Public Health

Question 1

What is Public Health ?

Answer 1

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

Question 2

What is Equity ?

Answer 2

Giving people what they need to achieve equal outcomes

Question 3

What is equality ?

Answer 3

giving everyone the same rights, opportunities and resources

Question 4

what is horizontal equity ?

Answer 4

equal treatment for people with equal health care needs
(e.g. same treatment used for penuomina in different patients in same severity)

Question 5

what is vertical equity ?

Answer 5

Unequal treatment for unequal health care needs
(Different treatments used in less severe vs. more severe pneumonias)

Question 6

what is the inverse care law ?

Answer 6

availability of health care tends to vary inversely with its need

Question 7

What acronym can be used for determinants of health ? what are these ?

Answer 7

PROGRESS
- Place of residence
- Race
- Occupation
- Gender
- Religion
- Education
- Socio-economic
- Social capital

Question 8

What are the 3 domains of public health practice ? expalin bit

Answer 8

• Health improvement (preventing disease, promoting health)
• Health protection (control infectious disease)
• Improving services (safe and high quality services)

Question 9

What 2 systems can be used to assess quality of healthcare ?

Answer 9

• maxwells dimensions of the quality of healthcare
• structure, process, outcome

Question 10

What 3 factors contribute to a health needs assessment ?

Answer 10

• Need (ability to benefit for an intervention)
• Demand (what people ask for)
• Supply (what is provided)

Question 11

What is an epidemiological perspective of health needs assessment ?

Answer 11

looks at size of pop, services available

Question 12

What is a comparative perspective of health needs assessment ?

Answer 12

compares services/outcomes received by a population with others (could compare different areas or patients or ages)

Question 13

What is a corporate perspective of health needs assessment ?

Answer 13

ask local population what their health needs are (use focus groups, interviews)

Question 14

What is an egalitarian medical mindset ? pros ? cons?

Answer 14

Provide all care that is necessary and required for everyone
- Pros: equal
- Cons: too expensive

Question 15

What is an Maximising medical mindset ? pros ? cons?

Answer 15

act is evaluated solely in terms of its consequences
- pros: resources allocated to those who are most likely to benefit form it
- Cons: those who don’t make the cut receive nothing

Question 16

What is an Libertarian medical mindset ? pros ? cons?

Answer 16

Each is responsible for their own health
- Pros: promotes positive engagment
- Cons: most diseases are not self inflicted

Question 17

What is primary prevention ? example

Answer 17

preventing the disease form occurring in the first place
(vaccine)

Question 18

what is secondary prevention ? example

Answer 18

early identification of th eidsease to alter disease course
(screening)

Question 19

what is tertiary prevention ? example

Answer 19

limit consequences of established disease
(prevent worsening renal function in CKD)

Question 20

Disadvantages of screening ? (3)

Answer 20

• exposure of well individuals to distressing diagnostic tests
• Detection and treatment of sub-clinical disease that wouldn’t have caused a problem
• preventive interventions that may cause harm to individual

Question 21

What are the 5 young people and adult screening programmes ?

Answer 21

• AAA screening
• Bowel cancer screening
• Breast cancer screening
• Cervical screening
• Diabetic eye screening

Question 22

What criteria used to determine to screen something ? describe this criteria

Answer 22

Wilson and Junger Criteria (INASEP - In Exam Season NAP)
- Important disease
- Natural history of disease understood (eg known disease marker)
- Acceptable to public (not too invasive)
- Simple, safe precise test
- Effective treatment (early outcome has better outcomes)
- policy agreed on who to treat

Question 23

What is sensitivity ?

Answer 23

proportion of those with disease who are correctly identified

Question 24

what is specificity ?

Answer 24

proportion of people without disease who are correctly excluded by screening test

Question 25

What is the hierarchy of evidence ? what are at the top ?

Answer 25

- systematic reviews and meta analysis - RCT - Cohort studies - Case controlled studies, cross sectional studies - case series - expert opinions

Question 26

What is a case-control study ? advantage? disadvantage ?

Answer 26

retrospective, observational study looking at cause of disease. compares molar participation with dies to controls without - pros: good for rare outcomes, can investigate multiple exposures - cons: difficultés finding control to match with case, prone to selection bias

Question 27

What is cross-sectional study ? pros ? cons?

Answer 27

retrospective observational collects data from a population at a specific point intake "snapshot) - Pros: quick and cheap, provide dat on preveane at single point - cons: risk of reverse causality, cannot measure incidence

Question 28

What is a cohort study ? pros? cons ?

Answer 28

Prospective longitudinal study looking at separate cohort with different treatments of exposures - pros: can follow up group with a rare exposure - cons: takes a long time, people drop out

Question 29

What is a randomised control trial ? pros ? cons ?

Answer 29

prosecute study, all participants randomly assigned exposure or control intervention - pros: low risk of bias and confounding, can infer causality - cons: time consuming, drop outs, inclusion criteria may exclude some populations

Question 30

What is an ecological study ?

Answer 30

look sat the prevalence of the disease over time (population data rather than individual) - shows prevelance and association but not causation

Question 31

What is the Bradford-hill criteria ? describe

Answer 31

group of nine principles that can be useful in establishing epidemiologic evidence of a causal relationship between a presumed cause and an observed effect

Question 32

What are the factors in the Bradford-hill criteria ? (9)

Answer 32

- strength (stronger association between exposure and outcome) - Temporality ( exposure prior to outcome) - coherence - consistency (same results from various studies) - Plausibility - Analogy - Dose response - Reversibility - Specificity

Question 32

What is incidence ?

Answer 32

Number of new cases over a certain time period

Question 33

what is prevalence ?

Answer 33

the number of people iwht a disease at a certain point in time

Question 34

What is health behaviour ?

Answer 34

aimed to prevent disease (regular exercise)

Question 35

what is illness behaviour ?

Answer 35

aimed to seek remedy (going to the doctor)

Question 36

what is the sick role behaviour ?

Answer 36

aimed at getting well (taking medication)

Question 37

name some models of behaviour change ? (5)

Answer 37

- health belief model - theory of planned bahaviour - stages of change/trantheoretical model - social norms theory - motivational interviewing

Question 38

What is the health belief model

Answer 38

example of model of behaviour change - Indiciduals change their behaviour if: believe susceptible to the condition, there are serious consequences, taking carton reduces susceptibility, benefits of action outweigh cost

Question 39

What is the theory of planned behaviour ?

Answer 39

example of model of behaviour change - takes into account: person attitude, perceived social pressure (subjective norm) and their perceived behavioural control

Question 40

What are the stages of change (trans theoretical model) ?

Answer 40

- pre-contemplation - contemplation - preparation - Action - Maintenance - Relapse

Question 41

what is in mallows hierarchy of needs ?

Answer 41

TOP - self actualisation - esteem need - belongingness and love needs - safety needs - physiological needs BOTTOM