PMHP Flashcards
what is capacity to benefit
the difference between the need for health and the need for healthcare
what is normative need and an example of this
professionally defined need
- patient has check up and is told they need a filling
what is felt need and give an example
patient’s perception of their need
- patient has toothache and thins they need treatment
what is expressed need and give an example
patient has toothache and turns up to emergency appointment
- felt need translated into action by using or requesting services
what is comparative need and give an example
comparing the health needs of similar groups of people
- town A had 3 dental practices and town B of the same size has 5
what is unmet need and give an example
differences between the health care provided and health care judged as necessary
- in X town there are 50,000 people and only 1 dentist
what are non-static influences on need, supply and demand that can change
time
person
place
what are the nine protected characteristics
age
disability
gender reassignment
marriage and civil partnership
pregnancy and maternity
race
religion or belief
sex
sexual orientation
name two examples of current influences on need in dentistry
aging population
immigration
name two examples of current influences on supply in dentistry
distribution of workforce
full time vs part time working
name two examples of current influences in demand in dentistry
NHS vs private
new advanced treatments
how is oral health need determined on an individual level
diagnosis and treatment
how are oral health needs determined at a population level
needs assessment
what is a health needs assessment
systematic method of identifying the public health, health needs of a population and making recommendations for changes to meet these needs
what are the four components of an oral health needs assessment
examine and describe the characteristics of the population
identifying the needs of the population
examine the current service provision
identify how gaps can be met
what is the purpose of OHNA
identify and quantify oral health needs
identify potential health gains
prioritise identified needs
inform the planning of services
what are the 6 elements to communication
understanding non-verbal
listening
engaging people to talk
asking questions
acknowledging other’s feelings
giving feedback
give 6 aspects of non-verbal communication
eye contact
body posture
body orientation
body movement
distraction
interest
what are the six emotions of facial expression
anger
disgust
fear
happy
sad
surprise
what are the 5As in the 5 Step Learning Curve of Evidence Based Dentistry
ask
align
acquire
appraise
apply
what does a peer reviewed research mean
the research has passed the scrutiny of other scientists and is considered valid, important and original
what is PICO
used when asking questions about research about to be undertaken
population
intervention
comparison
outcome
what system do you use to try to find relevant papers when you are unsure on what clinical technique to use
PICO
what are the four principles of health promotion
right to health
equity
empowerment
community participation
what are determinants of health
range of social, personal, economic and environmental factors that determine the health status of individuals
name an example of a whole population approach in dentistry
child smile - toothpaste packs to all children
name an example of a high risk approach in dentistry
toothbrushing in P1 and P2 in the most deprived 20% of schools
name 4 key oral health messages
reduce consumption and frequency of sugar
effective control of plaque and fluoride use
appropriate use of dental care
dont smoke and avoid excessive alcohol intake
what are the classifications of sugars
intrinsic
extrinsic - milk vs non-milk sugars
non milk sugars = fruit juices, recipe sugar, table sugar
what is needed for caries to progress
host
time
diet
microorganism
what is the Stephan curve
effect of carbohydrates on acid formation by dental plaque
what are extended duty dental nurses
dental nurses that have had additional training
they can give toothbrush instruction, fluoride varnish application
what are the 3 parts of childsmile
childsmile toothbrushing
childsmile nursery and school fluoride varnish
childsmile community and practice
what is part of the childsmile toothbrushing packs
every child receives toothbrush and toothpaste on at least 6 occasions by the age of 5
every child receives free flow drinking cup in the first year of life
what is the amount of toothpaste recommended for a) children up to 3 years and b) children aged 3 years and over
children under 3 = smear
children over 3 = pea sized
how much fluoride is used for nursery and primary 1 children
0.25ml
what is the concentration of fluoride in fluoride varnish
22, 600 ppmF
how much fluoride varnish is used for children in P2 and above
0.4ml
what type of consent is used for childrens participation in toothbrushing in school
negative consent - parents have to ask for their children not to take part
what type of consent is used for application of fluoride varnish in school settings
positive consent - parents have to agree to it
what are the two medical contra-indications for application of fluoride varnish
severe asthma (hospitalisation)
allergy to colophony
what are the four aspects of the behaviour change wheel
capability
motivation
opportunity
behaviour
what is COM-B model
in order to change their behaviour (b) the patient must have : capability (c), opportunity (o) and motivation (m)
what are BCTs
behaviour change techniques
what is the Ottawa charter
the first health promotion conference
name the 9 GDC standards
patients interests first
communicate effectively with patients
obtain valid consent
maintain and protect patient’s information
have clear and effective complaints procedure
work with colleagues for patient’s best interest
work within your professional knowledge and skills
raise concerns if your patients are at risk
personal behaviour maintains patient’s confidence in dentistry
what are the 4 medical principles
justice, respect for autonomy, beneficence, non-maleficence
what is AMCUR when associated with capacity
act
make
communicate
understand
retain memory
what is valid consent
with capacity
informed
voluntary
not coerced
not manipulated
what is included in the parental responsibility act
mothers automatically have parental responsibility
natural fathers acquire parental responsibility by being married to the mother
after may 2006 in scotland unmarried natural fathers acquire parental responsibility if they are registered on the birth certificate
name three situations when there can be lawful disclosure of confidential information
when patients give consent
when it is a requirement by law (court order)
when there is a compelling public interest
if a patient wants to have access to their dental records what is required
written request
what is risk
the chances of something happening
how do you calculate risk
number of events of interest divided by the total number of observations
what are odds
number of events of interest divided by the number without the event
what are starting and modified risks
the chances of the outcomes in the untreated and treated groups
what are contingency tables used for
using test group and placebo
the outcome of it not happening in one column
outcome of it happening in the other column
what is a risk of relative risk reduction
overestimate the benefit
what is the absolute risk reduction
the difference between the two values (treated vs untreated)
what is NNT
number needed to treat
the number of patients you would need to treat to prevent one patient from developing the disease
1 divided by the absolute risk difference
what is risk ratio
risk in treatment group divided by risk in control group
what is the value of no difference for absolute risk ratio
0 (you take the numbers away from each other)
what is the value of no difference for risk ratio
1 (as you divide the numbers by each other)
what do confidence intervals do
quantify the level of uncertainty in samples compared to the whole population
it is the range of values that a true population treatment effect is likely to lie
with regards to confidence intervals, when would there be insufficient evidence for a difference between treatment and control group
if it overlaps the value of no difference
value of no difference for ratio = 1
if 1 is not within the range = all good
difference between to quantities = 0
what are observational uncontrolled studies
researchers watch what happens to a group of people
no intervention
could be a group of patients being treated with a drug
controlled studies
what is the gold standard of study trials
randomised controlled trials
what are case report studies
report on single patient or series of patients with outcome of interest
no control group
name 1 advantage and 2 disadvantages of case report studies
identify new disease outcome
cannot demonstrate valid statistical associations
lack control group
what is a cross sectional study
observation of defined population at single point in time or time interval
used to estimate prevalence of disease
name 2 disadvantages of cross-sectional studies
cannot link causality
confounding variables
what is a case control study
study of people with a disease and a suitable group of people without the disease
then look back to see if key exposures can be identified
name 2 disadvantages of case control studies
confounding variables
recall bias
selection of controls
time relationships - did exposure occur before disease
what is a cohort study
establish group of individuals in population
measure exposures
follow over period of time
used for estimating incidence of disease and cause of disease
name 2 disadvantages of cohort studies
controls difficult to identifying
confounding variables
time consuming
what are randomised control trials
define population
inclusion and exclusion criteria
randomise for which treatment group patients go in
follow up at the end
what is the best type of trial to use when investigating the effectiveness or efficacy of a drug
randomised control trials
what are the four design elements of randomised controlled trials
exclusion/ inclusion criteria
comparison/ control groups
randomisation
blinding/ masking
why do we need control groups
people often get better on their own
what are disadvantages to randomised control trials
ethical issues - ie pregnancy
cost
feasibility
still some risk of bias
what is CONSORT
checklist of things required to be reported when using a randomised control trial
