Public Health 2 Flashcards
What are the lifestyle changes used to prevent CHD?
SNAP
- Smoking
- Nutrition
- Alcohol
- Physical activity
Reasons cited for smoking
- nicotine addiction
- coping with stress
- habit
- socialising
- fear of weight gain
Stages of change model for quitting smoking:
- Pre contemplation
- Contemplation
- Preparing to change
- Action
- Maintenance (greater than 6 months non smoking)
- Stable changed lifestyle/relapse
What is influenza A?
The strain which causes pandemics
What is influenza B?
Seasonal influenza
What is the reproduction number? r0
The mean number of secondary cases following a single infection
What is the criteria for pandemic spread?
- a novel virus
- capable of infecting humans
- capable of causing illness
- large pool of susceptible people
- ready and sustainable transmission from person to person
List the types of transmission of infective causes
- Direct e.g STI’s
- Indirect e.g malaria
- Airborne e.g TB
What are control measures for diarrhoea?
- hand washing with soap
- safe drinking water
- safe disposal of human waste
- breast feeding of infants and young children
- safe handling and processing of food
- control of flies/vectors
- vaccination
Groups at risk of diarrhoea..
- poor hygiene
- children at pre-school/nursery
- those preparing/serving uncooked foods
- health care and social works
What is the recommended daily alcohol intake?
Men: 3-4 units a day
Women: 2-3 units a day
1 bottle of wine is approx. 10 units
What is the standard unit of alcohol?
10ml/8g of ethanol
What are the symptoms of foetal alcohol syndrome?
- growth retardation
- CNS abnormalities
- craniofacial abnormalities
- congenital defects
- increased risk of birthmarks and her hernias
What are the withdrawal symptoms of alcohol?
- tremors
- activation syndrome (agitation, shakes, rapid HR, high BP)
- seizures
- hallucinations
- delirium tremens
What are the social implications of alcohol?
- violence
- rape
- depression or anxiety
- driving offences
What are the CAGE questions for alcohol dependency?
- ever felt you should cut down?
- been annoyed by people telling you to cut down?
- do you ever feel guilty about how much you drink?
- eye opener: ever had a drink first ging in the morning?
List the types of transmission of infective causes
- Direct e.g STI’s
- Indirect e.g malaria
- Airborne e.g TB
What are control measures for diarrhoea?
- hand washing with soap
- safe drinking water
- safe disposal of human waste
- breast feeding of infants and young children
- safe handling and processing of food
- control of flies/vectors
- vaccination
Groups at risk of diarrhoea..
- poor hygiene
- children at pre-school/nursery
- those preparing/serving uncooked foods
- health care and social works
What is the recommended daily alcohol intake?
Men: 3-4 units a day
Women: 2-3 units a day
1 bottle of wine is approx. 10 units
What is the standard unit of alcohol?
10ml/8g of ethanol
What are the symptoms of foetal alcohol syndrome?
- growth retardation
- CNS abnormalities
- craniofacial abnormalities
- congenital defects
- increased risk of birthmarks and her hernias
What is compliance?
It the extent to which a patients behaviour coincides with medical or health advice.
What are reasons for non-compliance?
- Unintentional e.g. Forgetting or not understanding instructions
- Intentional e.g not taking prescribed medication or continuing with behaviours against medical advice
What is adherence?
Adherence acknowledges the importance of patients beliefs
What is concordance?
Concordance thinks of patients as equals in care
What are some ethical considerations of patient-centred medicine?
- mental capacity
- decisions detrimental to patients well being
- potential threat to health of others
- children: when the child is of sufficient understanding, they must give permission, otherwise a parent or guardian must consent. If there is dispute, a court must intervene
List 3 assessments of limitation.
- Katz
- Barthel
- Instrumental activity of daily living scales
What is palliative care?
It improves the quality of life of patients and families who face life-threatening illness by providing pain and symptom relief, spiritual and psychosocial support from diagnosis to the end of life and bereavement.
What is the difference between gerontology and geriatrics?
Gerontology: concerned with studying the changes in the body and mind that accompany ageing.
Geriatrics: concerned with the diagnosis and treatment of disorders that occur in old age.
What is ethics?
It is the attempt to arrive at an understanding of the nature of human values, of how we ought to live and of what constitutes right conduct.
What are example of rivals to ethics?
- law
- codes of ethics
- religious or cultural beliefs
- personal conscience
What are the different forms f ethical arguments?
- Top down deductive - where one specific theory is consistently applied to each problem
- Bottom up inductive - using past medical problems to create guides to practice.
- An approach where theories are considered which fit ones own beliefs before applying.
- Analogies
What are the 4 ethical principles?
- autonomy - allowing a patient to make a rational and informed decision
- beneficence - doing the right thing, to benefit someone else
- non-maleficence - preventing harm, reducing harm and doing no harm
- justice - being fair
What is utilitarianism?
It is an act evaluated solely in terms of it’s consequences. It acts to maximise good e.g killing one to save many
What is deontology?
The theory get the features of the act themselves determine worthiness
What is virtue ethics?
Focus on the character of the person, integrating reason and emotion. An act can be virtuous only if it is performed by a person in the right state of mind.
What are the 5 focal virtues?
- compassion
- discernment
- trustworthiness
- integrity
- conscientiousness
What does evidence-based practise involve?
- asking focused questions
- finding the evidence
- critical appraisal
- making a decision
What is the hierarchy of evidence?
1a: systematic reviews or meta analysis of RCT’s gold standard
1b: at least 1 RCT
2a: at least one controlled trial without randomisation
2b: at least one type of quasi-experimental study.
Etc… Continues to 4d
What is the purpose of critical appraisal?
To assess and consider validity, reliability and applicability
What is validity?
It is how close to the truth something is
What is reliably?
How consistent the results are
What is the criteria used to evaluate the likelihood that an association is causal?
- consistency
- strength of association
- specificity (single cause for a single effect)
- dose-response relationship
- temporal relationship
- biological plausibility
- coherence with existing theories
- altered by experimentation
What is a systematic review?
A review of a clearly formulated question that used symptomatic and explicit methods to identify, select and critically appraise relevant research, and to collect and analyse data from the studies that are included in the review.
Why is meta-analysis used?
It may be used to analyse and summarise the results of the included studies. It can be graphically represents as a forest plot.
Why is routine health data collected?
- to monitor health of the pop.
- to generate hypotheses on causes of ill health
- inform planning of services
- evaluate and assess performance of policies and services
What are different types of qualitative research?
- Ethnography - emerging oneself in a particular lifestyle or group
- Interviews
- Documentary analysis
