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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
case control
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
26
cohort
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
27
RCT
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
28
confounders
rfs other than those being studies that influence outcome
29
types of Bias
SIP selection information (measurement,observer,recall,reporting) publication
30
3 domains public health
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
31
inverse care law
availabilty of medical or social care tends to vary inversely with the need of the population served
32
determinents of health
PROGRESS place of residence race/ethinicity occupation gender religeon educaton sociecon status social capital/resources
33
equality
= equal shares
34
equity
equal tx for equal need unequal tx for unequal need
35
what is health needs assesment
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
36
3 types of health needs assesment
epidemiological comparative corporate
37
incidence
no. of new cases per unit time increased by: screening n inc RFs reduced by: decreasing RFs ie primary preventions
38
prevelance
no. of existing cases at a particular point in time
39
nudge theory
changing environment to make the healthy option the easiest option
40
sensitivity
probabilty of pt w dz obtaining +ve test ie how well it picks it up true pos/(tp-fn)
41
specificity
pt w/o disease testing -ve ie how well recog those w/o disease tn/(tn+fp)
42
positive pred value
prop of pplw +ve result that have dz
43
negative pred value
prop of ppl w/o dz correctly excluded by screening test
44
agaisnt screning programm
damage caused by false pos and false neg adverse effects of screening tool on healthy ppl personal choice is compromised
45
prevention paradox
preventative measure which brings much benefit to the pop often offers little to each participating indivifual
46
high risk approach to screening
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
population approach to screening
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
primary prevention CHD
SNAP smoking nutrition alcohol physical activity
49
cardiac rehab phases
in hospital early post discharge 4 mths long term maintence of lifestyle changes (snap)
50
modifiable chd rf
high cholest htn t2dm smoking inactivity obesity poor nut alcohol
51
unmod chd rf
sex age ethnicity fhx
52
crit for pandermic spread
novel capable infect humans capable causing human illness large pool suscept ppl ready and sustaible transmission from person to person
53
chain of infection
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
c.diff SIGHT
SIGHT suspect c.diff isolate case gloves n apron hand washing test stool
55
cage
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
assessment of limitation
Katz barthel instrumental activity of daily livig scakes
57
gerontology
studying changesin the body and mind that acompany anging
58
geriatrics
dx and tx of disorder that occur in old age
59
doctrine of double effect
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
utilitarianism
An act is evaluated solely in terms of its consequences. It acts to maximise good e.g. killing one to save many.
61
deontolgy
Deontology The theory that the features of the act themselves that determine worthiness.
62
virtue ethics
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
5 focal virtues
compassion discernment trustworthiness integrenty consciencousness
64
Pico
population intervention comparator outcome
65
validity
how close to truth it isr
66
reliability
how consistent results are
67
appilicability
how relevant study is to clinical med
68
study types
observational experimental interventional
69
observational studies descriptive descriptive and analytucal analytical
descriptive case reports ecological studies descriptive and analytucal cross sectional analytical case control cohort
70
experimental/interventional study eg
RCT non RCT
71
reverse causality
unclear which variable independant and which dependant
72
crit for likelihood association is causal
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
how can meta analyiss be graphucally rep
forest plot
74
graphs continousdata
stem and leaf histogram
75
graphs showing discrete categorical ata
bar charts pie charts
76
standard deviation
average distance of observations from the mean vale used to find outliers
77
non random sampling types
conveience -all pt avaible at point in time purposive/ quota sampling
78
random sampling types
simple random stratified random cluster sampling
79
standard error
precsion
80
confidence interval use what
sample mean and standard error
81
p value
probabilty of result being due to chance given that the null hypothesis is true
82
NNT
1/ARR
83
NNH
1/ARD
84
odds ratio
ratio of odds for exoposed group to odds fot not exposed group (Pexposed/1-Pexposed) / (punexpo/1-punexpos)
85
cant calculate relative risk which study what insteas
case control odds ratio
86
sore throat critera
centor tonsillar exudate absence of cough tender/large cerv ln fever
87
key concerns of public health
inequalties in health wider determinants ofhealth prevention
88
what needs to be done before health intervention is made
health needs assesment
89
1,2,3 orevention eg
change 4life 5 day breast screening programme diabetic foot care and eye care physio post stroke to prevent immobility
90

finals (28 decks)

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