MHS Flashcards

1
Q

What is human trafficking?

A

Illegal recruitment or movement of people

  • by deception or coercion
  • nationally or internationally
  • for exploitation
  • sexually, domestic servitude or manual labour
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2
Q

Of those trafficked, how many are women + children?

A

70% female

50% children

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3
Q

What is cultural competency?

A

Provision of services and care that are respectful and responsible to the values, health beliefs, practices, cultural and linguistic needs of diverse patients.

  • May require adaptation of skills or approach
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4
Q

What are the stages you may go through to become culturally competent? (crandall et al.)

A
Unconscious incompetent
Conscious incompetent 
Conscious competent
Unconscious competent
Unconscious supercompetence
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5
Q

What does a clinician who is unconsciously incompetent recognise?

A

recognises cultural groups, but not that they differ culturally from one another

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6
Q

What does a clinician who is conscious competent recognise?

A

Believes that a patient with different health beliefs is vital to the negotiation and planning process of their care

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7
Q

What skills does a clinician who is unconsciously supercompetent have?

A

Recognises cultural identification and can unconsciously adjust to a wide range of cultural beliefs

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8
Q

What is the mini-ethnography approach of cultural competency?

A

6 steps
Ethnic identity
what is at stake?
The illness narrative
Psychosocial stresses
Influence of culture on clinical relationships
Has approach worked in that case? reassess

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9
Q

Why do you critically appraise literature?

A

To distinguish what is..

  • valid
  • reliable
  • Generalisable
  • useful
  • Clinical
  • effective
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10
Q

What is the hierarchy of evidence of trial types?

A
Systematic reviews + meta analyses
Randomised controlled trials
Cohort studies
Case-control
Cross-sectional
Ecological
Case series
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11
Q

What are examples of observational studies?

A

Cohort
Case Control
Cross-sectional
Ecological

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12
Q

Describe a basic cohort study

A

You have a population without the disease
You see which will be exposed to a particular factor
And a group that wont be exposed
Follow them up and see if they develop the disease assoc. with the exposure

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13
Q

What are cohort studies good for?

A

Rare exposures

When you can’t deliberately expose someone

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14
Q

What type of risk /analysis do you do in a cohort study?

A

Attributable risk

Relative risk

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15
Q

What is a confounder?

A

A factor that affects your exposure + the disease - so you don’t know which way the influence goes

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16
Q

How do you deal with confounders?

A

Adjust for them in the design - eg. population selection

Adjust in the analysis - stratify results

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17
Q

What is bias?

A

Systematic error / random error

Due to poor study design / data collection

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18
Q

What is neyman’s bias?

A

Prevalence-incidence bias - a form of selection bias in case-control studies - due to selective survival among the prevalent cases
ie. mild cases resolve
Severe cases may be fatal
So you end up just studying the middle group

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19
Q

What is Berkson’s bias?

A

A type of selection bias which may occur in case-control studies which are based entirely on hospital studies

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20
Q

Describe a basic case-control stidy

A

Start with cases, look for controls in the same population without the condition, question them about exposures.

Retrospective

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21
Q

What are case-control studies good for?

A

Rare diseases
Multiple exposures
Long latent periods
Quick + cheap, as no waiting around

22
Q

What stat result/analysis do you look at with case-control studies?

A

Odds ratio

23
Q

What could any association found in a study be due to?

A

Chance
Bias
Confounders
True

24
Q

In are rare disease would you do cohort or case-control?

A

Case controlled

25
Q

In a rare cause would you do cohort or case-control?

A

Cohort

26
Q

To test multiple effects of a cause would you do cohort or case-control?

A

cohort

27
Q

Is the probability of selection and recall bias highest in cohort or case-control?

A

Case-control

28
Q

Is loss to follow up more likely in cohort or case-control?

A

Cohort

29
Q

What is a good tool to use when reading a paper?

A

Greenhalgh - how to read a paper

CASP - Critical appraisal skills program

30
Q

Does a man have the right to seek an abortion?

A

No. Just the women

31
Q

Does an unborn child have a legal personality?

A

No

32
Q

Are you allowed to selectively terminate one fetus in a multiple pregnancy?

A

Yes - if they fit criteria for an abortion + it is done in NHS hosp or approved place

33
Q

What is the main cause of homelessness?

A

Relationship breakdown

34
Q

Many who are homeless suffer from tri-morbidity - what are the 3 factors?

A

Physical illness
Mental health problems
Substance misuse

35
Q

What 3 things must you think of when thinkign of soemthing that may cause harm?

A

Stats - how likely is it to happen
What are the consequences
Time - is it an immediate threat?

36
Q

What sort of questions are RCTs useful for?

A

How good treatment is
Should we screen for x?
What causes the disease

37
Q

What is selection bias? How is it controlled?

A

Sample selection and treatment allocation bias

- fix with randomisation, allocation concealment + checking demographic tables

38
Q

What is performance bias?

A

The quality of control and treatment group regimes

- fix with blinding of the carers, patients, asessors)

39
Q

What is attrition?

A

Drop outs, loss to follow up.

Fix with sensitivity analysis and intention to treat analysis

40
Q

What is the power of a study?

A

The ability to demonstrate an association if one exists

41
Q

What can be done to improve the power of the study?

A

Increase the sample size

42
Q

What is the risk assesment model?

A

Chain that must be completed for the risk to come to light

Source - Pathway - Receptor

43
Q

What steps should you follow if a risk is possible/an adverse event happens?

A
Prevention
Planning and preparedness
Detection and alert
Response
Communication
Recovery
44
Q

Why would you do a systematic review?

A
reduce quantity of research
Generalisability
Consistency - explain inconsistencies + conflicts
Reliability, reduce bias and errors
Increase power and precision
45
Q

What problems do you come accross when doing a systematic review?

A
Statistical heterogeneity
Clinical heterogeneity
Quality difference
Dependance
Publication bias
46
Q

What is a funnel plot?

A

Plots the size of effect of individual studies against their statistical power

47
Q

How do we measure demographics?

A

Census - every 10 yrs

48
Q

What are the 2 types of census?

A
De Factor (where you are on night)
De Jure (Where you are enumerated / live)
49
Q

What assumptions are replied upon for population predictions?

A

Birth rate
Death rate
Net migration

50
Q

What is the difference of a population estimate to a prediction?

A

Estimate - calculating the current population between a census - so use registered births and deaths and migration records