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Phase 3A > Public health revision session > Flashcards

Public health revision session Flashcards

1
Q

what are the three domains of public health

A

Health improvement
Health protection
Improving services

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2
Q

What is health protection

A

Against spillages and risks and dangers and stuff

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3
Q

What is imrpoving services

A

Clinical governance

Evaluation

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4
Q

Healthy equality

A

Giving everyone the same thing

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5
Q

Health equity

A

Giving everyone the things needed to achieve thier health needs

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6
Q

Causes of health inequality

A 
Place of residence
Race
Occupation
Gender
Religion
Economic status
Social capital
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7
Q

Horizontal equity

A

Equal treatment for equal need

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8
Q

Vertical equity

A

Unequal treatment for unequal need

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9
Q

Cohort study

A

Longitudinal study in similar groups with different risk factors and treatments

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10
Q

Advantages of cohort study

A

Good for rare exposure

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11
Q

Disadvantages of cohort study

A

Bad for rare diseases
Large sample size needed
Expensive

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12
Q

Case control study

A

Observational study looking at cause of a disease. Compares similar participants with disease and controls. Retrospectively

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13
Q

Advantages of case control

A

Quick
Good for rare outcomes
(you choose the people)

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14
Q

Disadvantages of case control

A

Recall bias

Dificulty finding appropriately matched controls

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15
Q

Cross sectional study

A

Observational study collecting data from a population at a specific point in time

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16
Q

Advantages of cross sectional

A

Quick
Cheap
Large sample size

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17
Q

Disadvantages of cross sectional

A

Risk of reserve causality
Bad for rare outcomes
Lead time bias

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18
Q

Randomised control trial

A

Interventional

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19
Q

Advantages of RCT

A

Low risk of bias and confounding

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20
Q

Disadvantages of RCT

A

Ethical issues (not giving best care)
Expensive
Drop out

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21
Q

How do you get over RCT ethical issues

A

Have clear stopping rules which are minimum standards of care which must be met and if they arent then participant stops

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22
Q

Incidence

A

Number of new cases within specific population in a specific time period

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23
Q

Prevalence

A

Number of cases present within a population in a specific time period

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24
Q

How do you calculate relative risk

A

Compares incidence or prevalence.

Work out the two rates then divide them

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25
Q

How do you calculate attributable risk

A

Relative risk - background rate

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26
Q

How do you calculate number needed to treat/harm

A

1/attributable risk and ALWAYS ROUND UP

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27
Q

Define sensitivity

A

percentage of people with the disease who have been correctly identified

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28
Q

Define specificity

A

percentage of people correctly excluded as disease free

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29
Q

Wilson and young screening criteria

A 
Important disease
Understand cause
Recognisable early or latent phase
Simple, safe, precise and validated test
Acceptable to the population
Effective treatment with early detection, with better outcomes than late detection
Policy of who should be treated
30
Q

What can cause association

A 
Bias
Chance
Confounding
Reverse causality
True causation
31
Q

Define bias

A

Systematic error which results in a deviation from the true effect of an exposure on an outcome

32
Q

Selection bias

A

Non response of certain groups, allocation bias.

Bias in which participants are selected

33
Q

Information bias

A

Measurement bias, observation bias, recall bias, reporting bias

34
Q

Publication bias

A

Trials with negative results less likely to be published

35
Q

Lead time vis length time bias

A

Lead time bias- looks like longer life expectancy because screening has found them earlier (ahead)
Length time bias- Less likely to see people with longer diseases (longer)

36
Q

Define confounding

A

Apparent association between exposure and disease. Independently associated with both disease and exposure.

37
Q

Bradford hill criteria for causation

A 
Temporality (exposure before disease)
Reverse causality
Dose response
Strength of association
Reversibility
Consistency
38
Q

Planning cycle for health services

A

Needs assessment
Planning
Implementation
Evaluation

39
Q

Define health

A

A state of complete biomedical, social, physical, spiritual wellbeing and not merely the absence of disease

40
Q

Bradshaws needs

A

Felt need
Expressed need
Normative need
Comparative need

41
Q

Felt need

A

What the patient thinks they need

42
Q

Expressed need

A

What the patient tells you they need

43
Q

Normative need

A

What we say they need

44
Q

Comparative need

A

Differences in health services available to two populations

45
Q

Demanded and supplied but not needed

A

Antibiotics for viral

46
Q

Needed and supplied but not demanded

A

Smoking cessation

47
Q

Three approaches to a health needs assessment

A

Epidemiological approach
Comparative approach
Corporate approach

48
Q

Epidemiological approach

A

Use prevalence and incidence data

Doesnt take into account felt need

49
Q

Corporate approach

A

Takes into account stake holders
Takes felt needs into account
Blur need and demand
Influenced more by big dogs

50
Q

Comparative approach

A

Compares health access of two populations. Based on comparative need.

51
Q

Donabedian approach to evaluation

A

Structure
Process
Outcome

52
Q

Structure (in evaluation)

A

Building, staff, equipment

/1000 population

53
Q

Process (in evaluation)

A

What is done, how many seen or done

/1000 population

54
Q

Outcome (in evaluation)

A

Morbidity, mortality, disability, dissatisfaction

/1000 population

55
Q

Evaluation

A

Process which seeks to assess how a service systematically achieves its objectives

56
Q

Maxmells dimensions of quality

A

Effectiveness, efficiency, equity

Acceptability, accessibility, appropriateness

57
Q

Models of behaviour change

A

Health belief model
Theory of planned behaviour
Stages of change
(Nudging, financial incentives, motivational interviewing)

58
Q

Health belief model

A 
Influencing patient perception to increase health promoting behaviour.
Susceptibility to ill health
Severity of ill health
Benefits of behaviour change
Barriers to taking action
59
Q

Theory of planned behaviour

A

Attitudes, subjective norm and percieved behaviour control influence intention. And then they will definitely change behaviour

60
Q

Transtheoretical/ stages of change

A

Precontemplation, contemplation, preparation, action, maintenance, relapse
Doesnt take into account personal

61
Q

Communicable disease control

A

Kills people, contagious, expensive to treat, effective interventions. (blood borne viruses normally arent)

62
Q

Who do you tell communicable disease

A

Public health england, any registered medical practicioner should

63
Q

When do you tell communicable disease

A

On basis of clinical suspicion.

Written notification or telephone if urgent

64
Q

What do you tell about communicable disease

A

NHS number, DOB, contact details, details of disease/ contamination

65
Q

Define cluster

A

Aggregation of cases of a condition which may or may not be linked

66
Q

Define suspected outbreak

A

More cases than would be expected in a specific place and time

67
Q

Confirmed outbreak

A

Epidiomoligical or pathophysiology link

68
Q

Epidemic

A

Occurance within an area in excess of what is expected

69
Q

Pandemic

A

Different countries

70
Q

Endemic

A

Normal rates

71
Q

Hyper endemic

A

Higher than normal levels

72
Q

What is a secondary prevention

A

Screening

Phase 3A (25 decks)

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