Block 9 - part 2 Flashcards
Intervention strategies for HIV/AIDS
Blood donor screening, promotion/distribution of condoms, peer education for high risk groups, promotion of safe sex, diagnosis and treatment of STDs, HIV voluntary counselling and testing
Determinants of effective outcomes of intervention
Economics, priorities, setting
Current problems and issues surrounding HIV/AIDS intervention
Africa struggles against debt, trade restrictions and inadequate aid provisions,
global fund under-resourced,
US politics are retrogressive and harmful
7 PH objectives of vaccination
Reduce mortality and morbidity from vaccine preventable infections, Prevent outbreak/epidemics, Contain infection in a populations, Redue number of infections, Interrupt transmission to humans, generate herd immunity, eradicate infectious agent
9 factors influencing utility of vaccination for disease prevention
Disease burden risk of exposure age, health status, vacc Hx special risk factors reactions to previous vaccine risk of infecting othrs cost other ways to control? impact on public perception
3 things required for disease to be eradicated using vaccination
No other reservoirs of infection exist in animals or environment,
consequences of infection are very high,
scientific and political prioritisation exist
2 diseases which have been eradicated with vaccine
smallpox
polio
Herd immunity
level of immunity in population which protects whole population
what does herd immunity only apply to
Diseases which are passed from person to person
what is R0
Basic reproduction rate
Basic reproduction rate =
average number of individuals directly infected by infectious case during the infectious period, in a totally susceptibe population
factors affecting R0
rate of contacts in host population, probability of infection being transmitted during contact, duration of infectiousness
Effective reproduction rate (R)
estimates average number of secondary cases per infectious cases in a population made up of both susceptible and non susceptible hosts
Equation for effective reproduction rate
R=R0x
x=fraction of host population which is susceptible (50% - x=0.5)
R>1
Number of cases increases
R<1
number of cases decreases, needs to be maintained for elimination
R=1
Epidemic threshold
Equation for herd immunity
H = (R0-1)/R0
What is a susceptible population
Any person who is not immune to a particular pathogen
reasons for person to be susceptible
never encountered infection or vaccine before, unable to mount an immune response, vaccination contraindicated for them
Role of WHO in vaccination
recommendations for countries on vaccination policy
supports less able countries wiht implementation strategy
Works through internation health regulations to ensure maximum security against international spread of disease
3 examples of international immunisation programmes
Expanded programme on immunisation (EPI)
Global polio eradication initiative (GPEI)
Global alliance for vaccines and immunisation (GACI)
Who/why of vaccination program implementation
Protect vulnerable, contain outbreak, eradicate disease
How of vaccination implementation
Pilots, phased introduction, global vaccination
When is vaccination implemented
greatest impact of disease burden
What is shared decision making?
Conversation between patient and their healthcare professional to reach a health care choice together
When is shared decision making important
more than one reasonable option, no option has the clear advantage, possible benefits/harms affect patient differently
8 pros of vaccination
Can save life ingredients safe in amounts used adverse reactions rare herd immunity save children and parents time and money protect future generations economic benefits for society
7 cons of vaccination
side effects
harmful ingredients
goverment intervention in people’s choices
contain ingredients people object to (chicken eggs)
unnatural
pharmaceutical companies aim to make profit
some diseases vaccines target re relatively harmless (rotavirus)
6 factors which influence decision making
lifestyle perception of health beliefs about childhood diseases risk perception of the diseases perceptions about vaccines trust in institution
Popular vs individual debate individual argument
protections by ‘herd immunity’ may be safest option as avoids risk of vaccine
popular vs individual debate community argument
avoidance of vaccination leads to reduced coverage so diminishes herd immunity
2 websites useful for travel vaccine info
NHS fitfortravel
National travel health network and centre NaTHNeC
Which travel vaccines available
diptheria, polio, tetanus, typhoid, hep A, cholera
Which travel vaccines are private
Hep B, japanese encephalitis, meningitis, rabies, TB, yelow fever
Factors to consider when deciding to get travel vaccines
Country visiting, when travelling, where staying, how long for, age and health, what doing, working as aid worker, working in medical setting, in contact with animals
5 most common cancers (incidence) in UK in order
Breast/prostate Lung Bowel Melanoma Non-Hodgkin Lymphoma
5 most common causes of cancer mortality in the UK in order
Lung, bowel, prostate/breast, pancreas, oesophagus
Most common cancers in children
Leukaemias
Most common causes of cancer mortality in children
Brain, CNS, intracranial tumours
How do patterns of cancer in UK differ from that in developing country
Mortality higher in UK (29%)
Role and legal lifestyle changes in reducing incidence and mortality of cancer
Prevention, screening, diagnosis
Define bad/difficult news
Any news that drastically and negatively alters the patient’s (or their relatives) view of his or her future
Factors which can affect the impact of news on a patient
Institutionalised beliefs personality types gender culture/race religion patients knowledge relatives
Anxieties of health care professionals about breaking bad news
uncertinaty about pt expectations, fear of destroying hope, fear of their own inadequacy in controlling disease,
not feeling prepared to manage pt emotions,
embarrassment at having previously painted too optimistic picture
ABCDE of breaking bad news
Advanced preparation Building relationship Communicate well Deal with patient reactions Encourage and validate emotions
SPIKES of breaking bad news
Setting up Perception Invitation Knowledge Emotions Strategy/summary
Emotions a patient may feel on receiving bad news
Grief, distress, denial, anger, agitated/restless
How can cancer change partner relationships
Change in roles, responsibilities, physical needs, emotional needs, sexuality and intimacy, future plans
