Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GP/Public Health > Definitions/Waffly shit > Flashcards

Definitions/Waffly shit Flashcards

1
Q

What is Epigenetics?

A

expression of genome depending on the environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is Allostasis?

A

stability through change, our physiological systems have adapted to react rapidly to environmental stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Allostatic load?

A

long term overtaxation of our physiological systems leads to impaired health (stress)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is Salutogenesis?

A

favourable physiological changes secondary to experiences which promote healing and health.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is Emotional Intelligence?

A

the ability to identify and manage one’s own emotions, as well as those of others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is primary care for?

A

managing illness

preventing illness

promoting health

shared decision making with patients

managing clinical uncertainty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 domains of public health?

A

Health improvement

Health protection

Improving services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is health improvement?

A

Social interventions aimed at :
a) preventing disease

b) promoting health
c) reducing inequalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some aspects of health improvement?

A

Education

Housing

Employment

Lifestyles

Community

Surveillance and monitoring of specific diseases and risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is health protection?

A

Measures to control infectious disease risks and environmental hazards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some aspects of health protection?

A

infectious diseases

chemicals and poisons

radiation

emergency response

environment health hazards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is improving services?

A

The organization and delivery of safe, high quality services for prevention, treatment and care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some aspects of improving services?

A

clinical effectiveness

efficiency

service planning

audit and evaluation

clinical governance

equity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a health needs assessment?

A

Systemic method for reviewing the health issues facing a population, leading to :

i) agreed priorities ii) resource allocation

that will

i) improve health ii) reduce inequalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the different approaches to a health care assessment?

A

Epidemiological

Comparative

Corporate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the adv and disadv to a epidemiological approach to health care assessment?

A

Adv - uses existing data, can evaluate services by trends over time

disadv - quality of data variable, data collected mat not be data required, doesn’t take into account opinions of people involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the adv and disadv to a comparative health care assessment?

A

quick and cheap
gives a measure of relative performance

may be difficult to find comparable population
data may not be available/quality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the adv and disadv to a corporate health care assessment?

A

based on opinions of population in question
takes into account knowledge and experience of those in popln
takes into account wide range of views

difficult to distinguid need from demand
may be influenced by poilitcal agendas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Primary, Seconday and Tertiary prevention?

A

Primary prevention
- preventing disease before it has happened

Secondary prevention – catching disease in the pre-clinical or early phase

Tertiary prevention – preventing complications of disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the 2 approaches to prevention?

A

Population approach - preventative measure eg. dietary salt reduction through legislation to reduce bp

High risk approach – identify individuals above a chosen cut off and treat – eg. screening for high bp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the different kinds of screening?

A
  • Population-based screening programmes
  • Opportunistic screening
  • Screening for communicable diseases
  • Pre-employment and occupational medicals
  • Commercially provided screening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the disadvantages to screening?

A
  • Exposure of well individuals to distressing or harmful diagnostic tests
  • Detection and treatment of sub-clinical disease that would never have caused any problems
  • Preventive interventions that may cause harm to the individual or population
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the Wilson and Junger criteria?

A

The condition being screened for should be an important health problem

The natural history of the condition should be well understood

There should be a detectable early stage

Treatment at an early stage should be of more benefit than at a later stage

A suitable test should be devised for the early stage

The test should be acceptable

Intervals for repeating the test should be determined

Adequate health service provision should be made for the extra clinical workload resulting from screening

The risks, both physical and psychological, should be less than the benefits

The costs should be balanced against the benefits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is lead time bias?

A

When screening identifies an outcome earlier than it would otherwise have been identified this results in an apparent increase in survival time, even if screening has no effect on outcome.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is length time bias?

A

Type of bias resulting from differences in the length of time taken for a condition to progress to severe effects, that may affect the apparent efficacy of a screening method

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the advantages and disadvantages of a cross sectional study/survey?

A

Relatively quick and cheap
Provide data on prevalence at a single point in time
Large sample size
Good for surveillance and public health planning

Risk of reverse causality (don’t know whether outcome or exposure came first)
Cannot measure incidence
Risk recall bias and non-response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the advantages and disadvantages of a case-control study?

A

Good for rare outcomes (e.g. cancer)
Quicker than cohort or intervention studies (as the outcome has already happened)
Can investigate multiple exposures

Difficulties finding controls to match with cases
Prone to selection and information bias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the advantages and disadvantages of a cohort study?

A

Can follow-up a group with a rare exposure (e.g. a natural disaster)
Good for common and multiple outcomes
Less risk of selection and recall bias

Takes a long time
Loss to follow up (people drop out)
Need a large sample size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the advantages and disadvantages of a randomised control trial?

A

Low risk of bias and confounding
Can infer causality (gold standard)

Time consuming
Expensive
Specific inclusion/exclusion criteria may mean the study population is different from typical patients (e.g. excluding very elderly people

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the odds of an event?

A

the ratio of the probability of an occurrence compared to the probability of a non-occurrence.

Odds = probability/(1-probability)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the odds ratio?

A

The odds ratio is the ratio of odds for exposed group to the odds for the not exposed groups.

OR = {Pexposed/ (1 – Pexposed)}
{Punexposed/ (1 – Punexposed)}

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is incidence?

A

new cases, denominator, time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is prevalence?

A

existing cases, denominator, point in time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is incidence rate?

A

= (No.of persons who have become cases in a given time period)/(Total person-time at risk during that period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is a never event?

A

serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented

surgery - wrong site/implant

medication - wrong preparation/route

mental health - suicide

misidentification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is sensitivity?

A

the proportion of people with the disease who are correctly identified by the screening test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is specificity?

A

the proportion of people without the disease who are correctly excluded by the screening test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is positive predictive value?

A

the proportion of people with a positive test result who actually have the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is negative predictive value?

A

the proportion of people with a negative test result who do not have the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are predictive values dependent on?

A

underlying prevalence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is person time?

A

measure of time at risk, i.e. time from entry to a study to (i) disease onset, (ii) loss to follow-up or (iii) end of study. Used to calculate incidence rate which uses person time as the denominator.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Association between exposure and outcome can be attributed to?

A

Bias

Chance

Confounding

Reverse causality

a true causal association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What types of bias are there?

A

selection bias - a systematic error in selection of participants, allocation of participants to different study groups

information/measurement bias : systematic error in the measurement of classification of exposure/outcome e.g. observer bias, recall bias, reporting bias, instrument

publication bias -

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is bias?

A

a systemic deviation from the true estimation of the association between exposure and outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is confounding?

A

situation in which the estimate between an exposure and an outcome is distorted because of the association of the exposure with another factor (confounder) that is also independently associated with the outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is reverse causality?

A

this refers to the situation when an association between an exposure and an outcome could be due to the outcome causing the exposure rather than the exposure causing the outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the criteria for causality?

A

Bradford-hill criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the Bradford-hill criteria?

A

Sally Did Come To Russia but Cassie Annoyed Sally

strength of association

dose-response

consistency

temporality

reversibility

biological plausibility

coherence

analogy

specificity

49
Q

What are some acute effects of dependent drug use?

A

complications of injecting (DVT, abscesses)

overdose (resp depression)

poor pregnancy outcomes

side effect of opiates (constipation, low salivary flow)

50
Q

What are some chronic effects of dependent drug use?

A

blood-borne virus transmission

effects of poverty

51
Q

Effects of dependant drug use can divided into 4 subsections, what are they?

A

Physical - acute, chronic

Social

Psychological

52
Q

What is harm reduction for a heroin user?

A

action to prevent deaths (safe injections, not mixing, reducing amount after tolerance lost)

action to prevent blood borne virus transmission (sharing needles, condoms, hep vaccination)

referral where appropriate

53
Q

What are steps in management for heroin user?

A

harm reduction

detox - buprenorphine

maintenance - methadone, buprenorphine

relapse prevention - naltrexone

psych interventions

54
Q

What are the 3 health behaviours?

A

health behaviour - prevent disease (eating healthily)

illness behaviour - to seek remedy (going to doctor)

sick role behaviour - aimed at getting well (taking medicine, resting)

55
Q

What is the theory of planned behaviour?

A

best predictor of behaviour is ‘intention’ - I intend to give up smking

56
Q

What is intention determined by?

A

Attitude - persons attitude towards behaviour

Subjective norms - perceived social pressure to undertake the behaviour

Perceived behavioural control - persons appraisal of their ability to perform the behaviour

57
Q

What are criticisms of theory of planned behaviour?

A

lack of temporal element

lack of direction of causality

Rational belief - patient may not be thinking rationally

Attitudes and social norms cant be measured

58
Q

What are the stage models of health behaviour?

A

precontemplation

contemplation

preparation

action

maintenance

59
Q

What is motivational interviewing?

A

counselling approach for initiating behaviour change by resolving ambivalence

60
Q

What is Nudge theory?

A

‘nudge’ the environment to make the best option the easiest

  • opt-out schemes such as pensions
  • placing fruit next to checkouts
61
Q

What are some typical transition points?

A

leaving school

entering the workforce

becoming a parent

becoming unemployed

retirement

bereavement

62
Q

What is the NCSCT?

A

A social enterprise to support the delivery of effective evidence-based tobacco control programmes and smoking cessation interventions provided by local stop smoking services. The NCSCT:
– delivers training and assessment programmes
– provides support services for local and national providers
– conducts research into behavioural support for smoking cessation

63
Q

What are the measure of quality assurance used by the NCSCT for their programmes?

A

knowledge and skills of stop smoking practitioners

interventions are evidence based

clinical effectiveness

professional development

64
Q

Why should you notify the health protection agency about a notifiable disease?

A

so HPA can take urgent control measures

may be the only one who can tell HPA

duty of registered medical practitioners

65
Q

What things should the HPA be made aware of?

A

Notifiable diseases

Infection which could present sig harm to human health

contamination which could present sig harm to human health

66
Q

How would you manage an outbreak?

A

clarify problem (diagnosis)

outbreak? (2 or more related cases of communicable disease)

if so, help (microbiologists, consultant in infectious disease, health visitors)

call an outbreak meeting

identify cause

initiate control measures

67
Q

What are maslows hierarchy of needs? examples?

A

Physiological - breathing, food, water, sex

Safety - security of body, employment, family, health

Love/Belonging - friendship , family, sexual intimacy

Esteem - self-esteem, confidence, achievement

self-actualization - morality, creativity, problem solving, lack of prejudice

68
Q

What are some causes of homelessness?

A

mental illness/breakdown

domestic abuse

disputes with parents

bereavement - ‘no family ties’

69
Q

What are health problems faced by the homelss?

A

TB

hepatitis

poor feet and teeth

violence and rape

sexual health

mental illness
addicitons

70
Q

Barries to healthcare for the homeless?

A

access - opening times, location

integration - housing, social service

other things on their mind - do not prioritiese health

may not know where to find help

71
Q

Asylum seeker vs refugee?

A

asylum seeker - person who has made an application for refugee status

refugee - a person granted asylum and refugee status - usually 5 years and then reapply

72
Q

How do asylum seekers live?

A

no choice dispersal

vouchers/income support

NASS support package

full access to NHS

not allowed to work

73
Q

Health condition of asylum seeker?

A

illness from home

injuries war and travel

no previous health surveillance/screening/immunisaitons

malnutrition
abuse

infestations

communicable disease

PTSD

74
Q

Why is safety compromised so often?

A

healthcare is complex and high risk

resource intensive

system, patient and practitioners interaction

responsibilities are often shared

practitioners often take risks unknowingly

75
Q

What are some common issues in medicine?

A

wrong diagnosis

wrong plan

medication reconciliation

high conc. medication solutions

patient identification

patient care handovers

76
Q

How are errors classified?

A

Intention (skill-based, rule-based, knowledge based)

Action (generic, task specific factors)

Outcome (near miss, successful detection and recovery, death/injury/loss of function)

Context (anticipations and perseverations, interruptions an distractions)

77
Q

What are different perspectives on error?

A

Person approach - error are the product of wayward mental processes, unsafe acts

System approach - errors are commonplace, remedial efforts directed at removing error traps and strengthening defences

78
Q

Strategies to reduce errors and harm?

A

simplification and standardisation of clinical processes

checklists and aide memoires

information technology

team training

risk managemnent programmes

mechanisms to improve uptake of evidence based treatment patterns

79
Q

What are some tools of risk identification?

A

incident reporting

complaints and claims

audit

benchmarking

external accreditation

active measurement/compliance

80
Q

What are some leadership styles?

A

Inspirational

Transactional - reward employees for what they do

Laissez-faire - who embrace it afford nearly all authority to their employees.

Transformational - inclusive leadership throughout all levels of organisation

81
Q

Mechanisms underlying inhumane behaviour?

A

bystander effect

pressing situational factors can override explicitly announced value systems

unwillingness to speak out against prevailing view

82
Q

Basic types of errors?

A

Sloth

Fixation and loss of perspective

Communication breakdown

Poor team working

Playing the odds

Bravado (timidity)

Ignorance

Mis-triage

Lack of skill

System error

83
Q

Why do things go wrong?

A

system failure

human factors

judgement failure

neglect

poor performance

misconduct

84
Q

What is the Swiss Cheese model?

A

organization’s defence against failure are modelled as a series of barriers, represented as slices of cheese

Holes represent weaknesses in individual parts of system and are continually varying in size and position across the slices

failure = when a hole in each slice momentarily aligns > trajectory of accident opportunity > failure

85
Q

What is the negligence assessment?

A

is there a duty of care?

was there a breach in that duty? - support from others? Bolam test, Bolitho test

did patient come to any harm?

did the breach cause the harm?

86
Q

How is the patient compensated?

A

must demonstrate that it was your action/inaction that caused the harm

if successful - how much depends on : loss of income, cost of extra care, pain and suffering

87
Q

What are Bolam and Bolitho test?

A

Bolam - would a group of responsible doctors do the same?

Bolitho - would it be reasonable of them to do so?

88
Q

What is the tripartite model of learning?

A

Surface - fear of failure, desire to complete course

Strategic - desire to be successful > patchy and variable understanding

Deep - personal understanding, making links across material , look for general principles

89
Q

What are the types of learner?

A

Theorist - can question ideas, offered challeneges

Activist - new experience, extrovert

Pragmatist - wants feedback, purpose, may like to copy

Reflector - watches others, reviews work and analyses

90
Q

What is kolb’s learning cycle?

A

Activist > Reflector > Theorist > Pragmatist

91
Q

Why teach about diversity?

A

Better health outcomes for patient (drs identify patient problems more accurately, patients more likely to adhere, fewer diagnostic tests and referrals

More satisfying doctor-patient encounters (doctor more time efficient, fewel complaints)

92
Q

What is culture?

A

socially transmitted pattern of shared meanings by which people communicate, perpetuate and develop their knowledge and attitudes about life. An individual’s cultural identity may be based on heritage as well as individual circumstances and personal choice and is a dynamic entity

93
Q

What is ethnocentrism?

A

The tendency to evaluate other groups according to the values and standards of one’s own cultural group, especially with the conviction that one’s own cultural group is superior to the other groups

94
Q

What is a stereotype?

A

Involve generalisations about the ‘typical’ characteristics of members of a group.

95
Q

What is prejudice?

A

Attitude towards another person based solely on their membership of a group

96
Q

What is discrimination?

A
  • Actual positive or negative actions towards the objects of prejudice
97
Q

What is rationing? Why have rationing needs increased?

A

Resource is refused because of lack of affordability rather than clinical ineffectiveness

  • Shift from acute illness to chronic long term
  • Normal physiological events medicalised
  • Increase in choice and increase in expensive drugs
98
Q

What are some allocation theories?

A

Egalitarian principles

Maximising principles

Libertarian principles

99
Q

What are the egalitarian principles? What is its weakness?

A

provide all care that is necessary and appropriate to everyone.
o Challenge: tension between egalitarian aspirations and finite resources.

100
Q

What are the libertarian principles?

A

each is responsible for their own health, well being and fulfillment of life plan

101
Q

What rights are frequently engaged in healthcare?

A
  • Art 2 – the right to life (limited)
  • Art 3– the right to be free from inhuman and degrading treatment (absolute)
  • Art 8– the right to respect for privacy and family life. (qualified)
  • Article 12 – right to marry and found a family
102
Q

What are some benefits of social media?

A

wider and diverse social and professional networks

engage public and colleague in debates

public access to accurate health info

patient access to services

103
Q

What are some disadvantages to social media?

A

loss of personal privacy

potential breaches of confidentiality

unprofessional

offensive

risk of posts being reported to media or employers

104
Q

GMC duties of a doctor?

A

 Make the care of your patient your first concern
 Protect and promote the health of patients and the public
 Provide a good standard of practice and care
 Treat patients as individuals and respect their dignity
 Work in partnership with patients
 Be honest and open and act with integrity

105
Q

What are the components of a planning cycle?

A

needs assessment > planning > implementation > evaluation

106
Q

As a qualified doctor, how can you improve the health of patients in two main ways?

A

treating individual patients

influencing the services available to patients

107
Q

Define evaluation?

A

assessment of whether a service achieves its objectives

108
Q

What is the Donabedian framework for health service evaluation?

A

Structure

Process (+output)

Outcome

109
Q

What is structure? Examples?

A

buildings, staff and equipment

e.g. number of ICU beds/1000, number of vasc surgeons/1000 population

110
Q

What is process? examples?

A

what is done?

process through which patients go in A&E (where and when is patient first seen)

can also include output e.g. number of operations performed

111
Q

What is outcome?

A

classification of health outcomes

5Ds

death (mortality)

disease (morbidity)

disability (quality of life)

discomfort (quality of life)

dissatisfaction

112
Q

What are the issues with health outcomes?

A

cause and effect between health service provided and health outcome may be difficult to establish (many other factors involved)

time lag between service provided and outcome may be long (intervention in childhood diet and type 2 incidence)

large sample size needed

data may not be available

issues with data quality ( CART = completeness, accuracy, relevance , timeliness)

113
Q

How would evaluate the quality of healthcare?

A

Maxwell’s dimensions of quality (3es and 3as)

Effectiveness

Efficiency

Equity

Acceptability

Accessibility

Appropriateness (right people at right time?)

114
Q

What are two evaluation methods?

A

Qualitative

Quantitative

115
Q

What are some qualitative methods of evaluation?

A

consult relevant stakeholders (staff, patients, policy makers)

observations (participant and non participant observation)

Interviews

Focus groups

Review of documents

116
Q

What are some quantitative methods of evaluation?

A

routine collected data (hosp admissions; mortality)

review of records

surveys

special studies (epidemiological methods)

117
Q

What is the general framework of evaluating a health service?

A

define what service is and what it includes

what re the aims/objectives

framework (structure, process, outcome)

methodology to be used (qualitative, quantitative, mixed methods)

results, conclusions and recommendations

118
Q

Exam Questions

A

Donabedian’s “structure, process, outcome” is a useful
framework to use when carrying out evaluation of health
services. Explain what is meant by “structure”.
When assessing the quality of health services, Maxwell’s
classification lists six dimensions. List the six dimensions.
Although using measures of health outcomes is desirable in
evaluation of health services, there are potential limitations.
Explain why it may be difficult to attribute a health outcome to
the service provided.

GP/Public Health (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions