public health Flashcards
what is the Gini coefficient?
a statistical representation of nation’s income distribution among its residents - the lower the coefficient the more equality
UK has rather high inequality compared to Scandavian countries
what is proportionate univerasalism?
focusing on the disadvantaged only will not help to reduce the inequality, action must be universal but with a scale and intensity proportional to the disadvantage
fair distribution of wealth is important
what are the domains of public health?
health protection
improving services
health improvement
addressing wider determinants of health
what does ad hominem mean?
responding to arguments by attacking someone’s character
what does begging the question mean?
assuming the initial point of the argument
what are motherhoods?
inserting a soft statement to disguise the disputable one e.g “all humans are equal”
what does no true scotsman mean?
modifying argument
no scotsman would do such thing
but this one did
well, no true Scotsman would
what are the 3 main notifiable diseases?
must be reported to WHO
cholera
yellow fever
plague
when can confidentiality be broken?
required by law
public at risk
individual in vulnerable to exploitation
patient consent
what is health behavioru?
aimed to prevent disease
what is illness behaviour?
aimed to seek remedy
what is the sick role behaviour?
aimed at getting well
what is the health belief model?
individuals must believe theh are suceptible to the condition
must beleive it has serious consequences
must believe takng action reduces their risks
must believe that the benefits of taking action outweigh the costs
what is the transtheoretical model?
1 precontemplation 2 contemplation 3 preparation 4 action 5 maintenance 6 relapse ???
define morality
concerned with the distinction between good and evil or right and wrong
define ethics
system of moral principles and a branch of philosophy which defines what is good for individuals and society
what is utilitarian/consequentialism?
an act is evaluated solely in term of its consequences,
maximising good and minimising bad
what are the 4 principles?
autonomy
benevolence
non-maleficence
justice
what are the GMC “duties of a doctor”?
protect and promote the health of patients and the public
provide good standard of practice and care
recognise and work within the limits of your competence
work with colleagues in the way that best serves patients interests
treat patients and individuals and respect their dignity
what are the challenges of ageing population?
strains on pension increasing demand for health care bigger need for trained health workforce increasing demand for long term care pervasive ageism (denying older people the rights and opportunities available for other adults)
what is intrinsic ageing?
natural, universal, inevitable
what is extrinsic ageing?
dependent on external factors, e.g. UV ray exposure, smoking, air pollution
why do women live longer?
20% biological - hormones protect from heart disease
80% environmental - more lifestyle risks
name 5 types of dementia?
alzheimers (most common) vascular mixed alzheimers and vascular lewy bodies fronto temporal
what is medicalisation of death?
where death is seen as a failure
what is the chain of infection?
susceptible host - low immunity, low white cell count
causative micro-organism
resevoir - where the spread originates
portal of entry/exit
mode of transmission: exogenous spread (direct/indirect contact, vector, airbourne)
endogenous spread (self spread)
how do you break chain of infection?
hand decontamination
disposal of clinical waste
standard infection control precautions
what is the 3As? for patient approach
ask
advice
assist
what is the digital divide?
the difference in access to information
what are the 3 leading causes of death in children in developing world?
pneumonia
diarrhoea
malaria
what are key foundations involved in global health?
rockefeller foundation
bill and melinda gates foundation
what are some examples of migrants?
asylum seekers, refugees, trafficked people
where are alot of asylum seekers from?
pakistan, iran, sri lanka, syria
where are alot of economic migrants from?
romania, poland, spain, italy, bulgaria
what are the goals of the NHS?
equity of access
reducing gap in health equalities
providing services for the vulnerable
ensuring the services are appropriate and accessible
define sustainability?
being able to define the needs of today without compromising the ability of future generations to meet the needs of tomorrow
what is the Bradford hill criteria?
a group of minimal conditions necessary to provide adequate evidence for a causal relationship
strength consistency specificity temporality biological gradient coherence analogy
what is primary prevention?
to prevent a disease from occurring
what is secondary prevention?
detection of early disease in order to alter the course of the disease and maximise the chances of a complete recovery
tertiary prevention
what is sensitivity?
the proportion of people with the disease who are correctly identified by the screening test
what is specificity?
the number of people without the disease who are correctly excluded by the screening test
what is the positive predictive value?
the proportion of people with a positive test result who actually have the disease
what is the negative predictive value?
the proportion of people with a negative test result who do not have the disease
what is prevalance?
the proportion of a population found to have the disease
what is incidence?
the number of new cases within a specified time period divided by the size of the population initially at risk
what are the Wilson and Jungner criteria for screening?
should be serious health problem facilities for diagnosis and treatment avaliable detectable early accepted treatment no unmanageable extra clinical workload suitable test acceptable test for patients intervals for the test agreed policy on whom to treat cost balanced against the benefits
what are 3 types of bias?
selection bias
lead time
length time
what is selection bias?
people who choose to participate in screening programmes may be different from those who do not
what is lead time bias
screening merely identifies the disease earlier than before and thus gives the impression that survival is prolonged (but is unchanged)
what is length time bias?
diseases with longer periods of presentation are more likely to be detected than those with shorter time of presentation
what are the 3 human error types?
omission
commission
negligence
what are errors of omission?
required action delayed / not taken
what are errors of commission?
wrong action is taken
what are errors of negligence?
actions or omissions do not meet the standard of an ordinary, skilled persons professing
what are routine violations?
cutting corners
what is the SBAR checklist?
when reporting a case S - situation B - background A - assessment R - recommendation
what is the mental health WHO definition?
state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is bale to make a contribution to his or her community
what are some common mental health problems?
depression anxiety panic disorders phobias OCD PTSD
why are CMHPs dangerous?
negative impact on quality of life
increase risk of physical illness
increased mortality from physical illness
depression is a major risk factor for suicide
what are 4 types of stressors?
acute - noise danger infections injuries hunger
chronic - health home finances work family
physical - inflammation infection
psychological - attitudes believes personal expectations worries
what is spleens response to stress?
more RBCs are discharged
what is mouths response to stress?
drier as saliva and mucus dry up
what is immune systems response to stress?
WBCs redistributed
what is skins response to stress?
blood flow directed away to support skeletal muscles and heart
what occurs during the general adaptation syndrome?
alarm - when threat/stressor identified
adaptation - defensive countermeasures engaged
exhaustion - body begins to run out of defensive
what are the 5 signs of stress?
biochemical physiological behavioural cognitive emotional
what occurs during physiological stress?
shallow breathing, raised BP, more HCL produced
what occurs during behavioural stress?
over-eating, anorexia, insomnia, more alcohol or smoking
what occurs during cognitive stress?
negative thoughts, no concentration, worse memory, tension headaches
what occurs during emotional stress?
mood swings, irritability, aggression, boredom, apathy, tearfulness
what is reactive reactions?
defending NHS rep
what is proactive actions?
improving and protecting population health
causes of obesity?
car culture
americanization of diet and society
greater avaliability of energy dense food, cheaper
replacing water with sugary drinks
genetic cause of obestiy?
prader willi syndrome
what is satiation?
what brings an eating episode to an end
what is satiety?
inter-meal period
what is energy compensation?
the adjustment of energy intake following the ingestion of a particular food
energy compensation is lower with liquids than solids (except of soup)
what are the 4 main STIs?
chlamydia
gonorrhoea (drug resistance)
syphilis
trichomoniasis
what are HIV safety ABC?
abstain
be faithful
condom use
what must sexual and reproductive health eduction do?
involve young people as they are key decision makers
provide comprehensive, accurate info
address barriers to accessing health services
empower adolescents to make life choices that are best for them
what does CAM stand for?
complementary and alternative medicine
what are the big 5 NHS CAM?
acupuncture chiropractic therapy homeopathy herbal medicine osteopathy
what are major concerns of CAM?
unrealistic expectations
delayed conventional care
general safety
what is equity?
fair distribution of goods and services based on individual need
what is equality?
fair distribution of goods and services
what is the basic economic problem?
resources are finite
desire for good and services is infinite
no country treats all treatable ill health
choice cannot be avoided
what is opportunity cost?
the loss of other alternatives when one alternative is chosen
what is economic efficiency?
achieved when resources are allocated between activities in such a ways as to maximise benefit
what is economic evaluation?
the method used to see whether economics benefited max
what are 3 types of economic evaluation?
cost-effectiveness analysis
cost-utility analysis
cost-benefit analysis
what is cost-effectiveness analysis?
outcomes measured in natural units: incremental cost per life year gained
what is cost-utility analysis?
measured in quality adjusted life years: incremental cost per QALY gained
what is cost-benefit analysis?
outcomes measured in monetary units: net monetary benefit
