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Phase 3A > Public Health > Flashcards

Public Health Flashcards

1
Q

What is the definition of allostatic load?

A

Longterm overtaxation of our physiological systems leading to impaired health

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2
Q

What is the definition of salutogenesis?

A

Favourable physiological changes secondary to experiences that promote healing and health

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3
Q

What are the four stages of health needs assessment?

A

Needs assessment
Planning
Implementation
Evaluation

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4
Q

Name and describe 4 different types of need

A

Felt need - individual’s perception of variation from normal health
Expressed need - individual seeks help (same as demand)
Normative need - Professional defined intervention appropriate for expressed need
Comparative need - severity versus range of interventions versus cost

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5
Q

What are the pros of the epidemiological approach to health needs assessment? (2)

A

It uses existing data

It can evaluate trends over time

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6
Q

What are the cons of the epidemiological approach to health needs assessment? (3)

A

Data quality is variable or data is not available
The data collected already may not be the data required
It does not consider felt need

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7
Q

What are the pros of the comparative approach to health needs assessment? (2)

A

Quick and cheap

Gives a measure of relative performance and health inequalities

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8
Q

What are the cons of the comparative approach to health needs assessment? (2)

A

Can be difficult to find a suitable comparison population

May not determine the appropriate service needed

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9
Q

What are the pros of the corporate approach to health needs assessment? (2)

A

Based on felt and expressed need

Recognises local knowledge and experience

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10
Q

What are the cons of the corporate approach to health needs assessment? (2)

A

Hard to distinguish need from demand

Can be influenced by political agendas

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11
Q

What are the three components of Donabedian Framework for health needs assessment?

A

Structure - what is there
Process/Output - what is done
Outcome - 5 Ds

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12
Q

What are the 5 Ds of outcome in Donabedian framework of health needs assessment?

A

Death, disease, disability, discomfort, dissatisfaction

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13
Q

What are Maxwell’s Dimensions of Quality? (6)

A 
Effectiveness
Efficiency
Equity
Acceptability
Accessibility
Appropriateness
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14
Q

What 10 criteria must be met for a screening programme to be valid? (10)

A

The condition

1) It must be an important health problem
2) Have a latent/preclinical phase
3) Have a known natural history

The test

4) Must be suitable (sensitive, specific, cost effective)
5) Acceptable (level of invasiveness, risk etc.)

The treatment

6) Must be effective
7) Agreed policy on who to treat

The organisation and costs

8) Facilities must be available
9) Costs must be acceptable
10) Ongoing process in place

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15
Q

Define sensitivity

A

The proportion of people with the disease that are identified

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16
Q

Define specificity

A

Proportion of people without the disease that are correctly excluded

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17
Q

Define positive predictive value

A

Proportion of people with a positive test result that have the disease

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18
Q

Define lead time bias

A

When screening identifies an outcome earlier than it would have, it can cause an apparent increase in survival time even if screening had no effect on outcome

19
Q

Define length time bias

A

Variation in length of time taken for a condition to progress to severe effects can effect the apparent efficacy of screening
More likely to identify slower, less aggressive tumours
More likely to miss the faster growing, more aggressive tumours

20
Q

What is the Bradford-Hill criteria for causality? (9)

A 
Strength of association
Dose-response
Consistency
Temporality
Reversibility
Biological plausibility
Coherence
Analogy
Specificity
21
Q

Define incidence

A

the number of new cases over a specified time (e.g) 200 per year)

22
Q

Define prevalence

A

The proportion of a population affected at a point in time

23
Q

How is relative risk calculated?

A

Risk for exposed group/ Risk for unexposed group

24
Q

How are odds calculated?

A

Probability / (1 - probability)

25
Q

In models of health behaviour change, in the health belief model, what 4 criteria must be met for change to occur?
What is the biggest obstacle for behaviour change?

A

Belief that they are susceptible to the condition
Belief that it has serious consequences
Belief that taking action will reduce susceptibility
Belief that benefits will outweigh the costs

Perceived barriers

26
Q

What are the stages of the transtheoretical/stage model of health behaviour change? (5)

A 
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
27
Q

What can be prescribed to aid smoking cessation, how do they work? (4)

A

Bupropion - decreases nicotine cravings and withdrawal symptoms
Varenicline (Champix) - decreases cravings and pleasurable effects

28
Q

In the theory of planned behaviour what are the three things that determine intention?

A

The person’s attitude to the health behaviour
Perceived social pressure
Self efficacy/perceived behavioural control

29
Q

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

A 
Physiological
Safety
Love/Belonging
Esteem
Self actualisation
30
Q

What must be fulfilled to satisfy Fraser Guidelines? (5)

A

1) They must have sufficient maturity and intelligence
2) The cannot be persuaded to tell their parents
3) They are likely to continue to have sexual intercourse regardless
4) Their mental health is likely to suffer if they do not receive advice +/- treatment
5) The advice/treatment is in the young person’s best interest

31
Q

What three medications other than metformin can be used to manage type 2 diabetes before insulin therapy is considered?

A

DPP4 inhibitor (‘gliptin’ e.g.) Saxagliptin)
Pioglitazone
Sulfonylurea

32
Q

What is the Bolam test?

A

It determines if a group of their professional peers would have acted the same

33
Q

What is the Bolitho test?

A

Would it be reasonable and logical for a group of doctors to act in a certain way

34
Q

What is a lapse error (type of human error)?

A

The action plan put in place is correct but one or more of the planned actions was skipped

35
Q

What is a slip error (type of human error)?

A

The action plan put in place was correct but one or more of the planned actions was performed incorrectly

36
Q

What is a rule-based mistake?

A

When an action plan is incorrect due to choice of the wrong rule after misinterpreting a situation

37
Q

What is a knowledge based mistake?

A

When an action plan is incorrect due to lack of knowledge or incorrect application

38
Q

What type of study is this:

Follows a group of people to track risk factors and outcomes over time

A

Cohort study

39
Q

Describe a case control study

A

Compares the histories of people with a condition to people without a condition

40
Q

Describe a cross-sectional survey (1)

A

Assesses the prevalence of an outcome in a broad population and one point in time

41
Q

What is the WHO definition of health? (1)

A

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

42
Q

What is PICO? (4)

A

Patient/Population/Problem
Intervention/Exposure
Comparison/Control
Outcome

43
Q

What is Utilitarianism? (1)

A

Utilitarianism holds that the most ethical choice is the one that will produce the greatest good for the greatest number.

QALYs are based on utilitarianism principles.

44
Q

What is the acid test? (4)

A

Determines if a person requires DoLS

1) Does the person lack capacity to consent to the arrangements?
2) Is the person subject to continuous supervision and control?
3) Is the person free to leave?

Phase 3A (6 decks)

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