MHS Flashcards
What is human trafficking?
Illegal recruitment or movement of people
- by deception or coercion
- nationally or internationally
- for exploitation
- sexually, domestic servitude or manual labour
Of those trafficked, how many are women + children?
70% female
50% children
What is cultural competency?
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
What are the stages you may go through to become culturally competent? (crandall et al.)
Unconscious incompetent Conscious incompetent Conscious competent Unconscious competent Unconscious supercompetence
What does a clinician who is unconsciously incompetent recognise?
recognises cultural groups, but not that they differ culturally from one another
What does a clinician who is conscious competent recognise?
Believes that a patient with different health beliefs is vital to the negotiation and planning process of their care
What skills does a clinician who is unconsciously supercompetent have?
Recognises cultural identification and can unconsciously adjust to a wide range of cultural beliefs
What is the mini-ethnography approach of cultural competency?
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
Why do you critically appraise literature?
To distinguish what is..
- valid
- reliable
- Generalisable
- useful
- Clinical
- effective
What is the hierarchy of evidence of trial types?
Systematic reviews + meta analyses Randomised controlled trials Cohort studies Case-control Cross-sectional Ecological Case series
What are examples of observational studies?
Cohort
Case Control
Cross-sectional
Ecological
Describe a basic cohort study
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
What are cohort studies good for?
Rare exposures
When you can’t deliberately expose someone
What type of risk /analysis do you do in a cohort study?
Attributable risk
Relative risk
What is a confounder?
A factor that affects your exposure + the disease - so you don’t know which way the influence goes
How do you deal with confounders?
Adjust for them in the design - eg. population selection
Adjust in the analysis - stratify results
What is bias?
Systematic error / random error
Due to poor study design / data collection
What is neyman’s bias?
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
What is Berkson’s bias?
A type of selection bias which may occur in case-control studies which are based entirely on hospital studies
Describe a basic case-control stidy
Start with cases, look for controls in the same population without the condition, question them about exposures.
Retrospective