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Med 2024-2028 > HADPOP 2 > Flashcards

HADPOP 2 Flashcards

1
Q

What is health?

What is public health?

A

Absence of infirmary

The prevention of disease, prolonging life + promotion of health in society through organised efforts

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2
Q

Public health model

A
  1. Surveillance - WHAT IS THE PROBLEM?
  2. Risk factor ID WHAT IS CAUSE?
  3. Intervention + evaluation SOLVE>
  4. Implementation - HOW TO INTERGRATE INTERVENTION
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3
Q

Who arethe 3 stakeholders in public health?

A
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4
Q

State examples of key public health interventions

A
  1. Vaccination programmes - HPV
  2. Motor vehicle safety - THINK road safety campaign
  3. Family plannig- FREE CONTRACEPTION
  4. Infectious disease control - HIV, COVID-19
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5
Q

What is the difference between equity and equality

A

EQUALITY - eveeryone recieves same thing regardless of situation - SAMENESS

EQUITY - everyone recieves what they need based on their individual circumstances - FAIRNESS

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6
Q

What is the definition of health equity ?

A

Absence of avoidable differences among groups of people

Deals with rising issues made prevalent by socioeconomic deteminants of health

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7
Q

What are socioeconomic determinants of health?

A
  • Race
  • Gender
  • Job
    Where you live
    Where you were born
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8
Q

What is health inequality ?

A

Health variation that is
1. Unfair
2. Avoidable

Directly related to inverse care law

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9
Q

What is inverse care law?

A

Good medical care less available to those who actually need it compared those who don’t

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10
Q

What are the two main types of health surveillance?

A
  1. Routine
    Encompases whole population
    Demographics, health events
    GOOD FOR TREND MONITORING
    regular intervals
  2. Ad Hoc
    Study done when there is a specifc need for a study to be conducted. No intetion of repitition
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11
Q

State 3 pros and 3 cons of routine data

A

Pros
- Readily available
- limited costs
- Trend monitoring

Cons
- Bias
- Poor presentation
- Limited determinants details, focus on conditions not causes

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12
Q

What is a population cencus?
What important info can we get from a cencus?

Pros of cencus
Cons

A

Recorded demoghraphic data by govt - specific time, pertains to all persons in that area

Info:
- Unemployment
- deaths
- lack of amenities

Personal enumeration
Regular occurance
Govt tun

Cons
- General statements about population

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13
Q

How do we apply cencus information?
What do we use population pyramids?

A

POPULATION PYRAMIDS
- Allow us to make predictions regarding the future demographics of population - predict services required (population estimates (current application) or population projections (future application))

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14
Q

What is the difference between fertilty and fecundity

A

Fertility - ability to produce offspring
Fecindity - Ability to produce life offspring

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15
Q

What is the difference between birth notification vs birth registration

A

Birth notification - Done by midwife, within 36 hours to child health register

Birth reg - parent, 42 days

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16
Q

What is the difference between mortality certification and mortality regstration ?

A

Cert - doctor responsibility, info of likely cause of death

Reg - qualified info, 5 days fo death, requires death cert from dr

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17
Q

What are notifiable diseases?
Give 5 examples

A

Disease that can lead to public health crisis
Must be reported to UK HAS when detected

  • Cholera
  • Botulism
  • Malaria
  • TB
  • Whooping cough
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18
Q

What is under reporting?
Why can it occur?

A
  • Specific disease + prevalence not accurate, due to incorrect monotring of conditions

Why?
- Lack of Dr knowledge
- Misdiagnosis
-How commin the condition is
- Decreased severity
Conditions affecting men vs women

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19
Q

What do scatter plots show?
How can we describe them?

A

Relationship between two continous variables

Liner / Non - linear

STRONG/WEAK correlation (how close together dors are)

Correlation coefficient

Slope
-positive
-negative
-0 if not postive or neg

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20
Q

What is a correlation coefficient?

A

Number that shows the strength of correlation between two variables
- If +1, X causes Y
- If -1. X does not cause Y

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21
Q

What are the two ways we use to measure disease?

A
  1. Incidence
    No. new cases
  2. Prevalance
    No of cases of disease in population at specific time
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22
Q

Formula for incident risk and rate

A
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23
Q

What is point prevalance ?
Formula?
What factors change prevalance?

A

Number. of cases (past, current) at specific time peroid as proportion of

total numebr of ppl in population

  1. Chance
  2. Demgrhaphics
  3. Ttreatment
  4. True changes
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24
Q

What is the difference between risk and association?

A

Risk - probability outcome will occur
Association - correlation between exposure and outcome
(causation, correlation)

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25
Q

What is the formula for relative risk?

A

Risk ratio

Incidence risk in exposed / incidence risk in unexposed

RR> 1 - positive assication
RR < negative association

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26
Q

What are the 4 levels of prevention?

A

Primary - prevent illness
Secondary - earlty diagnosis, minimise effects
Tertiary - prevent further complications
Primordial - remove disease from population enitrely

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27
Q

Stages of change model

A

Relapse/Prolapse
Pre-contemplation
Contemplation
Preperation / determination
Action
Maintenance

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28
Q

The 6As

A

As
Acknowledge
Asess
Assist
Advise
Arrange

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29
Q

How many units per week is the limit for men and women?

A

14 units per week regularly

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30
Q

What does the CAGE questionnaire stand for?

A

Cut back
Annoyed
Guilty
Eye opener

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31
Q

What is “pack years smoking” ?

A

Determines how many cigarettes a person has had in lifetime

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32
Q

What is the definition of a survey?
What are 3 purposes of surveys?

A

Investigation, info systematically collected and experimental not used

  1. Measures risk in population
  2. Measures outcomes
  3. Assess prevalence of diseases
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33
Q

What type of study is a prevalance study?
pros, cons

A
  • Cross secrtional
  • Snapshot in time

QuicK
Good for trend planning

NOT GOOD FOR SHORT TERM CONDITIONS
NOT USED FOR CAUSATION

34
Q

What is a sample?
Why do they need to be representative of whole population?
What is a sample frame?

A
  • Representative subset of population
  • To make accuate inferences about population
  • List of everyone in population that can be sampled
35
Q

What makes a good sample group?

A
  1. Large sample size
  2. Random
  3. Representative
36
Q

Quality vs Quantity

A
37
Q

Sampling methods

A
  1. Random
    equal probability of drawing anyone in frame being chosen
  2. Cluster - natural cluster
  3. Simple - ID + selection
  4. Stratified - dividing of population into strata
  5. Systematic - very nth member, good for preserving representation
  6. Non-random
    -easier
    -covenient
38
Q

What errors can you have with systematic sampling?

What erros can we have with random sampling?

A

Bias - intrument failure

Random - altered results, due to chance

39
Q

Explain two sources of bias

A
  1. Selection bias
    - Sampling (non representative)]
    -Non response bias
  2. Information
    - Instrument (equipment incorrectly calibrated)

-Interobserver (3rd party observer irepretate things differently yo how respondent means them)

Confounding Bias
Lack of comparability between exposed and
unexposed populations

40
Q

Precision vs Accuracy

A

Accuracy - How close to expected value results are
Low accuracy = random error

Precision
How close together results are
Low precision - systematic error

41
Q

Health protection services

A

Surveillance+ control of new and recurrent infections

National coordination- UKHSA
Regional coordination - HAS
Local - Health protetion teams

42
Q

What is routine surveillance?

A

Regular collection of data from one source (GPs, health clnic, local hoospital records)

  • Age
  • Sex
    -Health problems
  • Current access to healthcare
43
Q

What is the difference between passive and active surveillance?

A

Passive - regular reporting from hospitals, GP, to govt body.

Active - govt asks specific health teams to make reports on specific health groups

44
Q

What to CCDC do?

A
  1. Interview affected indivduals
  2. Confirm dianosis
  3. Tracing contacts of index case
    4/ Identification + prevention
45
Q

What are limitations of surveillance?

A
  • Lack of denomintators
    -Under reporting
  • Lack of representativeness of reported cases
  • difficult to interpret trends
46
Q

Descibe process of transmission

A

Index - first case identified
Priamry - case brings condition into population
Secondary - infected by primary
Tertiary - infected by secondary
- IT SPREADS

47
Q

What is a reservoir?

A

Host whhich is not affacted by virus
Viurs safely grows, replicates, lives
e.g. kangaroos for ross river vius RRV

48
Q

What is a vector?

A

Host that can carru + spread pathogens
e.g. mosquitos for RRV

49
Q

State features of an endemic outbreak

A
  • Constant rates of cases in population
  • Disease rate is predictable, managed by local healthcare teams
  • Limited to specific area
  • Occurance of cases is at expected frequency
50
Q

What is an epidemic?
What is a pandemic?

A

Increase in number of expected cases
Pandemic - global epidemic

51
Q

What is a healthcare acquited illness?
2 causes

A
  • Any illness caught in healthcare setting
  • Resistant pathogens
  • Inapropriate isolation
52
Q

How can limit presence of reservoirs and vectors?

A

Wearing long clothing, not going to place durng speicif season

53
Q

Why do we limit immediate sources?

A

People who are immediately affected
Prevent presence of excess sources of pathogens

54
Q

What do we need to tackle to prevent spread of disease?

A
  1. Immediate sources
  2. Reservoirs, vectors
  3. Mode of transmission
  4. Susceptible - protective isolation
55
Q

Why do we source isolate?
What are the room conditions for isolation

A
  • Unexplained rashes
  • Suspected communicable diseases
  • Infleunza symptoms
  • Resistant viruses

SINGLE VENTILATED ENSUITE ROOM
Negative pressure

56
Q

Why do we protectively isolate?
Difference in conditions between this and source isolation ?

A
  • Immunocompromised individuals
  • Pregnant patients
  • Frail

Difference - positive pressure in room

57
Q

Evidence Based Medicine
Give an example of a database for medical research
What is PICO?

A

Pubmed, Google scholar
PICO
- population
- intervervention
- comparison
-outcome

58
Q

What is meant by “health need” ?
What do we need to consider during health needs assesment?

A

What has capacity to benefit health population group as a whole

WHO
WHAT
WHERE
WHEN
HOW

59
Q

How do we conduct a randomised control trial? Clinical trial

A
  1. Randon assignment of patients
  2. Control vs treatment groups
  3. Adminster placebo and medication
  4. Compare results
60
Q

What is blindng / masking? Benefit
What are the types?

A

Hiding info about who is getting which treatment (Concealment of intervention allocation)
Reduce measurement bias

Types
- Single - patient does not know
- Double - patient, dr does not know
- Tripple - patient, dr, researcher

61
Q

How do we reduce bias in RCTs?

A
  1. Measuremet bias - blinding
  2. Allocation bias - allocation concealment
62
Q

What is placebo effect?

A

Placebo - inert substance idenical to intervention in every wy

Attitude patient has towards a medication can influence their health ourcome and can lead to the feeling that something positive happened

63
Q

State advantages of RCTs
Disadvantage

A
  • Unbiased distrobution of confounders
  • Blinding
  • Randomisation

-ve
- Epensive
- Ethically problematic
- volunter bias

64
Q

What is intention to treat?

A

Comparitive step
Compares outcome for
- intervenion group patients
with
-control group pations

Shows if intervention would be useful in clinical practice

65
Q

Describe the differnce betwene causation and association

A
66
Q

What are the 7 Bradford Hill Criteria?

A
  • Strength assocation
  • Dose-response relationship
  • Consistency of findings
  • Biolocal plasuability
  • Coherence of evidience
  • Specificity of association
67
Q

What is a confounder?

A

Third variable impacting results of experiment trial

68
Q

What type of study is a cohort study?

A

Observational study

Where you follow a group of people over time and see how different factors (exposures) affect likelihood of developing certain conditions.

69
Q

What is relative risk?

A

Risk of contracting disease based on exposure level to specific exposure

70
Q

How do we interpretate relative risk?

A

RR =1: NO DIFFERENCE
RR > 1: exposure increases risk
RR < 1: Exposure is protective

71
Q

What does it mean by “95% confidence interval?”

A

95% chance true value falls within your stated value

72
Q

What does it mean by Null Hypothesis?

A
73
Q

How can we better studies?

A
  1. Increase sample size
  2. Use more representative sample group
  3. Eliminate user bias
  4. Ensure appropriate explanation of study
  5. Repar tests for validity
74
Q

State 3 advantages and disadvantages of cohort studies

A

+ve

  • Good for different outcomes
  • Good for rare exposures

-ve
- Surveryor bias
- larger, more resiurces
- longer

75
Q

What is a case control study?
What is a -ve?

A

Take patients witha condition, take patients without condition

Compare history
Make conclusions

Useful for rare conditions
But, cannot identify cause.

76
Q

What are odds? How do we work our the odds of an event occuring?

A

Probability event will occur to probability of same eevnt not occuring

how likely an event is to happen compared to it not happening.

77
Q

What is odds exposure? How do we work it out?

How do we interpet the value?

A

This measures likelihood of having been exposed to a particular factor among individuals with a certain condition compared to thise without the condition.

OE<1 - exposure is protective against condition

78
Q

How do we interpretate OE?

A
79
Q

What is Meta-analysis?

A

Combines results of multiple studies to get clearer overall picture
(2 or more primary studies, which address same hypothesis)

80
Q

What is a systematic review?

A

Type of research that provides overview of all available primary studies on specific topic

81
Q
A

Med 2024-2028 (56 decks)

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