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PPP > Spina Bifida Wk1 > Flashcards

Spina Bifida Wk1 Flashcards

1
Q

What is public health?(1)

A

The art and science of preventing disease, prolonging life and promoting health through the organised efforts of society.

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2
Q

What is the population perspective of public health?(3)

A
  • Large studies on the epidemiology of disease/ill health to inform diagnosis, prognosis and treatment decisions
  • Developing preventative health programmes
  • Ensure patients get best available treatment by developing guidelines, considering access and equity
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3
Q

What is epidemiology?

A

The quantitative study of the distribution, determinants and control of disease in populations

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4
Q

What is the epidemiology of spina bifida? (5)

A
  • Neural tube defect
  • Incidence varies across different populations
  • More common in females than males
  • Prenatal diagnosis
  • Folic acid supplementation given for prevention (including in bread)
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5
Q

What are the risk factors for spina bifida? (6)

A
  • Folic acid deficiency
  • Genetic susceptibility
  • Family history
  • Medications
  • Maternal obesity
  • Diabetes
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6
Q

How do we collect data? (1)

A

UK surveillance systems - British Paediatric Surveillance system

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7
Q

What do cohort research studies tell us? (2)

A
  • Tell us the risk of developing a condition

- Prognosis of disease

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8
Q

What do case-control research studies tell us? (1)

A
  • Tell us risk factors of a disease/cause of a condition
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9
Q

What are randomised controlled trials? (1)

A

Split into 2 groups, one folate supplement given and one control treatment given (with any other factors randomised) and outcomes recorded.

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10
Q

What are outcomes with folic acid? (4)

A
  • All women who could become pregnant - 400 mag/day prior to conception and until 12th week of pregnancy
  • Women with neural tube defect prior take 5mg/day prior to conception and until 12th week of pregnancy
  • Oct 2018 - Public Health Minister announced a consultation on mandatory fortification of colour with folic acid to prevent fetal abnormalities. June 2019 - consultation launched.
  • Possible increased risk of cancers, and masking vitamin B12 deficiency.
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11
Q

What is sociology? (1)

A

A social science that seeks to understand all aspects of human behaviour - its contexts, relations and structures. Through empirical and theoretical research at every level of society, it examines how individual lives are affected by wider social forces.

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12
Q

What is sociology when applied to medicine? (1)

A

Seeks to understand the social contexts within which health, illness and medicine are formed, experiences and practiced. It provides a disciplinary framework for the teaching of empirical evidence and utilises relevant theories and concepts to inhale understanding of evidence.

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13
Q

Outcomes of professional values and behaviours(6)

A
  • Professional and ethical responsibilities
  • Legal responsibilities
  • Patient safety and quality improvement
  • Dealing with complexity and uncertainty
  • Safeguarding vulnerable patients
  • Leadership and team working
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14
Q

Outcomes of professional skills (4)

A
  • Communication and interpersonal skills
  • Diagnosis and medical management
  • Prescribing medications safely
  • Using information effectively and safely
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15
Q

Outcomes of professional knowledge

A
  • The health service and healthcare systems
  • Applying biomedical scientifically principles
  • Applying psychological principles
  • Applying social science principles
  • Health promotion and illness prevention
  • Clinical research and scholarship
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16
Q

Biomedical Model

A
  • Reductionist: explains illness by simplest possible process (e.g. disordered cells)
  • Single-factor causes: looks for the cause of illness rather than contributory factors (e.g. looking for a genetic explanation of alcoholism or smoking)
  • Focus on illness (not health)
  • People not responsible for illness
17
Q

Biopsychosocial model

A
  • Holistic: looks at all levels of explanation from micro-level (e.g. biochemical changes in the body) to macro-level (e.g. the culture that you live in)
  • Does not look for single-factor causes: multi-factorial model assumes that health and illness have many causes and can produce many effects
  • Does not focus exclusively on illness: assumes that the continuum between health and illness must be analysed as a system (system theory approach)
  • People’s behaviour influences health (responsibility) and people can change behaviour
18
Q

Stigmatising conditions

A

Conditions that set their possessors apart from ‘normal’ people, that mark them as socially unacceptable or inferior beings

19
Q

Courtesy stigma

A

Members of families of stigmatised individuals experience stigma because of their affiliation with the stigmatised individual rather than through any characteristics of their own

20
Q

What are ethics?

A
  • A branch of philosophy
  • Refers to the study of how human beings should behave: what is right and what is wrong behaviour
  • All interactions can be seen as ethically relevant
  • Relates not just to the individual but to whole systems and societies
21
Q

How do you thrive in life?

A
  1. Social animals
  2. Ethics/Ethics
  3. Trust/Needs
  4. Collaboration/Wellbeing
  5. Performance
  6. Successful society
22
Q

What do people want as social animals?

A
  • Acknowledgement
  • Care
  • Acceptance
23
Q

What do doctors aim to do ethically?

A

Reduce human suffering

24
Q

What involves medical ethics?

A
  • Increased need; we meet patients at a time of intense vulnerability, both social needs and need to trust people around them will be much more pressing when ill.
  • Medical power; putting trust in doctors with knowledge - patients will have to live with consequences
    3. Decisions; the kinds of decisions doctors make have far-reaching ramifications for individuals and society (e.g. what treatment, withdrawing treatment, end of life)
25
Q

Why do we study medical ethics?

A
  • Know legal and professional regulations
  • Learn to navigate uncertainty, identify and confront your own biases, and deal with people who will not agree with you
  • Develop your own ethical standards as a professional
26
Q

What is clinical communication?

A
  • Any communication that takes place in a clinical setting
  • Leads to better outcomes for patients and relatives
  • The means by which you represent yourself as a competent, caring professional
27
Q

What lies behind negative communication e.g. culture of not reporting issues)?

A
  • Fear (of being powerless to help)
  • Ignorance (lack of knowledge/training)
  • Culture (everyone else reacts like this)
28
Q

What must expected responses contain?

A
  • Empathy
  • Honesty and Understanding
  • Openness
  • Sharing knowledge
  • Support
  • Kindness
29
Q

GMC outcomes for graduates

A

Newly qualified doctors must be able to communicate clearly, sensitively and effectively with patients, their relatives, carers or other advocates and with colleagues, applying patient confidentiality appropriately.

30
Q

What is health psychology?

A

The process of using psychology to understand health. It challenges the notion that mind and body are separate entities - considers direct and indirect connections between psychology and health.

31
Q

Different views of diability

A
  • The Tragedy Model/Charity Model : disabled people were viewed as tragic and in need of charity.
  • Disability was seen as a thing that needed curing.
  • Social Model of Disability : disability as a consequence of environmental, social and attitudinal barriers.
32
Q

Who first wrote about spina bifida?

A
  • Dr Tulp: Observationes Medicae
  • 6 Cases in his notes
  • Punctured sac on child’s back, who then died of an infection
  • Discovered neural element
33
Q

Surgery in late 1800s

A
  • Anti/asepsis
  • Hydrocephalus
  • Spitz-Halter shunt (1955)
  • 90% mortality to 80% survival rate
  • Renal failure
  • Taken on a case-by-case basis : more and more operated early
  • Surgery 1 week to 2 years
  • 12 to 48 hours after birth
34
Q

Lober vs. Zachary (1970s)

A
  • Dr John Lorber vs Robert Zachary
  • Lorber = even if doctors can operate they shouldn’t, they’ll have no friends, no jobs and no love
  • Zachary = ‘extreme disability not synonymous with unhappiness’ - Z’s view won

PPP (19 decks)

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