Block 9 - part 1

Question 1

EBDM definition

Answer 1

Process for identifying and using most up to date evidence to inform decisions for individual and patient problems.

Question 2

4 things ebdm involves

Answer 2

patient preferences
available resources
research evidence
clinical expertise

Question 3

Why do we need ebdm?

Answer 3

Limited time to read, textbooks inadequate, disparity between clinical judgement and clinical performance.

Question 4

Different types of research studies (6)

Answer 4

Cohort
Case control
RCT
Qualitative approaches
Diagnostic/screening studies
Systematic reviews

Question 5

When are cohort studies usefull

Answer 5

prognosis, cause

Question 6

when are case control studies used

Answer 6

cause

Question 7

when are RCTs used

Answer 7

treatments
benefits and harm
cost effectiveness

Question 8

when are qualitative approaches used

Answer 8

patient/practitioners perspectives

Question 9

When are diagnostic/screening studies used

Answer 9

identification

Question 10

when are systematic reviews used

Answer 10

summary of evidence for a specific question

Question 11

5 steps of process of ebdm

Answer 11

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

Question 12

4 steps to smoking cessation

Answer 12

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

Question 13

define antibiotic resistance

Answer 13

bacteria change so antibiotics no longer work in people who need them to treat infections

Question 14

2 reasons for widespread antibiotics use

Answer 14

increase in global availability

uncontrolled sale in low/middle income countries

Question 15

5 causes of antibiotic resistance

Answer 15

use in livestock for growth promotion
releasing antibiotics into environment during manufacture
volume of antibiotic prescribing
missing doses
inappropriate prescribing

Question 16

5 ways to prevent antibiotic resistance

Answer 16

using antibiotics only when prescribed by doctor
completing prescription
never sharing antibiotics/using leftover prescriptions
only prescribing when necessary
use correct antibiotic

Question 17

5 factors which influence infection

Answer 17

infectious agents, environment, mode of transmission, portal f entry, host factors

Question 18

Infectious agents

Answer 18

ability to reproduce, survival, ability to spread, infectivity, pathogenicity

Question 19

environment

Answer 19

contamination, other humans, animals, water

Question 20

mode of transmission

Answer 20

droplet, airborne, aerosol, direct consumption, fecal-oral, blood, sexual, zoonosis

Question 21

portal of entry

Answer 21

mouth, nose,ears, genital tract, skin

Question 22

host factors

Answer 22

chronic illness, nutrition, immunity, lifestyle

Question 23

10 most important diseases in UK

Answer 23

Diptheria
Haemophilius influenzae
Measles
Mumps
Poliomyelitis
Rubella
Pneumococcal disease
Tetanus
Whooping cough

Question 24

4 most important diseases in developing countries

Answer 24

Pneumonia
chronic diarrhoea
malaria
HIV/AIDS

Question 25

Define surveillance

Answer 25

Systematic collection and analysis of data and dissemination of results so that appropriate control measures can be taken.

Question 26

3 purposes of surveillance

Answer 26

early warning for impending PH emergencies
Document impact of intervention/track progress
Monitor and clarify epidemiology of health problems.

Question 27

Which infectious diseases are becoming more common in the UK?

Answer 27

Hospital acquired: MRSA, STIs, mumps

Question 28

Define nosocomial

Answer 28

Originating in hospital

Question 29

More common nosocomial examples

Answer 29

UTI, pneumonia, LRTI, surgical wounds, septicaemia

Question 30

Less common nosocomial examples

Answer 30

chicken pox, TB, legionella, MRSA

Question 31

Feature of less common nosocomial infections

Answer 31

More dangerous

Question 32

How can risk of nosocomial infection be reduced?

Answer 32

Prevention
Detection/investigation/control
Policies/procedure

Question 33

Measures of prevention

Answer 33

Hand washing, infection control programs, advisory service, surveillance, sterilisation and decontamination of instruments

Question 34

Detection/control measures

Answer 34

screening, barrier nursing/isolation, sharp disposal

Question 35

Policies/procedures measures

Answer 35

Dissemination and implementation of policies, education/training, monitor clinical practice

Question 36

What is international health

Answer 36

health defined by geography, problems, instruments, and recipient donor relationship

Question 37

What is global health?

Answer 37

health of global population, improving health and equality, emphasises transnational health issues

Question 38

4 major functions of global health

Answer 38

Provide health related public goods, manage cross national externalities, mobilise global solidarity, convene stakeholders to reach consensus on key issues

Question 39

Motivation for public health

Answer 39

Increased awareness of global health disparities, enthusiasm to make a difference internationally

Question 40

90/10 gap

Answer 40

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.

Question 41

Solution of 90/10 gap

Answer 41

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

Question 42

Impact of travel and migration diseases in UK

Answer 42

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.

Question 43

WHO definition of environment

Answer 43

All physical, chemical, and biological factors external to a person, and all the related behaviours.

Question 44

What does environmental health consist of

Answer 44

preventing/controlling disease, injury, and disability related to interactions between people and their environment

Question 45

Define outbreak

Answer 45

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.

Question 46

Define epidemic

Answer 46

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

Question 47

Define pandemic

Answer 47

Worldwide epidemic

Question 48

5 ways to prevent epidemics

Answer 48

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

Question 49

Role of WHO in PH

Answer 49

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