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Y2 Health & Society > Block 15 - part 2 > Flashcards

Block 15 - part 2 Flashcards

1
Q

GI cancer prevalent in middle east and china

A

oesophageal

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2
Q

GI cancer prevalent in russia

A

gastric

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3
Q

GI cancer prevalent in western world, e.g. UK

A

colon

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4
Q

dietary intake which increases risk of colorectal cancer

A

fat intake

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5
Q

evidence base for ‘5 a day’

A

observational epidemiology that average fruit/veg intake of less than 200g associated with increased risk of cancer, but possibly little additional benefit beyond 400g/day, very little evidence that 5 a day have impact on cancer

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6
Q

relationship between beta carotene and cancer

A

beta carotene found in fruit and veg, cohort study indicated protective relationship against cancer, RCT showed increased risk of cancer, cohort groups had reduced risk due to confounding factors

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7
Q

problems with measuring diet

A

random error, homogeneity of exposure, bias, confounding

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8
Q

different measures of diet

A

food disappearance data, household survey, individual survey

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9
Q

pros of food frequency questionnaires

A

captures usual diet and less work to code/compete

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10
Q

cons of food frequency questionnaires

A

doesn’t record actual diet as eaten, overstimulates fruit and veg, poor measure of energy intake, less flexible

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11
Q

food frequency questionnaires

A

limited checklist of foods and beverages with a frequency response section for subjects to report how often each item was consumed over a specified period of time

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12
Q

pros of diet diaries

A

records diet as eaten, better estimate of energy and absolute intake, more flexible

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13
Q

cons of diet diaries

A

required effort to complete and expensive to code

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14
Q

main dietary associations with oesophageal cancer

A

alcohol, obesity

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15
Q

main dietary associations with stomach cancer

A

possible salted preserved foods

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16
Q

main dietary associations with pancreatic cancer

A

overweigh obesity

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17
Q

main dietary associations with hepatic cancer

A

aflatoxin contamination

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18
Q

main dietary associations with colorectal cancer

A

preserved and red meat, alcohol, body fat

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19
Q

main dietary associations with breast cancer

A

alcohol, overweight

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20
Q

main dietary associations with urologic cancer

A

high calcium

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21
Q

tend of alcohol consumption in UK

A

lower consumption per capita than many European countries, people start drinking earlier and tend to drink more on single occasions ‘binge drinking’

22
Q

when was peak of alcohol consumption in UK and why

A

2008 - affordability

23
Q

percentage of men and women with alcohol use disorder

A

38% men, 16% women

24
Q

percentage of men and women who are binge drinkers

A

28% men, 25% women

25
Q

percentage of total population who are alcohol dependant

A

3.6%

26
Q

where is identification and brief advice (IBA) delivered

A

range of settings, primary secondary care, community settings

27
Q

specialised treatment available for alcohol problems

A

CBT, behavioural approaches, motivational interviewing, social behaviour and network therapy (SBNT)

28
Q

medical conditions which are wholly attributable to alcohol (6)

A

alcoholic liver disease, alcoholic neuropathy, chronic pancreatitis, alcoholic cardiomyopathy, alcoholic gastritis, alcohol related accidents

29
Q

social consequences of alcohol consumption

A

death, crime and disorder, domestic violence, poor productivity at work, absences/sick leave from work, family effects

30
Q

more effective policies for alcohol health promotion

A

increased prices, restricting availability

31
Q

moderately effective policies for alcohol health promotion

A

restricting exposures of young people to adverts, treatment - identification and brief advice

32
Q

less effective policies for alcohol health promotion

A

drugs/alcohol education, mass media campaign

33
Q

key UK departments involved in alcohol policy

A

home office (focus on public order), department of health (focus on PH)

34
Q

‘alcohol strategy’ 2012

A

minimum unit price policy dropped, multi-buy promotion offers not banned as suggested, local health bodies able to investigate review of licences, double fine for selling alcohol to underage people, ‘enforced sobriety’ - 1 year pilots based on US models, overview alcohol consumption guidelines for adults, alcohol included in NHS health check for adults 40-75

35
Q

efficiency

A

target resources to those activities that give the greatest health gain for the money spent as this will maximise population health gain

36
Q

what is required to inform choices for efficiency

A

estimation of value of what is given up when a patient is treated, and what is gained in terms of improvements in health of pts

37
Q

allocative efficiency

A

investing in health care interventions that are worthwile

38
Q

technical efficiency

A

investing in health care interventions which make the best use of scarce resources

39
Q

equity in financing

A

geographic allocation of funding by weighted capitation, resourcing determined by population weighted by need

40
Q

class equality/inequality in health care

A

evidence of social class equality in the use of primary care and social class inequality in use of secondary care

41
Q

concept of the ‘margin’

A

incremental change in resources (inputs and their costs) committed to an activity that produces an incremental change in effects (improved pt outcomes)

42
Q

importance of the margin

A

incremental investments in an activity may be associated with diminishing returns

43
Q

why do we need economic evaluation

A

values both inputs (opportunity costs) and outputs (health outcomes) of any intervention, assess if changes in resource allocation are efficient, important because increasing healthcare expenditure needs best outcome for the money

44
Q

how is cost measured

A

cost to NHS - NICE perspective, cost of drug, cost of delivery
cost to pt, carers and society - lost working days

45
Q

how is benefit measured

A

health gain = increase in length +QoL

46
Q

cost-minimisation analysis

A

chooses cheapest option between treatments that ahve identical outcomes

47
Q

cost-effective analysis

A

costs and outcomes are combined into a single measure in the same therapeutic area only

48
Q

cost-utility analysis

A

combines multiple outcomes into a single measure (QALY) using QoL instruments e.g. EQ5d

49
Q

what does cost-utility analysis allow

A

comparisons between alternatives in different therapeutic categories, e.g. CV and cancer

50
Q

cost benefit analysis

A

puts cost and benefit into monetary/numerical terms

51
Q

when can cost-effectiveness analysis be used

A

if outcome measures are just clinical, if other generic outcome measures are used use cost analysis to get QALY (NICE use it)

Y2 Health & Society (15 decks)

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