My notes block 9 Flashcards
What goes into an evidence based decision?
Patient preferences
Available resources
Research evidence
Clinical expertise
Why do we need evidence based medicine?
Increasing medical knowledge
Limited time to read
Inadequacy of traditional resources
Disparity between diagnostic skills and up to date knowledge
What is the 10/90 gap?
A paradox- 90% of the population only get 10% of the healthcare resources
What is the motivation for global health?
Increased awareness of global health disparities and wanting to make a difference
What is global health?
The health of the global population, so it involves interdependence, transnational, clinical care, wider aspects of health and all disciplines and sectors
How is global health different from international health?
International health is defined by geography, problems and a donor- recipient relationship, whereas global health is a interdependent all working together to improve everyones health
What are some pitfalls of global health?
Practical issues, security, ethics, human rights, governance
What is the ABCDE method of breaking bad news?
Advance preparation Build a relationship Communicate well Deal with patient reactions Encourage and validate emotions
What is the SPIKES method?
Setting up Perception Invitation Knowledge Emotions Strategy and summary
What are the top 5 most common cancers worldwide?
Lung Breast Colorectal Stomach Prostate
What are the top 5 most common cancers in the UK?
Breast Prostate Lung Bowel Malignant melanoma
What are the top 5 cancers in men in the UK?
Prostate Bowel Lung Bladder Kidney
What are the top 5 most common cancers in women in the UK?
Breast Lung Bowel Uterine Malignant melanoma
What are the top 5 cancer deaths worldwide?
Lung Stomach Liver Breast Colorectal
What are the top 5 cancer deaths in the UK?
Lung Colorectal Breast Prostate Pancreas
What are the most common childhood cancers?
Leukaemia
Lymphoma
Brain tumours
What are the different types of prevention?
Primary- reduce exposure/ stop you getting disease
Secondary- early disease detection
Tertiary- Improve quality of life in someone with disease
What are the functions of a clinical record?
Support patient care Financial planning Medico-legal documents Audits Helps future patient care Helps monitoring of condition Helps diagnosis and treatment Allows for continuity of care
What does the Calman-Hine plan involve?
All patients have access to a uniformly high quality of care
Public and professional education to recognise early cancer symptoms
Patients, families and carers should be given clear information about treatment options and outcomes
Development of cancer services should be patient centred
Primary care to be central to cancer care
Psychosocial needs of sufferers need to be recognised
Cancer registration and monitoring of outcomes is essential
What are the NHS cancer aims?
Save more lives
Ensure people get right care, support and treatment
Tackle health inequalities- unskilled workers are 2x more likely to die from cancer
Build for future through investing in cancer workforce
What did the cancer reform strategy 2007 focus on?
Prevention Diagnosing cancer earlier Ensuring better treatment Living with and beyond cancer Reducing cancer inequalities Delivering care in most appropriate setting
What is the NAEDI hypothesis?
Hypothesis as to why we have late cancer diagnoses: Low awareness of symptoms Difficulty accessing primary care Negative beliefs about cancer Low uptake of screening Barriers to help seeking Age/ sex/ ethnicity etc.
What was Improving outcomes- a strategy for cancer 2011 focused on?
Prevention and early diagnosis
Quality of life and patient experience
Better Treatments
Reducing Inequalities
What did reducing inequalities patient survey 2010 show?
Men generally have a more positive experience
White people have a better experience than ethnic minorities
Younger people have worse experience
LGBT have worse experience
Disabled people have worse experience
Rare cancer type have worse experience
No real link between deprivation and patient experience
What was the purpose of the independent cancer taskforce 2015?
Spearhead radical upgrade in prevention and public health
Drive national ambition for early diagnosis
Transform approach to support people with cancer
Invest to improve services
What is the basic reproductive number? R0
The average number of individuals directly infected by an infectious case during the infectious period in a totally susceptible population
What does the basic reproductive number depend on?
Length of time a disease is infectious for
Number of contacts a case has with susceptible hosts
Chance of transmitting infection during an encounter with a susceptible host
Therefore it may differ for different diseases in the same population, or for the same disease in a different population
What is the effective reproductive number R?
Actual average of secondary cases per primary case observed in a population
How is the effective reproductive number R calculated?
R = R0 X S
Where S is the susceptible population, so in a place with no measures in place then R will be the same as R0, but if some people have been vaccinated then R will be lower than R0
