Public Health & Critical Numbers Flashcards
What is the definition of distress?
Negative, damaging and harmful
What is the definition of eustress?
Positive, beneficial and motivating
What are the 5 responses to stress?
Biochemical (altered hormone levels)
Behavioural (smoking and alcohol)
Cognitive (-ve thoughts, poor concentration)
Emotional (tearful, mood swings, irritable)
Physiological
What are some chronic stressors?
Relationships
Unstable finances
Lack of friends
Poor physical health
What are some of the migrating factors for stress?
Social support
Beliefs
Personality
Lifestyle
Give three examples of how people can be encouraged to stop smoking
Taxation
Banning smoking in public places
Cessation services
List 4 types of economic evaluation
Cost minimisation analysis
Cost effectiveness analysis
Cost utility analysis
Cost benefit analysis
How do you calculate incremental cost ratio?
Incremental cost = new treatment cost – old treatment cost
How do you calculate the effectiveness ratio?
Efectiveness ratio = incremental cost/difference in QALY (where QALY = years increase x utility time)
Define prevalence
The number of cases of a disease that are present in a particular population at a given time
Define incidence
The number of new cases that develop in a given period of time
Define absolute risk
The changing in risk of an outcome of a given treatment of activity in relation to a comparison treatment or activity
Define relative risk
Ratio of the probability of an event occurring (e.g. developing a disease) in an exposed group to the probability of the event occurring in a comparison, non-exposed group
Define prevention paradox
Contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the high risk population
Define inverse care law
The availability of good medical or social care tends to vary inversely with the need of the population served
What is the equation for BMI?
Weight / height^2
Define reverence probability
Probability of disease in the entire population at any point in time
Define incidence probability
Probability that a patient without disease develops the disease during an interval
Define sensitivity
Probability of a positive test among patients with disease
Define specificity
Probability of a negative test among patients without disease
Define incidence rate
Number of new gases per population at risk in a given time period
Define rate ratio
Compare the incidence rates of events occurring at any given point in time
What is the 95% confidence interval?
95% certain that the true result mean falls within the range of X & Y
Define odds ratio
The odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure
What is the doctrine of dual effect?
Aim to do good
increase QALY, decrease total years
What are the 5 types of variables?
Nominal - two or more categories
Binary - only take two values
Discrete - can only take on finite number of values
Continuous - any value between min & max
Ordinal - order matters but not difference between values
What is statistical significance?
P<0.05
Reject null hypothesis
What is clinical significance
Defined by the smallest clinically beneficial & harmful values
What is the top down deductive?
One specific ethical theory is consistently applied to each problem
What is the bottom up inductive?
Using past medical problems to create guides in practice
What are 2 other ethical arguments?
An approach where theories are considered which best fit one’s own beliefs before applying.
Analogies can also be used
What are the 4 ethical principles?
Autonomy
Beneficence
Non-maleficence
Justice
What is utilitarianism?
Act is valued in terms of its consequences/effect
Many not few
What is deontology?
The act itself determines the worthiness
Characteristics that a doctor should have (compassion, discernment, trustworthiness, integrity, conscientiousness)
What are virtue ethics?
Focuses on the character of the person who is doing the act
What are 5 GMC duties of a doctor?
Protect & promote health of patients & public
Provide good standard of practice & care
Recognise & work within limits of competence
Work with colleagues in the ways that best serve patients’ interests
Treat patients as individuals & respect their dignity
What is the gini coefficient?
Statistical representation of nation’s income distribution among its residents (smaller less equality)
What is social class?
Measure of occupation, stratification, social position & access to power & resources
What are the key challenges of an ageing population? (5)
Strains on pension & social security systems Increasing demand for healthcare Bigger need for trained health workforce Increasing demand for long term care Pervasive ageism
What are 5 reasons for smoking?
Nicotine addiction Coping with stress Habit Socialising Fear of weight gain
Stages of change model (6)
1) pre-contemplation
2) contemplation
3) preparation
4) action
5) maintenance
6) relapse
What are the 3 types of human error?
Omission
Commission
Negligence
What is the healthy BMI range?
18.5-24.9
What are some causes of obesity?
Physical
Socio-cultural
Economic
What is opportunity cost?
The next best alternative forgone
What is the equation for sensitivity?
Number of true positives/all with disease (TP and FN)
What is the equation for specificity?
Number of true negatives/all without disease (FP and TN)
What is the equation for the probability of it being a case? (Pe)
Exposed case / all exposed
What is the equation for the probability of it being a case? (Pne)
Not exposed case / all not exposed
What is the equation for the odds of a case? (Oe)
Exposed case / exposed non case
What is the equation for the odds of a non case? (One)
Not exposed case / not exposed not case
What is the equation for the absolute risk difference?
Pe-Pne
What is the equation for the risk ratio/relative risk?
Pe/Pne
What is the equation for the odds ratio?
Oe/One
What is the equation for the positive predictive value?
true positives / all positives
What is the equation for the negative predictive value?
true negatives / all negatives
What is the equation for probability?
number of cases/total population
What is the equation for odds?
number of cases/number of non-cases
What is the equation for prevalence proportion?
number of existing cases at time t / total population size at time t
What is the equation for incidence proportion?
number of new cases during period / size of population at risk at start of period
What are the 2 main types of quantitative study designs?
Experimental (clinical); assign exposures
Observational (epidemiological)
What are the 2 types of experimental study?
Randomised control trials
Non-randomised (quasi-) experiments
What are the 2 main types of observational study?
Analytical (comparison group)
Descriptive (no comparison group)
What are 4 types of descriptive study?
Case reports
Case series
Cross sectional
Ecological studies
What are the 3 types of analytical studies?
Cohort (exposure > outcome)
Cross-sectional (exposure <> outcome)
Case-control (outcome > exposure)
Define standard deviation
Measure of the variability in the data
Define standard error
Standard deviation of repeated samples from a population
What is conditional probability? P(A|B)
Probability that event A will happen given that some other event B has already occurred
What is the length time bias?
Diseases with a longer duration are more likely to be captured in prevalence
What is the number needed to treat?
Number of people you need to treat in order to prevent one outcome
