Public Health

Question 1

What are the 8 duties of a doctor?

Answer 1

1. Care of patient = first concern
2. Keep knowledge and skills up to date
3. Treat patient politely and considerately
4. Respect right to confidentiality
5. Listen, respond to concerns and preferences
6. Never discriminate
7. Work with colleagues to best serve patient
8. Treat as individuals, respect their interest

Question 2

What type of personality increases risk of CHD?

Answer 2

Type A - hostile, competitive, impatient

Question 3

What psychosocial factors can increase risk of CHD?

Answer 3

1. Type A personality
2. Depression/anxiety
3. Psychosocial work characteristics
4. Lack of social support

Question 4

What psychosocial work characteristics can increase risk of CHD?

Answer 4

High demand, low control

>11hs per day

Question 5

What can doctors do for those with psychosocial CHD risk?

Answer 5

Screen for depression/anxiety
Ask about occupation
Liaise with social support
Vascular screening
Risk reduction - promote healthier lifestyle

Question 6

What is the Bradford Hill criteria?

Answer 6

Set of nine criteria to provide epidemiologic evidence of a causal relationship between a presumed cause and an observed effect

Question 7

What are the nine criteria for evidence of cause and effect?

Answer 7

1. Strength of association
2. Consistency (reproducibility)
3. Specificity
4. Temporality
5. Dose response
6. Removal
7. Biological plausibility
8. Experimental

Question 8

What is strength of association? (BHC)

Answer 8

Large association = more likely to be causal

Question 9

What is consistency? (BHC)

Answer 9

Reproducibility = consistent findings observed by different persons in different places with different samples

Strengthens the likelihood of an effect

Question 10

What is specificity?

Answer 10

Causation = likely

Specific population with no other likely explanation

Question 11

What is temporality?

Answer 11

Effect occurring after the cause

Question 12

What is dose response?

Answer 12

Greater exposure leading to greater incidence of effect

Question 13

What is plausibility?

Answer 13

Is there a likely mechanism between cause and effect (limited by current knowledge)

Question 14

What is removal/reversibility?

Answer 14

If cause is removed the observed effect should also disappear

Question 15

What are three benefits of alcohol consumption?

Answer 15

1. Mildly euphoriant
2. Socialisation
3. Cardioprotective in low doses

Question 16

What is one unit of alcohol? (Definition)

Answer 16

8g/10ml of pure alcohol

Question 17

What are some examples of one unit of alcohol?

Answer 17

Half a pint of beer
Small glass of wine
Single measure of 40% vol spirit

Question 18

Units of alcohol in a drink equation

Answer 18

= (strength (%) x amount (ml))/1000

Question 19

What is FRAMES?

Answer 19

Motivational interviewing to help with alcohol abuse

Question 20

What does FRAMES outline?

Answer 20

1. Feedback about risk of personal harm
2. (Stresses) Responsibility for making change
3. Advice to cut down/stop
4. Menu of alternative strategies for changing drinking
5. Empathetic interview style
6. Self efficacy - intuitive style leaves patient enhanced, feels able to cope with goals they have agreed