SELF-TEST primer questions Flashcards
Distinguish between the natural history and the clinical course of a disease.
Natural history refers to the sequence of changes and progression in a disease that is untreated. Treatment may modify this, producing the clinical course. If treatment is ineffective (as in using antibiotics for a viral illness) the two may be the same.
- Contrast the underlying philosophies of health promotion and health protection.
Health promotion seeks to foster the capacity for self-responsibility in a community, enabling it to improve its health via collective action. Health protection is set of actions, often supported by legislation, applied by an external authority to avoid adverse health consequences. Involvement of the community may be limited.
- Summarize the elements in the Ottawa Charter for Health Promotion
Building healthy public policy; Creating supportive environments; Strengthening community action; Developing personal skills, and Re-orienting health services. Now give examples of how these might be put into practice in a typical family medicine centre in the city where you live.
- Name the stages of change and suggest how to recognize each one according to what patients say.
-
What are the major influences that determine if an intervention will be applied?
In clinical situation, some factors influence the clinician, others influence the patient and yet others influence both.
Patient factors: personal factors, such as the patient’s education, health knowledge, and income.
Physician factors: the physician’s training and technical expertise.
Health care delivery system factors: the costs, risks, effectiveness and acceptability of the intervention itself.
Situational factors: cues to action during the consultation influence intervention.
What are the basic values of a health-promoting approach?
According to the Ottawa Charter (see figure 8.7) the values are:
evidence forms the basis of agreements between programme and policy decision-makers;
health promoters analyze all possibilities and act within their jurisdiction;
there is a need for overall coordination of activity;
society as whole must take care of all its members;
interactions between people and their physical and social surroundings affect health and health behaviours;
social justice, equity, mutual respect and caring are necessary for health;
health care, health protection and disease prevention complement health promotion.
Give an example of a primary preventive intervention recommended in clinical practice.
Consultation of guidelines such as those produced by the US task force on preventive care produce a number of such interventions, such as counselling against the use of tobacco, counselling for the use of seat-belts, or prescribing folic acid to women wishing to become pregnant. Primary prevention refers to interventions that are offered before disease occurs.
Give an example of a primary preventive intervention that can be applied to a population.
- passing laws on seat-belts and on bicycle and motorcycle helmets, as well as those restricting advertising, selling and consumption of tobacco products.
- municipal activities in regulation of housing, water supply and sewage,
- programmes of food inspections also contain elements of primary prevention.
- Activities that promote healthy lifestyles, such as the construction of cycle paths and the offer of healthy cooking classes in impoverished areas are others.
Name and briefly describe the stages of risk assessment.
Hazard identification: explore the environment to identify possible sources of hazard.
Risk characterization: describe the effects of the hazard.
Exposure assessment: describe the duration of exposure and the levels of the hazard.
Level of an exposure
Risk estimation: integrate and analyse the information from the three previous steps to judge how much the hazard contributes to patient’s problem.
List the psychological influences on interpretation of quantitative data.
- optimistic/glass full vs empty
- perceived threat
- loss aversion
- number vs proportion
- relative vs absolute risk
What are the rights of workers?
- Right to know. That is the right to know about work-related hazards.
- Right to participate in health and safety (health and safety committee)
- Right to refuse. Employees can refuse to work if the work is dangerous
4.
List the 5 basic principles of workers compensation
- No-fault compensation
- Collective liability
- Security of payment (prompt)
- Exclusive jurisdiction
- Independent board - independent of government or special interest group
List 6 essential activities of public health
- Health protection (water, food, air safety)
- Health surveillance (track and forecast)
- Disease and injury prevention (contact tracing)
- Population health assessment (understand community health)
- Health promotion
- Emergency preparedness and response
