Health and Society Flashcards
Define the following:
- Endemic
- Epidemic
- Pandemic
- constant presence and/or usual prevalence of a disease or infectious agent in a population within a geographic area
- an increase, often sudden, in the number of cases of a disease above what is normally expected in that population in that area
- an epidemic that has spread over several countries or continents, usually affecting a large number of people
describe the components of the chain of infection (5)
- infectious agent
- reservoir/environment
- mode of transmission
- portal of entry
- Host
What is an outbreak?
a sudden increase in occurences of a disease in a particular time and place
name 4 difficulties in using mass vaccination as a control measure
- long incubation period
- consent
- identification of new cases
- isolation of cases
Name examples of the following:
- infectious agent
- reservoir/environment
- mode of transmission
- portal of entry
- host
- ability to reproduce, survival, spread, infectivity, pathogenicity
- exposures, water systems, animals, environmental contamination, water systems
- respiratory, ingestion, blood borne, sexual contact
- mouth, nose, ear, GI tract, skin
- chronic illness, nutritional status, age, immunity, lifestyle factors
- what is surveillance?
- name 3 purposes of surveillance
- name 4 ways in which surveillance is carried out
- systemic collection, collation and analysis of data, and dissemination of the results so that appropriate control measures can be taken
- serves as an early warning system
- document the impact of an intervention, or track progress towards specific goals
- monitor and clarify the epidemiology of health problems to inform public health policy and strategy
- serves as an early warning system
- notifications of infectious disease
lab testing
follow up of contacts
surveillance questionnaires
- What is a nosocomical infection?
2. name 5 ways in which these infections can be controlled
- an infection contracted in hospital
- hospital environment hygiene (including isolation of cases)
hand hygiene
safe use of PPE
safe use and disposal of sharps
principle of sterility
what is the 10/90 gap?
that 10% of the world’s population receive 90% of healthcare resources
- what is international health defined by?
- name 5 characteristics of recipients
- name 5 characteristics of donors
- geography (poor nations), their problems, and instruments, in a recipient, donor relationship
- poor, ignorant, threatened by some risk, needy and passive, traditional
- rich, knowledgeable and skilful. benevolent, philanthropic and active, modern
what are the concerns of public health? (4)
- prevention
- equity
- population based approaches
- scientifically validated technical approaches
- what is global health?
- what does global health place priority on?
- what does global health involve?
- what does global health put an emphasis on?
- health of the global population, not excluding our own
- transnational (not bounded by borders; we are one society)
- many disciplines, and promotion of interdisciplinary collaboration
- INTERDEPENDENCE
- name 4 solutions of global health
2. name 4 pitfalls of global health
- regulation of the quality of imported food, medicines, manufactured goods and inputs
getting timely access to info about the global spread of infectious disease
procurement of sufficient vaccine and drug supplies in pandemic
ensuring sufficient corps of well trained health personnel - practical issues - security and governance
common health issues are different across nations
ethics - human rights and equity based values
name 5 global health issues that affect us all
- global warming
- development, poverty and inequality
- food and water security
- wars and security threats
- migration
name the three strategies of global health
- development aid
- international co-operation
- global solidarity
What are the major functions of global health
- to provide health related public goods
- to manage cross national externalities through epidemiological surveillance, info sharing and co-ordination
- name the three strategic aims of vaccination
2. name 5 programmatic aims of vaccination
- selective protection of the vulnerable
elimination
eradication
2. prevent deaths prevent infection prevent transmission prevent clinical cases prevent cases in a certain age group
- Define basic reproductive number (R0)
- What is R0 determined by?
- What is R0 proportionate to?
- What is the effective reproductive number?
- How do you calculate R in a homogenously mixing population?
- the average number of individuals directly infected by an infectious case during the infectious period in a total susceptible population
- basic biological features of the micro-organism, and of the population
- length of time that it remains infectious
number of contacts
chance of transmitting the infection during the encounter - the actual number of secondary cases per primary case observed in a population
- R= R0 x s (where s is proportion susceptible)
- What is the epidemic threshold
- Based on the epidemic threshold, what is S?
- what is the equation of the herd immunity threshold?
- the threshold at which above number of cases increases and below which the number of cases decreases. R=1
- s= 1/R0
- 1-s
- When planning a new vaccination programme, what questions need to be asked?
- When implementing a vaccination programme, what questions need to be asked?
- disease burden
- is immunisation best control strategy?
- how well is current immunisation programme working?
- how much disease will be prevented?
- what are the possible negative effects of the programme?
- What additional resources will be needed?
- is the vaccine a good investment?
- disease burden
- who, how and when?
define bad news
any news that drastically and negatively alters the patient’s (or their relatives) view of their future
- What is distancing?
2. Name 6 strategies of distancing
- reluctance to deliver bad news due to resulting anxiety, burden of responsibility for the news and fear of negative response
2. avoidance normalisation premature reassurance false reassurance switching/distraction jollying along
Describe the SPIKES framework for breaking bad news
S - setting up P - perception I - invitation K - knowledge E - emotion/empathy S - strategy and summary
In terms of child birth, what does the term “delivery” suggest?
suggests that women require some greater help in the physiological process of birth
- In history, who were childbirth attendants typically?
- When were males usually involved in the birth?
- When did men become more involved in childbirth?
- female family members or local women who had given birth and had developed expertise through experience over time.
- male surgeons and gynaecologists attended births usually when labour was obstructed
- In the 18th century, with medical advances in obstetrics
- When was there a political drive from the RCOG to encourage hospital births
- Why did they encourage this?
- 20th century (with Peel committee in 1970)
2. seen as inherently safer
Describe the aspects of active management of labour
labour diagnosis at 2cm
Early artificial rupture of membranes (at 2cm)
2 hourly vaginal examinations
Syntocinon when progress less than 1cm/hr and in second stage for descent or weak contractions
Personal nurse - 1:1 support
What can perceptions of the birth process be influenced by? (4)
- portrayals in the media
- negative birth stories from other women
- genuine fear of the unknown/know
- safety concerns for their baby or their own body
Which interventions decrease the natural production of oxytocin (5)
- Epidural (inhibits foetal ejection reflex)
- induction - floods receptor sites
- poor foetal position (with lying on bed)
- episiotomy
- separation following birth
