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3a > 3a Public Health > Flashcards

3a Public Health Flashcards

1
Q

Give 2 ways health psychology aims to put theory into practice

A

By promoting healthy behaviours and preventing illness

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2
Q

What are the 3 main behaviours classifies in health psychology?

A
  • Health behaviour
  • Illness behaviour
  • Sick role behaviour
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3
Q

What is health behaviour? Give an example

A

A behaviour aimed to prevent disease e.g. eating healthy

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4
Q

What is illness behaviour? Given a example

A

A behaviour aimed to seek remedy e.g. going to see the doctor

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5
Q

What is sick role behaviour? Give an example

A

Any activity aimed at getting well e.g. taking prescribed medications

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6
Q

Systematic review vs meta-analysis

A

A systematic review is a way of collecting, analysing and synthesising evidence to answer a specific question. A meta-analysis is a statistical procedure for combining numerical data from multiple studies - normally carried out as part of a systematic review

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7
Q

Give examples of health damaging behaviours

A
  • Smoking
  • Alcohol and substance abuse
  • Risky sexual behaviour
  • Sun exposure
  • Driving without a seatbelt
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8
Q

Give examples of health promoting behaviours

A
  • Exercise
  • Healthy eating
  • Vaccinations
  • Medication compliance
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9
Q

Give examples of health interventions at a population level

A

Clean Air Act, health promotion/awareness campaigns

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10
Q

Give examples of health interventions at an individual level

A

Cervical smear screening, childhood immunisations

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11
Q

What is the leading cause of preventable death in England?

A

Smoking

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12
Q

What is the NCSCT?

A

National centre of smoking cessation and training

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13
Q

What’s the most successful intervention for smoking cessation?

A

Group behavioural support plus medication

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14
Q

How much to South Yorkshire and Bassetlaw CCG currently spend on smoking related admissions?

A

Over £26m

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15
Q

How does the Lalonde Report (1974) classify the determinants of health?

A
  • Genes
  • Environment (physical/social/economic)
  • Lifestyle
  • Health care
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16
Q

Describe equity

A

Equity is about what is fair and just

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17
Q

Describe equality

A

Equality is concerned with equal shares

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18
Q

What is horizontal equity?

A

Equal treatment for equal need

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19
Q

What is vertical equity?

A

Unequal treatment for unequal need

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20
Q

How can the dimensions of health equity be classified?

A

Spatial and social:
- Spatial - geographical
- Social - age, gender, class (socioeconomic), ethnicity

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21
Q

How can health equity be examined?

A

Supply of health care, access to health care, resource allocation (health services/education/housing), health care outcomes

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22
Q

How is health equity assessed?

A
  • First assess inequality, then judge if inequitable
  • Note - equal utilisation may not be equitable
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23
Q

What are the 3 domains of public health practice?

A
  • Health improvement
  • Health protection
  • Health care
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24
Q

An intervention is anything done to improve public health. What are non-health interventions?

A

Interventions that improve the economy and social conditions - have an impact on public health

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25
Q

Give an example of a health intervention at a community level

A

Playground set up for the local community

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26
Q

Explain the difference between public health interventions delivered at the ecological and individual levels, using one example for each

A

Childhood immunisation is an example of an individual level intervention - the injection is delivered to each individual child so the intervention solely affects their health
Building a playground for a local community is an example of a community level intervention - the playground would provide a place for children within the community to exercise and socialise, benefiting the health of individual in a particular area

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27
Q

Give an example of horizontal and vertical equity

A

Horizontal - individuals with pneumonia should be treated equally
Vertical - individuals with pneumonia and a common cold should receive unequal treatment

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28
Q

What is primary prevention? Provide an example

A

Preventing diseases before they happen e.g vaccinations, bike helmets

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29
Q

What is secondary prevention? Provide an example

A

Identifying disease before problems become serious e.g. newborn screening/mammography/regular blood pressure testing

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30
Q

what is tertiary prevention? Provide an example

A

Managing disease post diagnosis to slow or stop disease progression e.g. post stroke rehabilitation/screening for complications/chemotherapy

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31
Q

Incidence vs prevalence

A

New cases vs existing cases

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32
Q

What is attributable risk? (+ formula)

A

The rate of disease in the exposed that may be attributed to the exposure (incidence in exposed minus incidence in unexposed)

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33
Q

What is relative risk? (+ formula)

A

Ratio of risk of disease in the exposed to the risk in the unexposed (incidence in exposed divided by incidence in unexposed)

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34
Q

The incidence of disease B in smokers is 8/1000 person-years. The incidence of disease B in non-smokers is 4/1000 person-years. Calculate 1) the attributable risk and 2) the relative risk

A

1) 4/1000 person-years
2) 2

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35
Q

What does the relative risk tell us?

A

The strength of association between a risk factor and a disease

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36
Q

What are the 2 main groups of bias?

A
  1. Selection bias
  2. Information (measurement bias)
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37
Q

Give 3 sources of information bias

A
  • Observer
  • Participant
  • Instrument
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38
Q

In a RCT the time at risk was determined from entry to the study to various end points. What measure is being used here?

A

Person-years

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39
Q

For patients with meningitis, the risk of dying has been estimated to vary 5-10%. What measure is being used here?

A

Case-fatality rate

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40
Q

If a meta-analysis showed the relative risk of CHD in smokers was A) 1.74 and B) 2.27 - how much higher is the relative risk of CHD in non-smokers vs smokers (in percentages)

A

a) 74%
b) 124%

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41
Q

What is the prevention paradox (Rose 1981)?

A

‘A preventative measure which brings much benefit to the population offers little to each participating individual’

42
Q

What is the number needed to treat?

A

The number of people we need to treat in order to prevent one person from developing the outcome

43
Q

Give 5 types of domestic abuse

A
  1. Psychological
  2. Physical
  3. Sexual
  4. Financial
  5. Emotional
44
Q

Give 4 models/theories of behaviour change

A
  1. Health belief model
  2. Theory of planned behaviour
  3. Stages of change/transtheoretical model
  4. Social norms theory
45
Q

What four components are crucial for behaviour change according the the Health belief model?

A
  1. Perceived susceptibility
  2. Perceived severity
  3. Perceived benefits
  4. Perceived barriers
46
Q

What are criticisms of the Health belief model?

A
  • Alternative factors may predict health behaviour e.g. outcome expectancy
  • The model does not consider the influence of emotions on behaviour
  • The model does not differentiate between first time and repeat behaviour
47
Q

What is the longest standing model of behaviour change?

A

Health belief model

48
Q

Give 3 examples of where the Health belief model can be applied

A
  • Breast self-examination
  • Vaccinations
  • Diabetes management
49
Q

According to the Theory of planned behaviour, what is the best predictor of behaviour change?

A

Intention

50
Q

According to the Theory of planned behaviour, what is intention determined by?

A
  1. Attitude
  2. Subjective norm (the perceived social pressure to undertake the behaviour)
  3. Perceived behavioural control
51
Q

What are criticisms of the Theory of planned behaviour?

A
  • Its useful for predicting people’s intention but not as successful for actual behaviours
  • It is a ‘rational choice model’, it doesn’t take into account how emotions could disrupt ‘rational’ decision making
52
Q

Give 3 examples of where the Theory of planned behaviour can be applied

A
  • Smoking
  • Abortion
  • Diet
53
Q

What does the transtheoretical model propose the five stages of change are?

A
  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance
54
Q

What are criticisms of the Transtheoretical model?

A
  • Change might not operate in discrete stages
  • People often change their behaviour in the absence of planning
55
Q

What are advantages of the Transtheoretical model?

A
  • It acknowledges individual stages of readiness
  • It accounts for relapse
56
Q

According to the transtheoretical model, what does moving back through the five stages of change indicate?

A

Relapse

57
Q

What is the third stage of the Transtheoretical model?

A

Preparation

58
Q

What is breast milk composed of?

A
  • Colostrum
  • Foremilk
  • Hindmilk
59
Q

What are the 3 distinct eating disorders in order of prevalence?

A
  • Binge eating disorder
  • Bulimia nervosa
  • Anorexia nervosa
60
Q

What % of the population is overweight/obese?

A

> 50%

61
Q

Give 3 dietary approaches to weight loss

A
  1. Restricting the amount of food eaten
  2. Avoiding certain types of food
  3. Avoiding eating for long periods of time
62
Q

What are the 2 main causes of homelessness?

A
  • Eviction by private landlords
  • Relatives/friends no longer able to offer accommodation
63
Q

Define refugee

A

A person granted asylum and refugee status. Usually means leave to remain for 5 yrs then reapply

64
Q

Define indefinite leave to remain

A

When a person is granted full refugee status and given permanent residence in the UK

65
Q

Give 3 things asylum seekers are entitled to and 2 things they are not

A
  1. Entitled to money
  2. Entitled to housing
  3. Entitles to free NHS care
  4. Not allowed to work
  5. Not entitled to any other form of benefit
66
Q

How much money as asylum seekers currently entitled to per week?

A

£37.75

67
Q

Define polypharmacy

A

The concurrent use of multiple medications in an individual

68
Q

What 3 public health approaches are there to health needs assessment?

A
  • Epidemiological
  • Comparative
  • Corporate
69
Q

What is the comparative approach to health needs assessment? Give 2 issues with it.

A

Compares the services received by one population with others.
1. May be difficult to find a comparable population
2. Data may be of variable quality

70
Q

What is the corporate approach to health needs assessment? Give 1 issue with it.

A

It is about obtaining the views of a range of stakeholders e.g. politicians, press, pharmaceutical companies
1. Groups may have vested interests

71
Q

Give 3 issues with the epidemiological approach to health needs assessment.

A
  1. Required data may not be available
  2. Variable data quality
  3. Does not consider felt needs of people affected
72
Q

Give one health related example of something that you consider is needed and supplied but not demanded

A

Health promotion

73
Q

Give one health related example of something that you consider is demanded but not needed or supplied

A

Cosmetic surgery

74
Q

What are the 3 opiod receptors?

A

MOR, KOR, DOR

75
Q

What framework, prosed by Donabedian, is widely used to evaluate health services?

A
  1. Structure
  2. Process
  3. Outcome
76
Q

Explain what is meant by ‘structure’ according to Donabedian’s framework for evaluating health services

A

What is there e.g. buildings, staff, equipment

77
Q

Explain what is meant by ‘process’ according to Donabedian’s framework for evaluating health services

A

What is done e.g. number of patients seen in a&e

78
Q

Explain what is meant by ‘outcome’ according to Donabedian’s framework for evaluating health services

A

Looking at health outcomes e.g. mortality, morbidity, QoL, patient satisfaction

79
Q

When assessing the quality of health services, Maxwell’s classification lists six dimensions. List the six dimensions

A
  • Acceptability
  • Accessibility
  • Appropriateness
  • Effectiveness
  • Efficiency
  • Equity
80
Q

Although using measures of health outcomes is desirable in evaluation of health services, there are potential limitations. Give a reason (+example) why it may be difficult to attribute a health outcome to the service provided

A

Time lag between service provided and outcome may be too long e.g. between healthy eating intervention in childhood and incidence of T2DM in middle age

81
Q

What is error of fixation/loss of perspective?

A

Unshakeable focus on one diagnosis

82
Q

What is error of bravado?

A

Working beyond competence

83
Q

What is error of ignorance?

A

Unconscious incompetence

84
Q

What is ‘playing the odds’ error?

A

Choosing the common and dismissing the rare

85
Q

What is ‘sloth’ error?

A

Inadequate documentation, not checking results for accuracy

86
Q

What is error of commission?

A

Doing something wrong e.g. giving the wrong antibiotic

87
Q

What is error of ommission?

A

Failing to do the right thing e.g not bothering to order a head CT

88
Q

What is negligence?

A

A breech in duty of care which results in damage

89
Q

When assessing if negligence occurred what two tests can you use?

A
  • Bolam test - would a group of reasonable doctors do the same?
  • Bolitho test - would it have been reasonable of them to do so?
90
Q

What 4 questions do you need to ask when negligence is suspected?

A
  1. Was there duty of care?
  2. Was this duty breeched?
  3. Was patient harmed?
  4. Was harm due to breach of care?
91
Q

Give 3 examples of allocation theories

A
  • Egalitarian
  • Maximising principles (utilitarian)
  • Libertarian principles
92
Q

What are 4 types of need?

A

FENC
- Felt need - what individuals state their need to be
- Expressed need - what services people use
- Normative need - expert opinion regarding appropriate standards
- Comparative need

93
Q

Give the 5 stages of Maslow’s Hierarchy of Needs

A
  1. Physiological
  2. Safety
  3. Love/belonging
  4. Esteem
  5. Self-actualisation
94
Q

Which is better at ruling in a disease - specific tests or sensitive test

A

Highly specific tests

95
Q

Which is better for ruling out disease - specific tests or sensitive tests?

A

Highly sensitive tests

96
Q

Describe lead time bias in relation to screening?

A

Early detection makes it look like people are surviving longer

97
Q

Describe length time bias in relation to screening?

A

Less aggressive conditions with slow progression are likely to be picked up by screening -> screening appears to improve survival

98
Q

What does NICE define as transition points in life that can influence behaviour change?

A
  • Leaving school
  • Entering the workforce
  • Becoming a parent
  • Becoming unemployed
  • Retirement
  • Bereavement
99
Q

What’s included in Edwards and Gross criteria for alcohol dependance?

A
  • Narrowing of repertoire
  • Salience of drink seeking behaviour
  • Increased tolerance
  • Repeated withdrawal symptoms
  • Relief/avoidance of ^^^ by drinking
  • Subjective awareness of compulsion to drink
  • Reinstatement after abstinence
100
Q

Which between the Fraser guidelines and Gillick guidelines are specific to contraception?

A

FRASER GUIDELINES!

3a (34 decks)

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