, victimisation, and discrimination arising from disability.

Reasonable adjustments are a legal duty for disabled people, including changes to premises, equipment, policies and communication.

The Public Sector Equality Duty requires public bodies to eliminate unlawful discrimination, advance equality of opportunity and foster good relations; the specific duties include publishing equality objectives.

Health inequalities arise from the social determinants of health and affect groups by socioeconomic status, ethnicity, disability, gender and geography.

Cultural competence involves awareness of one's own culture, knowledge of others' cultures, and skills to adapt communication and care accordingly.

Intersectionality describes how overlapping social identities (e.g. race, gender, class, disability) combine to produce distinct experiences of advantage or disadvantage.

Equity differs from equality: equality means treating everyone the same, while equity means allocating resources according to need to achieve fair outcomes.

Policy instruments include legislation, regulation, funding and commissioning, guidance, incentives and public information campaigns.

The NHS Constitution sets out seven principles and patient rights, including access to services within maximum waiting times and the right to be involved in decisions.

Statutory regulation of health professionals in the UK is overseen by the Professional Standards Authority across nine regulators, including the NMC, GMC and HCPC.

Clinical governance domains: clinical effectiveness, patient safety, patient experience, and leadership and accountability.

Commissioning is the process of planning, agreeing and monitoring services; integrated care boards commission most NHS services in England.

The inverse care law states that availability of good medical care tends to vary inversely with need in the population served.

The public health grant to local authorities funds services including sexual health, substance misuse, health visiting and school nursing.

The National Institute for Health and Care Excellence (NICE) produces evidence-based guidance and quality standards that inform commissioning and practice.

Equity differs from equality: equality means treating everyone the same, while equity means allocating resources according to need to achieve fair outcomes.

The Equality Act 2010 protects nine protected characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation.

Types of discrimination: direct, indirect, harassment, victimisation, and discrimination arising from disability.

Reasonable adjustments are a legal duty for disabled people, including changes to premises, equipment, policies and communication.

Cultural competence involves awareness of one's own culture, knowledge of others' cultures, and skills to adapt communication and care accordingly.

Intersectionality describes how overlapping social identities (e.g. race, gender, class, disability) combine to produce distinct experiences of advantage or disadvantage.

Health inequalities arise from the social determinants of health and affect groups by socioeconomic status, ethnicity, disability, gender and geography.

The Public Sector Equality Duty requires public bodies to eliminate unlawful discrimination, advance equality of opportunity and foster good relations; specific duties include publishing equality objectives.