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Anki 3a exports > Public health > Flashcards

Public health Flashcards

1
Q

Define public health

A

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

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2
Q

Define equity

A

Giving people what they need to achieve equal outcomes

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3
Q

Define equality

A

Giving everyone the same rights, opportunities and resources

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4
Q

Define horizontal equity

A

Equal treatments for people with equal healthcare needs

E.g. same tx used for pneumonia in different patients with the same severity of pneumonia

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5
Q

Define vertical equity

A

Unequal treatments for unequal health care needs

E.g. different treatments used in less severe vs more severe pneumonias

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6
Q

What is the inverse care law?

A

Availability of health care tends to vary inversely with its need

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7
Q

What are determinants of health?

A

Wide range of factors that influence a person’s health

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8
Q

Name some determinants for health

A

PROGRESS
Place of residence
Race
Occupation
Gender
Religion
Education
Socioeconomic
Social capital

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9
Q

What are the 3 domains of public health?

A

Health improvement
Health protection
Improving services/health care

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10
Q

What is meant by ‘health improvement’

A

Interventions aimed at promoting overall health-education, housing, employment

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11
Q

What is meant by ‘health protection’

A

Measures to control infectious disease and environment hazards-vaccination, radiation, emergency response

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12
Q

What is meant by ‘improving services’/health care

A

Organisation and delivery of safe, high quality services-clinical effectiveness, audit, etc

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13
Q

Name some frameworks used to assess the quality of healthcare

A

Maxwell’s dimensions of quality of healthcare
Structure, process, outcome

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14
Q

Describe Maxwell’s dimensions of quality of healthcare

A

3As and 3 Es

Acceptability
Accessibility
Appropriateness

Effectiveness
Efficiency
Equity

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15
Q

Give an example of a structure in the ‘structure, process, outcome’ framework

A

Number of hospitals, number of doctors etc

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16
Q

Give an example of a process in the ‘structure, process, outcome’ framework

A

Number of patients seen, number of tests done, number of surgeries done

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17
Q

Give an example of an outcome in the ‘structure, process, outcome’ framework

A

Number of deaths

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18
Q

What is a health needs assessment?

A

A systematic approach for reviewing health issues affecting a population in order to enable agreed priorities and resource allocation to improve health and reduce inequalities

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19
Q

What are the 3 main things taken into account in a health needs assessment?

A

Need: ability to benefit from an intervention
Demand: what people ask for
Supply: what is provided

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20
Q

Give an example of something that is supplied and demanded but not needed

A

Abx for a viral infection

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21
Q

Give an example of something that is demanded and needed but not supplied

A

Large waiting lists for procedures

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22
Q

Give an example of something that is needed and supplied but not demanded

A

Routine vaccinations

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23
Q

What are the types of needs in a health needs assessment

A

Felt need
Expressed need
Normative need
Comparative need

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24
Q

What is a ‘felt’ need? Give an example

A

Individual perceptions of variation form normal health-‘I feel unwell’, ‘My knee hurts’

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25
Q

What is an ‘expressed’ need? Give an example

A

Individual seeks help to overcome variation in normal health-goes to dr
E.g. going to the dentist for a toothache

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26
Q

What is a ‘normative’ need? Give an example

A

Professional defines intervention for the expressed need
E.g. Vaccinations, decision by surgeon that a patient needs an operation

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27
Q

What is a ‘comparative’ need? Give an example

A

Needs identified by comparing services received by one group vs another
E.g Rural village may identify need for a school if the neighbouring village has one

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28
Q

What are the 3 perspective of a health needs assessment?

A

Epidemiological
Comparative
Corporate

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29
Q

What does an epidemiological perspective of a health needs assessment look at?

A

1)Size of population-incidence/prevalence
2)Service available-prevention/treatment/care
3)Evidence base-(cost)effectiveness

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30
Q

What sources might be used when carrying out a epidemiological health needs assessment?

A

Disease registry
Admissions
GP databases

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31
Q

Name some advantages of using an epidemiological perspective to a health needs assessment

A

Uses existing data
Provides data on disease incidence/mortality/morbidity

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32
Q

Name some disadvantages of using an epidemiological perspective for a health needs assessment

A

Quality of data is variable
Data collected may not be data required
Does not consider felt needs/opinions of patients

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33
Q

Give an example of an epidemiological perspective

A

Looking at new incidence of measles in a certain town through GP records

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34
Q

What is involved in the comparative perspective of a health needs assessment?

A

Compares services/outcomes received by a population with others
Could compare different areas of patients of different ages etc

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35
Q

What does a comparative perspective of a health needs assessment look at?

A

Health status
Service provision
Outcomes

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36
Q

Name some advantages of using a comparative assessment for a health needs assessment

A

Quick and cheap if data available
Shows if services are better/worse than compared group

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37
Q

Name some disadvantages of using a comparative perspective for a health needs assessment

A

Can be difficult to find comparable population
Data may not be available/high quality

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38
Q

Give an example of a comparative perspective

A

Compare rated of CVD between town A and B

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39
Q

What is involved in a corporate perspective for a health needs assessment

A

Asks local populations what their health needs are
Uses focal groups, interview, public meetings
Wide variety of stakeholders

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40
Q

Name some advantages of using a corporate perspective for a health needs assessment

A

Based on felt and expressed needs of population
Recognises detailed knowledge and experience f those working with the population
Takes into account a wide range of views

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41
Q

Name some disadvantages of using a corporate perspective for a health needs assessment

A

Can be difficult to distinguish needs from demand
Groups may have vested interest
May have political agendas

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42
Q

Give an example of using a corporate perspective for a health needs assessment

A

Arrange focus group with patient from a GP surgery to discuss their views

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43
Q

Name some different approaches to resource allocation

A

Egalitarian: provide ALL care that is necessary and required for everyone(NHS)
Maximising: Act is evaluated solely in terms of its consequences(flu vaccine)
Libertarian: Each is responsible for their own health(private ehalthcare)

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44
Q

Name an advantage and disadvantage to an egalitarian approach to resource allocation

A

Good: equality
Bad: too expensive

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45
Q

Name an advantage and disadvantage to a maximising approach to resource allocation

A

Good: resources allocated to those most likely to benefit it
Bad: Those who don’t make the cut get nothing

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46
Q

Name an advantage and disadvantage to a libertarian approach to resource allocation

A

Good: promotes positive engagement
Bad: Most diseases are not self inflicted

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47
Q

What are the 3 kinds of prevention

A

Primary
Secondary
Tertiary

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48
Q

What is secondary prevention

A

Early identification of the disease to alter the disease course e.g screening, aspirin after a MI

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48
Q

What is primary prevention?

A

Preventing the disease from occurring in the first place
E.g. vaccination

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49
Q

What is tertiary prevention?

A

Limit consequences of established disease
E.g. prevent worsening renal function in CKD

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50
Q

What is a population approach to prevention

A

Delivered to everyone to shift the risk factor distribution curve
E.g. dietary salt reductions through legislation

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51
Q

What is a high risk approach to prevention?

A

ID all individuals above a chosen cut off an treat them
E.g. screening people for high BP and treating them

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52
Q

What is meant by the prevention paradox?

A

Preventative measure that brings much benefit to the population often offers little impact to each participating individual
E.g. mass immunisation

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53
Q

What is the purpose of screening?

A

ID apparently well individuals who have or at risk of developing a particular disease so you can have a real impact on the outcome

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54
Q

Name some disadvantages to screening

A

Exposure of well individuals to distressing/harmful diagnostic tests
Detection and treatment of sub-clinical disease that wouldn’t cause a problem
Preventative intervention that may cause harm to the individual or population

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55
Q

What screening programmes are done for pregnant women in the UK

A

Infectious diseases(hep B, syphilis, HIV)
Sickle cell and thalassaemia screening
Fetal anomaly screening(Down’s, Edward’s, Patau’s)

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56
Q

What screening programmes are in place for newborn babies?

A

NIPE(heart, eyes, hips, testes)
Hearing screening programme
Blood spot(sickle cell, CF, congenital hypothyroidism)

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57
Q

What screening programmes are done for young people and adults in the UK?

A

AAA screening
Bowel cancer
Breast cancer
Cervical screening
Diabetic eye screening

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58
Q

What criteria is used to determine if screening should be done for a disease?

A

Wilson and Jungner criteria

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59
Q

Describe the Wilson Jungner criteria

A

In Exam Season NAP
Important disease
Effective tx available
Simple and safe
Natural hx of disease known
Acceptable to patients
Policy on who to treat

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60
Q

Define sensitivity

A

Proportion of those with disease who are correctly identified
(If you have the disease, what are the chances the test will pick it up?)

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61
Q

Define specificity

A

Proportion of people without disease who are currently excluded by screening test
(If you don’t have the disease, what are the chances the test will tell you you don’t)

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62
Q

Define positive predictive value

A

Proportion of people with a positive test result who actually have the disease
(SNIP-Sensitivity is positive)

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63
Q

Define negative predictive value

A

Proportion of people with a negative test result who do not have the disease
SPIN)Sensitivity is negative)

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64
Q

What are predictive values influenced by?

A

Underlying prevalence

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65
Q

How do you calculate sensitivity?

A

people with the disease+positive screening/everyone who has the disease

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66
Q

How do you calculate specificity?

A

People with negative result who don’t have disease/everyone who doesn’t have the disease

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67
Q

How do you calculate the positive predictive value?

A

people with positive result who have the disease/everyone with a positive result

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68
Q

How do you calculate the negative predictive value

A

Those with negative result who don’t have disease/everyone who receives a negative result

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69
Q

Name 2 biases associated with screening

A

Length time bias
Lead time bias

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70
Q

What is length time bias?

A

Screening is more likely to detect slow-growing disease that has a long phase without symptoms-> appear to be survival benefit to screening even when early detection doesn’t improve outcomes

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71
Q

What is lead time bias?

A

Patients diagnosed appear to live longer because they know the have the disease for longer-> awareness of disease makes it falsely seem like early diagnosed patients live longer

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72
Q

Describe the hierarchy oof evidence

A

Editorials and expert opinions
Case series and case reports
Case-control studies and cross sectional studies
Cohort studies
RCT
Systematic review and met-analysis

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73
Q

Describe the features of a case-control study

A

Retrospective, observational study looking at the cause of disease
Compares similar participant with disease to controls without
‘Case’ and ‘control’: look for exposure in both cases and control group and see what the effects are

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74
Q

Name some advantages of a case-control study

A

Good for rare outcomes
Quicker than cohort or intervention studies(outcome already happened)
Can investigate multiple exposures

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75
Q

Name some disadvantages of a case-control study

A

Difficulties finding controls to match with case
Prone to selection and information bias

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76
Q

Describe the features of a cross-sectional study

A

Retrospective observational collects data from a population at a specific point in time ‘snapshot’
Prevalence of risk factors and disease itself

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77
Q

Name some advantages of a cross-sectional study

A

Relatively quick and cheap
Provide data on prevalence at single point in time
Good for surveillance and PH planning

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78
Q

Name some disadvantages of a cross-sectional study

A

Risk of reverse causality
Can’t measure incidence
Recall and response bias risk(may miss quick recovery)

79
Q

Describe the features of a cohort study

A

Prospective longitudinal study looking at separate cohorts with different treatments/exposures and waiting to see if disease occurs

80
Q

Name some advantages of a cohort study

A

Can follow up group with a rare exposure
Good for common and multiple outcomes-> establish disease risk and confounders
Less risk of selection and recall bias

81
Q

Name some disadvantages of a cohort study

A

Takes a long time
People drop out
Need large sample size, expensive and time consuming

82
Q

Describe the features of a randomised control trial

A

Prospective study, all participants randomly assigned exposure or control intervention

83
Q

Name some advantages of a RCT

A

Low risk of bias and confounding factors
Can infer causality

84
Q

Name some disadvantages of RCT

A

Time consuming, expensive
Drop outs
Inclusion criteria may exclude some populations

85
Q

Describe the features of an ecological study

A

Looks at prevalence of disease over time(population data rather than individual)
Can show prevalence and association but not causation

86
Q

What are ‘odds’ used for looking at?

A

Looking at binary outcomes: disease occurs or does not

87
Q

How do you work out odds?

A

Probability of an event occurring/probability of an event not occuring

88
Q

What is an odds ratio used for?

A

Compare the odds of an outcome occurring between two groups: usually the group with the exposure/treatment and a control group

89
Q

How do you work out odds ratio?

A

Odds of an event(Condition A)/Odds of an event(condition B-control group)

90
Q

What is an absolute risk?

A

Number of events(good or bad) in a treated(exposed) or control(non-exposed) group, divided by the total number of people in that group
Compared risk of health event between 2 groups

91
Q

How do you calculate the absolute risk reduction?

A

Absolute risk of events in control group-absolute risk of events in the treatment group

92
Q

How do you calculate relative risk?

A

Absolute risk(treatment)/absolute risk(control)

93
Q

How do you calculate relative risk reduction?

A

1-relative risk

94
Q

How do you calculate the number needed to treat?

A

1/absolute risk reduction

95
Q

What is meant by numbers needed to treat?

A

Number of pts needed to treat for one to benefit

96
Q

How do you calculate the number to harm?

A

1/(absolute risk in treatment group-absolute risk in control group

97
Q

What does relative risk not take into account?

A

Baseline risk

98
Q

Describe the to interpret relative risk and odds ratios

A

=1: no statistical difference between control and intervention
>1: control better
<1: intervention bettwe

99
Q

How should you interpret confidence intervals?

A

95% statistically significant

100
Q

Name some advantages of using an odds ratio

A

Very simple
Don’t need incidence
Binary outcome
Usually used in retrospective studies

101
Q

Name a disadvantage of using an odds ratio

A

Can overestimate risk in rare disease

102
Q

Name some features that might make yu use relative risk rather than odds ratio

A

Needs incidence of disease
Usually prospective, cross sectional, cohort and RCT
Able to examine and model a variable over time

103
Q

Name some different types of bias

A

Measurement bias
Observer bias
Recall bias
Reporting bias
Selection bias
etc

104
Q

What are the 4 types of information bias

A

Measurement bias
Observer bias
Recall bias
Reporting bias

105
Q

What is measurement bias?

A

Different equipment measuring differently

106
Q

What is observer bias

A

Observers expectations influence reporting

107
Q

What is recall bias

A

Past events not recalled correctly

108
Q

What is reporting bias?

A

People don’t tell the truth because od shame or judgement

109
Q

What is selection bias?

A

Bias in recruiting for a study
Some may be lost to follow up

110
Q

What is publication bias?

A

Trials with negative results less likely to be published

111
Q

What criteria is used for assessing causality?

A

Bradford-Hill criteria

112
Q

Describe the Bradford Hil criteroa

A

Strength
Temporality
Coherence
Consistency
Plausability
Analogy
Dose response
Reversibility
Specificity

113
Q

What is meant by strength in the Bradford hill criteria

A

The stronger the association between exposure and outcome, the less likely the relationship is due to a different factor
High relative risk

114
Q

What is meant by temporality in the bradford hill criteria

A

Most important
Exposure occurs before the outcome
Smoke before getting lung cancer

115
Q

What is meant by dose-response?

A

More risk of outcome with more exposure
Heavier smokers have higher risk of lung cancer

116
Q

What is reversibility with regards to the Bradford hill criteria

A

Removing the exposre decreases/eliminates risk
Stopping smoking reduces risk of lung cancer

117
Q

What is consistency with regards to the Bradford hill criteria

A

Association is seen in different areas, different study designs, in different subjects-repeatability

118
Q

What is plausability with regards to the Bradford hill criteria

A

Existence of reasonable biological mechanism for the cause and effect lends weight to the association

119
Q

What is meant by coherence with regards to the Bradford hill criteria

A

Logical consistency with other information

120
Q

What is meant by analogy with regards to the Bradford hill criteria

A

Similarity with other established cause effect relationships

121
Q

What is meant by specificity with regards to the Bradford hill criteria

A

Relationship is specific to outcome of interest

122
Q

What is a confounder?

A

Apparent association between an exposure and an outcome is actually the result of another factor

123
Q

Name some causes of association

A

Bias
Confounding factors
Chance
Reverse causality
True association-confirmed by Bradford hill criteria

124
Q

Define epidemiology

A

Study of frequency, determinants and distribution of diseases and health related states in populations in order to prevent and control disease

125
Q

Define incidence

A

Number of new cases over a certain time period

126
Q

Define prevalence

A

Number of people with a disease at a certain point in time

127
Q

Define person time

A

Measure of time at risk for all patients n the study
(1000 patients studied for 2.5 years: 2500 person years)

128
Q

What is the difference between incidence and prevalence?

A

Incidence: changes with time, new cases
Prevalence: number at a set time of existing cases

129
Q

If 30000 students are with the UHS, 3600 are currently diagnosed with asthma. 1000 new cases diagnosed. Calculate the incidence over the past 10 years and the prevalence

A

Incidence:
1000 cases per 30000 people per 10 years
(1000/30000) x 100=3.3% per 10 years

Prevalence:
(3600/30000) x 100=12%

130
Q

What are the 3 kinds of behaviors related to health?

A

Health behaviour-prevent disease-going to dr
Illness behaviour-seek remedy-going to the dr
Sick role behaviour-getting well-taking medication

131
Q

According to Weinstein why do people practice health damaging behaviour

A

Inaccurate perceptions of risk and susceptibility-‘unrealistic optimism’

132
Q

Name some things that influence the perceptions of risk

A

-Lack of personal experience with problem
-Belief that it is preventable by personal action
-Belief that if it hasn’t happened by now, it’s not likely to
-Belief that the problem is infrequent

133
Q

What are transition points?

A

Points at which interventions are thought to be more effective

134
Q

Name some transition points

A

Leaving school
Entering the workforce
Becoming a parent
Becoming unemployed
Retirement and bereavement

135
Q

Name some models of behaviour change

A

Health belief model
Theory of planned behaviour
Stages of change/transtheoretical model
Social norms theory
Motivational interviewing

136
Q

Describe the health belief model

A

Individuals will change their behaviour if they:
-Believe they are susceptible to the condition
-Believe in serious consequences
-Believe taking action reduces susceptibility
-Believe that the benefits of taking the action outweigh the costs

137
Q

Name some disadvantages of the health belief model

A

Doesn’t account for social cues in change of behaviour
Doesn’t consider influence of emotions
Doesn’t differential between first time and repeat behaviour

E.g. alcohol

138
Q

Describe the theory of planned behaviour

A

Best predictor of behaviour is ‘intention’
Main factors:
-Attitude
-Subjective norm
-Perceived behaviour control
-Behavioural intention

139
Q

Name some advantages of the theory of planned behaviour mdoel

A

Takes into acocunt social influence
Useful for predicting intentions but not for actual behaviours

140
Q

Describe the theory of planned behaviour using smoking as the example

A

-Attitude: I don’t think smoking is a good thing
-Subjective norm: most people who are important to me want me to give up smoking
-Perceived behavioural control: I believe I have the ability to give up smoking
Behavioral intention: I intend to give up smoking

141
Q

Describe the stages of change(transtheoretical model)

A

Pre-contemplation(no intention)
Contemplation(no commitment but aware of problem)
Preparation
Action
Maintenance
Relapse

142
Q

Name some advantages and disadvantages od the stages of change model

A

A: Acknowledges differing stages of readiness, allows relapse
D: People may skip changes, doesn’t take cultural views into account

143
Q

Describe the features of addiction

A

Craving
Tolerance
Compulsive drug seeking behaviour
Withdrawal

144
Q

What can you offer a newly presenting drug user?

A

Screening for blood borne viruses
Health check
Sexual health advice/contraception
Check vaccination history
Signposting to drug services

145
Q

What are the principles of treating drug users

A

Reduce harm to user, family and friends
Improve health
Stabilise life
Reduce crime

146
Q

What is positive and negative conditioning with regards to drug use

A

Positive conditioning: Addiction increases desire to use drug
Negative conditioning: People don’t quit due to unpleasant symptoms

147
Q

What receptors does heroin act on?

A

Opiate receptors

148
Q

Name the symptoms of heroin use

A

Euphoria
Miosis
Drowsiness

149
Q

Name the negative sx of heroin use

A

Dependence
Bad withdrawals
Nausea
Itching
Sweating
Constipation
Respiratory depression

150
Q

Name some medications used in opiate dtox

A

Methadone: used for transition-free, no theft, not injected
Naltrexone
Buprenorphine

151
Q

How is cocaine/crack ingested?

A

Oral/snorting/IV

152
Q

How does cocaine cause pleasurable sensation?

A

Blocks reuptake of serotonin-intense pleasure

153
Q

How does cocaine cause negative symtpoms

A

Depletion at secretory neurones-> anxiety, panic, adrenaline secreiont-#> depression, panic, paranoia

154
Q

Describe Maslow’s Hierarchy of needs

A

Bottom-top
-Physiological needs-food, water, rest(basic)
-Safety needs(basic)
-Belongingness and love needs(*psychological)
-Esteem needs-accomplishment(psychological)
-Self-actualization(self-fulfillment)

155
Q

How is alchol use assessed?

A

CAGE questionnaire
AUDIT->15-refer for specialist support
Calculating units

156
Q

How do you calculate the number of units?

A

Volume drunk(L) x % of alcohol= untis

157
Q

What factors are used to assess the level of alcohol dependency

A

-Withdrawal sx
-Cravings
-Drinking despite consequences(physical/social/work life)
0Tolerance
Primacy-neglecting other activities
-loss of control
Narrowing of repertoire

158
Q

Describe 2 medications that can be used to treat alcohol dependency

A

Disulfiram
Acamprosate

159
Q

Describe the features of disulfram

A

Promotes abstinence-> alcohol intake causes severe reaction due to inhibition of acetaldehyde dehydrogenase
CI: IHD and psychosis

160
Q

Describe the features of acamprosate

A

Reduces cravings
Weak antagonist of NMDA receptors

161
Q

What is an asylum seeker?

A

Someone who is applying for refugee status

162
Q

What is a refugee?

A

Someone who has been granted asylum status, usually for 5 years

163
Q

Name some barriers for refugees accessing health

A

Reluctance of GPs to register them
illiteracy
Communicaiton
Lack of permanent site
Mistrust of professionals

164
Q

What care to asylum seekers receive

A

Vouchers to live off
NASS support package
Access to NHS
Not allowed to work initially, no control over location

165
Q

What happens for healthcare access if an asylum seekers claim is refused?

A

Can only access emergency NHS services-charged for anything else

166
Q

Name some health problems for refugees

A

Injury/illness from war/traveling
Communicable disease
Lack of health screening and immunisation
Malnutrition
Untreated chronic disease
Mental illness

167
Q

What is malnutrition?

A

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

168
Q

What 3 groups are covered by malnutrition?

A

Undernutrition-stunting(low height), wasting(low weight for height), underweight(low weight for age), micronutrient
Overweight/obesity: + diet related noncommunicable diseases(heart disease, stroke, diabetes etc)
Micronutrient deficiencies-hidden hunger

169
Q

What are the 4 dimensions of food insecurity

A

-Availability(affordability) of food
-Access-economic and physical
-Utilisation-opportunity to prepare food
-Stability of the 3 dimensions over time

170
Q

Name some errors in practice

A

Sloth-not checking results/information for accuracy
Lack of skill
Communication breakdown-uncelar instructions and not listening to others
System failure-machine/equipment
Human factors-bravado, timidity
Judgement failure
Neglect
poor performance
Misconduct

171
Q

Describe the classifications of error

A

Intention-failure of planned action to reach desired action
Action-task specific
Outcome-near miss or death
Context-interruptions, team factors

172
Q

Name some strategies to reduce error in practise

A

Team training
Checklists
Simplification and standardisation of clinical practice

173
Q

What are the 4 stages of negligence?

A

-Was there a duty of care?
-Was there a breach in that duty?
-Was the patient harmed?
-Was the harm due to the breach in care?

174
Q

What is a never event?

A

Serious, largely preventable patient safety incidents, should not occur if the available preventative measures have been implemented
E.g cutting of the wrong leg

175
Q

What tests can be used to check for negligence?

A

Bolam: would a group of reasonable doctors do the same?
Bolitho: Was the action taken reasonable?

176
Q

What are the different approaches to dealing with negligence?

A

Person approach-hols one person acocuntable
Systems approach: ID errors in system

177
Q

Name an advantage of the systems approach to negligence

A

Eliminates blame culture

178
Q

Name 2 models for understanding accidents and improving safety?

A

Swiss cheese model-problems occur when multiple holes line up
Buckets model

179
Q

Describe the buckets model

A

3 buckets:
-Self(fatigue, lack of knowledge/experience)
-Context(distractions, poor handover, no team support)
-Task(complexity, incomplete)

180
Q

What is intervention at a population level?

A

Health promotion=enabling people to exert control over their health
-Awareness campaigns
Screenign and vaccination

181
Q

What is intervention at the individual level?

A

-Patient centred approach-care responsive to individual needs

182
Q

What is the duty of candour?

A

Every healthcare professional must be open and honest with patients when something that goes wrong with their treatment has the potential to cause harm or distress

183
Q

Describe the rules for childhood consent

A

Never inform parents-encourage them to inform
<13yrs can’t consent-> social services

184
Q

Describe the Fraser guidelines

A

Contraception for <16yrs
Does she understand the advice?
Has the dr encouraged her to tell her parents?
Will she have sex anyway?
Is the mental/physical health going to be affected if you don’t give it?
Best interests?

185
Q

Describe the features of Gillick’s competence

A

-Does a child <16yrs ahve capacity to make own medical decisions
-Clinical judgement made by the dr-takes into account age, capacity, maturity

186
Q

How should you report a notifiable disease?

A

Case details, NHS no, DOB, contact details to public health England
Report by writing within 3 days or telephone within 24 hours if urgent
Always report on clinical suspicion-don’t wait for lab confirmation

187
Q

Name some features of a disease that make it a public health concern

A

High mortality
High morbitiy
Highly contagious
Expensive to treat
Effective intervetions

188
Q

Name some notifiable disease

A

Encephalitis/meningitis
Food poisoning
Invasive Group A strep
Measles
Mumpls
Rubella
Scarlet fever
Smallpox
TB
Whooping cough
Emergency infectious disease, known chicken pox in healthcare worker, radiological/chemical hazard

189
Q

What are the key points in communicable disease control

A

Surveillance
Prevention
Control

190
Q

What is a cluster?

A

Group of cases that might be linked?
E.g. scabies in a care home

191
Q

What is an epidemic?

A

More than expected incidence in a country

192
Q

What is a pandemic?

A

> 1 country

193
Q

What is an endemic?

A

Persistent levels of disease ocurrence

194
Q

What is a hyper-endemic?

A

Persistently high level of disease occurence

195
Q

Describe the swiss cheese model

A

Failed or absent defences against errors happening(latent failures)
Organisational influences-> unsafe supervision-?> preconditions for unsafe acts-> unsafe acts

196
Q
A

Anki 3a exports (12 decks)

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