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Y2 I and P > Lectures > Flashcards

Lectures Flashcards

1
Q

What is population health

A

The health outcomes of a group of individuals, including the distribution of such outcomes within the group

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2
Q

What is public health

A

The art and science of preventing disease, prolonging life and promoting health through the organised efforts of society

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3
Q

What are health inequalities

A

Avoidable differences in health status between different population groups

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4
Q

What is necessary cause of disease

A

Presence is required for the occurrence of the event

Can’t have the disease without exposure to the cause but exposure doesn’t always lead to outcome

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5
Q

What sufficient cause of disease

A

A factor who presence leads to an effect. Exposure alone would induce the outcome but other exposures may induce the same outcome

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6
Q

What is the criteria for a cause which is a cause

A

Strength of the association
The consistency of the association
Specificity (Altering only the cause alters the effect)
Temporal relationship (cause preceded the effect)
Biological gradient (is there a dose response)
Biological plausibility (does it make sense)
Coherence (Does the evidence fit with what is known regarding the natural history and biology of the outcome)
Experimental evidence (are there any clinical studies supporting the association)
Reasoning by analogy (is the observed association supported by similar associations)

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7
Q

What is a population

A

The whole number of people or inhabitants in a region

A body of people having a quality or characteristic in common

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8
Q

What makes a good definition of a population

A

who
where
when

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9
Q

What are drivers of population change

A

Natural change (births - deaths)
Direct contribution form migration (immigration - emigration)
Indirect contribution from migration (changes in fertility and mortality)
Increases in life expectancy

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10
Q

What is an ACE

A

Adverse childhood experience

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11
Q

What is health protection

A

Protecting individuals, groups, and populations from single cases of infectious disease, incidents and outbreaks and non-infectious environmental hazards such as chemicals and radiation

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12
Q

What is the role of health protection

A

On notification of a communicable disease they allow implement actions to:

  • Minimise spread of communicable disease
  • Reduce population burden of disease
  • Provide advice and support for clinicians in community and hospital settings managing communicable disease
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13
Q

What makes up the multi-disciplinary team in PHE health protection

A

Specialist practitioners
Administrative staff
Consultants that work closely with other organisations

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14
Q

What are health protection responsible for

A

Local disease surveillance
National and local plans for communicable disease
Investigating and managing health protection incidents

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15
Q

How is an infectious outbreak managed

A 
Clarify the problem
Decide if it is an outbreak
Get help needed 
Call outbreak control meeting (equivalent to PHE ward round)
Identify the cause
Initiate control measures
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16
Q

What does health protection risk include

A 
Infectious diseases
Chemical poisons
Radiation
Emergency response/ major incidents
Environmental health hazards
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17
Q

What are the human health impacts of climate change

A

Poor air quality: cardio diseases (heart attacks, strokes), respiratory diseases (asthma, COPD), cognitive decline
Flooding increase: direct (drowning, injury) indirect (contamination of water supply, displacement of people, results in diseases such as cholera)
Heatwaves: heat exhaustion and heat stroke causing fatalities due to dehydration resulting in cardiac issues, wildfires (burns, pollutants causing respiratory side effects)
Vector-Borne diseases: Rise in temperatures allows diseases such as malaria to spread more globally due to mosquito miserable temps being met
Climate migration: strain on society’s ability to handle large influxes of people
Mental health: eco-grief

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18
Q

What is eco-grief

A

Panic and anxiety about insufficient action being taken about climate change

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19
Q

What is the NHS contribution to climate change

A

Employs 1.65 million people in UK
40% of public sector carbon emissions
590,000 tonnes of waste in 2016/17
NHS related travel 9.5bn miles in 2017

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20
Q

What is an anchor institution

A

A large organisation which sits in a local community and is unlikely to migrate out of that community and therefore is dependent on the wellbeing of the community for its own long term sustainability

21
Q

What are the three categories of ways which the NHS can tackle climate change and give an example of each

A

Direct: cut down carbon emissions
Leadership: air quality improvement action
Influence: individual actions of employees

22
Q

Why was NICE created

A

To standardise quality of care across the NHS and drive uptake of new technologies

23
Q

What is NICE’s role

A

The national point of reference for advice on safe, effective and cost effective practice in health and social care, providing guidance, advice and standards aligned to the needs of its users and the demands of a resource constrained system

24
Q

How does a drug get entered into the new Cancer drugs fund at NICE

A

Access to cancer drugs where NICE indicated that there is insufficient evidence to support a recommendation for routine commissioning

The drug must display plausible potential for satisfying the criteria for routine use

Entry into CDF subject to the company agreeing to fun the collection of a pre-determined data set, during a period normally lasting no longer than 24 months, and a commercial access arrangement which makes the drug affordable within the CDF budget

25
Q

Why would departure from standard practice as set out in NICE guidelines be justified

A
  • The patient has been given a full explanation of the issues and the doctor has checked they understand
  • The patient gives informed consent, if they have mental capacity
  • There is clear documentation in patient’s notes, including reason why departed from the guideline
  • Doctor is acting in good faith
26
Q

When exploring issues with a patient, what four things should be remembered

A

Choice
Risk
Impracticality
Benefits

27
Q

What are the core principles of NICE guidance

A

Comprehensive evidence base
Expert input
Patient and public involvement
Independent advisory committees
Genuine consultation with all stakeholders
Regular review and updating
Open and transparent process- meetings held in public

28
Q

What are the principles of the NHS

A

Predominantly publicly funded and owned
Supplemented by private insurance schemes
Largely free at point of use
Comprehensive
Universally accessible
Ultimately responsible to parliament via Secretary of state for health

29
Q

What are the funding sources for the NHS

A
  1. 8% comes from general taxation and national insurance

1. 2% comes from patient charges

30
Q

What does international health emphasise

A

Specific diseases and conditions in particular countries
Often in ‘other’ countries, not in one’s own
More the differences between countries than their commonalities
One-way flow of ideas for development initiatives

31
Q

What does global health emphasise

A

Characterised by health issues beyond the capacity of individual countries to address through domestic institutions
Recognises that health is determined by problems, issues and concerns that transcend national boundaries
Focused on people across the whole planet rather than concerns of particular nations
Requires multi-disciplinary responses from many countries

32
Q

What is the definition of Global health

A

An area for study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide
Emphasises transnational health issues, determinants and solutions; involves many discipline within and beyond the health sciences and promotes interdisciplinary collaboration; is a synthesis of population-based prevention with individual- level clinical care

33
Q

What are the 3 main classifications of disease

A

Group 1: communicable disease
Group 2: non-communicable disease
Group 3: injuries

34
Q

What is the global burden of disease study

A

GBD
Most comprehensive, global, observational epidemiological study to date
Describes mortality and morbidity form major diseases, injuries and risk factors to health at global, national and regional levels

35
Q

What are MDGs

A

Millennium development goals
The 8 international development goals for the year 2015 that were established follow the millennium summit of the United Nations in 2000, following the adoption of the UN Millennium Declaration

36
Q

What are the 8 MDGs

A
  • Eradicate extreme poverty and hunger
  • Achieve universal primary education
  • Promote gender equality and empower women
  • Reduce child mortality
  • Improve maternal health
  • Combat HIV/Aids, malaria and other diseases
  • Ensure environmental sustainability
  • Develop a global partnership for development
37
Q

How has child mortality rate changed in the past 25 years

A

reduced by >50% falling from 90 to 43 deaths per 1000 live births globally but failed to meet the MDG target of a drop of 2/3

38
Q

How has maternal mortality rate changed in the past 25 years

A

fallen by 44%, still short of MDG aim of 2/3

Still every day 830 women die from pregnancy or childbirth related causes

39
Q

What is the definition of maternal death

A

The death of a woman while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management but not from accidental or incidental causes

40
Q

What are the most common causes of maternal death

A 
Postpartum bleeding (15%)
Complications from unsafe abortion (15%)
Hypertensive disorders of pregnancy (10%)
Postpartum infections (8%)
Obstructed labour (6%)
41
Q

What are communicable diseases

A

Any condition which is transmitted directly or indirectly to a person from an infected person or animal through the agency of an intermediate animal, host, or vector, or through the inanimate environment

42
Q

What is a chronic disease

A

Requires ongoing medical care, limits what one can do and is likely to last longer than one year
Can by controlled but not cured

43
Q

How many people suffer with chronic diseases in the UK

A

60% of adults, 45% of which have multiple co-morbidities

75% of over 35s

44
Q

What does insufficient intake of fruit and veg estimate to cause worldwide

A

4% of GIT cancer deaths
11% of ischaemic heart disease deaths
9% of stroke deaths

45
Q

What are the facts about urban slums

A

1 in 4 of the world’s urban population live in slums
Densely populated, neglected parts of cities where living conditions are exceptionally poor
Many socio-economic and health problems
Poor access to safe water, sanitation, overcrowding, poor housing, rat infestation, leading to high rates of communicable disease
Caused by rapid population growth, rural to urban migration and failure of urban governance

46
Q

What is the meaning of the term ‘the social determinants of health’

A

Term used to describe the social and environmental conditions in which people are born, grow, live, work and age, which shape and drive health outcomes

47
Q

What are the infection prevention precautions

A 
Hand hygiene 
Personal protective equipment
Decontaminating equipment
Isolation/ quarantine
Disinfection
Education
48
Q

What is the incubation period

A

Time from exposure to when symptoms develop

49
Q

What is the infectious period

A

Time when patient is infectious and can spread the disease

Y2 I and P (1 decks)

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