Public Health Extra Flashcards
What does the health belief model and Theory of Planned Behaviour say the most important factor in addressing behaviour change is?
Health Belief: Perceived Barriers
Theory of Planned Behaviour: Intention
What are the key determinants of health?
- Genes
- Environment
- Lifestyle
- Health care
What are some developing food behaviours?
- Maternal Diet
- Breastfeeding
- Parenting Practices
- Age of introduction to solids and types of food given
What is a health need assessment for?
Systematic method for reviewing the health issues facing a population
Therefore to determine resource allocation
What aspects of public health are involved in Health Needs Assessments and resource allocation?
- Maslow’s Heirarchy of Needs
- Types of health care need: Felt, Expressed, Normative, Comparative
- Health needs assessment (Resource allocation)
- Approach to Health Needs Assessments: Epidemiological, Comparative, Corporate
- Resource allocation Methods: Libertarian, Maximising, Egalitarian
What aspects of Public Health are involved with evaluation of health services and assessing the quality of health care?
- Evaluation: Assessment of whether a service achieves its objectives
- Donabedian Framework: Structure, Process, Outcome
- Maxwell’s Dimensions of Quality of Health Care: 3A’s and 3E’s
What is bias?
A systemic deviation from the true estimation of the association between exposure and outcome
What are some types of bias?
Selection bias: selection of participants
Information Bias: observers recall and reporting, instruments wrong
Allocation bias: Different participants in different groups
Publication Bias: Trials with negative results are les likely to be published
Lead time bias: Earlier screening does change survival outcome
Length time bias: diseases with slower progression more likely to be identified by screening
Explain what these features mean on the Bradford Hills Criteria:
- Strength
- Dose response
- Consistency
- Temporality
- Reversibility
- Biological Plausibility
- Coherence
- Analogy
- Specificity
- Strength - The strength of the association
- Dose-response – does a higher exposure produce higher incidence?
- Consistency – similar results in different studies and populations
- Temporality – does the exposure precede the outcome
- Reversibility – removing exposure reduced risk of disease
- Biological plausibility – does it make sense biologically
- Coherence – logical consistency with lab information e.g. incidence of lung cancer
with increased smoking is consistent with lab evidence that tobacco is carcinogenic - Analogy – similarity with other established cause-effect relationships in the past e.g.
thalidomide in pregnancy, not other teratogenic drugs show similar effects - Specificity – Relationship is specific to the outcome of interest e.g. introducing
helmets reduced head injuries specifically, it wasn’t that there has been an overall
lower injury rate
Should you ever inform parents about a childs actions?
No but encourage them to inform
What should you do if an Under 13 year old presents saying they have had sex?
Refer to social services
What are the Fraser Guidelines?
- Does she understand the advice?
- Has the doctor encouraged her telling the parents?
- Will she have sex anyway?
- Is the mental/physical health going to be effected if you don’t give it
- Best interests
What is Gillick’s Competency?
Does a child under 16 have capacity to make own medical decisions?
Clinical judgement made by the doctor; age, capacity, maturity
What are some different types of error and what do they mean?
- Sloth = inaccurate documenting/not checking results for accuracy
- Fixation/loss of perspective = focus on one diagnosis – confirmation bias
- Communication breakdown = unclear plan/not listening and explaining well - - - - - -
- Poor team working = some individuals out of depth and others underutilised
- Playing the odds = choosing the common and dismissing the rare
- Bravado/timidity = working beyond competence/not having confidence to object
- Ignorance = lack of knowledge (can be conscious or unconscious incompetence)
- Mistriage = over or under-estimating the severity of the situation
- Lack of skill = not having appropriate skills/training/practice
- System error = environmental/technological/equipment failure\
