Public Health Flashcards
1
Q
Public Health
A
the science and art of promoting and protecting health and well-being, preventing ill health and prolonging life throughout the organised efforts of society
2
Q
Domains of public health
A
health promotion- increasing education, access and transport
Health protection- vaccinations, monitoring infection rates
Improving Health services- Quality and qantative care, cost of treatments, language barrier
3
Q
Theories for social inequalities
A
- critical periods- certain things happen at a certain time in life that has a bigger impact on the individual than it would normally.
- Accumulations- hazards and their impacts build up over time- plumbers are likely to get bad knees
- Interactions and pathways- increased likelihood of exposure to violence.
4
Q
evidence base medicine
A
the use of the best evidence in making informed decisions
5
Q
hierachy of evidence
A
level 1a- evidence from a systematic review of a meta analysis of randomised control trial
1b- at least once randomised control trial evidence
2- at least one control trial
2b- evidence from one type of quantitative study
3- evidence from non experimental study
4- evidence from expert committee reports/opinions
6
Q
grading of evidence from A-D
A
A= evidence from hierarchy 1
B= evidence from hierarchy 2
etc
7
Q
relative risk
A
how many times more likely is it than an event will occur in the intervention group relevant to the control group
8
Q
relative risk reduction
A
rate of the outcome in the intervention group compared to the control group
9
Q
absolute risk reduction
A
absolute differences in rate of events between the two groups- gives an indication of baseline risk and intervention effects
10
Q
number needed to treat
A
the number of patients needed to be treated to prevent a bad outcome
11
Q
Push evidence of evaluating evidence
A
accessing EBM journals regularly
12
Q
Pull evidence of evaluating evidence
A
Record formulated questions using PICO and obtain the information by hand
13
Q
Health promotion
A
enabling people to understand why health is important and therefore improve their individual help
14
Q
stages of changing health behaviours
A
precontemplation, contemplation, preparation, action and then maintenance
15
Q
probity
A
declaring personal status- alcoholic, disability, drug addict
16
Q
error
A
any preventable event that may lead or cause a patient harm
17
Q
saftey
A
the ability to succeed under varying conditions so that the number of intended and acceptable outcomes is maximal
18
Q
adverse event
A
an incident that causes harm to a patient which is not a direct effect of the illness
19
Q
near miss
A
an event which arises during care and has the potential to cause harm but fails to develop
20
Q
omission error
A
action is delayed or missed
21
Q
commission error
A
the wrong action is taken
22
Q
negligence
A
practitioners actions do not meet the standards required.
23
Q
violation error
A
the deliberate deviation from the standard procedure for a situation
24
Q
name 4 types of limitations to cutting corners
A
- Automaticity- automatic thoughts without conscious guidance
- Cognitive Interference- a more complex task interfering with demands
- selective attention- not taking in the whole picture
- cognitive biases- long term memory theory rather than facts
25
2 approaches to managing error
1- individual approach
| 2- systemic organisational approach- make checklists, team training, risk management etc
26
Name 4 priverleges of a medical proffesional
1. to recover fees
2. the right to respect the possesion and prescription of certain drugs
3. right to sign death certificates
4. right to be appointed as medical practioners
27
define the Doctrine of Dual effect
if you administer a drug to relieve pain in doses that you know may be fatal then provided your intentions is not to shorten life but to relieve pain the administration is not unlawful. (deliberate administration is murder.)
28
Name 5 duties of a doctor
1. respect and protect confidential information
2. ensure personal beliefs do not prejudice patient care
3. make sure that your patient is your 1st concern
4. give patients information in a way that they can understand it
5. be honest and recognize the limits of your professional competence.
29
when is the sterilization of an individual lawful
to prevent the transmission of hereditary diseases.
30
Justice principles
moral obligation to act on the base of fair aducation between competing claims
31
autonomy principle
treat all patients with confedentiallity and honesty
32
beneficience principle
do the right thing for the patient
33
non-maleficience principle
not harming patients intentionally of inadvertently where possible
34
Assult
if the patient is unable to give consent you are only able to give treatment to preserve life and in the event of an emergency.
35
disability
a problem with the functions on the body and its effect or impact upon the individuals acticity
36
ultilitarisan
an approach to maximise the good in their actions
37
consequentialist
an individual who bases their actions on the consequences
38
deontologist
treat those how you would like to be treated.
39
virtue ethics
these focus on the character of the person, integrating reason and emotion. An action can be vertuous only if it is performed by a person in the right state of mind
40
principalist approach
decisions made on the 5 principles: compassion, discernment, trustworthiness, integrity and conscientiousness.
41
sustainability
meeting the needs of the present without compromising the needs of future generations from meeting their own needs
42
primary prevention
aims to prevent a disease becoming established by reducing exposures by behaviour changes or population changes
43
secondary prevention
the aim is to detect early disease and slow down or halt the progress of it
44
tertiary prevention
aims to reduce the complications or severity of the disease by offering appropriate treatments or interventinos
45
the prevention paradox
a larger number of people at small risk of disease may contribute to more cases of that disease than a smaller number of people who are at a greater individual risk.
46
What is the purpose of screening
1. to reduce the risk of disease development
2. to provide early treatment
3. to provide information, advice and support to enable coping strategies
47
sensitivity
the proportion of people with the disease who are correctly identified by the screening test. Measures howw good the test is at identifying those with the disease.
48
specificity
the proportion of people without the disease who are correctly excluded by the screening test. Measures how good the test is at recognizing who doesn't have the disease.
49
positive prediction value
the proportion of people with a positive test result who do not have the disease
50
negative predicted value
the proportion of people with a negative test result who do not have the disease
51
name 5 types of screening
1. opportunistic screening
2. population screening
3. screening for communicable disease
4. pre-employment and occupational medicals
5. commercial screening
52
health protection
planning and delivering interventions that protect a threathend population
53
health promotion
interventions which encourage people to live healthier lives
54
3 reasons why routine data is collected
to monitor the health of the population
to inform planning services to meet the needs of the population
to evaluate and asses the performances of polices and services
55
incidence
the rate at which new cases occur in a population at a given time
56
prevelance
the proportion of the population with a disease at a certain time
57
what determines the quality of data
CART. Completeness, Accuracy, Relevance/representativeness, Timeliness
58
critical appraisal
the process of systematically examining research evidence to asses its validity, results and relevance before using it to inform a decision
59
meta analysis
the use of statistical techniques to integrate the results of several studies which answer related research hypotheses.
60
forest plots of blobbographs
used to compare results of multiple medical studies as they show a graphical representation of the individual results.
61
homogenity
occurs when studies have similar and consistent results
62
heterogeneity
indicates the variability of the results above and beyond what is expected
63
sensitivity analysis
determines how sensitive the results are to change and how the review was done
64
satiation
what brings an eating episode to an end
65
satiety
the inter-meal period
66
global health
health problems issues and concerns that trasncend national boundaries which may be influenced by cicumstances or experiences in other countries and are best reviewed by co-operative actions and solutions.
67
ageing
our unprecedented survival has produced a revolution in logevity which is shaking the foundation of societies around the world and profoundly altering our attitudes to life and death
68
intrinsic ageing
natural, universal and inevitable
69
extrinsic ageing
dependent upon external factors- exposure to UV rays, smoking and air pollution
70
4 principles of good primary care
to prevent unnecessary loss of function
to prevent and treat health problems which adversely affect the quality of life in old age
to give older people a good death as well as a good life
to supplement the existing system of informal care and prevent its breakdown.
71
Informal care
main source of support for older/frail people
72
invisible care
not accounted fro or valued on the national accounts
73
Name 3 data collection methods
1. interviews.
2. focus groups
3. observations
74
Health
a state of complete physical mental and social well being and not merely the absence of disease or infirmity
75
social class
a measure of occupation, stratification, social position and access to power and resources. It can be measured using the NS-SEC model.
76
the inverse care law
the availability of good medical care tends to vary inversely with the need for it within a population
77
sociology
the study of social relations and social processes. It measures how socially interdependent we are
78
iatrogenesis
the unintended adverse effects of a therapeutic intervention
79
name 3 health related millennium goals
1. reduce childhood (under the age of 5) mortalitity by 2/3rds globally by 2015
2. improve maternal global health
3. achieve universal treatment of HIV by 2010 for those who need it
80
positive predicted value
the proportion of people with a positive test result who actually have the disease
81
negative predicted value
the proportion of people without the disease who are correctly excluded by the screening test.
82
give 3 examples of a screening test
Guthrie test- for CF and Sickle cell disease
Newborn Hearing test
Genetic diseases
83
determine the 4 phases of cardiac rehabilitation
1. hospital care
2. early post discharge
3. 4-16 weeks maintenance
4. long term self management and maintenance including lifestyle changes (smoking, nutrition, alcohol and physical activity)
84
define type A behaviour individuals
competitive, hostilie, and impatient.
85
name the ways in which nicotine replacement therapy is available
patches, gum, nasal spray, microtab, lozengers and inhalors. It is available on the NHS.
86
name 4 reasons for smoking
social pressure, fear of weight gain, coping with stress, nicotine addiction
87
reproduction number of influenza rO
the mean number of secondary cases following a single infection
88
compliance of the patient
the extent to which the patients behavior coincides with medical or health advice
89
adherent patient care
takes into account the importance of the patients beliefs. The health professional enhances the patients knowledge to the recommended medical regime
90
concordant patient care
patients are equal in care- it is expected they will take part in treatment decisions- they are in equal concordance with the consultant.
91
gerontology
studying the changes in the body and mind that accompany aging.
92
geriatrics
the diagnosis and treatment of disorders that occur in old age.
93
name the 5 focal virtues
compassion, discernment, trustworthiness, integrity and conscientiousness
94
valitdity
how close to the true value it is
95
reliability
consistency of the results
96
applicabiliy
how relevant a study is to clinical medicine
97
3 types of qualititive research
interviews, documentary analysis and ethnography- emerging oneself in a particular group
98
types of graphs showing discrete, catagorical data
bar charts, pie charts
99
types of graphs showing continuous data
histograms, stem and lead diagrams, box and whisker plots
100
standard deviation
the average distance of the observations from the mean value. It is used to find abnormal results or outliers
101
positive skew
the mode is less than the median which is less than the mean
102
negative skew
the mode is greater than the median which is greater than the mean
103
p value
the probability of obtaining the test statistic from the data provided the null hypothesis is true. if the p value is very small (less than 0.05) the null hypothesis can be rejected.
104
power of a study
the probability of rejecting the null hypothesis when it is actually false
105
clinically significant difference
a difference that is big enough to be worthwhile. The size of the sample needs to be at 5% significance level with at least 80% power.
106
absolute risk difference
the difference between the risk in an exposed group- the risk in an unexposed group
107
the probability of an occurrence compared to the probability of a non-occurrence
the odds of an event
108
odds ratio
the probability of the event/ 1- the probability of the event
109
Stress
occurs when the demands made upon an individual are greater than their ability to cope. Eustress= good motivating stress, Distress= damaging and harmful
110
epidermology
the study of the distribution and determinants of health related states or events in specific populations
111
name 3 neurological disorders of public health importance
stroke, migraine, dementia
112
what is CKD
a collective term referring to the types of chronic kidney disease, or long term kidney dysfunction.
113
3 most important risk factors leading to disease in LEDCs
malnutrition, unsafe sex and unsafe water and sanitation
114
3 important risk factors leading to diseases in MEDCs
tobacco, high blood pressure, alcohol
115
why is it important to work in a team?
efficiency, improves decision making, reduces medical error.
116
obsticals in medical healthcare teams
different ward locations, contact times and frequencies, management from different employers, shifts and rotations.
117
name the 7 steps to patient saftey
```
build a safety culture
lead and support your staff
integrate your risk management activity
promote reporting
involve and communicte with the patients
learn and share safety lessons
implement solutions to prevent harm
```
118
describe a strategy to reduce patient harm
simplify clinical process
checklists and aid memoirs
team training
risk management programmes
119
error
any preventable event that may cause or lead to patient harm
