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PPS Flashcards

1
Q

What is allocation theory based on??

A

egalitarianism
libertarian
maximising

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2
Q

What is egalitarianism

A

Require all care that is necessary and appropriate to everyone – equal access

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3
Q

What are maximising principles?

A

Criteria that maximise public utility

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4
Q

What are libertarian principles?

A

Each is responsible for their own health, well being and fufillment of life plan

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5
Q

What ethical issues does sustainability highlight

A

autonomy and justice

as those who have to deal with effects less likely to have caused them

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6
Q

what is sustainability?

A

Sustainability is using environment as we need while preserving for future generations.
What is the rule of rescue?

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7
Q

What is the rule of rescue?

A

ethical imperative to save an individual life

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8
Q

What is a con of rule to rescue?

A

resources could be spent better to save more lives rather than just focusing on the one

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9
Q

What are duties of a doctor?

A

Make care of patient your first concern, take prompt action if you think patient safety, dignity or comfort compromised and be honest and open and act with integrity.

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10
Q

Why do things go wrong?

A

human error
neglect
poor performance
misconduct

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11
Q

What causes human error?

A

poor communication or judgement
plus lapses
omissions
violations

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12
Q

What is neglect?

A

falling below accepted standard
repeat minor mistakes and culture of not caring
care is withheld, nutritional and personal care and medical care not to standard and pt not safeguarded

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13
Q

What is poor performance?

A

problem of attitude, failure to learn from mistakes and listen to advice

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14
Q

What is misconduct?

A

deliberate harm
lack of candour
fraud/theft and improper relationship

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15
Q

What is medical negligence?

A

outcome of court case
civil claim
balance of probabilities
liable not guilty

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16
Q

what are the four tests that must be passed to not be medically negligent?

A

duty of care - who takes responsibility for the failing
breach in duty (Bolam and Bolitho test)
patient come to harm?
breach cause harm?

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17
Q

what is the Bolam test?

A

would a group of reasonable doctors do the same?

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18
Q

what is the Bolitho test?

A

would it be reasonable of them to do so - decided by the court

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19
Q

how does the court decide what costs to award?

A

loss of income
cost of care
pain and suffering

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20
Q

what is intuitive decision making?

A

ability to understand something instantly w/o conscious reasoning
often relies on pattern recognition, one part of dual process theory

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21
Q

What is dual process theory?

A

consist of an implicit (automatic), unconscious process and an explicit (controlled), conscious process.

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22
Q

what is heuristics

A

cognitive shortcuts
examples: availability (what you know well)
anchoring (suggested reference point, make diagnosis based on that point because its what you know)
representativeness

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23
Q

What are the biases in intuitive thinking?

A
  1. over attachment - confirmation bias, premature closure
  2. failure to consider alternative - search satis
  3. inheriting thinking
  4. prevalence perception - availability bias, gamblers fallacy
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24
Q

what is availability bias?

A

type of mental shortcut that involves basing judgments on info and examples that quickly come to mind

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25
Q

what is gamblers fallacy?

A

To put it another way, it is the incorrect assumption that if a random outcome occurs more often than expected over a period of time then it is less likely to happen in the future.
example of coin toss

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26
Q

What is analytical thinking?

A

basis of EBM
good at measuring and calculating odds or values
second part of dual process theory

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27
Q

What are the advantages and disadvantages of analytical decision making?

A

advantages:
accurate, reliable
disadvantages:
slow, resource intensive and cognitively demanding

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28
Q

How do we reduce the risks of intuition?

A

decision environment
personal debiasing
structural debiasing

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29
Q

What is personal debiasing??

A

acknowledgement of bias and personal accountabiloity

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30
Q

What is structural debiasing?

A

training in dual process theory and structural forcing technique

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31
Q

What is consequentialism/utilitarianism?

A

act is evaluated solely on consequences

32
Q

What is virtue ethics

A

morality of an action is based on the character of the agent, focusing on compassion, discernment, trustworthiness, integrity, and conscientiousness

33
Q

What is deontology?

A

concerned with the actions not the consequences

34
Q

How does the law work with the doctrine of the double effect?

A

Normally, if you carry out an action knowing that X is a likely consequence of that act then the law regards you as intending to cause X.

35
Q

what are the five focal virtues?

A 
Compassion
Discernment
Trustworthiness
Integrity
Conscientiousness
36
Q

Give ethical analysis tools

A

seedhouse ethical grid

Four quadrants approach

37
Q

What is the seed house ethical grid based on?

A

moral theory

38
Q

What are the layers of the grid about generally?

A

inner - individuals
2nd - duties and motives
3rd consequence
4th external consideration

39
Q

What are the advantages of the seed house ethical grid?

A

Provides structure and coherence in a field in which it is lacking
Based on Moral theory
Can be used over time at different points in the research
Seems to embrace many of the ideas described elsewhere

40
Q

Explain the four quadrants approach

A
  1. medical indications
  2. Patient preferences
  3. Quality of life
  4. Contextual features - religious, cultural, legal factors
41
Q

What is the difference between compliance and concordance?

A

compliance - following medical advice

concordance - pt and professional coming to an agreement on rx

42
Q

what are barriers to concordance?

A

Patients may not want to disclose certain things to their doctor.
Patients may want doctors to tell them what to do.
Poor communication from healthcare professionals.
Time, resources or other organizational restraints.

43
Q

What are ways of improving concordance?

A 
Improving communication.
Increased patient involvement.
Understand the patient’s perspective.
Provide information.
Review medications.
44
Q

What is a neomaterialist epxlanation of inequalities in health?

A

that economic disadvantages account for the inequalities observed

45
Q

What are psychosocial explanations for health inequalities?

A

access to resources including social support and health care are key social determinants for such inequalities in health.

46
Q

What is standard deviation?

A

the measure of the average distance of data from the mean

47
Q

What is standard error?

A

a measure of how variable the mean will be if you repeat the study

48
Q

what is confidence interval?

A

where the true value is likely to lie - it describes the amount of uncertainty associated w a sample estimate of a population parameter

49
Q

what is social class

A

measure of occupation,stratificaiton, social position and access to power and resources

50
Q

What is Maslows triangle of needs?

A

describes heirarchical levels of human needs

51
Q

Describe the levels in mallows triangle

A 
physiological - breathing, food etc
safety 
love/belonging
esteem
self-actualisation - morality, creativity etc
52
Q

what are the 6 recommendations of the marmot review?

A
  1. Give every child the best start in life.
  2. Enable all children, young people and adults to maximize their capacities and have control over their lives.
  3. Create fair employment and good work for all.
  4. Ensure a healthy standard of living for all.
  5. Create and develop healthy and sustainable places and communities.
  6. Strengthen the role and impact of ill health prevention
53
Q

What is clinical significance?

A

one that is big enough to be worthwhile

sample size should be adequate to detect clinically significant result

54
Q

what is proportionate universalism

A

to reduce steepness of social gradient, action must be universal, but with a scale and intensity that is proportionate to the disadvantage

55
Q

what is sociology?

A

study of social relations and social processes

56
Q

what is sociology a measure of ?

A

social interdependencies

57
Q

what are risk factors for health inequality?

A 
PROGRESS
Place of Residence (rural, urban, etc.)
Race or ethnicity
Occupation
Gender
Religion
Education
Socioeconomic status
Social capital or resources
58
Q

what is health?

A

a state of complete physical, mental and social wellbeing. Not merely the absence of disease or infirmity

59
Q

what is article 2 of the human rights act?

A

right to life

60
Q

what is article 3 of the human rights act?

A

right to freedom from inhumane and degrading treatment

61
Q

what is article 8 of the human rights act?

A

Right to respect for privacy and family life

62
Q

what is article 12 of the human rights act?

A

right to marry and found a family

63
Q

what is article 14 of the human rights act?

A

right to freedom from discrimination

64
Q

What is health improvement?

A

Social interventions and preventing disease, promoting health and reducing inequalities

65
Q

what is health protection?

A

Measures to control infectious disease risk and environmental hazards

66
Q

What is improving service?S

A

Organization and delivery of safe high quality services

67
Q

What are the 5 geriatric giants?

A
  1. incontinence
  2. iatrogenic
  3. impaired homeostasis
  4. falls
  5. confusion
68
Q

How is diarrhoea in hospitals and nursing homes managed/

A 
SIGHT:
Suspect c.diff as a cause of diarrhea, isolate the case,
Gloves and aprons must be worn,
Hand washing with soap and water,
Test stool for toxin.
	Treat with Metronidazole or vancomycin
69
Q

What is the rx of suspected c. diff

A

metronidazole or vancomycin

70
Q

What is criteria for a pandemic spread?

A
  1. A novel virus
  2. Capable of infecting humans
  3. Capable of causing human illness
  4. Large pool of susceptible people
  5. Ready and sustainable transmission from person to person
71
Q

What are phases of a pandemic

A

1-3 (animal infections w few human inf
4 - sustained human-human transmission
5-6 widespread human infection
post peak - possibility of recurrent events
post pandemic - disease returns to seasonal levels

72
Q

Which strain of influenza causes pandemics and which causes seasonal influenza?

A

A causes pandemics

B causes seasonal

73
Q

What is reproduction number r0

A

mean no. of secondary cases following a single infection

74
Q

What are the surface antigens of influenza?

A

haemagglutinin

neuraminidase

75
Q

Give examples of direct routes of transmission

A

STIs

faecal oral route

76
Q

give examples of indirect transmission

A

vector borne - malaria

vehicle borne - viral gastroenteritis

77
Q

Give examples of airborne transmission

A

resp route - TB

Public Health (12 decks)

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