Block 9 - part 2 Flashcards

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1
Q

Intervention strategies for HIV/AIDS

A

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

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2
Q

Determinants of effective outcomes of intervention

A

Economics, priorities, setting

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3
Q

Current problems and issues surrounding HIV/AIDS intervention

A

Africa struggles against debt, trade restrictions and inadequate aid provisions,
global fund under-resourced,
US politics are retrogressive and harmful

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4
Q

7 PH objectives of vaccination

A
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
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5
Q

9 factors influencing utility of vaccination for disease prevention

A
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
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6
Q

3 things required for disease to be eradicated using vaccination

A

No other reservoirs of infection exist in animals or environment,
consequences of infection are very high,
scientific and political prioritisation exist

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7
Q

2 diseases which have been eradicated with vaccine

A

smallpox

polio

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8
Q

Herd immunity

A

level of immunity in population which protects whole population

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9
Q

what does herd immunity only apply to

A

Diseases which are passed from person to person

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10
Q

what is R0

A

Basic reproduction rate

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11
Q

Basic reproduction rate =

A

average number of individuals directly infected by infectious case during the infectious period, in a totally susceptibe population

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12
Q

factors affecting R0

A

rate of contacts in host population, probability of infection being transmitted during contact, duration of infectiousness

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13
Q

Effective reproduction rate (R)

A

estimates average number of secondary cases per infectious cases in a population made up of both susceptible and non susceptible hosts

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14
Q

Equation for effective reproduction rate

A

R=R0x

x=fraction of host population which is susceptible (50% - x=0.5)

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15
Q

R>1

A

Number of cases increases

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16
Q

R<1

A

number of cases decreases, needs to be maintained for elimination

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17
Q

R=1

A

Epidemic threshold

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18
Q

Equation for herd immunity

A

H = (R0-1)/R0

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19
Q

What is a susceptible population

A

Any person who is not immune to a particular pathogen

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20
Q

reasons for person to be susceptible

A

never encountered infection or vaccine before, unable to mount an immune response, vaccination contraindicated for them

21
Q

Role of WHO in vaccination

A

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

22
Q

3 examples of international immunisation programmes

A

Expanded programme on immunisation (EPI)
Global polio eradication initiative (GPEI)
Global alliance for vaccines and immunisation (GACI)

23
Q

Who/why of vaccination program implementation

A

Protect vulnerable, contain outbreak, eradicate disease

24
Q

How of vaccination implementation

A

Pilots, phased introduction, global vaccination

25
Q

When is vaccination implemented

A

greatest impact of disease burden

26
Q

What is shared decision making?

A

Conversation between patient and their healthcare professional to reach a health care choice together

27
Q

When is shared decision making important

A

more than one reasonable option, no option has the clear advantage, possible benefits/harms affect patient differently

28
Q

8 pros of vaccination

A
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
29
Q

7 cons of vaccination

A

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)

30
Q

6 factors which influence decision making

A
lifestyle
perception of health
beliefs about childhood diseases
risk perception of the diseases
perceptions about vaccines
trust in institution
31
Q

Popular vs individual debate individual argument

A

protections by ‘herd immunity’ may be safest option as avoids risk of vaccine

32
Q

popular vs individual debate community argument

A

avoidance of vaccination leads to reduced coverage so diminishes herd immunity

33
Q

2 websites useful for travel vaccine info

A

NHS fitfortravel

National travel health network and centre NaTHNeC

34
Q

Which travel vaccines available

A

diptheria, polio, tetanus, typhoid, hep A, cholera

35
Q

Which travel vaccines are private

A

Hep B, japanese encephalitis, meningitis, rabies, TB, yelow fever

36
Q

Factors to consider when deciding to get travel vaccines

A

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

37
Q

5 most common cancers (incidence) in UK in order

A
Breast/prostate
Lung
Bowel
Melanoma
Non-Hodgkin Lymphoma
38
Q

5 most common causes of cancer mortality in the UK in order

A

Lung, bowel, prostate/breast, pancreas, oesophagus

39
Q

Most common cancers in children

A

Leukaemias

40
Q

Most common causes of cancer mortality in children

A

Brain, CNS, intracranial tumours

41
Q

How do patterns of cancer in UK differ from that in developing country

A

Mortality higher in UK (29%)

42
Q

Role and legal lifestyle changes in reducing incidence and mortality of cancer

A

Prevention, screening, diagnosis

43
Q

Define bad/difficult news

A

Any news that drastically and negatively alters the patient’s (or their relatives) view of his or her future

44
Q

Factors which can affect the impact of news on a patient

A
Institutionalised beliefs
personality types
gender
culture/race
religion
patients knowledge
relatives
45
Q

Anxieties of health care professionals about breaking bad news

A

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

46
Q

ABCDE of breaking bad news

A
Advanced preparation
Building relationship
Communicate well
Deal with patient reactions
Encourage and validate emotions
47
Q

SPIKES of breaking bad news

A
Setting up
Perception
Invitation
Knowledge
Emotions
Strategy/summary
48
Q

Emotions a patient may feel on receiving bad news

A

Grief, distress, denial, anger, agitated/restless

49
Q

How can cancer change partner relationships

A

Change in roles, responsibilities, physical needs, emotional needs, sexuality and intimacy, future plans