PMHP Flashcards
3 main skills in communication needs with patients?
- Telling expert advice
- Listening
- Reasoning
4 main communication skills with patients when asking CO history for example? OARS
4 stages for behavioural change management?
RARR
What should you do if an individual has decided they cannot quit their addiction?
Advise to cut down to reduce harmful risks
Why are E-Cigs used? - benefits to user
- Aid smoking cessation
- Less toxic
- cheaper
- Can use where cig banned
Pros and cons of E-cigs for public health?
5 stages for a clinician helping a patient with smoking cessation?
AAA AA
- ASK
- how many a day (measurement = 20 [1pack] /day = 1 pack year)
- when started
- what product (roll up / cig)
- tried to quit before (how many times / what helped / want help now?) - ADVISE
- on personal benefit from examination and general health - assess
- person willing to quit this time (two factors - confidence and willingness)
(ACT):
4. assist
- send in direction of pharmacist / help groups
- arrange
oral effects of smoking
Smoking cessation products
nicotine withdrawal symptoms
benefits of quitting smoking to patient
What is a critical appraisal? and what are the 3 things to consider while doing this? and when would this be done?
- Process of assessing and interpreting evidence by considering its:
1. validity- Focused Q (PICO)
- conduct of study
- well randomised
- finish with everyone started with
- did they know what treatment they got
- groups equally treated
- results
- effect of treatment
- relevance
- link to what your looking for
- to compare quality of outcome of different types of treatment for the same issue (i.e. carious tooth, hall technique or composite success rate)
What is the tool used to help critically appraise trials and what does it help with?
CASP (critical appraisal skills programme)
helps make sense of trials and thus compare two outcomes
what is the pneumonic used for finding papers when doing a critical appraisal? and what are the 4 definitions of each letter?
PICO
population
- how describe group of people intervention is for
Intervention
- What is the new thing being done to patient
Comparison
- what current treatment comparing intervention to
outcome
- desired or undesired
example:
What are the 3 factors involved in ensuring the results of a clinical trial are sufficient? (Statistics)
what is a care bundle in improvement of dental systems?
Way of improving the system to help the patient and thus the outcome
example
what is done for water fluoridation and what is its purpose?
- adjust water fluoride conc. to 0.5-1.2ppm (depends on climate as drink more)
- by adding hydrofluorosilic acid / hexafluosilicic acid / sodium fluorosilicate / sodium silcofluoride
- to decrease caries prevalence while preventing fluorosis
what is done for water fluoridation and what is its purpose?
- adjust water fluoride conc. to 0.5-1.2ppm (depends on climate as drink more)
- by adding hydrofluorosilic acid / hexafluosilicic acid / sodium fluorosilicate / sodium silcofluoride
- to decrease caries prevalence while preventing fluorosis
UK legalisation effecting water fluoridation and reviews that have taken place
Also Catfish study
what is Scotlands alternative to fluoridating the water supply now?
Focusing on Childsmile while reviewing english progression
CATFISH study for water fluoridation:
1. what is it reviewing (2)
2. why being done
3. results
Error in healthcare:
1. causes (1 main one with 4 sub sections)
2. causes of risk
3. how to reduce errors
what was the main legal case in regards to consent that changed how consent was confirmed? and what happened? and what was the change to consent laws?
consent law now states ‘informed consent’ required
major legal cases in regards to consent in recent history?
Montgomary vs Lanarkshire health board (2015)
Role of GDP in regards to head and neck cancer
- early detection (soft tissue exams)
- photos, notes
- refer
- pre-treatment assessment
when to refer a patient for suspicion of head and neck cancer?
What is the name for the team of medical bodies working together for a cancer patient?
Multidisciplinary team (MDT)
Aim and Treatment by a GDP for a patient about to start head and neck cancer treatment?
And what is the specific oral hygiene advice given (5)
what are the oral effects of head and neck cancer treatment? (10)
Aim of Childsmile? why it was made? when was it made?
aim: improve oral health of scottish children and reduce inequalities in oral health and access to dental services
why:
- had 60% caries rate in children
- water fluoridation not an option
- advice was not not enough alone (ineffective on less affluent)
when: made in 2005, trialled from 2006 and made national in 2011
what are some of the upstream and downstream actions of childsmile
upstream:
- national / local policies
- legalisation
downstream:
- clinical prevention
- chair side OHI
- school dental health education
- media campaigns
What type of approach did the government take towards childsmile
theory based approach
what is done in the nursery child-smile programme? and hat are its positives and negatives?
what are other aspects of childsmile that dont link to child care
- caring for smiles for elderly
- dental practice visits
- working with disability services
what are the parts of childsmile for school and what are its benefits (similar to nursery)
what are the main 3 sectors covered by childsmile?
- school / nursery
- GDP
- community services
general alcohol information
- safest way to drink = 14 units a week and evenly over 3 days
- alcohol turns into acetaldehyde (carcinogenic part) then acetate then co2 and water
- antihistamines make stomach empty faster
- blood alcohol peaks 1 hr after consumption and declines over 4 hrs
- 90%metabolised in liver, 2-5% excreted in sweat/breath/urine
- women worse - smaller blood volume and alcohol assumed more before metabolised (as less dehydrogenase)
- effect on boy = anaesthetic, sedation, dopamine and serotonin
- genetic risk of alcoholism
possible negative effects of heavy drinking on body
- NCTSL (acidic alcohol/vomiting/reflux/brutism)
- hypertension
- liver problems
- vitamin deficiencies
- pancreatic disease
- osteoperosis / malacia
- poor wound healing
- epilepsy
- oral cancer
- xerostomia
- osteomyelitis
- stroke
- cardiac arrhythmias
- violence trauma
- dental trauma
1 unit : ml and percentages for different types of alcohol
- beer 4% 250ml
- spirit 40% 25ml
- wine 13% 76ml
- cider 4.5% 218ml
14 units = 6 pints, 6 wines, 14 shots
In behaviour science when is someone most open to change.
can in some way relate to the adverse effects of something:
- witnessing someone else’s negative effect
- experiencing their own negative effect
definition of domestic abuse? and the two types? who most at risk?
any form of physical, verbal, sexual, psychological or financial abuse - at home, elsewhere or ONLINE
types: situational couple violence and coercive and controlling behaviour violence
women 16-24 / long term illness or disability / mental health problem
what are types of coercive control in domestic abuse?
- isolation
- degredation
- micro-regulation of entire life
- often charming to everyone else
what is the purpose of ACES in children
Adverse childhood events (4 or more = more likely to be victim or perpetrator of violent abuse)
- abuse (physical, emotional, sexual)
- neglect (physical, emotional)
- household dysfunction (mental illness, relative in prison, mother treated bad, substance abuse, divorce)
signs of domestic abuse
- repeated injuries
- bruises at multiple stages of healing
- unlikely explanations for injury
- bruising: facial, neck, fingertip, behind ears
- delayed seeking for help for injury
- tries covering up
- can be trafficking
stages of AVDR in domestic abuse investigation? and what are supportive items you can give them?
ASK - about injury / abuse
VALIDATE - show your concern
DOCUMENT - quotes / photos
REFER - signpost to correct location / give call line details (card or covert lip-balm)
What is SIMD and what is it used for
Scottish Index of Multiple Deprivation
Used to target policies/resources at area with greatest need
What is a null hypothesis
When the two factors of a hypothesis have no significant difference (maybe a bad CI?)
Definition of prevalence and incidence
2 types of prevalence
Prevalence = number of cases of disease in specific population at specified period of time
Types = point prevalence (for specific point of time), and period prevalence (for specified period of time)
Incidence = rate of NEW cases of disease in a specific population over specific period of time
Dependence in addiction meaning
Dependence = state of relying on to feel normal / being controlled by
What are the 6 types of studies for research
- Observational uncontrolled studies
- what happens to a group of people being treated with something - Case/series report
- report on single patient / series of similar patients (to identify disease outcome - no control) - Cross sectional study
- observe specific population at a SPECIFIC POINT IN TIME - identify exposure and outcome at same time
CONTROLLED STUDY:
- Cohort study
- observe specific group of people over A PERIOD OF TIME and identify who gets disease and exposures (DIFFERENCE BETWEEN COHORT AND CROSS SECTIONAL) - Case control study
- study of people with a disease and suitable control group without disease (looks back at exposures to find cause) - RANDOMISED CONTROLLED STUDY
- gold standard - best results
- people randomly placed in two groups (control and intervention)
- design elements:
I - specify participants (inclusion/exclusion) - age, disease/severity, exact definitions (unambiguous)
II - control / comparison groups
III - randomisation.
IV - blinding/ masking
How to avoid bias in studies
- double blind (masking) - researchers and subjects don’t know who is placebo and who is not
- same people finish with that started with (all ethnicity etc)
- proper random selection, not selected from specific group
What is the gold standard study model?
What is the use of blinding / masking
Advantages and disadvantages
Randomised controlled trial (clinical trial)
Participant / researcher / assessor of outcome / data analyst / administrator - could treat person dif if know what group in
Good
- gives strongest and most direct evidence for something
- blinding = more true actual results (proven by as much as 40%)
Bad
- more difficult to design (ethical issues, cost)
- still chance of bias
- not suitable for all research questions
