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Phase 1 definitions > Public Health > Flashcards

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

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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

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3
Q

Theories for social inequalities

A
  1. critical periods- certain things happen at a certain time in life that has a bigger impact on the individual than it would normally.
  2. Accumulations- hazards and their impacts build up over time- plumbers are likely to get bad knees
  3. Interactions and pathways- increased likelihood of exposure to violence.
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4
Q

evidence base medicine

A

the use of the best evidence in making informed decisions

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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

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6
Q

grading of evidence from A-D

A

A= evidence from hierarchy 1
B= evidence from hierarchy 2
etc

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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

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8
Q

relative risk reduction

A

rate of the outcome in the intervention group compared to the control group

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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

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10
Q

number needed to treat

A

the number of patients needed to be treated to prevent a bad outcome

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11
Q

Push evidence of evaluating evidence

A

accessing EBM journals regularly

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12
Q

Pull evidence of evaluating evidence

A

Record formulated questions using PICO and obtain the information by hand

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13
Q

Health promotion

A

enabling people to understand why health is important and therefore improve their individual help

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14
Q

stages of changing health behaviours

A

precontemplation, contemplation, preparation, action and then maintenance

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15
Q

probity

A

declaring personal status- alcoholic, disability, drug addict

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16
Q

error

A

any preventable event that may lead or cause a patient harm

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17
Q

saftey

A

the ability to succeed under varying conditions so that the number of intended and acceptable outcomes is maximal

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18
Q

adverse event

A

an incident that causes harm to a patient which is not a direct effect of the illness

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19
Q

near miss

A

an event which arises during care and has the potential to cause harm but fails to develop

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20
Q

omission error

A

action is delayed or missed

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21
Q

commission error

A

the wrong action is taken

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22
Q

negligence

A

practitioners actions do not meet the standards required.

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23
Q

violation error

A

the deliberate deviation from the standard procedure for a situation

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24
Q

name 4 types of limitations to cutting corners

A
  1. Automaticity- automatic thoughts without conscious guidance
  2. Cognitive Interference- a more complex task interfering with demands
  3. selective attention- not taking in the whole picture
  4. cognitive biases- long term memory theory rather than facts
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25
Q

2 approaches to managing error

A

1- individual approach

2- systemic organisational approach- make checklists, team training, risk management etc

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26
Q

Name 4 priverleges of a medical proffesional

A
  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
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27
Q

define the Doctrine of Dual effect

A

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.)

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28
Q

Name 5 duties of a doctor

A
  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.
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29
Q

when is the sterilization of an individual lawful

A

to prevent the transmission of hereditary diseases.

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30
Q

Justice principles

A

moral obligation to act on the base of fair aducation between competing claims

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31
Q

autonomy principle

A

treat all patients with confedentiallity and honesty

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32
Q

beneficience principle

A

do the right thing for the patient

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33
Q

non-maleficience principle

A

not harming patients intentionally of inadvertently where possible

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34
Q

Assult

A

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.

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35
Q

disability

A

a problem with the functions on the body and its effect or impact upon the individuals acticity

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36
Q

ultilitarisan

A

an approach to maximise the good in their actions

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37
Q

consequentialist

A

an individual who bases their actions on the consequences

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38
Q

deontologist

A

treat those how you would like to be treated.

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39
Q

virtue ethics

A

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

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40
Q

principalist approach

A

decisions made on the 5 principles: compassion, discernment, trustworthiness, integrity and conscientiousness.

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41
Q

sustainability

A

meeting the needs of the present without compromising the needs of future generations from meeting their own needs

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42
Q

primary prevention

A

aims to prevent a disease becoming established by reducing exposures by behaviour changes or population changes

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43
Q

secondary prevention

A

the aim is to detect early disease and slow down or halt the progress of it

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44
Q

tertiary prevention

A

aims to reduce the complications or severity of the disease by offering appropriate treatments or interventinos

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45
Q

the prevention paradox

A

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.

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46
Q

What is the purpose of screening

A
  1. to reduce the risk of disease development
  2. to provide early treatment
  3. to provide information, advice and support to enable coping strategies
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47
Q

sensitivity

A

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.

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48
Q

specificity

A

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
Q

positive prediction value

A

the proportion of people with a positive test result who do not have the disease

50
Q

negative predicted value

A

the proportion of people with a negative test result who do not have the disease

51
Q

name 5 types of screening

A
  1. opportunistic screening
  2. population screening
  3. screening for communicable disease
  4. pre-employment and occupational medicals
  5. commercial screening
52
Q

health protection

A

planning and delivering interventions that protect a threathend population

53
Q

health promotion

A

interventions which encourage people to live healthier lives

54
Q

3 reasons why routine data is collected

A

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
Q

incidence

A

the rate at which new cases occur in a population at a given time

56
Q

prevelance

A

the proportion of the population with a disease at a certain time

57
Q

what determines the quality of data

A

CART. Completeness, Accuracy, Relevance/representativeness, Timeliness

58
Q

critical appraisal

A

the process of systematically examining research evidence to asses its validity, results and relevance before using it to inform a decision

59
Q

meta analysis

A

the use of statistical techniques to integrate the results of several studies which answer related research hypotheses.

60
Q

forest plots of blobbographs

A

used to compare results of multiple medical studies as they show a graphical representation of the individual results.

61
Q

homogenity

A

occurs when studies have similar and consistent results

62
Q

heterogeneity

A

indicates the variability of the results above and beyond what is expected

63
Q

sensitivity analysis

A

determines how sensitive the results are to change and how the review was done

64
Q

satiation

A

what brings an eating episode to an end

65
Q

satiety

A

the inter-meal period

66
Q

global health

A

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
Q

ageing

A

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
Q

intrinsic ageing

A

natural, universal and inevitable

69
Q

extrinsic ageing

A

dependent upon external factors- exposure to UV rays, smoking and air pollution

70
Q

4 principles of good primary care

A

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
Q

Informal care

A

main source of support for older/frail people

72
Q

invisible care

A

not accounted fro or valued on the national accounts

73
Q

Name 3 data collection methods

A
  1. interviews.
  2. focus groups
  3. observations
74
Q

Health

A

a state of complete physical mental and social well being and not merely the absence of disease or infirmity

75
Q

social class

A

a measure of occupation, stratification, social position and access to power and resources. It can be measured using the NS-SEC model.

76
Q

the inverse care law

A

the availability of good medical care tends to vary inversely with the need for it within a population

77
Q

sociology

A

the study of social relations and social processes. It measures how socially interdependent we are

78
Q

iatrogenesis

A

the unintended adverse effects of a therapeutic intervention

79
Q

name 3 health related millennium goals

A
  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
Q

positive predicted value

A

the proportion of people with a positive test result who actually have the disease

81
Q

negative predicted value

A

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

82
Q

give 3 examples of a screening test

A

Guthrie test- for CF and Sickle cell disease
Newborn Hearing test
Genetic diseases

83
Q

determine the 4 phases of cardiac rehabilitation

A
  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
Q

define type A behaviour individuals

A

competitive, hostilie, and impatient.

85
Q

name the ways in which nicotine replacement therapy is available

A

patches, gum, nasal spray, microtab, lozengers and inhalors. It is available on the NHS.

86
Q

name 4 reasons for smoking

A

social pressure, fear of weight gain, coping with stress, nicotine addiction

87
Q

reproduction number of influenza rO

A

the mean number of secondary cases following a single infection

88
Q

compliance of the patient

A

the extent to which the patients behavior coincides with medical or health advice

89
Q

adherent patient care

A

takes into account the importance of the patients beliefs. The health professional enhances the patients knowledge to the recommended medical regime

90
Q

concordant patient care

A

patients are equal in care- it is expected they will take part in treatment decisions- they are in equal concordance with the consultant.

91
Q

gerontology

A

studying the changes in the body and mind that accompany aging.

92
Q

geriatrics

A

the diagnosis and treatment of disorders that occur in old age.

93
Q

name the 5 focal virtues

A

compassion, discernment, trustworthiness, integrity and conscientiousness

94
Q

valitdity

A

how close to the true value it is

95
Q

reliability

A

consistency of the results

96
Q

applicabiliy

A

how relevant a study is to clinical medicine

97
Q

3 types of qualititive research

A

interviews, documentary analysis and ethnography- emerging oneself in a particular group

98
Q

types of graphs showing discrete, catagorical data

A

bar charts, pie charts

99
Q

types of graphs showing continuous data

A

histograms, stem and lead diagrams, box and whisker plots

100
Q

standard deviation

A

the average distance of the observations from the mean value. It is used to find abnormal results or outliers

101
Q

positive skew

A

the mode is less than the median which is less than the mean

102
Q

negative skew

A

the mode is greater than the median which is greater than the mean

103
Q

p value

A

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
Q

power of a study

A

the probability of rejecting the null hypothesis when it is actually false

105
Q

clinically significant difference

A

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
Q

absolute risk difference

A

the difference between the risk in an exposed group- the risk in an unexposed group

107
Q

the probability of an occurrence compared to the probability of a non-occurrence

A

the odds of an event

108
Q

odds ratio

A

the probability of the event/ 1- the probability of the event

109
Q

Stress

A

occurs when the demands made upon an individual are greater than their ability to cope. Eustress= good motivating stress, Distress= damaging and harmful

110
Q

epidermology

A

the study of the distribution and determinants of health related states or events in specific populations

111
Q

name 3 neurological disorders of public health importance

A

stroke, migraine, dementia

112
Q

what is CKD

A

a collective term referring to the types of chronic kidney disease, or long term kidney dysfunction.

113
Q

3 most important risk factors leading to disease in LEDCs

A

malnutrition, unsafe sex and unsafe water and sanitation

114
Q

3 important risk factors leading to diseases in MEDCs

A

tobacco, high blood pressure, alcohol

115
Q

why is it important to work in a team?

A

efficiency, improves decision making, reduces medical error.

116
Q

obsticals in medical healthcare teams

A

different ward locations, contact times and frequencies, management from different employers, shifts and rotations.

117
Q

name the 7 steps to patient saftey

A 
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
Q

describe a strategy to reduce patient harm

A

simplify clinical process
checklists and aid memoirs
team training
risk management programmes

119
Q

error

A

any preventable event that may cause or lead to patient harm

Phase 1 definitions (7 decks)

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