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Public Health Flashcards

1
Q

What were the findings in the 1980 black report

A

Social inequalities lead to mortality and the inequalities are widening. Answer in political intervention.

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2
Q

What are the four mechanisms outlined in the black report

A

Artifact, social selection, behaviour and material circumstance

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3
Q

What is the artifact mechanism in the 1980 black report

A

The findings are just a response of statistical anomalies

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4
Q

What is the social selection mechanism in the 1980 black report

A

People are in the lower social class because of their ill health, not the other way around

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5
Q

What is the behaviour mechanism in the 1980 black report

A

The poorer you are the harder it is to control your behaviour and choose healthy behaviour

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6
Q

What is the material circumstance mechanism in the 1980 black report

A

No control over the resources available to them to improve health

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7
Q

What was the whitehall study

A

Looked at civil servants and linked employment differences to health inequalities

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8
Q

What was the archeson report of 1988

A

It found that although mortality reduced, inequality increased and made recommendations

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9
Q

What were the recommendations of the archeson report

A

Evaluate policies, prioritise families and children, reduce income inequality and improve the housing of the poor

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10
Q

What are the three theories of causation of health inequalities

A

Neomaterialist, psychosocial and lifecourse

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11
Q

What is the lifecourse theory

A

Poorer people have fewer resources (physical and mental) to overcome the stressors which accumulate. Critical periods, accumulation, interactions + pathways

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12
Q

What is the psychosocial theory

A

Low social status, lack of friends and stress in early life

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13
Q

What is the neomaterialist theory

A

Poverty exposes to health hazards, lack of resources and systematic underinvestment across society

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14
Q

Why do women live longer than men

A

Hormones, fewer hazards and more likely to see doctor

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15
Q

Three ways to reduce the health inequalities

A

Change perspectives, change systems and change education

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16
Q

What are the two parts of the medical licensing assessment

A

Test of applied knowledge and test of clinical/proffesional skills

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17
Q

What are the three outcomes states in the 2017 GMC outcomes for graduates

A

Professional values and behaviours, professional skills and professional knowledge

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18
Q

Define patient compliance

A

The extent to which the patient’s behaviour (in terms of medications, following diets or other lifestyle changes) coincides with medical or health advice

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19
Q

What % of chronic prescribed medications arent taken

A

30-50%

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20
Q

Examples of non adherence

A

Not taking meds, wrong dose, wrong frequency, stopping meds, modifying treatment for activities, continuing behaviours against advice

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21
Q

What are unintentional (practical) reasons for non adherence

A

Capacity and Resource. Can’t understand, use, pay or remember

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22
Q

What are intentional (motivational) reasons for non adherence

A

Perceptual. Due to beliefs about disease or treatment and preferences of treatment

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23
Q

What is the necessity concerns framework

A

Adherence is improved when necessity increases and concerns are reduced

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24
Q

Define necessity beliefs

A

Perceptions of personal need for treatment

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25
Define concern beliefs
Concerns about a range of potential side effects
26
What is the patient centredness change
Shift in focus from treatment to process of care
27
How does patient centredness change the consultation
Holistic view of the patient in a social context and a shared control of the consultation
28
What are the four consequences of good patient-doctor communications
1-better health outcomes 2-increased compliance 3-increased patient and clinician satisfaction 4-decrease in malpractise risk
29
What are the principles of concordance rather than adherence
Recognises it is a negotiation between equals and a respect for the patient's agenda
30
What are the steps in shared decision making
1-define problem 2-Dr opinions differ 3-options 4-information 5-Understood? 6-concerns and expectations 7-accept? 8-involve patient 9-review 10-review
31
How are staff made aware of infection control
Policy development, education and audit
32
What is infection
Affect with disease causing organism which does harm to the individual
33
What does the virulence of an organism depend on
Ease of spread, likelihood of causing infection and consequence of infection if it occurs
34
What are the infection controls at an environmental level
Design, clearing and isolation
35
What are the infection controls at a patient level
Isolation and antimicrobial stewardship
36
What are the infection controls at a staff level
Barrier precautions, isolation and handwashing and PPE
37
What are the stages in identifying an infected patient
Risk factors, screening, clinical diagnosis and lab diagnosis
38
What are the most common cause of UTI and intraabdominal infection
CPEs (Carbapenemase producing enterobacteriaceae) aka coliforms
39
Where do CPEs colonise
Large bowel, skin below the waist and moist sites
40
Name examples of CPEs
E.coli, klebsiella, enterobacter
41
What are carbapenams
Broadest spectrum beta lactam
42
What are class A carbapenamases
serine beta-lactamases
43
What are class B carbapenamases
metallo beta-lactamases
44
What are class D carbapenamases
OXA variants
45
What is the MIC of an antibiotic
Minimum inhibitory concentration. How much antibiotic is needed to prevent the growth of an organism
46
What factors increase norovirus' deadliness
No envelope so easy spread of RNA, low infecting dose, short lived immunity, persists in environment and resists cleaning.
47
When should you do handwashing
Before and after handling patients or food or carrying out an aseptic procedure. After handling soiled item, using toilet or removing protective equipment
48
When should you use alcohol gel
When hands are visibly clean or after hand washing for invasive procedures or when barrier nursing
49
What are endogenous infections
Infection of a patient by their own flora
50
Which material is used as an antiinfective, such as for door handles
Copper
51
What is used for killing spores
Hydrogen peroxide vaping machines
52
What is the single most effective way of preventing cross infection
Hand hygeine
53
Which bugs arent eliminated by alcohol gel
C dificile and norovirus
54
What counts as a low risk encounter
No barrier nursing or fluid exposure - alcohol gel fine
55
How does the C dificile mechanism work
Spores germinate into bascilli normally following antibiotic therapy. This restricts the flora of bowel and allows C dificile to grow
56
What is the UNAIDS 2020 90/90/90 target
90% diagnosed, of those 90% on antiretrovirals, of those 90% viral suppression
57
Which age group has highest prevelance of HIV
35-49
58
Why are rates increasing in the 50-64 category
People stop using condoms, high divorce rate and poor sex education
59
What is classed as a late diagnosis
CD4 count below 350
60
How recent can HIV be picked up
4 weeks
61
Define palliative care
Palliative care 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 end of life and bereavement
62
What are the four philosophies of palliative care
Holistic, individualised, multidisciplinary and patients etc are clients
63
What are the inequalities seen with increasing age (in life)
Greater impairment (from diseases+treatments), increased psychological distress, increased social isolation, poverty and poorer living conditions
64
What are the inequalities seen with increasing age (in death
Less likely to go to hospice, die where they want, be involved in discussions or have plans. More likely to have repeated hospital admissions
65
Key issues in living with COPD
Unpredictable illness trajectory, unsure prognosis, poor patient understanding and limited access to specialist palliative care
66
How do COPD and lung cancer patients compare
COPD patients have more depression, worse activities of daily living, less certainty and less support than lung cancer patients
67
Define epidemiology
The study of how often diseases occur in different groups of people and why
68
Define incidence
The rate at which new cases occur in a population during a specified time period
69
Define prevalence
Proportion of the population which have the disease at a given time
70
How are prevalence and incidence linked in an equation
Prevalence=incidence x average duration
71
What is mortality
Incidence of death from a disease
72
What are reasons for geographical variations in COPD
Socioeconomic differences and deprivations, historic industry, developing world (indoor cooking and smoking), passive smoking
73
What are the bradford-hill criteria
For relationship. Strength, Consistency, specificity, reverse causation, dose response, experimental evidence, biological plausibility, coherence and analogy
74
What are components of good work
Safe, reliable, fair, social, individual control and good work/life balance
75
What are sources of data for occupational disease
Labour force survey, death certificate, disablement benefit and surveilance schemes (SWORD and EPIDERM etc)
76
Define hazard
Something that is potentially harmful
77
Define risk
The probability of harm

phase 2 (17 decks)

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