Publc health Flashcards

1
Q

defne health

A

a state of complete mental and socal wellbeng not just the abscence of dsease

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2
Q

what are the three domans of public health

A

health protecton - nfecton nd enviomental
health imporvemt - preventng dease through social intervention
servce mporveent - safe hgh ualty servces for prevention, treatment and care

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3
Q

define health needs assesment

A

A systematic approach for reviewing the health issues affecting a population which leads to agreed priorities and resource allocation that will improve health and decrease inequalities

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4
Q

what is bradshaws taxonomy of socal need

A

FENC

felt - ndvdual perceptions of varaton from orla health

expressed - person seeks help to overcome variation in normal heaklth

normative - professonal defnees nterventon approprtate for teh expressed need

omperatve - comparton of serverty ranhe of interventions nad cost

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5
Q

defne teh nverese care law

A

the avalblty to good medal care tends to vary inversly with teh need for it in the populatino served - tudoir hart lancelet

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6
Q

what is teh difference bwteen need, demand and supply

A

need is th ability to benefit fromteh intervention

demand is what people want tna dask for

supply is what you provide

thbn of t le a venn dagram overlappng 4 ways

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7
Q

state and define teh 3 approaches to health needs assesment

A

epdemologcal - person place and tme of eth rpevelance of the disease

Comperatve- compares services recieved by one population to another

corperate - takes into account the views of groups with ant interests - pateitns, health professionalt, politicains, media

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8
Q

epdemilogial HNA limitations

A

data availabe may be poor
doesnt consider felt need
may be inadetate evidance base

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9
Q

HNA omparative limitations

A

data availble may vary in quality
hard o find complarabel populations
comparitsions migt not be prefect

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10
Q

HNA corperatelimitatiosn

A

hard to distinguish need from demand

grioups have vested intreest leading to bias

dominant indicuidulas may have undue inflence

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11
Q

what are teh layes of maslows hierachy of need

A

physiological
safety
love
esteem
self aculisation

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12
Q

what are teh three approaches to rescource allocation

A

egalitarian - provide all care that is necsasary and required to everyone

maximising - based solely on consequnce

libertarina- each person is responsible for theriowen health

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13
Q

define horiazontal and vertical equity

A

horizontal - equal treatmetn for equal need

vertical - unequal treatment for uneqal need - poor health areas needhigh expenditure

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14
Q

what are teh threee levels of ealth intervention

A

ecological - general interventions - banning smoking in public places

commnity - in a local commnity level not national

idividuak- childhood imunisatios

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15
Q

list and explain the different preventions catogries

A

primordial - prevent risk from developing in the healthy (laws taht penalise use of drugs

primary - prevention of prpbelem when teh risk exists (education and health promotion)

secondary - prevent progression of dieases in someone wh has it (needle exchange, safe injecting sights)

tertiary - has conditoin and trying to prevent worst outcome

quaternery - avoid over treatment by empowerig teh individla to seek thier own balance

0- risk
1 - disease
2 - progression
3 - severe
4- overtretment

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16
Q

what are maxwells dimensions for assesing te qualityof a service

A

access
equity
appropritte relevant need
aceptability
efficent
effective

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17
Q

what is teh transtheoretical mofel of health psychology

A

PC PAM!!!

precontemplation
contemplation
preparation
action
maintinance

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18
Q

advanategs and disadvantags of the transtheoretila model

A

+
acknowledges individual stages of readiness
accounts for relase
temporal element

  • some people skip stages
  • chanegs may be continous and not discrete
  • doestn consider vales - socail and cultural influences
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19
Q

what is teh theory of planned behavious

A

attitudes, subjective norms, perceved behaviour control

then intenetion to change

brigdeing teh gap- P PAIR
Preparatory actions
Perceived control
Anticipated regret
Implementation intentions
Relevance to self

then behaviour change

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20
Q

list teh models of behaviour change

A

trantheoretical - PC PAM

theory of planned behaviours - PPLAN

Health belief model

21
Q

theory of planned behaviours advantages and disadvantages

A

cna be applied ot wide vatiet
useful for predicting intentio
takes into accont the importnce of social pressures

no temporal affect diretio or causality
doesnt consider emptions
assumes atitudes cna be measured

22
Q

explain teh health belif model for behavioural change

A

perceived susceptability
percieved severity
health motivtin
percieved benefits
percieved barriers

likliood of acito
action

23
Q

evauate teh health belief model

A

+ wide variety of hea;lth behaviours
longest standing model
cues ot action are a uniqeue componenet

  • doesnt consider emoetion
  • doesnt differentiate between first tme and repeated behaviours
24
Q

what are teh 2 rules of medical negligance

A

bolam rule - would a reasonalbe doctor do teh same?

Bothilo rule - would that be resoanbl?

25
what are teh 4 questios of medical negligance
was there a duty of care was there a breach in the dty was teh oatietn harmed was this due o teh breach
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lists the types of medical negilgance errors
sloth - being too lazy lack of skill system erroe- technology falireu, lack of safeguarding mistreiage - over/under treating teh severit of eth situation ignorance bravado/timidity playing te odds - dismissig the rare poor team work communication break down fixation/ loss of perspective
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define nerver event
serious, largely preventable patient safety incident that should not occur i preventative meausre shave been implicated
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defien screening and list 4 types
identifibg apperently well indiciduals who have or at risk of having a disease bowel cancer newborn heal prick cervical cancer breast ancer
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what are teh criteria for a screening test
diseae: important natural history known early treatment better than late Test: acceptable to teh population facilities aviable simple, safe, preccise and vaildates outcoumes: cost benefit analysis treatmetn availeble ongoign feasability
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cross sectional study design explain and exaulate
Snapshot data of those with and without disease to find associations at a single point in time Quick and cheap Few ethical issues Prone to bias No time reference
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case contral study design explain and evaulaet
Retrospective observational study which looks at a certain exposure and compares similar participants with and without the disease Good for rare diseases Inexpensive Can only show association (not causation) Unreliable due to recall bias
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cohort study explaina dn evaluate
Longitudinal prospective study which takes a population of people recording their exposures and conditions they develop Can show causation Less chance of bias Large amount lost to follow up Expensive
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RCT study exlana nd evaulate
Similar participants randomly controlled to intervention or control groups to study the effect of the intervention Gold standard Can infer causality Less risk of bias/ confounders Time consuming and expensive Ethical issues can interfere
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define bias and what are teh 3 types
= a systematic error that results in a deviation from the true effect of an exposure on an outcome SIP Selection bias: discrepancy of who is involved Information bias: Measurement bias: different equipment Observer bias Recall bias: past events incorrectly remembered Reporting bias: responder doesn’t tell the truth Publication bias: some trials are more likely to be published than others
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defne epdemology
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defne thses terms: incidene prevelane absoloe risk relatve risk #attributable risk
incidene - number of new cases in a period of time prevelane - umber of exusngi cases in a poulation at one time absoloe risk - feel for actual numbers ncolved and has units relatve risk - risk in one catogy compaerd to anotehr wth no units #attributable risk - rate of diease in teh exposed taht can be attributed to teh exposure
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what is teh criterisa for causality and 3 parts of it
bradford hill criteria strength dose response - does a higher dose prodice a higher incidence reversability does removing teh exposure reduce risk of disease
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what areteh 2 approaches to prevention
population approach - preventative methods delovered to eeuones to shift eh risk factor distrbution curve high risk - idenify individials who are high rrks who are above a chosen cut off and treat them
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what s teh rpeventoin paradox
apreventatve measure a beinf much benefit to teh ppulation overall but offere little benefit to ech particiating individual individually
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types of screening
populaiton based oportunistic screenig for communicable disease pre-employment medicals comerically provided screening
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what is teh criteria for screening and the different factors
wilson and jungner odition: important natural history is known diease should have a laternet detectabel stahe test: simple, safe and preise valodated screenig should be accebtable to particicants an agreed polic on furtehr diagnsositc pro ess fr nidividualks wit a posative test resut TREATBENT: shoudl be an affectve treatment for teh condition that has better outcoes with earileir treatment agreed policy on what to treat SCREENING ongogn and not just ne off cost effetive
41
define positive predicative vlue and negative predicative value
proportionfo people with a positive tets result who actualky have teh disease negatie predicative value - proportionof people who have a negative resukt and acutually do not have teh duease
42
define specificity and sensitivity
specifictiy - proportion of teh people wihtout teh diease who are correctly excluded sensivity - proportion who have teh diease who are identified by teh screening test
43
how to work out sensitivity, specificity, psotiive predicinve value and negative predeicative valuev
sen - tru positive/(true postuve+ false negatve ) spec - true negative/ false positive +true negative PPV - true positive /true positive and flase positive NPV - true negative/ false negative and true negative
44
what s teh bucet model of erroe
slef - poor nowledge, fatgue, feeling unwell CONTEXT - dstracton poor handover lac of team support eqpment TAS - erroes tas complexty new tas
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bradford hll crtera
Strength (effect size): A small association does not mean that there is not a causal effect, though the larger the association, the more likely that it is causal. Consistency (reproducibility): Consistent findings observed by different persons in different places with different samples strengthens the likelihood of an effect. Specificity: Causation is likely if there is a very specific population at a specific site and disease with no other likely explanation. The more specific an association between a factor and an effect is, the bigger the probability of a causal relationship.[1] Temporality: The effect has to occur after the cause (and if there is an expected delay between the cause and expected effect, then the effect must occur after that delay). Biological gradient (dose–response relationship): Greater exposure should generally lead to greater incidence of the effect. However, in some cases, the mere presence of the factor can trigger the effect. In other cases, an inverse proportion is observed: greater exposure leads to lower incidence.[1] Plausibility: A plausible mechanism between cause and effect is helpful (but Hill noted that knowledge of the mechanism is limited by current knowledge). Coherence: Coherence between epidemiological and laboratory findings increases the likelihood of an effect. However, Hill noted that "lack of such [laboratory] evidence cannot nullify the epidemiological effect on associations". Experiment: "Occasionally it is possible to appeal to experimental evidence". Analogy: The use of analogies or similarities between the observed association and any other associations.
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