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Public Health Flashcards

1
Q

What is the inverse care law?

A

Where access and availability to good healthcare varies inversely with the need of the population

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2
Q

What is the Individualisation of risk?

A

Where there is a shift from state provided services and funding to state providing the minimum and the individual is responsible for the rest

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3
Q

What are the four parts of the Health Belief Model?

A

People are more likely to take steps to improve health if they:

  • Believe they susceptible to the condition
  • Believe that it has serious consequences
  • Believe that taking action reduces the susceptibility
  • Believe that the benefits of taking actions outweigh the cost
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4
Q

What is the Theory of Planned Behaviour

A

-The best predictor of behaviour is intention

Intention is determined by:

  • Individuals attitude to the behaviour
  • Perceived social pressure to carry out behaviour or social norm
  • Individuals perceived control
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5
Q

What are the Stage Models of Health Behaviour?

A
  • Pre-contemplation
  • Contemplation
  • Preparation
  • Action
  • Maintenance
  • (Relapse)
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6
Q

What is Health Behaviour?

A

Refer’s to a persons beliefs and actions regarding their health

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7
Q

What is Illness Behaviour?

A

Refer’s to the manner in which a person monitors the body and interprets the symptoms and takes remedial action

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8
Q

What is Sick Role Behaviour?

A

Refer’s to the adaptive behaviours that take place after acceptance of being ill e.g. excusing yourself from social roles, cooperation wit health services

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9
Q

What is the definition of Epidemiology?

A

The study of frequency, distribution and determinants of disease

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10
Q

What is Incidence?

A

The number of new cases in a population in a unit of time

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11
Q

How do you calculate Odds using the incidence?

A

Number of new cars in a period of time/Number of people who did not become a case in the time period

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12
Q

How do you calculate Risk using incidence?

A

Number of new cases in a period of time/Total number of people at risk at the start of the time period

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13
Q

How do you calculate Incidence rate?

A

Number of new cases in a time period/Total person-time at risk during the time period

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14
Q

What is Prevalence?

A

The number of existing cars in a defined population at a given point in time

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15
Q

What is Person-time?

A

Time from entry into the study until disease onset or loss to follow-up or end of study

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16
Q

What is Absolute Risk?

A

Number of incident in a given population

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17
Q

What is Relative Risk?

A

Risk in one category relative to another e.g. Incidence in exposed group/Incidence in unexposed group

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18
Q

What is Attributable Risk?

A

The rate of disease in the exposed group that may be attributed to the exposure (incidence in exposed minus incidence in non-exposed)

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19
Q

What is meant by Confidence Interval?

A

The is the likelihood that the actual value lies between the values given e.g. 95% CI 1-3% means 95% confident that the actual value is between 1 and 3%

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20
Q

What is Reverse causality?

A

Where the outcome causes the exposure e.g. coffee may not reduce IHD, those with IHD may drink less coffee

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21
Q

what is the Prevention Paradox?

A

This is when a number of people need to take preventative measures to benefit one person and therefore a number of people take the preventative measure with no benefit to themselves

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22
Q

What is a Cohort Study?

A

A group fo people who share a characteristic are studied and those who are exposed to a factor and those who are not are compared in terms of outcomes

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23
Q

What is a Case-control study?

A

This is where a group of people with an outcome and a group of people without an outcome are compared retrospectively to looks for a cause

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24
Q

What is a Cross-sectional study (prevalence study)?

A

Measures the prevalence of an outcome in a group who have been exposed to a factor and a group who has not been exposed to a factor

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25
What is an Ecological study?
Looks at the exposure in a population and looks at the outcome and assesses the relationship
26
What is a Case Report?
A detailed report on an individual and their case
27
What is a Case series?
A study which tracks people who have been exposed to something and looms fro the outcomes
28
What is a Randomise Control Trail?
A study in which participants are randomly allocated into groups and variables are controlled
29
What are the strengths of a Randomised Control Trial?
- Minimise bias and confounders - Multiple outcomes can be studied - Strong evidence of causal relationships
30
What are the weakness of a Randomised Control Trial?
- Expensive - Multi-centre - Ethical concerns - Can lead to large drop-out rates
31
What is the Bradford Hill Criteria used for?
It is a set of 9 criteria that can be used to provide evidence that there is a causal relationship
32
What are the nine criteria in the Bradford Hill Criteria?
- Strength (effect size) - Consistency (reproducibility) - Specificity - Temporality - Biological gradient - Plausibility - Coherence - Experiment - Analogy
33
What is the definition of Equality?
Giving people the same despite unequal needs
34
What is the definition of equity?
The absence of avoidable differences among groups of people e.g. redistribution of resources so people are treated fairly
35
What are the headings that make up the PICO Framework?
Population Intervention.exposure Comparison or control Outcome
36
What is the definition of Need?
The ability to benefit from an intervention
37
What are the Four parts of \Bradshaw's taxonomy of Need?
- Felt need - Expressed need - Normative need - Comparative need
38
What is Felt need?
Individual perceptions of variation from normal health
39
What is Expressed need?
Individuals seek help to overcome variation in normal health (demand)
40
What is Normative need?
Professionals define intervention that is appropriate for expressed need
41
What is Comparative need?
Comparison between severity, range of interventions and cost
42
What are the parts of the Need Led Planning Cycle?
- Needs assessment - Planning - Implementation - Evaluation
43
Give an example of something that is demanded and supplied by not needed
Antibiotics for oral illnesses, PSA for prostate cancer
44
Give an example of something that is demanded and needed but not supplied
Cure for cancer, cures for chronic disease, Bettie mental health services
45
Give an example of something that is supplied and needed but not demanded
Smoking cessation (some cases), alcohol cessation, colorectal screening
46
Give an example of something that is demanded, supplied and needed
Free contraception, breast cancer screening, smoking cessation (some cases)
47
What is an Epidemiological health Needs Assessment?
A health needs assessment that looks at person, place and time. This looks at the problems based on the extent of the issue
48
What is an advantage of an epidemiological health needs assessment?
Addresses a clear problem
49
What are the disadvantages of an epidemiological health needs assessment?
Expensive, involves data analysis and collection and reinforces the biomedical model
50
What is a Corporate Health Needs Assessment?
A health needs assessment that involves stakeholders e.g. Doctors, funding bodies, patients, politicians
51
What is an advantage of a corporate health needs assessment?
Recognises people as important in the service success and is based upon the wishes and needs of relevant parties
52
What is a disadvantage of a corporate health needs assessment?
Demand and need can be blurred together, may fit a particular stakeholders agenda, balancing act to keep everyone engaged, political agendas can be involved
53
What is a Comparative Health Needs Assessment?
A healthcare assessment that compare the health needs with similar populations or situations
54
What is a advantage of a comparative health needs assessment?
Can see the evidence of benefit and success, can be quick and inexpensive
55
What is a disadvantage of a comparative health needs assessment?
Hard to find similar populations
56
What are the parts of Maslow's Hierarchy of Need?
Top to Bottom: Self-fulfilment: - Self-actualisation = achieving one's full potential including creative activities Psychological needs: - Esteem needs - prestige and feeling accomplished - Belongingness and love needs - intimate relationships and friends Basic needs: - Safety needs - security and safety - Physiological needs - food, water, warmth and rest
57
Whats the Donabedian Evaluation Framework?
Evaluation in the form of: - Structure/Inputs - Process - Outputs - Outcomes
58
What is the Black Evaluation Framework?
Is about setting priorities - Effectiveness - Efficiency - Equity - Humanity
59
What makes Maxwell's Dimensions of Quality?
Remember 3 E's and 3 A's - Effectiveness - Efficiency - Equity - Acceptability - Accessibility - Appropriateness
60
Give as many examples of error types as you can
- System error - Lack of skill - Lack of knowledge - Communication breakdown - Miss-triage - Playing the odds - Bravado - Sloth
61
Screening Bias - How is selection bias relevant to screening?
People who participate in screening may differ to general population e.g. higher socioeconomic groups may be more likely to attend
62
Screening Bias - What is length-time bias in relation to screening?
As screening happens at regular intervals, if the disease is long or short in duration people may be missed due to the timing of the screening
63
Screening Bias - What is lead-time bias in relation to screening?
Relates to the difference between knowing about a disease and making a difference - screening may mean someone knows about their illness for longer but not benefit from the knowledge
64
What is the definition of Sensitivity?
The proportion of people with the disease who are correctly identified by the screening process
65
What is the definition of Specificity?
The proportion of people without a disease that are correctly excluded through the screening programme
66
What is a Positive Predictive Value?
The proportion of people who have positive screening who turn out to have the disease
67
What is the Negative Predictive Value?
The proportion of people who have negative screening who turn out to not have the disease

Phase 3a (5 decks)

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