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PH Basic Lecture 2 > All > Flashcards

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prep for exam

1
Q

Frailty triangle

A

Sarcopenia, Malnutrition, chronic Inflammation

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2
Q

Malnutrition

A

Undernutrition, overnutrition, inflammation

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3
Q

Greenhouse gasses

A

CO2, CH4, N20, Flourinated gasses

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4
Q

Austria temperature changes

A

+2C since 1880, +1C since 1980

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5
Q

Global temperature changes

A

+0.85C since 1880, +0.5C since 1980

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6
Q

Greenhouse effect

A

Climate System: solar radiation from sun to earth, about half absorbed by earth’s surface and warms it, some reflected by atmosphere and earth, infrared radiation emitted from earth’s surface
Greenhouse Effect: some of the infrared radiation passes through the atmosphere but most is absorbed and re-emitted in all directions by greenhouse gas molecules and clouds (water vapor) = warms lower atmosphere and earth

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7
Q

Climate change - Vulnerability - Probability

A

Condition —- Vulnerability —- Probability
Heat exposure —- High (risk groups), moderate (general population) —- High
Extreme events —- Moderate – high (depending on region) —- High
New emerging pathogens, allergens, food safety —- Less robust Assessment possible —- Low

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8
Q

Classical Test Theory - psychometric properties

A

Objectivity – The result does not depend on the person who administers the instrument.
Validity – The instrument measures what it intends to measure.
Reliability – Readministration of an instrument leads to the same result, inter-rater (different raters) and intra rater (same rater twice) reliability
Sensitivity to change – the instrument measures the change produced by the intervention

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9
Q

Evidence-based medicine - Sackett definition

A

integration of the best research evidence with clinical expertise and patient values

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10
Q

Economic evaluation - Drummond definition

A

the comparative analysis of alternative courses of action in terms of both theirs costs and their consequences

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11
Q

Types of economic evaluation

A

Type/outcome unit
Cost-minimisation: equal effectiveness and safety of interventions
Cost-effectiveness: natural units (life years, cases detected…)
Cost-utility: QALY (longevity and quality of life)
Cost-benefit: monetary valuation of outcomes

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12
Q

Opportunity cost

A

the potential benefits which are sacrificed when resources are committed to one purpose rather than another; = the health benefit that could have been achieved had the money been spent on the next best alternative intervention

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13
Q

economic evaluation perspective

A

affects what costs are included

individual, government, health provider, society

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14
Q

Austrian finance of health expenditure (2014)

A 
33% general government
45% social security
17% private out-of-pocket
5% private insurance
(fairly close to EU28 average)
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15
Q

Austrian health expenditure (2014)

A

11% GDP (typically 10-11% every year)

36.25 billion

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16
Q

Austrian health care system

A

Bismarck type

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17
Q

Austria private insurance

A

~35% of population has private insurance

direct payments, cost sharing

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18
Q

Austrian hospitals (2014)

A

271 hospitals; 178 acute care
7.6 beds/1000
# beds declined 10% 2000-2010

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19
Q

Austrian physicians (2009)

A

19,000

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20
Q

Non-contract physician fees

A

Patients can claim reimbursement from their insurer - 80% of the relevant contract physician fee

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21
Q

Long-term care allowance (1993)

A

independent of age, income level/availability of asset

care must be expected to be needed for at least 6 months

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22
Q

Emission - Exposure

A 
50% cars --> 62%
30% cities/homes? --> 31.5%
11% factories/industrial? --> 5.4%
9% refineries? --> 1.3%
rainbow graphic
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23
Q

Ecological Crisis

A

humans have always affected the ecosystem, but since the industrial revolution, anthropogenic effects on ecosystems increased quantitatively and qualitatively

population growth –> demand on resources

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24
Q

Prevalence definition

A

Prevalence (P) is the number of cases (having a particular disease or health trait) in a population at a given time (Pt0 = point prevalence) or in a given time period (Pt1-tn = period prevalence). It corresponds to the sum of all cases (existing and new cases) and thus indicates the existence of a disease in a population.

Magnitude of epidemic

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25
Q

Prevalence equation

A

Number of persons with the illness or trait at a certain time (t0) or in a certain period (t1-tn)/Number of persons in the population at risk at a certain time (t0) or in a certain period (t1-tn)
* 100.000

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26
Q

Incidence definition

A 
The incidence (I) describes the number of cases that newly occur in a defined population over a defined period of time. This "population at risk" is, strictly speaking, the sum of the individual time sequences each individual has spent under exposure (= risk) (e.g., sum of person years, if 1 year, then = number of persons). The incidence thus measures the occurrence of new cases (persons with a specific disease).
This means that at least two examinations would actually be necessary to determine the incidence: In a first step, the cases that already have the disease to be examined would have to be excluded from the study. They can not be included in either the numerator or the denominator because only persons who can get the disease (population at risk) can appear there. Then it would be necessary to determine in an observation period how many really new cases occur. Only new cases belonging to the observed population may be counted. For large populations, the incidence cases are not removed from the population under observation (denominator), as the distortion of calculated rate by them is in the decimal range and is irrelevant.

Danger of epidemic

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27
Q

Incidence equation

A

Number of persons who become ill during the observation period/Sum of the length of stay of each individual person in population at risk
* 100.000

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28
Q

Mortality

A

Number of deceased/Number of population

* 1.000 or 10.000 or 100.000

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29
Q

Perinatal mortality

A

number of still-born, and those who died at birth and during the first week of life, relative to the number of live births in the same calendar year.

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30
Q

Infant mortality

A

Deceased in the first year of life, relative to the number of live births in the same calendar year.

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31
Q

Case Fatality (Lethality)

A

Number of persons with a certain disease who died during the observation period/Number of Persons who suffered from this disease within this time
* 100
(usually expressed as percentage)

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32
Q

relative number

A

E.g.: In Austria (2006) in total there are 3,360,072 men over the age of 15 years. Of these, 1,848,040 men are overweight or obese according to Statistics Austria’s health survey. With these numbers (1,848,040 out of 3,360,072), the order of magnitude are not readily apparent.

This becomes much easier when calculating relative numbers: The numbers above correspond to a total of 55% of the male population over 15 years. At the same time, it also equals 550 per thousand (550 per 1000), or 5500 / 10,000, or 55,000 / 100,000 and 550,000 / 1,000,000 men. One could say so well that of one million men in Austria, 550,000 are overweight or obese.

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33
Q

rate

A

E.g.: In Austria in 2004 (= 1 year of observation) a total of 17,343 women were newly affected by cancer. This corresponds to a “new disease rate” (incidence) of 17,343 / 4,205,543 female-years = 412.4 / 100,000 female-years. This means that in 2004, of 100,000 (theoretically observed) women (= 100,000 person years), 412.4 had cancer.

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34
Q

Dietetic factors with convincing blood pressure lowering effects

A

body weight (+ visceral fat) - adverse - ++
salt (sodium chloride) - adverse - ++
60% salt-sensitive HT
potassium - protective - ++
supplementation problematic (overdose/GI issues), increase intake through food
alcohol - adverse - ++
sympathetic NS activation
DASH (dietary approaches to stop HT) diet - protective - ++

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35
Q

European guidelines on cardiovascular disease prevention in clinical practice
Characteristic of a healthy diet

A

➢Saturated fatty acids to account for <10% of total energy intake, through replacement by polyunsatureated fatty acids
➢ Trans-unsaturated fatty acids: as a possible, preferably no intake from processed food, and <1% of total energy intake from natural origin.
➢ <5g of salt per day
➢ 30-45g of fibre per day, from wholegrain products, fruits and vegetables
➢ 200g of fruit per day (2-3 servings)
➢ 200 g vegetabled per day (2-3 servings)
➢ Fish at least twice a week, one of which tob e oily fisch (omega 3, Vit. D)
➢ Consumption of alcoholic beverages should be limited to two glasses per day (20g/day of alcohol) for men and one glass per day (10g/day of alcohol) fo women.

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36
Q

Nurse Model

A 
Naming: naming emotions
Understanding: showing understanding
Respecting: show respect for your opposite`s feelings and emotions
Supporting: offer support
Exploring: explore the background
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37
Q

medical pluralism

A

multiple medical systems/healing traditions coexist

typically biomedicine dominant

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38
Q

hybridization

A

people see multiple types of care at the same time, such as TCM and biomedicine
often in places with resource shortages

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39
Q

idioms of distress

A

varieties of ways that people express their distress in a clinical setting
culturally-constructed but within a culture there is a wide range

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40
Q

bioculturalism

A

interaction between biology and culture in health and illness
pain is biological, but the expression and experience is cultural
culture/behaviour impacts infectious disease spread

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41
Q

biopower

A

form of social control within context of modern nation states
modern regimes of knowledge/practice –> control through dissemination of knowledge in institutionalized form
control turns into behaviour (choices are not independent - socially constructed)
M. Foucault
It relates to the practice of modern nation states and their regulation of their subjects through “an explosion of numerous and diverse techniques for achieving the subjugations of bodies and the control of populations”

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42
Q

syndemics

A

= synergistic epidemic
critique of treating diseases as isolated, distinct entitites, independent of social context
example: HIV and TB
the aggregation of two or more concurrent or sequential epidemics or disease clusters in a population with biological interactions, which exacerbate the prognosis and burden of disease.

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43
Q

structural violence

A

“suffering structured by historically given, economically driven, processes and forces that constrain agency” P Farmer
health systems reinforce political economic regimes of oppression
a form of violence wherein some social structure or social institution may harm people by preventing them from meeting their basic needs (such as institutionalized racism)
“the increased rates of death and disability suffered by those who occupy the bottom rungs of society, as contrasted with the relatively lower death rates experienced by those who are above them”

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44
Q

intersectionality

A

different aspects of social location are related
various forms of social stratification, such as class, race, sexual orientation, age, religion, creed, disability and gender, do not exist separately from each other but are woven together.

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45
Q

structural competency

A

ability of health care providers and trainees to appreciate how symptoms, clinical problems, diseases and attitudes toward patients, populations and health systems are influenced by ‘upstream’ social determinants of health.

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46
Q

Executive body of the most important organization in the Austrian health care system

A

Federal Health Commission

Bundesgesundheitskommission

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47
Q

Which body funds public hospital care in Austria?

A

Health platforms of regional health funds

Die Landesgesundheitsfonds, Gesundheitsplattform

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48
Q

Number of sickness funds in Austria

A

18

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49
Q

Compared to international peers, Austria stands out for what type of care?

A

being hospital-centered, relying less on ambulatary care

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50
Q

Compared to international peers, Austria stands out for which types of health staff?

A

high number of practicing physicians

low number of nurses

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51
Q

Compared to international peers, Austria stands out for various items?

A

high number of day surgeries

low number of midwives

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52
Q

Does Austria have gate-keeping?

A

No

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53
Q

Share of Austrian population covered by social health insurance?

A

99.9%

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54
Q

Austrian life expectancy (2015)

A

79 men
84 women
(81 average)

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55
Q

Approaches to health care financing

A

1) tax funded - UK (from general taxes)
2) social insurance - Germany, Austria (from employment tax) - Bismarck type
3) private insurance - USA, switzerland

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56
Q

Odds Ratio definition

A

The odds ratio is defined as the ratio of the odds of A in the presence of B and the odds of A in the absence of B, or equivalently (due to symmetry), the ratio of the odds of B in the presence of A and the odds of B in the absence of A. Two events are independent if and only if the OR equals 1
= RR if disease is rare

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57
Q

OR equation

A

AD/BC = (A/C)/(B/D)
EECN/CEEN
(EE/EN)/(CE/CN)

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58
Q

Relative Risk (risk ratio) definition

A

the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group
RR = 1 means that exposure does not affect the outcome;
RR < 1 means that the risk of the outcome is decreased by the exposure;
RR > 1 means that the risk of the outcome is increased by the exposure.
= OR if disease is rare

59
Q

RR equation

A

experimental event rate (EER) / control event rate (CER)
(EE/ES)/(CE/CS)
EE(CE+CN)/CE(EE+EN)
A(B+D)/B(A+C)

60
Q

Selection Bias

A

Error from: 1) selection of participants (case-control) or 2) uneven dropout (cohort)

  • Must depend jointly on exposure and disease
  • systematic
61
Q

Observation Bias

A

Error from the way information is obtained during the study

*systematic

62
Q

Recall Bias

A

Differential recall of information between study groups (such as based on disease status)

  • Not possible in cohort studies
  • systematic
63
Q

Misclassification

A

error in assessment of data, such as error in confounding variable classification

1) random: towards the null (misclassification of subjects based on exposure does not depend on disease or vice versa)
2) non-random: away from the null (depends on other variables)
* systematic

64
Q

Confounding

A

“mixing effect”
distortion of the effect of one risk factor by the presence of another factor
1) C must cause or be a risk factor of O
2) C must be related to E
3) C must not be on the causal pathway between E and O

stratified OR/RR are the same and/or are on the same side of the crude OR/RR

report adjusted OR/RR

65
Q

Effect of randomization on confounding

A

blocks confounders from determining exposure

66
Q

How to minimize confounding

A

design: restricting, matching, randomization
analysis: stratification, multivariate analysis

67
Q

descriptive studies

A

case report/case series
ecological/correlation
cross-sectional
cross-sectional/assessment @ 1 point in time

68
Q

analytic studies

A 
Observational:
case-control (retrospective)
cohort (prospective)
Interventional:
RCT
69
Q

Ecological Measures

A

aggregate measures of groups (mean, proportions)

environmental, global measures

70
Q

Ecological Fallacy

A

An ecological fallacy (or ecological inference fallacy) is a formal fallacy in the interpretation of statistical data that occurs when inferences about the nature of individuals are deduced from inferences about the group to which those individuals belong.
i.e. making inferences on the individual level using group-level data

71
Q

Effect Modification

A

outcome-exposure relationship differs by level when stratified by a third variable
*different groups have different risk estimates
Want to highlight this, not bury it

stratified OR/RR are different

report stratum-specific OR/RR

72
Q

Outcomes research definition

A

The study of the end results of health services that takes patients’ experiences, preferences, and values into account.

73
Q

Outcomes - types

A 
clinical signs and symptoms
intervention results
quality of life
functioning
pain, fatigue
what is most important for patients?
74
Q

Rasch analysis

A

transform ordinal scale to metric interval scale
The probability of the response to an item is a logistic function of the ability of a person and the difficulty of an item.

75
Q

Instrument vs. survey

A

instrument: to determine a specific concept, to test the ability of a person. needs to be psychometrically valid (use state-of-art instruments). designed to be used multiple times in multiple settings.
survey: develop questions based on theory. could be self-developed. designed to be used once.

76
Q

value-based health care (Porter)

A

maximising the value of care for patients and reducing the cost of healthcare (patient outcomes/costs per patient)

77
Q

research validity

A

intervention/therapeutic trials
RCT = best
non-randomized controlled trial
pre-post trial

78
Q

problems with pre-post trials

A

Spontaneous course of the disease
Therapeutic effect of study participation
Regression to the mean („Physician‘s friend“)

79
Q

simpson’s paradox

A

observe no effect or the opposite effect when switching from amalgamated analysis to stratified analyses

80
Q

PICO

A

Patient/Disease
Intervention
Control
Outcome

81
Q

evidence grading

A

1a) systematic review or meta-analysis of RCTs
1b) at least one high-quality RCT
1c) all or none
2a) systematic review or meta-analysis of observational cohort studies
2b) at least one high quality (prospective) cohort-study or „low-quality“ RCT
3a) systematic review or meta-analysis of case-control-studies
3b) at least one high quality case-control-study
4) cross-sectional studies, uncontrolled or non-randomized interventional studies, case-series, „low-quality“ cohort- or case-control-studies
5) expert opinion, clinical reasoning

82
Q

absolute risk reduction

A

personal risk * RR

2.2*0.6 = 1.3%

83
Q

number needed to treat/harm

A

for example, per 100 people in 1 year
100/absolute risk reduction
(100/1.3 = 77)

84
Q

cancer risk factors

A

smoking, unhealthy weight/low activity, alcohol, sun, genes, some infections
age!

85
Q

carcinogens

A

damage genome, promote carcinogenesis

classification structure, legal thresholds

86
Q

harvesting

A

when environmental exposure causes deaths that were going to happen soon anyway - death rate returns to normal afterward

non-harvesting: causes premature deaths; death rate does not return to normal afterward

87
Q

Effect chain of environmental agents

A

primary source (emission) > environmental media (immission) > incorporation (exposure) > resorption/distribution/metabolism/storage > biological effect/disease/death

88
Q

how to observe chain of environmental agents?

A

emission assessment > analytics > dose assessment > biomonitoring > bioeffect monitoring, diagnostics

89
Q

dose pathways

A

inhalation, ingestion, dermal, parenteral (blood)

90
Q

key differences between inhaled agents?

A

for gas/vapor
is it water or lipid soluble?
water soluble - absorbed higher in lungs
lipid-soluble - goes deeper into lungs (alveols), stored in body longer

for particles/aerosols
size!
air velocity, directional change

example: danger of smog (smoke and SO2)

91
Q

toxicokinetics

A

exposure > intake (absorption, distribution, toxification, resorption) > toxic product, target organ

92
Q

consideration of half life of agent

A

may never go above the toxicity threshold even though the agent itself is technically toxic
OR may take some time to go over the threshold & then you stay over it

93
Q

toxic effects of air pollution agents

A 
psychovegetative
pulmonary
neurotoxic
nephrotoxic
hepatotoxic
94
Q

influence of environmental contaminants on cancer

A

DNA - genome damage or epigenetic processes

approx. 15%

95
Q

carcinogenesis

A

main stages:
neoplastic conversion - DNA reaction, DNA damage, expression, fixation
neoplastic development - pre-neoplastic cell, promotion, progression, neoplasia

DNA change - mostly repair and/or apoptosis, if not > initiation (irreversible) leads to initiated cell - mostly apoptosis, if not > proliferation leads to pre-neoplastic focal lesion > promotion (reversible) leads to proliferation > neoplasia > more mutations, progression (irreversible) leads to malignant metastases

cancerous cell secrete growth hormone itself

96
Q

development of cancer - cancer mechanisms

A

sustained proliferative signaling > evasion of growth suppression > resistance to cell death > cellular immortality > neoangiogensis > acquiring invasive properties

97
Q

processes to prevent abnormal development

A

contact signals between cells, apoptosis trigger, telomerase (cell division counter), size constrained by passive nutrition

98
Q

how does a cancerous cell circumvent the processes to prevent abnormal development?

A

secretion of growth hormone, blocking adhesion signal, mutation of p53 (lost ability to process apoptosis trigger), change telomerase signal path, induce growth of blood vessels to the tumor to facilitate active nutrition (secretion of VEGF), epithelial-mesenchymal-transition

99
Q

genetic factors increasing risk of cancer

A

proto-oncogene > mutation > oncogene
*dominant > increased risk

tumor suppressor gene > mutation > loss of heterozygosity; haplo insufficiency
*recessive > increased risk

100
Q

DNA damage - alkylation

A

formation of adducts by covalent binding of alkyl groups

destabilization of Abasic sites

101
Q

DNA damage - adducts

A

formation of adducts by covalent binding of large molecules

block transcription
disturbance of DNA structure
chromosomal bridges and deletions

102
Q

DNA damage - cross-links

A

covalent binding of bases across DNA strands

block translation and transcription
deformation
maybe frame-shift mutation

103
Q

DNA damage - oxidation

A

oxidation of DNA bases

DNA cross-links
base mispairing

104
Q

DNA damage - Deamination

A

hydrolysis of DNA bases

base loss

105
Q

DNA damage - strand breaks

A

single- or double-strand breakage

breakage of chromosomes
deletions
genome instability

106
Q

DNA damage - epigenetic processes

A

CpG methylation
histone modification
microRNA disturbance

107
Q

rarity of cancer

A

~250 malignant transformations per day but 99.99% repaired

108
Q

genotoxic carcinogens

A

Mutations
Aneuploidy
Rearrangement of chromosomes
Gene amplification

109
Q

non-genotoxic carcinogens

A
  • increase cell proliferation
  • block apoptosis
  • disrupt hormone activity
  • modulate gene expression
  • cause chronic inflammation
  • are cytotoxic
  • suppress the immune system
  • cause oxidative stress
  • cause epigenetic changes
110
Q

Incremental Cost-Effectiveness Ratio (ICER)

A

(Cost1 - Cost2) / (Effect1 - Effect 2)

111
Q

5 Ds

A

death, disease, disability, discomfort, dissatisfaction/destitution

112
Q

what IS intersectionality?

A

IS:

  • based on mutually constituted & intersecting social categories
  • a way of understanding inequalities as dynamic relationships
  • based on the understanding that power configurations are time/location dependent
  • focus on structural/political factors which shape inequalities
  • explores how social inequalities are shaped by power relations
  • focus on implications for vulnerable/marginalized within a group
  • researchers reflect upon how their own background identity shapes research process and interpretation of results
113
Q

what ISN’T intersectionality?

A
  • based on adding up advantages and subtracting disadvantages assuming equivalence between them
  • static examination of inequalities which omit relational aspect
  • group of a priori assumptions re: the importance of any one/multiple social categories
  • focus on individual behaviour w/o consideration of structural/political constraints
  • ignores impact of power relations on social inequalities
  • focus on implications for those whose status are protected/elevated with a group
  • researchers attempt to completely remove themselves from the research/analysis process
114
Q

intersectionality wheel

A

1st ring: systems (politics, economics, history, education, law, etc)
2nd ring: isms, phobias (racism, sexism, homophobia, etc)
3rd ring: characteristics (social status, class, gender, education, ethnicity, work, etc)
4th ring: unique circumstances of power, privilege, and identity

115
Q

research & intersectionality

A

ask questions:
who is being studied? who is being compared to whom?
who is the research for and does it advance the needs of those under study?
what is the frame of research?

116
Q

public health action cycle

A

definition of the problem > defining strategy (policy) > implementation > evaluation > (circle)

117
Q

definition of gender (Payne)

A

„Women ́s and men ́s identities as something „that is done“ as opposed to biological sex ascribed at birth according to external genitalia and where women and men ́s identity, behaviour and expectations placed upon them reflect socially constructed ideas about femininity and masculinity“

118
Q

importance of gender

A

relational social determinant of health - alters the way we consider any of the social determinants of health, but the effectiveness of gender as a framework is dependent on how we understand it

119
Q

gender medicine

A

sex-specific biology

social construction

120
Q

prevention and management of Type 2 diabetes (diet)

A

reduce: meat, esp. processed, red; sugary drinks; refined grains
eat more of: whole grains; green, leafy vegetables; coffee

121
Q

dehydration

A

1-2.5% body mass: decline in performance
>3% body mass: decline in cognitive function and memory, increased heart rate, tiredness
higher: serious neurological symptoms

122
Q

supplements

A

vitamin d during the winter!
vegetarians/vegans - iron (amount absorbed is much lower than amount consumed), esp for child-bearing women
B12

123
Q

symptoms of dehydration

A 
dry skin und mucosa
• fatigue und loss of concentration
• headache
• dizziness
• confusion (especially in elderly)
• obstipation
• risk for urinary tract infections and renal stones (chronic dehydration)
• rise of body core temperature
124
Q

vitamin d

A

UV radiation is most important source; unavailable during winter months above ~50 degrees latitude

skin > liver > kidney > body
hormone-inducing genomic effects

up to 80% of calcium uptake in the upper small intestine is dependent on vitamin D

impacts muscle function - increased risk of falls, also fractures

~100 ng/ml

125
Q

health aims for older adults

A
  • Maintain quality of life
  • Improvement independence
  • Prevention of institutionalisation
  • Management of chronic diseases
  • Prevention of complications and co‐morbidity
126
Q

Frailty definition

A

Frailty is theoretically defined as a clinically recognizable state of increased vulnerability resulting from aging‐associated decline in reserve and function across multiple physiologic systems such that the ability to cope with everyday or acute stressors is comprised.

127
Q

SHARE frailty index

A 
exhaustion (physical &amp; mental)
loss of appetite
low physical activity
walking difficulties
slowness
weakness (grip strength)
frail = 3+
pre-frail = 1-2
128
Q

weight management among elderly

A

improve and maintain physical function and quality of life and prevent dependence and institutionalization rather than prevention of medical problems associated with obesity.

minimize muscle and bone loss

BMI less important than other measures

activity > diet

129
Q

activity recommendations

A

at least 150 minutes of moderate activity per week (or 75 minutes of high-intensity)
2x muscle strengthening

130
Q

communication is not “being nice”

A

improves:
accuracy, efficiency, supportiveness
health outcomes for patients
satisfaction for patients and doctors

131
Q

why do we need communication in medicine?

A

bridge between evidence-based medicine and successfully working with individual patients

create a collaborative partnership
collect data
provide information
establish treatment adherence
create a more effective consultation
132
Q

problems in medical communication

A 
bad relationship between dr. and patient
unsatisfied patients - complaints
unsatisfied doctors - work aggravation
adherence issues
"difficult patients" 
lack of cooperation
133
Q

Calgary guide to medical interview

A

1) initiate session
2) gather information
3) physical information
4) explanation and planning
5) closing the session

throughout: providing structure, building the relationship

134
Q

core values of medical interviews

A

acceptance, authenticity, empathy (do not give up as if position)

135
Q

WWSZ

A

warten, wiederholen, spiegeln, zusammenfassen

136
Q

problems with information in medical communication

A

too much/too little information
unwanted information
incomprehensible information

137
Q

Burger method

A

McDonalds - small quantity of meat
ask/listen
inform
ask/listen

138
Q

medical anthropology definition

A
  • Medical anthropology is the study of health, disease, illness and healing across the range of human societies
  • Human experience
  • Behaviors, ideas, organization of resources
  • Understanding and response to challenges to their existence
  • Access to or exclusion from resources health restoring and maintaining
  • Social power and economic structures
139
Q

medicalization

A

Process of rapid expansion of scientific medicine into various walks of human life

140
Q

critical medical anthropology definition

A

political economy of health: study of inequalities
who and what is responsible for population patterns of health, disease, wellbeing - as manifested in present, past, changing social inequalities of health?
biological expressions of social inequalities
local biologies
individual sufferer’s experience and macrosocial processes

141
Q

training in old age prevents BIOLOGICAL issues

A

sarcopenia
falls
ADL deficits
insulin resistance

142
Q

training in old age prevents PSYCHOLOGICAL issues

A

cognitive deficits
depression
fear of falls

143
Q

training in old age prevents SOCIAL issues

A

social decline
reduced social participation
isolation
dependency

144
Q

training in old age prevents BIG issues

A

low quality of life
frailty
morbidity
mortality

PH Basic Lecture 2 (1 decks)

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