Sem 4 Flashcards
5 Requirements for Gender Recognition Act 2004 to change your birth assigned gender.
- Must be at least 18
- Must have a diagnosis of gender dysfunction
- Must have lived as that gender for 2 years
- Declaration of marital status
- Declaration that you live as new gender till death
What would you legally do if an elderly person, requiring institutional care, resists admission?
5 justifications.
Consult National Assistance act 1948
allows compulsory removal from homes if:
- Not Mentally ill (but suffer from grave chronic disease)
- Old
- Infirm or physically incapacitated
- Living in insanitary conditions
- Not receiving care and attention
REMOVE IN PATIENT’S BEST INTEREST
4 components of getting informed consent.
- Understand info
- Retain info
- Weigh up decision
- Communicate their decision
What is the goal in decision making?
- Maximise beneficial health outcomes
2. Minimise undesirable effects from occurring
Components of high quality decision making
- Correct assessment of clinical situation by healthcare professional
- Correct information therapy to communicate situation
- Px aware of consequences of treatment & no treatment
- Relevant info is required
- Info in the form: understood, accurate and unbiased
- Numeric risks are communicated in complex info
- Px makes decision on accurate info and their values
Demonstrations of Professional Boundaries
- Doctors must not treat themselves/ family
- Confidentiality must be upheld
- Whistleblowing to ensure patient safety
- Must act with integrity
- Personal health must be upheld - GP registration
- Probity - must act with beneficence (not own views)
Primary, Secondary and Tertiary intervention
Primary- removal of cause of disease - reduces incidence
Secondary- screening for early stage disease - early intervention and treatment to improve prognosis
Tertiary - treatment of established/ late disease - manage consequences of disease
Why is it not always beneficial to perform screening tests?
May be costly, harmful or unethical to perform investigation to find out who is at risk of certain diseases.
Define DR (sensitivity)
Proportion of individuals affected by the disease that had a positive test result
a/ a+c
Define False positive rate (FPR; 1-specificity)
Proportion of people who are unaffected that tested positive on the screening test/
b/ b+d
Define OAPR
Odds of being affected given a positive result
a:b
Define TP, TN, FP, FN
TP - True positive = positive result + HAS disease
FP - False Positive = positive result + NO disease
TN - True negative = negative result + NO disease
FN - False negative = negative result + HAS disease
Positive Predictive Value (PPV)
No. of affected individuals with positive results/ total number of individuals with positive results
Requirements for worthwhile screening programme
- Disorder = well defined medically
- Prevalence = known and public health importance
- Natural history = possible to identify early disease from healthy
- Treatment = effective treatment is available
- Test = should be simple, safe, easily implemented and acceptable
- Performance of test= must be known
- Ethical = test procedures after positive result must be acceptable to both parties
- Access = all people who could benefit should have access
- Financial = cost effective
Why have death rates gone down (squaring the rectangle) in the UK?
- Decreased infant mortality
- Improvements in diet
- Improvements in sanitation
- Improvements in healthcare
- Increased standard of living