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Public health Flashcards

1
Q

Domestic abuse definition:

A

Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are, who have been intimate partners of family members

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2
Q

What five types of abuse are there?

A
  • Psychological
  • Physical
  • Sexual
  • Financial
  • Emotional
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3
Q

How can domestic abuse affect health?

A
  • Injuries: fractures, wounds, bruises, haemorrhages
  • Problems with chronic disease: headaches, GI disorders, chronic pain
  • Psychological or psychosocial: PTSD, attempted suicide, substance misuse, depression
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4
Q

How can domestic abuse affect associated children?

A

Long-term impacts on self esteem, education, relationships and adverse stress responses
(there is also a link between child abuse and domestic abuse in later life)

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5
Q

What is the role of a Health Professional with regards to domestic abuse?

A
  • documentation
  • display helping info
  • create environment where people feel they can talk about it
  • ask direct questions
  • acknowledge problem and ensure they understand it is not okay
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6
Q

What should a health professional not do with regards to counselling on domestic abuse?

A
  • Avoid asking patient in front of family members - especially children.
  • Do not tell them what to do - empowering if they come up with solution themselves
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7
Q

What are the definitions of the three risk levels of domestic abuse?

A

Standard: current evidence not indicative of serious harm.
Medium: indicators of risk of serious harm - unlikely unless change in circumstance.
High: imminent risk of harm

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8
Q

How should a health professional act on risk assessment of domestic abuse?

A
  • give contact details for domestic abuse services

- if HIGH RISK then confidentiality can be broken and it can be reported to the police

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9
Q

What is the role of the Multi-Agency Risk Assessment Conference (MARAC)

A

links up to date info about victims, their needs and their risks to the provision of services and responses. It is for victim, children and nasty man/lady/gender-neutral

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10
Q

What is the role of Independent Domestic Violence Advisors (IDVA)

A

Works with women at highest risk from domestic abuse and increases their safety by:

  • advice
  • safety planning
  • support through court
  • signpost to help on housing ± legal services
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11
Q

What is the role of a Domestic Homicide Review?

A

A review of circumstances in which the death of a person aged 16 or over appears to have resulted from violence or neglect from significant other

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12
Q

Health Psychology definition:

A

Emphasises the role of psychological factors in the cause, progression and consequences of health and illness

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13
Q

The three constituents of Health Behaviour include:

A

Health behaviour
Illness behaviour
Sick role behaviour

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14
Q

What do the three constituents of Health Behaviour describe?

A

Health behaviour: aimed at preventing disease (e.g. health eating)
Illness behaviour: seeking remedy (e.g. going to doctor)
Sick-role behaviour: activity aimed at getting well (taking advised meds)

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15
Q

What percentage of patients with chronic disease are compliant with their medications?

A

50%

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16
Q

Give some examples of population-level health promotion…

A

Change 4 life
5-a-day
Stoptober

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17
Q

Give some examples of health interventions on an individual level…

A

Cervical smear screening

MMR vaccine

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18
Q

Why may an individual continue to practice health-damaging behaviour?

A

Inaccurate perceptions of risk and susceptibility.

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19
Q

What can influence an individuals perception?

A
  • Lack of personal experience with the problem
  • Belief that consequence is preventable by personal action
  • Belief that if it has not happened by now then it is unlikely to
    Belief that the problem is infrequent.

(health beliefs, situational rationality, culture, stress and age are also contributors)

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20
Q

How can doctors change health behaviours?

A
  • Working with patient priorities
  • Achievable targets
  • Set and record goals
  • Plan coping strategies
  • Review progress - VERY IMPORTANT
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21
Q

What is the definition of, ‘need’?

A

Ability to benefit from an intervention

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22
Q

What is the definition of, ‘demand?’

A

What people ask for

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23
Q

What is the definition of, ‘supply’?

A

What is provided

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24
Q

What is Health need?

A

The need for health . Examples of measurements include: mortality, morbidity etc.

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25
Q

What is Health Care Need?

A

The ability to benefit from health care intervention

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26
Q

What are the components Health Needs Assessment?

A

A cycle of: needs assessment, planning, implementation and evaluation.

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27
Q

Bradshaw’s Sociological perspective of Health Need consists of:

A

Felt need
Expressed need
Normative need
Comparative need

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28
Q

What is ‘felt need’?

A

Felt need: individual perceptions of variation from normal health.

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29
Q

What is ‘expressed need’?

A

Expressed need: individual seeks to help to overcome variation in health.

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30
Q

What is ‘normative need’?

A

Normative need: professional defines intervention appropriate for expressed need

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31
Q

What is ‘comparative need’?

A

Comparative need: comparison between severity, range of interventions and cost

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32
Q

Health Needs Assessment consists of what three approaches?

A

Epidemiological
Comparative
Corporate

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33
Q

What does the Epidemiological Approach consist of?

A 
Define problem
Size of problem
Services abailable
Evidence base
Models of care
Existing services
Recommendations
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34
Q

Problems with the epidemiological approach?

A

Required data may not be available
Variable data quality
Evidence base may be inadequate
Does not consider the felt needs of people affected

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35
Q

What is the comparative approach?

A

Compares the services received by a population with others:

  • comparing areas
  • considering different social groups (e.g. age, gender, class)
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36
Q

When can you break confidentiality regarding domestic abuse?

A

When high risk is likely and the patient is unwilling to seek help themselves

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37
Q

What is the corporate approach?

A

Consists of contributions from: (THINK Ps because v problematic)

  • commissioners
  • providers
  • professionals
  • patients
  • press
  • politicians
  • opinion leaders
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38
Q

What are the problems with the corporate approach to Health Needs Assessment

A
  • difficult to distinguish need from demand
  • groups have vested interests
  • influenced by political agendas
  • dominant personalities can cause undue influence
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39
Q

Explain what is meant by the comparative approach to Health Needs Assessment

A

Comparing the services received by a certain population with others - categorised by either spatial or social groups

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40
Q

Give one health related example of something you consider that is demanded but not needed or supplied, clearly explaining the reasons:

A

Demanding tests on unwarranted grounds:

  • PSA testing
  • CA125
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41
Q

Outline Maslow’s Hierarchy of needs:

A

Most important first:

  • physiological
  • safety
  • love/belonging
  • esteem
  • self-actualisation (fulfilling potential)
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42
Q

What are the health problems faced by homeless people?

A
  • resp. problems (recurrent infections, smoking, cold/damp)
  • poor condition of feet and teeth (hygiene)
  • infectious diseases (IVDUs, TB)
  • decreased access to services (sexual health, smears, contraception)
  • serious mental illness (predisposes to homelessness or and is exacerbated by)
  • poor nutrition
  • addictions/substance misuse
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43
Q

What are the needs for homeless children?

A
  • stability and emotional security
  • safety
  • immunisations
  • schooling
  • play/pals/toys = development
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44
Q

What are the barriers to healthcare in the homless !

A
  • Difficulties with access to health care: (e.g. opening times, appointment procedures, discrimination (actual and perceived))
  • Lack of integration between primary care services and other agencies
  • Other things on their mind: not prioritising health: more concerned with immediate survival
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45
Q

Barriers to Health for Gypsies

A
  • reluctance for GP to register them
  • reluctance of GP to visit sites
  • poor reading and writing skills
  • communication problems
  • frequent moving of sites
  • mistrust of professionals
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46
Q

What groups are involved in the Homeless Assessment and Support Service? (HASS)

A
  • mental health professionals
  • HIV specialists
  • specialist school nurse
  • outreach family resource worker
  • specialist midwife
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47
Q

What is an asylum seeker?

A

A person who has made an application for refugee status

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48
Q

What is a refugee?

A

A person who has been granted asylum and refugee status

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49
Q

How long can a refugee stay in the UK for?

A

Reapply every 5 years

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50
Q

Who can be granted humanitarian protection?

A

Someone who has not been granted asylum however face serious threat to life if return to homeland

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51
Q

What are asylum seekers entitled to?

A
  • £35 a week
  • housing
  • NHS care
  • social services and school
  • NOT ALLOWED TO WORK AND NO OTHER FORM OF BENEFIT
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52
Q

What are failed asylum seekers entitled to?

A

jack shit

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53
Q

What are the barriers to healthcare for asylum seekers?

A
  • lack of knowledge of NHS/where to get help
  • language/culture/communication
  • moving around a lot
  • not a homogenous group (refugees from different parts of world)
  • health not a priority
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54
Q

What issues may an asylum seeker have encountered?

A
  • separation from family
  • hostility
  • racism
  • poverty
  • poor housing
  • unemployment
  • detentions
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55
Q

What physical health problems may an asylum seeker have?

A
  • common illnesses
  • illnesses specific to country of origin (e.g. malaria?)
  • injuries from war/travel
  • no prev. health surveillance (screening/jabs)
  • malnutrition
  • torture
  • sexual abuse
  • communicable and blood-borne disease
  • untreated chronic disease
    (Mulberry practice helps with this)
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56
Q

What should you be aware about when considering the psychological health of a refugee?

A
  • symptoms can vary between individuals and from different situations
  • psychological expression is culture bound
  • apparently, psychological distress is common if you have fled a war zone
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57
Q

According to the Health Belief Model, individuals will change if they…

A
  • believe they are susceptible to the condition
  • believe there are serious consequences
  • believe taking action will reduce susceptibility
  • believe that benefits of taking action outweigh cost

(similar to screening criteria + what impacts perception of health psychology)

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58
Q

What are the problems with the Health Belief model?

A
  • alternative factors may influence behaviour: outcome expectancy + self efficacy (self belief)
  • cognitively based model - doesn’t consider influence of behaviour or emotions
  • cues to action are often missing in research
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59
Q

What does the Health Belief Model now consider;

A
  • demographics
  • psychological characteristics - e.g. personality
  • cues to action
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60
Q

According to the Theory of Planned Behaviour, what is the best predictor of behaviour?

A

Intention

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61
Q

According to the Theory of Planned Behaviour, what is intention determined by?

A
  • attitude to behaviour
  • subjective norm (perceived social pressure)
  • perceived behavioural control (appraisal of ability to perform the behaviour)
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62
Q

According to the Theory of Planned Behaviour, how do you bridge the intention-behaviour gap?

A
  • empower patient - increasing their perceived control
  • anticipated regret
  • preparatory actions (give sub-goals)
  • implementation intentions (start date of intervention)
  • relevance to self
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63
Q

What are the problems with the Theory of Planned Behaviour?

A
  • doesn’t take into account emotion
  • doesn’t explain how attitudes, intentions and perceived behavioural control interact
  • does not take into account habits and routines
  • assumes attitudes, subjective norms and perceived behavioural control are measurable
  • relies on self-reported behaviour
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64
Q

According to the Transtheoretical model, what are the 5 stages of change?

A
  • pre-contemplation
  • contemplation
  • preparation
  • action
  • maintenance
  • (relapse at any stage)
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65
Q

What are the advantages of the Transtheoretical model?

A
  • acknowledges stages of readiness
  • accounts for relapse
  • temporal element - takes time into account
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66
Q

What are the disadvantages of Transtheoretical model?

A
  • not all people move through every stage
  • change may be continuous, not discrete
  • doesn’t take into account values or culture
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67
Q

What are the typical transition points for behaviour change?

A
  • leaving school
  • entering work
  • becoming a parent
  • becoming unemployed
  • retirement
  • bereavement
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68
Q

What is the definition of evaluation?(of health service)

A

The assessment of whether a service achieves its objectives

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69
Q

What are the elements of to Donebedian’s framework for health services?

A
  • structure
  • process
  • outcome
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70
Q

What is meant by Donebedian’s structure?

A

What is there? - e.g. facilities like buildings, staff, bed

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71
Q

What is meant by Donebedian’s process?

A

What is done? - e.f. number of patients seen

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72
Q

What is meant by Donebedian’s outcome?

A

Classification of health outcome - e.g. mortality, morbidity, QOL, patient satisfaction

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73
Q

Describe the appearance of Donebedian…

A
  • elderly chap
  • good beard
  • fashionable glasses
  • very serious expression
  • v. black and white.
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74
Q

What are the issues of measuring health outcome? (Donabean)

A
  • link between service provided and health outcome may be difficult to establish as many other factors may be involved
  • time lag between service provided and outcome may be long
  • large sample size may be needed
  • data may not be available (shit 1)
  • may be issues with data quality (shit 2)
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75
Q

What are the elements of Maxwell’s Dimensions of Quality?

A
  • effectiveness
  • efficiency
  • equity
  • acceptability
  • assessibility
  • appropriateness
    3as and 3es
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76
Q

What two forms of data can be collected?

A
  • qualitative

- quantitative

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77
Q

What are the types of observational studies?

A
  • cohort = prospective

- case-control = retrospective

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78
Q

What are the positives of a cohort study?

A
  • good for rare exposures

- includes may risk factors

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79
Q

What are the negatives of a cohort study?

A
  • takes bare long so people die/move/drop off
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80
Q

What are the positives of a case-control study?

A
  • v. quick

- good for rare outcomes (not rare exposure)

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81
Q

What are the negatives of case-control study?

A
  • conditions are rare so difficult to find controls
  • hard to find a similar-enough populations
  • high risk of selection of information-bias
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82
Q

What is a cross sectional study?

A
  • prevalence study (snapshot of time): who has what at a particular moment of time within a certain population
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83
Q

What is an ecological study?

A
  • comparison of two cross-sectional studies (e.g. comparing prevalence in different cities)
84
Q

What is the gold standard study design for evidence?

A
  • RCT
85
Q

What are the advantages of RCT?

A
  • minimise bias
  • minimise confounding factors
  • measure many different outcomes
  • only trial where you can confidently infer causality
86
Q

What are the disadvantages of RCT?

A
  • time consuming
  • expensive
  • can be unrepresentative of population
  • people take part but don’t finish
87
Q

What are the reasons for an association noted in a study?

A
  • true association (causality)
  • reverse causality
  • confounding factors
  • pure chance
  • bias
88
Q

What is the WHO definition of health?

A

A state of complete physical, mental and social well-being and not merely the absence of disease and infirmity

89
Q

What is public health?

A

The science and art of preventing disease, prolonging life and promoting health through organised efforts of society

90
Q

What are the three domains of pubic health?

A
  • health improvement/promotion
  • health protection
  • improving services
91
Q

What is primary prevention?

A

Prevent a disease before it occurs

92
Q

Give an example of primary prevention…

A

Vaccinations

93
Q

What is secondary prevention?

A
  • Reducing the impact of a disease by halting or slowing its progression by detecting it early
  • also defined as reducing the recurrence of the same disease
94
Q

Give examples of secondary prevention

A

Screening (e.g. breast cancer, HPV)

Aspirin (stopping recurrence of MI or stroke)

95
Q

What is tertiary prevention?

A

Minimising disability and preventing complications of disease

96
Q

Give an example of tertiary prevention

A
  • Rehab after stroke

- dexamethasone on in meningitis

97
Q

What is the prevention paradox?

A

Something that brings about benefit to the population as a whole, however is not always felt on an individual level (e.g. wearing a seat belt)

98
Q

What four aspects of screening are considered within the Wilson and jungner criteria?

A
  • the condition
  • the test
  • the treatment
  • risks and benefits
99
Q

What are the Wilson and Junger Screening Criteria?

A
    • The condition –
      1) Condition should be important health problem
      2) Natural history should be well understood
      3) Should be a detectable early stage
  • -The treatment–
    4) Should be accepted treatment with the disease
    5) Facilities for diagnosis and treatment should be available
    6) Adequate health service provision should exist for people found positive on screening
  • -The test–
    7) A suitable test should exist for the early stage
    8) Test should be acceptable
    9) Should be repeated (not a one off)
  • -Risks and benefits–
    10) Should be an agreed policy on whom to treat
    11) Costs should be balanced against benefits
    12) Risks, psychological and physical, should be less than the benefit
100
Q

Give 6 examples of screening…

A
  • bosom cancer
  • : cancer
  • STI screening
  • newborn hearing
  • diabetic retinopathy
  • cervical screening
  • NHS health checks
101
Q

What are the two highest risk HPVs for cervical cancer?

A

16 and 18 - these are the ones detected on screening

102
Q

How regularly and between what ages is cervical screening carried out?

A

Between aged 25 and 64:

  • 25-50 = 3 yrly
  • 50-64 = 5 yrly
103
Q

What HPVs are vaccinated against, and when is it done?

A
  • 6, 11, 16, 18

- first vaccine is aged 13, then a booster 6-12 months later

104
Q

How often is breast screening done?

A
  • age 50-70 = every three years
105
Q

What happens if somebody has a positive breast screening test?

A
  • triple assessment:
    • imaging (US, if over 40 = mammography as well)
    • core biopsy (or fine needle aspiration)
    • clinical assessment
106
Q

What is tested in the newborn heel-prick test?

A
  • MCADD
  • cystic fibrosis
  • congenital hypothyroidism
  • phenylketonuria
  • maple syrup urine disease
  • Sickle Cell anaemia
107
Q

On a screening test, define a false positive result..

A

A result that says they have the disease, when they don’t really have the disease :(

108
Q

On a screening test, define a false negative result…..

A

A result that says they do not have the disease, when they actually do have the disease :( :(

109
Q

Define sensitivity with regards to screening…

A

The proportion of those with a disease who are correctly picked up by the screening test. (measure of disease)

true positive / (true positive + false negative)

110
Q

Define specificity with regards to screening…

A

The proportion of people without the disease who are correctly identified as not having the disease (measure of disease)

true negative/ (true negative + false positives)

111
Q

Define positive predicted value with regards to screening

A

Out of those with a positive result, what proportion actually have the disease
(measure of test)

true positive/ (true positive + false positive)

112
Q

Define negative predicted value

A

Out of those with a negative result, what proportion actually do not have the disease?
(measure of test)

true negative/ (true negative + false negative)

113
Q

What is length time bias?

A

Less aggressive disease (generally longer lived) will be picked up on screening more than more aggressive disease (generally shorter) because screening is done at regular intervals so they might miss out

114
Q

What is lead-time bias?

A

Diseases with insidious onset are picked up earlier so it appears they have a longer survival rate due to the screening, when actually it has just been picked up at an earlier point.

115
Q

What is prevalence?

A

The number of people with a disease at a point in time.

116
Q

What is incidence?

A

The number of new cases of a disease per unit population per time.

117
Q

What is odds with relation to disease frequency

A

affected: uneffected

118
Q

What are the 5 things that can lead to an association?

A
  • bias
  • confounding
  • chance
  • reverse causality
  • true association
119
Q

What is a communicable disease?

A

A disease that can be transferred from one person, to another

120
Q

What are the methods of prevention and management of communicable disease?

A
  • vaccination
  • education
  • prophylaxis
  • contact tracing
  • monitoring and surveilling
  • treatment
121
Q

What are the 3 parties involved in the chain of infection?

A
  • reservoir
  • agent
  • host
122
Q

Describe the portal of exit 😉

A

wink wink you’ll never know

123
Q

What are the three types of transmission?

A
  • direct
  • indirect
  • airborne
124
Q

What are the components of the incubation period?

A
  • incubation period = latent + infectious
125
Q

What is an endemic?

A

Persistent level of disease occurrence

126
Q

What is a hyper-endemic?

A

Persistent high levels of disease occurrence

127
Q

Define sporadic disease…

A

Irregular pattern or occurrence

128
Q

What is an epidemic?

A

Occurrence within one area in excess of expected in given time

129
Q

What is pandemic?

A

Epidemic, widespread over several countries

130
Q

What are the two definitions of outbreak?

A
  • 2 more more cases of a disease that are c

- occurrence of a disease in an areas that it isn’t expected

131
Q

What is a propagated outbreak?

A
  • outbreak spreading from person to person gradually
132
Q

Name sone notifiable diseases please…

A
  • acute encephalitis
  • acute meningitis
  • diptheria
  • malaria
  • measles
  • meningococcal septicaemia
  • mumps
  • rubella
  • scarlet fever
  • tuberculosis
  • whooping cough
133
Q

What is Gillick competence?

A
  • the ability of a patient under the age of 16 to consent to a medical treatment.
134
Q

What are the components of Gillick competence?

A

Are they able to…

  • understand what is being asked of them?
  • reason the pros and cons?
  • retain the information
  • are they able to respond/relay their answer?
135
Q

What are the fraser guidelines for?

A

These have to be met when assessing whether you should give a patient under the age of 16 contraception

136
Q

What are the components of the Fraser guidelines?

A
  • are they able to understand the treatment
  • would they continue to have unprotected sex without the contraception
  • if you do not give the contraception then they are likely to come to physical or psychological harm
  • cannot be persuaded to tell their parents
  • it is in their best interest to give them the contraception
137
Q

What is an advanced directive?

A
  • up to date and treatment-specific decisions made when a patient has capacity. Provides autonomy to patient and allows for their wishes to be carried out.
138
Q

What is a lasting power of attorney?

A

An allocated individual who is appointed to make decisions on behalf of the patient when the patient has capacity However they cannot consent or demand to anything but can refuse a treatment.
- can however be revoked if the lasting power of attorney is not acting in the patients best interest

139
Q

What is involved when acting in a patient’s best interest?

A
  • patient’s previous views

- family discussion regarding patients previous and future wishes - these are not determinant though.

140
Q

What does DOLS stand for?

A

Deprivation of Liberty Safeguards

141
Q

Describe the role of DOLS

A
  • depriving a patient of their liberties for their own safety, e.g. forcing to have medication, restricting access to areas, (e.g. if delirious not letting them outside), or taking their keys off them
142
Q

What’s the criteria for the use of DOLS?

A
  • over 18
  • have a mental illness (dementia, learning disability, anorexia nervosa)
  • not be able to be treated under mental health act –> cannot be sectioned
  • cannot have mental capacity
  • whatever you do has to be in their best interests
  • there cannot be an advanced decision that would override the DOLS
143
Q

What is the gold standard study design to provide evidence?

A
  • Meta-analyses
144
Q

Outline the hierarchy of study design (into three broad categories)

A

(top to bottom)

  • studies of studies
  • experimental studies
  • observational studies
145
Q

What are the three observational studies?

A
  • cohort studies
  • case control studies
  • case reports
146
Q

What are the two experimental studies?

A
  • RCTs

- quasi-experimental studies

147
Q

What are the two studies of studies?

A
  • meta-analyses

- systematic reviews

148
Q

What is the difference between a case-control study and a cohort study?

A
  • case control studies starts with people who do/don’t have the disease and analyse the differences in exposures
  • Cohort studies starts with assessing exposures and measure the onset of disease
149
Q

What is an ecological study and what does it measure?

A

A study carried out at a population level rather than an individual level that is often used to measure prevalence

150
Q

What does a cross-sectional study measure?

A

Measures prevalence amongst individuals

151
Q

What are the strengths of an RCT?

A
  • minimise bias and confounders
  • multiple outcomes can be studied and
  • Incidence of outcome can be measured
  • strong evidence of causal relationships between intervention and outcome can be provided
152
Q

What are the weakness of an RCT?

A
  • expensive
  • big study teams needed
  • multi-centre studies
  • ethical concerns
  • complex to manage
  • large drop outs
  • conflicting evidence from trials can occur
153
Q

What are the stopping rules of an RCT?

A

if clear harm of benefit then a trial can stop to ensure:

  • undue risk to participants
  • control group aren’t being deprived an effective intervention
  • continuing an ineffective intervention
154
Q

What are the three components of evidence-based medicine?

A
  • clinical judgement
  • relevant scientific evidence
  • patient’s values and preferences
155
Q

What are the 9 aspects of the Bradford-Hill criteria?

A
  • strength
  • consistency
  • specificity
  • temporality
  • biological gradient
  • plausibility
  • coherence
  • experiment
  • anal(ogy)
156
Q

What is PICO?

A
  • population
  • interventions/exposure
  • comparison/control
  • outcome
157
Q

What is bias?

A

Systematic error in studies that lead to an error in conclusions or skewed results

158
Q

What types of bias exist?

A
  • observer
  • measurement
  • lead-time
  • length
  • publishing –> only publishing results that help YOU
159
Q

How can you remove bias?

A

Blinding in studies

160
Q

What is single-blinding?

A

When the people taking part in the study do not know which group they are in

161
Q

What is double-blinding

A

Both researchers and participants do not know what group they are in

162
Q

How can you minimise the effect of chance?

A

Large and evenly distributed samples

163
Q

What is a confounder?

A

A factor that independently influences the outcome of a situation but doesn’t lie on the causal pathway. The confounder is the common factor. e.g. smoking, coffee consumption and lung cancer. Smoking is the confounding factor

164
Q

What is the P-value?

A

The probability of an event occurring, given the null hypothesis is true (between 0-1). AKA the probability of the relationship being due to chance/ whether result is statistically significant.

165
Q

What does a small P-value infer?

A

Results are unlikely when null hypothesis is true

166
Q

What does a large P-value infer?

A

Results are likely when the null hypothesis is true

167
Q

What is a Type I error?

A

False positives, accidentally rejecting the null hypothesis

168
Q

What is a Type II error?

A

False negatives, accidentally not rejecting the null hypothesis when it is actually false

169
Q

What are the four ethical pillars?

A
  • autonomy
  • beneficience
  • non-malificence
  • justice
170
Q

What is autonomy?

A

The right to choose for yourself your own treatment.

171
Q

What is beneficence?

A

To do good: the welfare of the patient is the priority

172
Q

What is non-maleficence?

A

To do no harm: ensure your actions do not cause harm

173
Q

What is justice?

A

Fairness to all - e.g. fair distribution of scarce resources

174
Q

What is utilitarianism?

A

Resources being allocated to less expensive treatments that provide greatest benefit. e.g. QALY

175
Q

What is deontology?

A

Based on morals alone. Consequences are not taken into consideration

176
Q

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

A
  • antibiotics for viral illness
  • PSA
  • CA125
177
Q

Give an example of something demanded and needed but not supplied…

A
  • cure for cancer

- better mental health

178
Q

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

A
  • smoking cessation,
  • alcohol cessation
  • colorectal cancer
179
Q

What are the five levels of Maslow’s Hierarchy of Need?

A

From bottom to top

  • physiological needs
  • safety
  • love and belonging
  • esteem
  • self actualisation = reaching your own potential (Karren has surpassed hers…. the worm)
180
Q

Give two questionnaires used to assess drinking habit…

A

CAGE

AUDIT

181
Q

What are the limits for driving?

A
  • 35 micrograms in 100 mls of breath

- or 80 mg /100 ml of blood

182
Q

How many units are recommended per week?

A

14 units per week

183
Q

What is a unit?

A

Jonathan

184
Q

What is a unit of alcohol?

A

8g of alcohol

185
Q

How do you calculate the number of units in a drink?

A

(vol in mls x % alcohol of drink ) / 1000

186
Q

Why do men metabolise alcohol faster?

A
  • lower body fat percentage
187
Q

What factors play a role in problem drinking?

A
  • occupation - e.g.doctor
  • availability - e.g. doctor wage
  • advertising
  • peer group - e.g. other doctors
  • family - e.g. religion, tradition, culture (family of doctors)
  • genetics
  • physique/health/gender
188
Q

What are the risk factors for problem drinking?

A
  • drinking in the family
  • childhood problem behaviour
  • early use of alcohol and drugs
  • poor coping responses to life events
  • depression
189
Q

What are the common causes of death due to alcohol?

A
  • accidents and violence
  • malignancies
  • cerebrovascular disease
  • coronary heart disease
190
Q

What system of the body does alcohol cause disease?

A

everywhere

191
Q

Give features of foetal alcohol syndrome…

A
  • small weight
  • slack muscle tone
  • mental retardation
  • facial appearance
    • epicanthic folds
    • thin upper lip
    • short, palpebral, fissure
    • smooth philtrum
    • microcephaly
    • upturned nose
    • hypoplastic jaw
  • renal
  • cardiac
192
Q

How would you manage an alcoholic requesting help?

A
  • physical and mental assessment
  • offer appropriate investigations:
  • follow up
  • referral
  • address other health issues
193
Q

What blood tests would you do and what would you expect to see if an individual was alcohol dependent?

A
  • Gamma GT would be raised

- MCV raised = due to folate deficiency anaemia

194
Q

What services are available for drug users?

A

SEX-C SHIT

  • sexual health screening
  • EXchange of needles
  • Contraception
  • Signposting
  • Health check- full
  • Immunisations (all the Heps)
  • Treatment = detox
195
Q

What do you give for alcohol detox?

A

Chlordiazepoxide

- and PABRINEX pls

196
Q

What is the drug treatment for heroin users?

A
  • Buprenorphine = safer = partial agonist
  • methadone
  • or lofexidine if not been a user for long, very young or want a rapid detox
    (Naloxone = opioid reversal agent)
197
Q

What are the withdrawal symptoms of heroin?

A
  • low energy
  • irritability
  • anxiety
  • agitation m
  • insomnia
  • aches and pains
  • abdo. cramping
198
Q

What is a never event?

A

Adverse events that should never happen

199
Q

Give examples of never events

A
  • wrong site of surgery
  • wrong implants
  • wrong route of administration
  • insulin OD
  • OD methotrexate
  • fall from windows
  • mental health stuff (leaving ligatures around innit)
200
Q

What are the four steps of negligence?

A
  • there was a duty of care
  • the duty of care was breached
  • a patient came to harm
  • the harm was due to the breach in the duty of care
201
Q

What is the Bolitho Caveat?

A

A judge can disagree with a panel of medics if they think it is unacceptable

202
Q

What is the inverse care law?

A

people who need healthcare most are the least likely to access it

203
Q

What is equality?

A

Giving people the same despite unequal needs

204
Q

What is equity?

A

Giving people varied resources to ensure they reach the same outcome/level of health

205
Q

What are the two types of equity?

A
  • horizontal = treating people the same

- vertical = redistribution of income

Public Health (1 decks)

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