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Phase 3a Medicine🩺 > Public Health🦠 > Flashcards

Public Health🦠 Flashcards

1
Q

What is the Mental Capacity Act?

A

It applies to adults over the age of 16 and sets out who can take decisions if the patient becomes incapacitated

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2
Q

What is a lasting power of attorney?

A

The Act allows for a person to appoint an attorney to act on their behalf if they should lose capacity in the future, replacing the current enduring power of attorney.

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3
Q

What is an incidence rate?

A

Number of new cases of a disease over a specified period of time as a proportion of the population at the start of that period.
IP= (* of new cases/ total population)

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4
Q

What is potential years of life lost?

A

An estimate of the years an individual would have lived if they had not died prematurely.

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5
Q

What is disability adjusted life years (DALY)?

A

Number of health years lost due to disability.
DALY=years of life lost+years of life disabled.

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6
Q

Define epigenetics?

A

The expression of a genome depends on the environment

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7
Q

Define allostasis?

A

The same as homeostasis. The stability through change of our physiological systems to adapt rapidly to change in environment.

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8
Q

Define allostatic load?

A

Long-term overtaxation of our physiological systems leading to impaired health (stress)

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9
Q

Define salutogenesis?

A

Favourable physiological changes secondary to experiences which promote healing and health.

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10
Q

What are the three domains of public health?

A
  1. Health improvement
  2. Health protection
  3. Improving services
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11
Q

What is the domain of health improvement concerned with?

A

Societal interventions:
Inequalities
Education
Housing
Employment
Lifestyles
Family/community
Surveillance and monitoring of specific diseases and risk factors

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12
Q

What is the public health domain of health protection concerned with?

A

Measures to control infectious disease risks and environmental hazards:
Infectious diseases
Chemicals and poisons
Radiation
Emergency repsonse
Environmental health hazards

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13
Q

What is the public health domain of improving services concerned with?

A

Organisation and delivery of safe, high quality services for prevention, treatment and care:
Clinical effectiveness
Efficiency
Service planning
Audit and evaluation
Clinical governance
Equity

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14
Q

What needs to be done/performed before a health intervention is made?

A

Health needs assessment

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15
Q

What is a health needs assessment?

A
  • A systematic method for reviewing the health issues facing a population
  • Leading to agreed priorities and resource allocation that will improve health and reduce inequalities.
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16
Q

What are the 3 different approaches of health needs assessment?

A

Epidemiological
Comparative
Corporate

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17
Q

Define need?

A

Ability to benefit from an intervention

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18
Q

Define demand

A

What people ask for

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19
Q

Define supply

A

What is asked for

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20
Q

What is a health need and how is it measured?

A
  • A need for health
  • Measured using - mortality, morbidity, socio-demographic measures
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21
Q

What is the high risk approach to prevention?

A

Aims to identify individuals above a chosen cut-off and treat them

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22
Q

What is malnutrition?

A

Deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients

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23
Q

What is public health?

A

The science and art of preventing disease, prolonging life and promoting health through organised efforts of society

24
Q

What are the three domains of public health practice?

A

Health improvement
Health protection
Health care

25
What is a health needs assessment?
Systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities
26
What is health psychology?
Emphasises the role of psychological factors in the cause, progression and consequences of health and illness
27
What is the health belief model?
This is the longest standing model of behaviour change and is successful for a range of health behaviours. Perceived barriers have been demonstrated to be the most important factor for addressing behaviour change. Individuals will change if they believe: they are susceptible to the condition in question, that it has serious consequences, that taking action reduces susceptibility and that the benefits of taking action outweighs the costs
28
What are the issues with health belief model?
-Alternative factors may predict health behaviour such as outcome expectancy and self-efficacy. -Does not consider the influence of emotions on behaviour. -Does not differentiate between first time and repeat behaviours
29
What is the theory of planned behaviour?
It proposes the best predictor of behaviour is intention. Intention is determined by: - Persons attitudes to the behaviour - Perceived social pressure to undertake the pressure - Persons appraisal of their ability to perform the behaviour
30
What are stage models of health behaviour/transtheoretical model?
Stage theories see individuals located at discrete ordered stages, rather than a continuum. Each stage denotes a greater inclination to change outcome, typically behaviour than the previous one
31
What is the action of nicotine?
This mimics the action of acetylcholine and works on nicotinic receptors within the brain. Nicotine particularly acts on the ventral tegmental area, which is important in controlling motivation
32
What is Varenicline (Champix)?
This is a nicotinic acetylcholine receptor partial agonist. It is only available on prescription. It works by reducing the desire to smoke by acting on nicotinic receptors
33
What is Bupropion (Zyban)?
This is an atypical antidepressant which is only available on prescription. Its action is unknown but it's thought to act via its ability to inhibit the neuronal reuptake of dopamine and noradrenaline.
34
What biomarkers can you use for smoking?
-Expired air carbon monoxide (CO) -Saliva continine (a metabolite of nicotine)
35
What is a case control study?
-identification of patients who have the outcome of interest (cases) and control patients without the same outcome -the cases are then examined to see if they had the same exposure of interest -can be useful in determining causality
36
What is a cohort study?
involves identification of two groups (cohorts) of patients: - one that received the exposure of interest - one that does not (control group) these cohorts are then followed, and the outcome studied can be prospective (in the future) or retrospective (in the past)
37
What is the Bradford-hill criteria?
It is a criteria for establishing causality
38
What are some typical transition points for behaviour change according to NICE?
leaving school entering work becoming a parent becoming unemployed retirement bereavement
39
What is a never event?
A serious incident that is entirely preventable such as wrong site surgery
40
What is the definition of screening?
Identification of a population at increased risk of a disease and testing them for signs of disease
41
What is Bowel cancer screening and when does it occur?
Offered to everyone between the ages of 60 and 74 a home test kit is sent every 2 years
42
What is the FeverPAIN score?
Assesses the likelihood of streptococcal pharyngitis scoring: 1 point each - fever in the last 24 hours - purulent tonsils - symptoms started 3 or fewer days ago - severely inflamed tonsils - §no cough or coryza interpreting score: 0 – 1: unlikely 2 – 3: delay antibiotics 4 – 5: prescription of empirical antibiotics (amoxicillin)
43
How do you calculate pack years?
Pack years = (Cigarettes per day/Pack size) / Years
44
What are the 3 core principles of the NHS?
- That it meets the needs of everyone - That it is free at the point of delivery - That it is based on clinical need, not the ability to pay
45
What is Inverse care law?
The principle that the available of good medical or social care tends to vary inversely with the need of the population served
46
What did the Marmot review show 10 years on?
- More deprived the area, the shorter the life expectancy - Marked regional differences - Mortality rates are increasing for men and women aged 45-49 - Child poverty has increased - Rise in homelessness
47
What are the five stages of Maslow's Hierarchy of needs?
Physiological, safety, love/belonging, esteem, self-actualization
48
What is negligence?
- A court's ruling on standard of care - Remedy is compensation for the patient, not punishment for the doctor - Liable, not guilty - Outcomes feeds into what employer knows about the doctor
49
What is prevention paradox?
Preventative measure which brings benefit to a population may offer little to each participating individual e.g. screening a large number of people to help only a small percentage.
50
How do you work out sensitivity?
True Positive/ True positive+ False negative
51
How do you work out specificity?
True negative/ True negative + False positive
52
How do you work out the positive predictive value?
True positive/ true positive + false positive
53
How do you work out the negative predictive value?
True negative/ True negative + False negative
54
What is lead-time bias?
Early detection and diagnosis makes it look like people are surviving longer so there is overestimation of survival duration
55
What are the transition points for changing behaviours?
- Becoming a parent - Leaving school - Becoming unemployed - Bereavement

Phase 3a Medicine🩺 (12 decks)

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