Block 9 - part 1 Flashcards
EBDM definition
Process for identifying and using most up to date evidence to inform decisions for individual and patient problems.
4 things ebdm involves
patient preferences
available resources
research evidence
clinical expertise
Why do we need ebdm?
Limited time to read, textbooks inadequate, disparity between clinical judgement and clinical performance.
Different types of research studies (6)
Cohort Case control RCT Qualitative approaches Diagnostic/screening studies Systematic reviews
When are cohort studies usefull
prognosis, cause
when are case control studies used
cause
when are RCTs used
treatments
benefits and harm
cost effectiveness
when are qualitative approaches used
patient/practitioners perspectives
When are diagnostic/screening studies used
identification
when are systematic reviews used
summary of evidence for a specific question
5 steps of process of ebdm
Convert need for info into answerable question
identify best evidence
critically appraise evidence
integrate critical appraisal with clinical expertise and pt circumstances
evaluate effectiveness of prev steps
4 steps to smoking cessation
Health education/enhance motive to quit
brief advice from health professional
Advice/nicotine replacement/follow up from specialist
specialised counselling rooms and agencies working within group sessions
define antibiotic resistance
bacteria change so antibiotics no longer work in people who need them to treat infections
2 reasons for widespread antibiotics use
increase in global availability
uncontrolled sale in low/middle income countries
5 causes of antibiotic resistance
use in livestock for growth promotion releasing antibiotics into environment during manufacture volume of antibiotic prescribing missing doses inappropriate prescribing
5 ways to prevent antibiotic resistance
using antibiotics only when prescribed by doctor
completing prescription
never sharing antibiotics/using leftover prescriptions
only prescribing when necessary
use correct antibiotic
5 factors which influence infection
infectious agents, environment, mode of transmission, portal f entry, host factors
Infectious agents
ability to reproduce, survival, ability to spread, infectivity, pathogenicity
environment
contamination, other humans, animals, water
mode of transmission
droplet, airborne, aerosol, direct consumption, fecal-oral, blood, sexual, zoonosis
portal of entry
mouth, nose,ears, genital tract, skin
host factors
chronic illness, nutrition, immunity, lifestyle
10 most important diseases in UK
Diptheria Haemophilius influenzae Measles Mumps Poliomyelitis Rubella Pneumococcal disease Tetanus Whooping cough
4 most important diseases in developing countries
Pneumonia
chronic diarrhoea
malaria
HIV/AIDS
Define surveillance
Systematic collection and analysis of data and dissemination of results so that appropriate control measures can be taken.
3 purposes of surveillance
early warning for impending PH emergencies
Document impact of intervention/track progress
Monitor and clarify epidemiology of health problems.
Which infectious diseases are becoming more common in the UK?
Hospital acquired: MRSA, STIs, mumps
Define nosocomial
Originating in hospital
More common nosocomial examples
UTI, pneumonia, LRTI, surgical wounds, septicaemia
Less common nosocomial examples
chicken pox, TB, legionella, MRSA
Feature of less common nosocomial infections
More dangerous
How can risk of nosocomial infection be reduced?
Prevention
Detection/investigation/control
Policies/procedure
Measures of prevention
Hand washing, infection control programs, advisory service, surveillance, sterilisation and decontamination of instruments
Detection/control measures
screening, barrier nursing/isolation, sharp disposal
Policies/procedures measures
Dissemination and implementation of policies, education/training, monitor clinical practice
What is international health
health defined by geography, problems, instruments, and recipient donor relationship
What is global health?
health of global population, improving health and equality, emphasises transnational health issues
4 major functions of global health
Provide health related public goods, manage cross national externalities, mobilise global solidarity, convene stakeholders to reach consensus on key issues
Motivation for public health
Increased awareness of global health disparities, enthusiasm to make a difference internationally
90/10 gap
Less than 10% of worldwide health resources devoted to health research were put towars health in developing countries, where 90% of all preventable deaths worldwide occured.
Solution of 90/10 gap
Regulation of quality of imported food/medicines/etc
timely access to info of global spread of infectious disease
Sufficient vaccine/drugs in pandemic
Sufficient corps of well-trained health personnel
Impact of travel and migration diseases in UK
Spread infectious disease
transmission of behaviour and culture increases risk of non-communicable diseases
may introduce diseases to new population
more in contact with animals (zoonosis)
migrants may bring diseases to countries which have not been exposed.
WHO definition of environment
All physical, chemical, and biological factors external to a person, and all the related behaviours.
What does environmental health consist of
preventing/controlling disease, injury, and disability related to interactions between people and their environment
Define outbreak
sudden increase in occurrences of a disease in a community which has never experienced the disease before, or when causes of disease occur in numbers greater than expected in a defined area.
Define epidemic
occurrence of a group of illnesses of similar nature and derived from a common source, in excess of what would normally be expected in a community or region
Define pandemic
Worldwide epidemic
5 ways to prevent epidemics
Insure poor countries against threat of pandemic, funds and responders to country with outbreak, development of vaccines, fast/early/planned response, monitor disease to prevent future outbreaks
Role of WHO in PH
Providing leadership on health matter
Engaging in partnership where joint action needed
Shaping research agenda
Setting norms and standards
Articulating ethical and EB policy options
Technical support
Monitoring situation and trends
