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publid health Flashcards

1
Q

number needed to screen

A

A number needed to screen is a reference to the number of patients who will need to be screened by the programme to prevent one excess death /morbidity

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2
Q

types of need

A

FENC

felt need
expressed
Normative
Comparitive

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3
Q

resource allocation

A

egalitarian
maximising
libertarian

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4
Q

maxwells dimensions to assesing wuality of service
3As 3Es

A

access
acceptibility
appropriat, relevant to need

equity
efficient
effective

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5
Q

donabedians aproach to assesing quality of service

A

structure
proces
outcome

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6
Q

wrights matrix of assesing service quality

A

maxwells dimensions= donabedians approach

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7
Q

health behaviour

A

aimed to prevent disease oe going for a run

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8
Q

illness behaviour

A

seeking remedy
ie going to gp for sx

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9
Q

sick role behaviour

A

activity aimed at getting well ie taking abx

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10
Q

transtheoretical model

smoker eg

A

precontemp - smoker
contemp - smoker thinking abt quit
prep -
action - ex smoker <6mths
maintence >6mths
stable changed lifestyle/relapse

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11
Q

transtheoretical model +ves

A

aknowledges different stages of readiness
accounts for relapse
temporal element

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12
Q

transtheoretical model -ves

A

some individuals skip stages
change maybe continous not discreet
doesnt consider values ie cultural and social factors

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13
Q

theory of planned behavoiurs

structure and influences

A

sees behavour change in terms of intention and behaviour aim is to bridge gap

intention is affected by; attitudes, subjective norms, percieved behaviour control

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14
Q

theory of planned behavoiurs

how to bridge gap between intention and behaviour

A

P PAIR

prepatory actions
percieved control
anticipated regret
implementation intentions
relevance to self

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15
Q

theory of planned behavoiurs +ves

A

applicable to variety of health behaviour

useful for predicting intention

takes into account importance of social pressures

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16
Q

theory of planned behavoiurs -ves

A

no temporal element direction or causality
doesnt consider emotions
assumes attitudes can be measured

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17
Q

health belief model

A

perceived susceptibility
perceived severity
health motivation
perceived benefits
perceived barriers

influence likelhood of action-> action <- cues to action

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18
Q

med negligence

A

1 duty of care ?
breach in duty?
pt harmed?
harm due to breech?

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19
Q

med negligence
bolam rule

A

would reasonable dr do the same

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20
Q

med negligence

bolithos rule

A

would that be reasonable ?

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21
Q

screening eg

A

newborn heel prick
breast ca mammography
cerv ca smear
bowel ca poo in post

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22
Q

screening test criteria

disease test outcomes

A

important
natural hx known
early tx better than late

test
acceptable to pop
facilities available
simple, safe precise and validated

outcomes
ongoing feasibility
tx available
cost benefit analysis

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23
Q

study design top to bottom

A

meta analysis
rct
cohort
case control
cross sec
case series
case report/anecdote

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24
Q

cross sec study

A

snapshot of w and w/o to find associatians at single time point

quick and cheap
few ethical issues

prone to bias
no time reference

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25
Q

case control

A

retrospective

observational - looks at certian exposure and compares similar particants w and w/o dz

good for rare isease
not expensive

can only show association not causation
unreliable bc recall bias

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26
Q

cohort

A

longtidunial perspective study takes a pop of ppl recording exposures and conditions they develop

can show causation
less chance of bias

large amount lost due to follow up
expensive

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27
Q

RCT

A

gold standard
similar participants randomly controlled to intervention or control groups to study the effect of the intervention

can infer causality
less risk bias/confounders

time consuming and expensive
ethical issues can intefer

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28
Q

confounders

A

rfs other than those being studies that influence outcome

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29
Q

types of Bias

A

SIP

selection
information (measurement,observer,recall,reporting)
publication

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30
Q

3 domains public health

A

health protection
health improvement
improving services

measures control infectious disease and envronmental hazards

social interventions aim preventing disease, promoting health and reducing inequality

organisation and deliv of safe high quality services

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31
Q

inverse care law

A

availabilty of medical or social care tends to vary inversely with the need of the population served

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32
Q

determinents of health

A

PROGRESS

place of residence
race/ethinicity
occupation
gender
religeon
educaton
sociecon status
social capital/resources

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33
Q

equality

A

= equal shares

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34
Q

equity

A

equal tx for equal need
unequal tx for unequal need

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35
Q

what is health needs assesment

A

systematic approach for reveiwing the health needs of a pop which leeds to agreed priorities and resource allocation that will improve health n dec inequalities

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36
Q

3 types of health needs assesment

A

epidemiological
comparative
corporate

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37
Q

incidence

A

no. of new cases per unit time

increased by: screening n inc RFs
reduced by: decreasing RFs ie primary preventions

38
Q

prevelance

A

no. of existing cases at a particular point in time

39
Q

nudge theory

A

changing environment to make the healthy option the easiest option

40
Q

sensitivity

A

probabilty of pt w dz obtaining +ve test

ie how well it picks it up

true pos/(tp-fn)

41
Q

specificity

A

pt w/o disease testing -ve

ie how well recog those w/o disease

tn/(tn+fp)

42
Q

positive pred value

A

prop of pplw +ve result that have dz

43
Q

negative pred value

A

prop of ppl w/o dz correctly excluded by screening test

44
Q

agaisnt screning programm

A

damage caused by false pos and false neg

adverse effects of screening tool on healthy ppl
personal choice is compromised

45
Q

prevention paradox

A

preventative measure which brings much benefit to the pop often offers little to each participating indivifual

46
Q

high risk approach to screening

A

target highest risk individuals
aims to reduce rsik to below set limit
accepted by society - treat those outsidenormal

favors priveleged bc engage , comply,means to change

47
Q

population approach to screening

A

target all indiv
aim to reduce risk for each individuals
recognises that low risk majority may contribute to most cases
concerns over treating the well and the ‘nanny state’

generally reduces social inequalityes

48
Q

primary prevention CHD

A

SNAP
smoking
nutrition
alcohol
physical activity

49
Q

cardiac rehab phases

A

in hospital
early post discharge
4 mths
long term maintence of lifestyle changes (snap)

50
Q

modifiable chd rf

A

high cholest
htn
t2dm

smoking
inactivity
obesity
poor nut
alcohol

51
Q

unmod chd rf

A

sex
age
ethnicity
fhx

52
Q

crit for pandermic spread

A

novel
capable infect humans
capable causing human illness
large pool suscept ppl
ready and sustaible transmission from person to person

53
Q

chain of infection

A

suscept host (reservoir)
person to spread (reservoir)
portal of exit for agent
mode of trans ie feacooral
port of enrty to suscept host
suscept host

54
Q

c.diff SIGHT

A

SIGHT

suspect c.diff
isolate case
gloves n apron
hand washing
test stool

55
Q

cage

A

ever felt u should cut down
been annoyed by people telling u to cut down
guilty abt how much drink
ever had drink first thing in the morning

56
Q

assessment of limitation

A

Katz barthel
instrumental activity of daily livig scakes

57
Q

gerontology

A

studying changesin the body and mind that acompany anging

58
Q

geriatrics

A

dx and tx of disorder that occur in old age

59
Q

doctrine of double effect

A

If you administer a drug to relieve pain in doses that you know may be fatal, then provided your intention is not to shorten life but to relieve pain, the administration is not unlawful.

60
Q

utilitarianism

A

An act is evaluated solely in terms of its consequences. It acts to maximise good e.g. killing one to save many.

61
Q

deontolgy

A

Deontology
The theory that the features of the act themselves that determine worthiness.

62
Q

virtue ethics

A

These focus on the character of the person, integrating reason and emotion.
An action can be virtuous only if it is performed by a person in the right state of mind (i.e. genuinely intending to do the right thing).

63
Q

5 focal virtues

A

compassion
discernment
trustworthiness
integrenty
consciencousness

64
Q

Pico

A

population
intervention
comparator
outcome

65
Q

validity

A

how close to truth it isr

66
Q

reliability

A

how consistent results are

67
Q

appilicability

A

how relevant study is to clinical med

68
Q

study types

A

observational
experimental
interventional

69
Q

observational studies

descriptive

descriptive and analytucal

analytical

A

descriptive
case reports
ecological studies

descriptive and analytucal
cross sectional

analytical
case control
cohort

70
Q

experimental/interventional study eg

A

RCT
non RCT

71
Q

reverse causality

A

unclear which variable independant and which dependant

72
Q

crit for likelihood association is causal

A

Consistency
Strength of association
Specificity (single cause for a single effect)
Dose-response relationship
Temporal relationship
Biological plausibility
Coherence with existing theories
Altered by experimentation

73
Q

how can meta analyiss be graphucally rep

A

forest plot

74
Q

graphs continousdata

A

stem and leaf
histogram

75
Q

graphs showing discrete categorical ata

A

bar charts
pie charts

76
Q

standard deviation

A

average distance of observations from the mean vale

used to find outliers

77
Q

non random sampling types

A

conveience -all pt avaible at point in time
purposive/ quota sampling

78
Q

random sampling types

A

simple random
stratified random
cluster sampling

79
Q

standard error

A

precsion

80
Q

confidence interval use what

A

sample mean and standard error

81
Q

p value

A

probabilty of result being due to chance given that the null hypothesis is true

82
Q

NNT

A

1/ARR

83
Q

NNH

A

1/ARD

84
Q

odds ratio

A

ratio of odds for exoposed group to odds fot not exposed group

(Pexposed/1-Pexposed) / (punexpo/1-punexpos)

85
Q

cant calculate relative risk which study what insteas

A

case control
odds ratio

86
Q

sore throat critera

A

centor

tonsillar exudate
absence of cough
tender/large cerv ln
fever

87
Q

key concerns of public health

A

inequalties in health
wider determinants ofhealth
prevention

88
Q

what needs to be done before health intervention is made

A

health needs assesment

89
Q

1,2,3 orevention eg

A

change 4life 5 day

breast screening programme

diabetic foot care and eye care
physio post stroke to prevent immobility

90
Q
A

finals (28 decks)

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