PMHP Flashcards
what is SIMD
Scottish index of multiple deprivation
it ranks data zones from most to least deprived - scale 1-10
it takes into account several factors of deprivation - geographic access to services, health, crime, income, housing, employment, education
what are the roles of epidemiology
assess risk of disease
measurement of distribution and amount of disease
study the causes and determinants for a disease
define incidence
number of new disease cases developing over specific period of time
define prevalence
number of disease cases within a population at a given time
what is the selective criteria for causal association called?
Bradford Hill Criteria
what are aspects of the Bradford Hill Criteria
strength of association
dose response
change in risk factor - reduction
time sequence
consistency
specificity - defined exposures
biological plausibility
experimental preventative trials
what are confounding variables
type of extraneous variable which for some reason has been left uncontrolled
what takes care of confounding variables
stratification
what is descriptive epidemiology
investigates patterns and trends NOT causes
it is hypothesis generating
what is ecological fallacy
when looking at trends of disease it geographical area, it assumes that everyone in that area is homogenous
define absolute risk
incidence rate of disease amongst people exposed to agent
define attributable risk
difference between the incidence rates in exposed group and the incidence rates of non exposed group
define relative risk
ratio of incidence rates in exposed group to non exposed group
it measures proportionate increase in disease rates of exposed group
what is a COHORT study
where you recruit a group of people who have NOT manifested a disease at the time of recruitment and assess risk factors
individuals are observed over time to measure frequency of occurrence of a disease among exposed and non exposed risk factor
what is a CASE-CONTROL study
retrospective study
where you compare individuals with disease with those without - trace back to assess risk factors
individuals are matched to eliminate bias
what are confidence intervals
measures range of values
it is the mean of your estimate +/- variation in that estimate if it does NOT include value of 0 = can be assumed that there is a statistically significant result
what it the P value
it mesures statistic significance
if P <0.05 = significant
the narrower the interval (CI) the smaller the P value
what are the standards developed to improve the reporting of RCTs
CONSORT
what is PICO
Population, Intervention, Comparison, Outcome
- it is the framework used to formulate research Qs
what are features of a RCT
- specific inclusion and exclusion criteria of participants
- there must be a control/comparison group
- random (generated by computer)
- blinded (participants and researchers = unaware)n
what are the 3 stages in managing NEGLECT
- preventive dental team management = raise concerns, offer support, document and monitor
- preventive multi-agency management = liaise with other professionals e.g. health visitor, school…
- child protection referral –> social services (contact via telephone + follow up in writing)
what is expected from the dental team when managing neglect
to:
-observe
- record
- communicate
- refer for assessment
NOT expected to diagnose
what are the 3As of smoking cessation
ASK - establish and record smoking status
ADVISE - on personal benefits
ACT - offer help + signpost to services e.g. pharmacy, local support groups, ASH Scotland
what are Qs you ask (smoking cessation)
would you like to seek help?
how many a day?
how long (years)?
what age did you start?
have you tried to quit? if so how many times?
what are the 5As for smoking cessation
ASK
ADVICE
ASSESS
ASSIST
ARRANGE (follow up)
what are examples of evidence based treatments for smoking cessation
NRT (nicotine replacement therapy)
Vareniciline
what is a periodontal phenomenon experienced by smokers when they quit
transient gingival bleeding due to revascularisation
what effects does smoking have on Oral Health
oral cancer
perio disease
increased risk for extraction + complications
halitosis
stained teeth
decreased healing ability
although e-cigs are better than smoking tobacco what are known problems with them
causes dry mouth
increased bacteria from sugar enriched vapour
increased risk for perio
what are 2 types of domestic abuse
situational couple violence - fighting/aggression (not involving control)
coercive and controlling behaviour
what are the stats for men and women experiencing domestic abuse (Scotland)
1 in 5 women
1 in 6 men
what are the age groups most at risk for domestic abuse
women - 16-24
men 16-19
what are ACES
adverse childhood events
- abuse
- neglect
- household dysfunction
70% of population have at least 1
what is gender based violence
violence directed against a person because of that person’s gender or violence that affects persons of a particular gender disproportionately.
a spectrum of various forms of abuse, not discrete but often interconnected
what is the optimal dose of fluoride in drinking water
approx 0.1mg/F
what are food and drink items that are naturally good sources for fluoride
black tea
wine
grape juice
raisins
crab
prawns
what are methods of topical fluoride application
fluoride varnish 22 600 ppm F
fluoridated gels (APF 12 300 ppm F)
fluoride mouthrinses - daily 0.05% 227 ppmF; weekly 0.2% 909 ppm F
high fluoride toothpaste
what are the mechanisms of topical fluoride that helps prevent caries
- enhances remineralisation - promotes deposition of Ca and PO4 ions in enamel (repair early stages of tooth decay)
- inhibits demineralisation - reduces acid production of bacteria in plaque
- formation of fluroapatite = more resistant to acid and demineralisation
what are the UK guidelines for F- tablets in children that have high risk caries
6m-3yrs 0.25mg F
3-6yrs 0.5mg F
>6yrs 1.0 mg F
what much F- ingested would risk fluorosis
0.1mg/F/kg bodyweight
how effective does fluoride mouthrinses reduce caries
by 30%
