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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
Q

Define health behaviour and give an example

A

Behaviour aimed at preventing disease e.g. healthy eating

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26
Q

Define illness behaviour and give an example

A

Behaviour aimed at seeking remedy e.g. going to the GP

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27
Q

Define sick role behaviour and give and example

A

Behaviour aimed at getting well e.g. taking medication

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28
Q

Give the 4 key points of unrealistic optimism

A
  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
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29
Q

Define felt need

A

Individual perception of variation from normal health.

30
Q

Define expressed need

A

Saying your need out loud

31
Q

Define normative need

A

Professional defines appropriate intervention for expressed need

32
Q

Name the 4 key points of the health belief model

A
  1. believes they are susceptible
  2. believes there are serious consequences
  3. believes taking action reduces risk
  4. believes benefits outweigh the cost
33
Q

Describe the theory of planned behaviour

A

Intention predicts behaviour

Intention is influenced by

  1. attitude
  2. social norm
  3. perceived behavioural control
34
Q

Describe the structure of a motivational interview

A 
F - feedback
R - responsibility
A - advice
M - menu
E - empathy
S - self efficacy
35
Q

Name 3 food and behaviour theories

A

Externality theorum - fat people respond to external cues
Goal conflict - tastes nice but is bad for you
Restraint theory - cognitive boundary wildy exceeded

36
Q

Describe the MUST score

A
  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
Q

When do you use the MCA and MHA?

A

MCA - lacking capacity

MHA - diagnosed disorder

38
Q

Breast cancer screening ages

A

50-70yo, every 3 years
>70yo , on request
<50yo, if high risk, using MRI

39
Q

Bowel cancer screening ages

A

55yo, flexible sigmoidoscopy
60-74yo, home testing kit every 2 years
>74yo, home testing kit on request

40
Q

Cervical cancer screening ages

A

25-49yo, every 3 years
50-64yo, every 5 years
>65yo, if one of the previous 3 was abnormal

41
Q

AAA screening

A

men aged 65+, one off USS

42
Q

Describe the FEVERPAIN score and interpret its results

A 
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
Q

Describe the Centor score and interpret its results

A

Pus
Lymphadenopathy
Fever
No cough

Score 0, 1 or 2 = no abx
Score 3 or 4 = immediate abx

44
Q

Define health inequality

A

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
Q

Describe Section 2

A 
Diagnosis and plan
Up to 28 days
Can treat against will
Can appeal in first 14 days
Right to IMHA
46
Q

Describe Section 3

A 
Treatment
Up to 6 months
Can treat against will
Can appeal once in the 6 month
Right to IMHA
Can renew
47
Q

Describe Section 5(2)

A

Doctor’s holding power
Up to 72 hours
Inpatients only (not A&E)

48
Q

Describe Section 135

A

Warrant needed
Private place
Police can enter with AMHP and HCP
For 24+12 hours

49
Q

Describe Section 136

A

No warrant
Public place
For 24+12 hours

50
Q

Compare anxiolytics and hyponotics

A

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
Q

Describe the triple swab

A
  1. Endocervical chlamydia swab
  2. Endocervical charcoal gonorrhoea swab
  3. HVS - BV, candida, trichmoniasis, GBS
52
Q

Name APGAR

A 
Appearance
Pulse
Grimace
Activity
Respiration
53
Q

8 week jabs

A

6 in 1
Men B
rotavirus

54
Q

12 week jabs

A

6 in 1
pneumococcal
rotavirus

55
Q

16 week jabs

A

6 in 1

Men B

56
Q

1 year jabs

A 
MMR
pneumococcal
Men B
Men C
Hib
57
Q

3 year 4 month jabs

A

MMR

4 in 1

58
Q

Define culture

A

socially transmitted pattern of shared responsibility by which people communicate and develop their knowledge and life attitude

59
Q

Define cross cultural education

A

acquiring cultural knowledge in order to better serve diverse groups

60
Q

Define cultural expertise model

A

training providing info on different groups who share on characteristic

61
Q

Define cultural competency

A

different cultural groups can be approached in different ways to reduce health inequality

62
Q

Name 3 theories of resource allocation

A

egalitarian
maximising
libertarian

63
Q

Describe egalitarian resource allocaiton

A

everyone gets the care the need and require
ignores resource limitation
‘ideal scenario’

64
Q

describe maximising resource allocation

A

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
Q

describe libertarian resource allocation

A

people have individual responsibility for their own health. more engaged patients will receive more resources.

66
Q

describe Bolam’s rule

A

would a reasonable doctor do the same?

67
Q

describe Bolitho’s rule?

A

would that be reasonable tho?

68
Q

name the 3 buckets of error

A

self
context
task

69
Q

describe the contents of the ‘self’ bucket

A

level of knowledge
level of skills
level of expertise
current capacity e.g. illness, fatigue

70
Q

describe the ‘context’ bucket

A 
equipment
physical env e.g. lighting
workspace
team support
organisation
management
71
Q

describe the ‘task’ bucket

A

errors
complexity
novel task
process

3A Public Health (2 decks)

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