Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine - Finals > Public Health > Flashcards

Public Health Flashcards

1
Q

Define epigenetics

A

How the expression of a genome can be affected by the environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define allostasis

A

The process of achieving stability (homeostasis) through physiological or behavioral change

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is allostatic load?

A

Long-term overtaxation of our physiological systems leading to impaired health (stress)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define salutogenesis

A

Favourable physiological changes secondary to experiences which promote healing and health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Define emotional intelligence

A

Ability to identify and manage one’s own emotions, as well as those of others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is health?

Define public health.

A

State of complete physical, mental and social well-being (not merely absence of disease and infirmity)

Science and art of preventing disease, prolonging life and promoting health through organised efforts of society.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 domains of public health?

A

Health promotion/improvement
Health protection
Improving services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the public health domain health promotion/improvement concerned with?

A

Lifestyle: Change4Life, NHS Quit smoking, Cough to 5K
Education
Employment
Housing
Surveillance and monitoring of specific diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the public health domain of health protection concerned with?

A 
Measures to control:
Infectious diseases
Radiation
Environmental disasters
Emergency responses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give an example of how Public Health England improves services?

A

Clinical effectiveness
Efficiency
Audit and evaluation
Clinical governance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 3 key concerns of public health?

A

Inequalities in health
Wider determinants of health
Prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can health interventions be applied?

A 
Individual level (vaccines to prevent individual illness)
Community level (opening new outdoor play area in town)
Population level (iodine in salt to prevent iodine deficiency)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What needs to be carried out before a health intervention is made?

A

Health needs assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a health needs assessment?

A

Systematic method for reviewing the health issues facing a population

Leading to agreed priorities and resource allocation that will improve health and reduce inequalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 4 components of a health needs assessment?

A

Needs assessment
Planning
Implementation
Evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 3 different approaches of health needs assessments?

A

Epidemiological
Comparative
Corporate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Define need

A

Ability to benefit from an intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Define demand

A

What people ask for

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define supply

A

What is provided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a health need, and how is it measured?

A

A need for health

Measured using:
Mortality
Morbidity
Socio-demographic measures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a health care need?

A

The ability to benefit from health care

Depends on the potential for prevention, treatment and care services to remedy health problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the 4 sociological perspectives of need (aka Bradshaw’s taxonomy of need)?

A

FENC
Felt: individual perceptions of variation from normal health
Expressed: individual seeks help to overcome variation in normal health
Normative: professional defines intervention appropriate for expressed need
Comparative: comparison between severity, range of interventions and cost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does an epidemiological approach to a health needs assessment involve?

A

Define problem
Look at size of problem (incidence/prevalence)
Services available (prevention/Rx/care)
Evidence base (effectiveness and cost-effectiveness)
Models of care (quality and outcome measures)
Existing services (unmet need; services not needed)
Recommendations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Give some potential sources of data for an epidemiological HNA?

A 
Disease registry
Hospital admissions
GP databases
Mortality data
Primary data collection (e.g. postal/patient survey)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Give 2 advantages of an epidemiological HNA?

A

Uses existing data
Provides data on disease incidence/mortality/morbidity, etc
Can evaluate services by trends over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Give 2 disadvantages of an epidemiological HNA

A

Quality of data variable
Data collected may not be data required
Does not consider felt needs/opinions of people affected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does a comparative approach to a HNA involve?

A

Compares the services received by a population/group with those received by a similar group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What factors might a comparative HNA examine?

A

Health status
Service provision
Service utilisation
Health outcomes (mortality, morbidity, QoL, patient satisfaction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Give 2 advantages of a comparative HNA

A

Quick and cheap (if data available)
Indicates whether health/services provision is better/worse than comparable areas (gives measure of relative performance)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Give 2 disadvantages of a comparative HNA

A

Difficulty finding comparable population
Data may not be available/high quality
May not yield what the most appropriate level (e.g. of provision or utilisation) should be

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What does the corporate approach to a HNA involve?

A

Ask local population what their health needs are
Uses focus groups, interviews, public meetings, etc
Wide variety of stakeholders (eg teachers, healthcare professionals, social workers, charity workers, local businesses, council workers, politicians)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Give 2 advantages of a corporate HNA

A

Based on felt + expressed needs
Recognises detailed knowledge and experience of those working with the population
Takes into account wide range of views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Give 2 disadvantages of corporate HNA

A

Difficult to distinguish ‘need’ from ‘demand’
Groups may have invested interests (biased)
May be influenced by political agendas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Define primary prevention and give an example

A

Preventing disease before it has happened

Eg Change4life, 5 a day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Define secondary prevention and give an example

A

Catching a disease in its early/ pre-clinical phase

Eg Breast screening programme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Define tertiary prevention and give an example

A

Preventing complications of a disease

Eg diabetic foot care, attending physio/rehab after a stroke to prevent immobility and aspiration pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are the 2 general approaches to prevention?

A

Population approach (preventive measures, e.g. adding iodine to salt to prevent iodine deficiency; dietary salt restriction through legislation to reduce BP)

High risk approach (identifying individuals above a chosen cut-ff and treat, e.g. screening for HTN)

38
Q

What is meant by prevention paradox?

A

Preventative measure which brings much benefit to the population often offers little to each participating individual

ie screening a large number of people to help a small number of people, e.g. enforcing the use of seatbelts

39
Q

What is screening?

A

Process which picks out apparently well people who are at a risk of a disease, in the hope of catching the disease at its early stage

40
Q

What are the Wilson and Hunger criteria needed for a screening programme?

A

1) Disease important problems
2) Recognisable early symptoms
3) Known progression of disease
4) Acceptable test
5) Treatment available
6) Agreed at-risk population to screen
7) Agreed policy on whom to treat
8) Cost < Benefit of screening

41
Q

Give the 6 key types of screening

A 
Population-based (eg breast cancer)
Opportunistic (eg BP in GP)
Communicable diseases
Pre-employment and occupational medicals
Commercially provided (eg genetic info)
Genetic counselling (people with FHx disease)
42
Q

Give 3 disdvantages of screening

A
  1. Exposure of well individuals to distressing or harmful diagnostic tests
  2. Detection and Rx of sun-clinical disease that would never have caused any problems
  3. Preventative interventions that may cause harm to the individual or population
43
Q

What is sensitivity? How is it calculated?

A

Proportion of people with the disease who are correctly identified

a/a+c (a = true +ve; c = false -ve)

44
Q

What is specificity? How is it calculated?

A

Proportion of people without the disease who are correctly excluded

b/b+d

45
Q

What is the PPV and how is it calculated?

A

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

True positive / [true positive + false positive’

46
Q

What is the NPV and how is it calculated?

How is it affected by prevalence?

A

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

True negative / [true negative + false negative]

NPV is lower if prevalence is higher

47
Q

Define incidence?

Define prevalence?

A

Incidence = no. new cases in a population over a given time period

Prevalence = no. cases in a population at a specific point in time

48
Q

What is meant by lead time bias?

A

Screening identifies outcome earlier that it would have otherwise been identified.
Results in apparent increase in survival time, even if screening has no effect on outcome

49
Q

What is meant by length time bias?

A

Screening may identify more indolent diseases that have longer courses, but miss shorter more aggressive diseases. May affect the apparent efficacy of a screening method

50
Q

What is a case control study? Advantage? Disadvantage?

A

Retrospective. Looks at people with a condition and matches them to people without the condition for age/sex/habitat, etc.

Study previous exposure to agent in question.

Good for rare outcomes and can investigate multiple exposures.

Susceptible to RECALL bias

51
Q

What is a cohort study? Pros and cons?

A

Usually prospective. Looks at a population without the disease and studies over time to see whether exposed to agent in question and whether they develop the disease.

Absolute, relative and attributable risks can e calculated. Good for common outcomes.

Takes a long time. High drop out rate. Large sample size required.

52
Q

What is a RCT? Pros and cons?

A

Patients randomised into groups - one given intervention, other given placebo. Outcome mreasured.

Confounding and biases minimised. Shows causation.

Time consuming, expensive, ethical issues (withholding treatment)

53
Q

What is an independent variable?

What is a dependent variable?

A

A variable that can be altered in a study

A variable that is dependent on the independent variables, or one that cannot be altered

54
Q

What is meant by the ‘odds’ of an event, and how is it calculated?

A

The odds of an event is the ratio of the probability of an occurrence compared to the probability of a non-occurrence

55
Q

What is meant by odds ratio and how is it calculated?

A

P(exposed)/[1-P(exposed)] / P(unexposed)/[1-P(unexposed)]

56
Q

What is meant by epidemiology?

A

The study of frequency, distribution and determinants of disease and health related states in populations in order to prevent and control disease

57
Q

Define incidence rate

A

[Number of people who have become cases in a given time period] / [total person-time at risk during that period]

58
Q

What is the denominator of incidence rate?

A

Person-time

59
Q

What is meant by person time?

A

The measure of time at risk, i.e. time from entry to a study to:

1) disease onset
2) loss to follow-up
3) end of study

60
Q

What is meant by attributable risk, and how is it calculated?

A

Rate of disease in exposed that may be attributed to the exposure

Attributable risk = incidence in exposed - incidence in unexposed

61
Q

What is meant by relative risk, and how is it calculated?

A

Ratio of risk of disease in the exposed to the risk in the unexposed

Relative risk = incidence in exposed / incidence in unexposed

62
Q

What is relative risk reduction, and how is it calculated?

A

Reduction in rate of outcome in intervention group relative to control group

[Incidence in unexposed - incidence in exposed] / incidence in unexposed

63
Q

What is the absolute risk reduction?

A

Absolute difference in rate of events between 2 groups

Incidence in unexposed - incidence in unexposed

64
Q

What is meant by NNT? How is it calculated?

A

Number of patients that need to be treated to prevent one bad outcome

NNT = 1/absolute risk reduction

(i.e. risk in unexposed - risk in exposed)

65
Q

What are the 5 factors that could be responsible if a study finds an association between an exposure and an outcome?

A 
Bias
Chance
Confounding
Reverse causation
True causation
66
Q

Define bias

A

Systematic deviation from the true estimation of the association between an exposure and an outcome

67
Q

What are the 3 main types of bias?

A

Selection (eg non-response, loss of follow up)
Information (eg measurement)
Publication (eg negative results may be less likely to be published)

68
Q

What are some potential sources of information/measurement bias?

A

Observer
Participant (recall, reporting)
Instrument (calibration)

69
Q

What is meant by confounding?

A

A situation in which the estimate of association between an exposure and outcome is distorted because of the association of the exposure and another factor (confounder) that is also indepenently associated with the outcome

70
Q

What are the Bradford-Hill criteria for causality?

A 
Strength of association
Dose-response
Reversibility
Biological plausibility 
Consistency
Temporality
Analogy etc
71
Q

What are the 3 main types of health behaviours?

A

Health (prevent disease, eg healthy eating)
Illness (seeking remedy, eg going to Dr)
Sick role (getting well, eg taking meds)

72
Q

What is the theory of planned behaviour?

What are the 3 factors that determine intention in the theory of planned behaviour?

A

Proposes that the best predictor of behaviour is INTENTION ie “I intend to give up smoking”

Attitude (think smoking is bad)
Subjective norms (people want me to stop smoking)
Perceived behavioural control (i CAN give up smoking)

73
Q

What are some criticisms of the theory of planned behaviour?

A

Does not take into account emotions
Relies on self-reported behaviour
Lack of temporal element
Assumes that attitudes, subjective norms and perceived behavioural control can be measured

74
Q

What are the 6 stages of the stages of chance model?

A 
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Relapse
75
Q

What are 3 advantages of the stages of change model?

A

Acknowledges individual stages of readiness
Accounts for relapse
Gives an idea of time-frame/progression

76
Q

Give a disadvantage of the stages of change model

A

Does not take into account values, habits, culture, social and economic factors

Not all people move through every stage

77
Q

What are the 4 factors of the health belief model?

A

Perceived:

  1. Susceptibility
  2. Severity
  3. Benefits
  4. Barriers
78
Q

Which factor of the health belief model has been shown to be most important?

A

Perceived barriers

79
Q

Give 3 disadvantages of the health belief model

A

Does not consider emotions and behaviour
Does not differentiate between first time and repeat behaviour
Cues to action are often missing

80
Q

What are some examples of cues to action which may influence behaviour change

A

Internal (increase in pain, decrease in ADLs)

External (reminders in post, pressure from families, etc)

81
Q

Give 4 factors that can be used to help people act on their intentions

A

Perceived control
Anticipated regret
Preparatory actions
Implementation intentions

82
Q

What are 3 allocation theories?

A

Egalitarian (all care necessary and appropriate is provided - difficult with finite resources)
Utilitarian (maximise public utility)
Libertarian (individual is responsible for their own health)

83
Q

Give 6 of the GMC duties of a doctor

A

1) care of patient = first concern
2) protect + promote health
3) provide good standard of practice + care
4) treat patients as individuals, respect dignity and confidentiality
5) work in partnership with patients
6) be honest, open and act with integrity

84
Q

What is meant by primary, secondary and tertiary intention with respect to wound healing?

A

Primary: little/no tissue loss, wound edges directly opposed

Secondary: wound edges not opposed, granulation and epithelialisation occurs

Tertiary: wound purposefully left open (eg debridement needed) - surgically closed later

85
Q

Give 3 patient factors that act as a barrier to healing

A 
Elderly
Diabetes
Malnutrition
Malignancy
Renal/hepatic failure
Drugs
Immunosuppression
Vitamin deficiencies
86
Q

5 main types of wound dressing?

A 
Hydrogel
Alginate
Hydrocolloid
Foams 
Non-adherent dressings
87
Q

What tool can be used to assess domestic abuse?

A

DASH tool (domestic abuse and sexual harassment tool)

88
Q

What do you do if you believe someone is HIGH risk for domestic abuse?

A

Refer to MARAC/IDVAS where possible (with consent)

Can break confidentiality if consent not obtained

89
Q

What is the definition of an evaluation of health services?

A

Assessment of whether a service achieves its objectives

90
Q

What are the 3 elements of the Donabedian framework for a health service evaluation?

A

Structure (buildings, staff, equipment)
Process (what is done, e.g. no patients seen in A+E)
Outcome (morbidity, mortality, QALYs, PROMs, patient satisfaction) - or 5 Ds - death, disease, disability, discomfort, dissatisfaction

Medicine - Finals (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions