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Phase 3a > Public Health > Flashcards

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
Q

What is an Ecological study?

A

Looks at the exposure in a population and looks at the outcome and assesses the relationship

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26
Q

What is a Case Report?

A

A detailed report on an individual and their case

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27
Q

What is a Case series?

A

A study which tracks people who have been exposed to something and looms fro the outcomes

28
Q

What is a Randomise Control Trail?

A

A study in which participants are randomly allocated into groups and variables are controlled

29
Q

What are the strengths of a Randomised Control Trial?

A
  • Minimise bias and confounders
  • Multiple outcomes can be studied
  • Strong evidence of causal relationships
30
Q

What are the weakness of a Randomised Control Trial?

A
  • Expensive
  • Multi-centre
  • Ethical concerns
  • Can lead to large drop-out rates
31
Q

What is the Bradford Hill Criteria used for?

A

It is a set of 9 criteria that can be used to provide evidence that there is a causal relationship

32
Q

What are the nine criteria in the Bradford Hill Criteria?

A
  • Strength (effect size)
  • Consistency (reproducibility)
  • Specificity
  • Temporality
  • Biological gradient
  • Plausibility
  • Coherence
  • Experiment
  • Analogy
33
Q

What is the definition of Equality?

A

Giving people the same despite unequal needs

34
Q

What is the definition of equity?

A

The absence of avoidable differences among groups of people e.g. redistribution of resources so people are treated fairly

35
Q

What are the headings that make up the PICO Framework?

A

Population
Intervention.exposure
Comparison or control
Outcome

36
Q

What is the definition of Need?

A

The ability to benefit from an intervention

37
Q

What are the Four parts of \Bradshaw’s taxonomy of Need?

A
  • Felt need
  • Expressed need
  • Normative need
  • Comparative need
38
Q

What is Felt need?

A

Individual perceptions of variation from normal health

39
Q

What is Expressed need?

A

Individuals seek help to overcome variation in normal health (demand)

40
Q

What is Normative need?

A

Professionals define intervention that is appropriate for expressed need

41
Q

What is Comparative need?

A

Comparison between severity, range of interventions and cost

42
Q

What are the parts of the Need Led Planning Cycle?

A
  • Needs assessment
  • Planning
  • Implementation
  • Evaluation
43
Q

Give an example of something that is demanded and supplied by not needed

A

Antibiotics for oral illnesses, PSA for prostate cancer

44
Q

Give an example of something that is demanded and needed but not supplied

A

Cure for cancer, cures for chronic disease, Bettie mental health services

45
Q

Give an example of something that is supplied and needed but not demanded

A

Smoking cessation (some cases), alcohol cessation, colorectal screening

46
Q

Give an example of something that is demanded, supplied and needed

A

Free contraception, breast cancer screening, smoking cessation (some cases)

47
Q

What is an Epidemiological health Needs Assessment?

A

A health needs assessment that looks at person, place and time. This looks at the problems based on the extent of the issue

48
Q

What is an advantage of an epidemiological health needs assessment?

A

Addresses a clear problem

49
Q

What are the disadvantages of an epidemiological health needs assessment?

A

Expensive, involves data analysis and collection and reinforces the biomedical model

50
Q

What is a Corporate Health Needs Assessment?

A

A health needs assessment that involves stakeholders e.g. Doctors, funding bodies, patients, politicians

51
Q

What is an advantage of a corporate health needs assessment?

A

Recognises people as important in the service success and is based upon the wishes and needs of relevant parties

52
Q

What is a disadvantage of a corporate health needs assessment?

A

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
Q

What is a Comparative Health Needs Assessment?

A

A healthcare assessment that compare the health needs with similar populations or situations

54
Q

What is a advantage of a comparative health needs assessment?

A

Can see the evidence of benefit and success, can be quick and inexpensive

55
Q

What is a disadvantage of a comparative health needs assessment?

A

Hard to find similar populations

56
Q

What are the parts of Maslow’s Hierarchy of Need?

A

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
Q

Whats the Donabedian Evaluation Framework?

A

Evaluation in the form of:

  • Structure/Inputs
  • Process
  • Outputs
  • Outcomes
58
Q

What is the Black Evaluation Framework?

A

Is about setting priorities

  • Effectiveness
  • Efficiency
  • Equity
  • Humanity
59
Q

What makes Maxwell’s Dimensions of Quality?

A

Remember 3 E’s and 3 A’s

  • Effectiveness
  • Efficiency
  • Equity
  • Acceptability
  • Accessibility
  • Appropriateness
60
Q

Give as many examples of error types as you can

A
  • System error
  • Lack of skill
  • Lack of knowledge
  • Communication breakdown
  • Miss-triage
  • Playing the odds
  • Bravado
  • Sloth
61
Q

Screening Bias - How is selection bias relevant to screening?

A

People who participate in screening may differ to general population e.g. higher socioeconomic groups may be more likely to attend

62
Q

Screening Bias - What is length-time bias in relation to screening?

A

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
Q

Screening Bias - What is lead-time bias in relation to screening?

A

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
Q

What is the definition of Sensitivity?

A

The proportion of people with the disease who are correctly identified by the screening process

65
Q

What is the definition of Specificity?

A

The proportion of people without a disease that are correctly excluded through the screening programme

66
Q

What is a Positive Predictive Value?

A

The proportion of people who have positive screening who turn out to have the disease

67
Q

What is the Negative Predictive Value?

A

The proportion of people who have negative screening who turn out to not have the disease

Phase 3a (5 decks)

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