Public Health Learning

Question 1

Coroner:

Answer 1

Unexplained death
When doctor did not see within 28 days
Within 24 hours of hospital admission
Accidents / Injuries
Suicides
Occupational association
Police custody
Poisoning
Ill treatment / Starvation / Neglect

Question 2

Trial Phases for research

Answer 2

0 - Pharmacodynamics / Kinetics
1 - Safety - Healthy volunteers
2a - Optimal Dosages
2b - Efficacy
3 - 100+ people: Comparison to current meds
4 - Post-market research

Question 3

Stats: Power and Errors

Answer 3

P value = A = Possibility of Type 1 error
Type 1 error (A) = H0 rejected when its true
Type 2 error (B) = H0 accepted when it is false
Power = 1-B = Chance that H0 is false and rejected.

Think of a grid with
———-H0 Accepted—— H0 Rejected
H0 T— xxxxxxxxxx——–P value / T1 error
H0 F—-T2 error (B)——–Power

Question 4

Health Belief Model

Answer 4

Change if they understand:
-Susceptible to disease
-Serious consequences of disease
-Change = less susceptible
-Benefits of change outweigh drawbacks

-Cues and health motivation from medical staff or family help
-Patient demographic background affect these all.

Drawbacks:
-Cognitive (So no factoring emotions or behaviour)
-Doesn’t factor in patients self-belief to change

Question 5

Theory of Planned Behaviour

Answer 5

Attitude,
Subjective Norms,
Perceived behaviour control.

Question 6

Stages of Change model AKA:

Answer 6

Transtheoretical Model

Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Relapse

Question 7

Domains of public health?

Population-levels of intervention?

Answer 7

Health Protection
Health Improvement
Improving Services

Individual; Beta-blockers
Community; Local anti-smoking signs
Population; Iodine salt in grain

Question 8

Health Needs Assessment

Answer 8

–Needs Assessment, Planning. Implementation, Evaluation… REPEAT

–Corporate - Health challanges to emplyees
–Epidemiological - Incidence, prevalence, mortality
–Comparative - Spacial/Social: Different populations, genders, races

Question 9

4 Error classifications + Examples

Answer 9

Intention:
-Misunderstanding guidlines
-Skill-based error

Action:
-Omission
-Wrong blood-vessel

Consequences/Outcomes:
-Litigation
-Patient morbidity / mortality

Context:
-Staffing issues
-Team issues

Question 10

Leadership Styles

Answer 10

Inspirational
-Motivation through shared value/sense of purpose

Transactional
-Rewards/Punishment for performance

Lassez-Faire
-Allow things to take their own course

Transformational
-Inclusive leadership; the whole team leads in some way.

Question 11

Questions to ask when negligence is suspected?

Answer 11

-Is there a duty of care?
-Was there a breach of this duty?
-Did the patient come to harm?
-Was the harm due to the breach of duty?

Regarding breaches:
-Would a group of responsible doctors do the same?
-Would it be reasonable for them to do so?

Question 12

Domestic Abuse:
1. What to do?

2. Tool used?

Answer 12

1. Document everything, talk away from children or others, document any injuries, inform police ONLY IF SAFE, tell them you can help.
2. DASH tool (Domestic Abuse and Sexual Harassment tool).

Question 13

Duties of a Doctor GMC

Answer 13

-Patient care first priority
-Promote public health and private patient health
-Respect, dignity, confidentiality to patients
-Work with patients
-Integrity
-Provide a good standard of care

Question 14

Service Evaluation, 3 stages and examples of each?

Answer 14

3 Stages of Service Evaluation

Structure:
-Buildings, staff, equipment

Process:
-Patients seen in A&E, surgeries done etc.

Outcome:
-Surgical deaths, quality of life, PPROMS etc…

Question 15

3 As and Es of an effective healthcare service?

Answer 15

Accessibility
Acceptability
Appropriateness

Effectiveness
Efficiency
Equity