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3A :0 > Publc health > Flashcards

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

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
Q

what are teh 4 questios of medical negligance

A

was there a duty of care
was there a breach in the dty
was teh oatietn harmed
was this due o teh breach

26
Q

lists the types of medical negilgance errors

A

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

27
Q

define nerver event

A

serious, largely preventable patient safety incident that should not occur i preventative meausre shave been implicated

28
Q

defien screening and list 4 types

A

identifibg apperently well indiciduals who have or at risk of having a disease

bowel cancer
newborn heal prick
cervical cancer
breast ancer

29
Q

what are teh criteria for a screening test

A

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

30
Q

cross sectional study design explain and exaulate

A

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

31
Q

case contral study design explain and evaulaet

A

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

32
Q

cohort study explaina dn evaluate

A

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

33
Q

RCT study exlana nd evaulate

A

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

33
Q

define bias and what are teh 3 types

A

= 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

34
Q

defne epdemology

A
35
Q

defne thses terms:
incidene
prevelane
absoloe risk
relatve risk
#attributable risk

A

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

36
Q

what is teh criterisa for causality and 3 parts of it

A

bradford hill criteria

strength
dose response - does a higher dose prodice a higher incidence
reversability does removing teh exposure reduce risk of disease

37
Q

what areteh 2 approaches to prevention

A

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

38
Q

what s teh rpeventoin paradox

A

apreventatve measure a beinf much benefit to teh ppulation overall but offere little benefit to ech particiating individual individually

39
Q

types of screening

A

populaiton based
oportunistic
screenig for communicable disease
pre-employment medicals
comerically provided screening

40
Q

what is teh criteria for screening and the different factors

A

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
Q

define positive predicative vlue and negative predicative value

A

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
Q

define specificity and sensitivity

A

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
Q

how to work out sensitivity, specificity, psotiive predicinve value and negative predeicative valuev

A

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
Q

what s teh bucet model of erroe

A

slef - poor nowledge, fatgue, feeling unwell

CONTEXT - dstracton poor handover lac of team support eqpment

TAS - erroes tas complexty new tas

45
Q
A

3A :0 (8 decks)

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