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3A Public Health > 3A Public Health > Flashcards

3A Public Health Flashcards

1
Q

Define equality, equity, horizontal equity and vertical equity

A

Equality = equal shares

Equity is fair and just.

Horizontal = equal treatment for equal need

Vertical = unequal treatment for unequal need

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2
Q

Give 6 variables you can measure for equity

A
  1. Supply
  2. Allocation
  3. Access
  4. Utilisation
  5. Outcomes
  6. Health status
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3
Q

Define Health Needs Assessment

A

A systematic method of reviewing a populations’ need, supply and demand

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4
Q

Name and define 3 approaches to Health Needs Assessment

A

Epidemiological - defines issue and size of issue, services available, effectiveness and unmet needs

Comparative - looks at two populations

Corporate - stakeholder views

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5
Q

Describe the person model of error

A

Error as a result of wayward mental processes. Anticipation of blame promotes coverup

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6
Q

Describe the system model of error

A

Errors are inevitable due to latent conditions and active failure. Latent conditions can be pro-actively modified by hard and soft engineering

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7
Q

Define medical negligence

A

Breach in a duty of care causing harm, as judged by court

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8
Q

Name 3 learning theories

A

Behaviourism
Cognitivism
Constructivism

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9
Q

Define behaviourism

A

New behaviours acquired through stimuli-response link

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10
Q

Define cognitivism

A

Learning occurs through internal processing of info

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11
Q

Define constructivism

A

Knowledge based on worldy experiences

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12
Q

How do you calculate attributable risk?

A

amount of disease caused by exposure

1-natural rate

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13
Q

Describe a cohort study

A

People without the disease are followed over time. Exposure and disease development noted and compared. Prospective

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14
Q

Describe a case control study

A

Retrospective study taking people with a disease and matched controls then studying historical exposure

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15
Q

Describe a cross sectional study

A

Looks at current disease prevalence and exposure

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16
Q

Describe an ecological study

A

Association between prevalence and exposure either geographically or over time

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17
Q

Define lead time bias

A

Screening results in earlier diagnosis so survival increases even if death is not delayed

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18
Q

Define length time bias

A

Screening picks up more mild disease. Aggressive disease presents and kills between screens. This makes it look like LE is longer than it really is

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19
Q

Define health improvement and give examples

A

Intervention aimed at preventing disease and reducing health inequalities

Education, housing, food supply, benefits

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20
Q

Define health protection and give examples

A

Intervention aimed at controlling infectious diseases and environmental hazards

Pollution control, disaster response

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21
Q

Define improving services and give examples

A

Delivery of safe and quality care

Audit, evaluation, clinical governance

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22
Q

How do you evaluate services?

A

SPO
S - structure e.g. # of beds
P - process e.g. # of pts
O - outcome e.g. death, disease, discomfort, dissatisfaction, disability

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23
Q

What are the 6 domains of clinical governance?

A
  1. educational training
  2. clinical audit
  3. clinical effectiveness
  4. research involvement
  5. open and honest
  6. risk management
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24
Q

Name Maxwell’s 6 dimensions of quality

A 
Access
Appropriateness
Acceptability
Effectiveness
Equity
Efficacy
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25
Define health behaviour and give an example
Behaviour aimed at preventing disease e.g. healthy eating
26
Define illness behaviour and give an example
Behaviour aimed at seeking remedy e.g. going to the GP
27
Define sick role behaviour and give and example
Behaviour aimed at getting well e.g. taking medication
28
Give the 4 key points of unrealistic optimism
1. lack of personal experience 2. believes disease is preventable by personal action 3. believes if its not happened yet, it won't 4. believes the disease is infrequent
29
Define felt need
Individual perception of variation from normal health.
30
Define expressed need
Saying your need out loud
31
Define normative need
Professional defines appropriate intervention for expressed need
32
Name the 4 key points of the health belief model
1. believes they are susceptible 2. believes there are serious consequences 3. believes taking action reduces risk 4. believes benefits outweigh the cost
33
Describe the theory of planned behaviour
Intention predicts behaviour Intention is influenced by 1. attitude 2. social norm 3. perceived behavioural control
34
Describe the structure of a motivational interview
``` F - feedback R - responsibility A - advice M - menu E - empathy S - self efficacy ```
35
Name 3 food and behaviour theories
Externality theorum - fat people respond to external cues Goal conflict - tastes nice but is bad for you Restraint theory - cognitive boundary wildy exceeded
36
Describe the MUST score
1. BMI >20=0; 18.5-20=1; <18.5=2 2. Unintentional wt loss in last 6 months <5%=0; 5-10%=1; >10%=2 3. Acute illness/likely to not eat for 5 days = 2 Scoring 0 = low = do nothing 1 = mod = food diary 2 = high = dietician
37
When do you use the MCA and MHA?
MCA - lacking capacity | MHA - diagnosed disorder
38
Breast cancer screening ages
50-70yo, every 3 years >70yo , on request <50yo, if high risk, using MRI
39
Bowel cancer screening ages
55yo, flexible sigmoidoscopy 60-74yo, home testing kit every 2 years >74yo, home testing kit on request
40
Cervical cancer screening ages
25-49yo, every 3 years 50-64yo, every 5 years >65yo, if one of the previous 3 was abnormal
41
AAA screening
men aged 65+, one off USS
42
Describe the FEVERPAIN score and interpret its results
``` F - fever P - pus A - attend within 3 days I - inflamed tonsils N - no cough ``` Score 0 or 1 = no abx Score 2 or 3 = delayed abx Score 4 or 5 = immediate phenoxymethlypenicililin
43
Describe the Centor score and interpret its results
Pus Lymphadenopathy Fever No cough Score 0, 1 or 2 = no abx Score 3 or 4 = immediate abx
44
Define health inequality
preventable, unfair and unjust differents in heath status that arise from unequal distribution of social, environmental and economic conditions within society, which determine the risk of people getting ill, their ability to prevent sickness, to take action and to access treatment
45
Describe Section 2
``` Diagnosis and plan Up to 28 days Can treat against will Can appeal in first 14 days Right to IMHA ```
46
Describe Section 3
``` Treatment Up to 6 months Can treat against will Can appeal once in the 6 month Right to IMHA Can renew ```
47
Describe Section 5(2)
Doctor's holding power Up to 72 hours Inpatients only (not A&E)
48
Describe Section 135
Warrant needed Private place Police can enter with AMHP and HCP For 24+12 hours
49
Describe Section 136
No warrant Public place For 24+12 hours
50
Compare anxiolytics and hyponotics
Anxiolytics - induce sleep at night. Used in anxiety. Benzodiazepines, propranolol, buspirone Hypnotics - sedate when given in the day. Used in ST insomnia and phobias. Benzodiazepines, zopiclone, antihistamines, melatonin
51
Describe the triple swab
1. Endocervical chlamydia swab 2. Endocervical charcoal gonorrhoea swab 3. HVS - BV, candida, trichmoniasis, GBS
52
Name APGAR
``` Appearance Pulse Grimace Activity Respiration ```
53
8 week jabs
6 in 1 Men B rotavirus
54
12 week jabs
6 in 1 pneumococcal rotavirus
55
16 week jabs
6 in 1 | Men B
56
1 year jabs
``` MMR pneumococcal Men B Men C Hib ```
57
3 year 4 month jabs
MMR | 4 in 1
58
Define culture
socially transmitted pattern of shared responsibility by which people communicate and develop their knowledge and life attitude
59
Define cross cultural education
acquiring cultural knowledge in order to better serve diverse groups
60
Define cultural expertise model
training providing info on different groups who share on characteristic
61
Define cultural competency
different cultural groups can be approached in different ways to reduce health inequality
62
Name 3 theories of resource allocation
egalitarian maximising libertarian
63
Describe egalitarian resource allocaiton
everyone gets the care the need and require ignores resource limitation 'ideal scenario'
64
describe maximising resource allocation
the people with the most ability to benefit will receive resources. those with mild needs, or conversely very high needs, who may benefit less, are ignored and receive nothing
65
describe libertarian resource allocation
people have individual responsibility for their own health. more engaged patients will receive more resources.
66
describe Bolam's rule
would a reasonable doctor do the same?
67
describe Bolitho's rule?
would that be reasonable tho?
68
name the 3 buckets of error
self context task
69
describe the contents of the 'self' bucket
level of knowledge level of skills level of expertise current capacity e.g. illness, fatigue
70
describe the 'context' bucket
``` equipment physical env e.g. lighting workspace team support organisation management ```
71
describe the 'task' bucket
errors complexity novel task process

3A Public Health (2 decks)

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