Year 3 FoPC Whirlwind Tour Flashcards
Sources of epidemiology data
- Hospital activity stats
- Drug misuse database
- Expenditure data from NHS
- General practice morbidity data
- Social securtiy stats
- Accident statistics
2 broad categories of studies
- Discriptive
- Analytical
What are discriptive studies
- Describe the amount and distribution of a disease in a given pop.
- Cheap quick and give valuable initial overview
- Can’t prove causation however
3 types of analytical studies
- Cross-sectional study = Looks at single point in time
- Case controlled studies = One group has disease one doesn’t, looks at risk factors as to why one group got disease
- Cohort studies = A healthy group are followed through time
Types of bias
- Selection = sample isn’t representiative of pop.
- Information = systemic error in measuring exposure or disease
- Follow up bias = Follow up some folk more than others
- Systematic error = Problem with measuring tool
What are confounding bias
- Distorts the relationshp between the exposure and the disease
- Factor which is associated independently with both the disease and exposure under investigation
Criteria for causality
- Strength of association
- Consistency (repeated observation in different pop.s under different circumstances)
- Specificity (a single exposure leading to a single disease)
- Temporality (timing, exposure comes before disease)
- Biological plausibility (Association agrees with know biology of the disease)
- Biological gradient (dose-response relationship ie more exposure more risk of disease)
What is protection
Aimed at factors beyond the control of the individual like changing laws
What is Health promotion
Any activity designed to prevent disease or enhance health (can be planned or opportunistic)
- Educational (informed choice)
- Socio-economic (make the healthy choice the easy choice)
- Psychological (change one’s attitude and behaviours)
Health promotion examples
- Primary care (planned or opportunisctic)
- Govt. legislation like age limit and taxes
Challenges to health promotion
- Doctors think resources could be better spent elsewhere
- Health promotion has no evidence for most health promotion activities
What are Wilson’s criteria
Disease
- Important
- Understood natural hx
- Pre-symptomatic stage
Test
- Cost-effective
- Sensitive and specific
- Acceptable
Rx
- Cost-effective
- Acceptable
- Better outcome if early rx
Cycle of change
- Pre-cotemplation
- Contemplation
- Preperation
- Action
- Maintenance
- Relapse
Types of prevention
- Primary prevention (preventing a disease, eg vaccines)
- Secondary (early (pre-clinical stage) detection to cure or prevent symptoms )
- Tertiary (limit morbidity caused by a disease)
Types of sustainability
- Global (climate change, resource depletion etc)
- NHS (Renewable energy, travel plans, Greener building design, meet funding challenges etc)
-Personal and career
+ves = secure job, workload ok, enjoy team working, work-life balance, are appreciated, develop special interests.
ves = high workload, difficult cases, running a buisiness
Occ. health Hx
- Current and previous jobs
- Exposure to hazards/PPE?
- Other folk doing the same job getting the same symptoms
- Symptoms ease when not being exposed (days off)
What does occ. health do
- Reduce work-related ill health
- Improve attendance
- Ensure a safe workplace (ensure enforcement of health and safety)
- Advice on ill-health retirment
Effect of work, unemployment and re-employment
- Employment = economic resources
- Unemplyment = Poor general health, early mortaltiy, higher morbidity
- Re-employment = improved general and mental health and self-esteem
Homeostatic reserve
- The abiltiy to stabilise one’s normal internal enviroment
- Get worse when old as fuck
- Young people look fine after being stabbed then go into hypovolaemic shock
-Global health
- Everyone is ageing, more old cunts wherever you go
- Mortality rates are dropping
- More imigration
- Lead to demographic change (health, social and economic and political groups)
Homeostatic reserve
- The abiltiy to stabilise one’s normal internal enviroment
- Get worse when old
- Young people look fine after being stabbed then go into hypovolaemic shock suddenly
anticipatory care plans
- Promotinog discusion with individuals close to them
- Legal, persona nd medical
Demographic changes
- Health= more geriatricians/facilities needed, more chronic conditions, more campaigns aimed at the old
- Social = More dependent on families and carers (who are also aging
- Economic = retirement age increase, young folk cant get a job, less people paying into taxes
- Polictical = Workforce planning
What is comorbidity
Coexistence of two or more long-term conditions
What is an anticipatory care plan
- Discusion with individuals and their care providers (often + family) where decisions are made about their future care
- Legal, persona nd medical
Legal aspect of an anticipatory care plan
- Welfare power of attorney
- Finaicial power of attorney
- Gaurdianship
Personal aspects of an anticipatory care plan
- Preferred place of death
- Belief regarding death
- Advanced directive
Medical aspects of an anticipatory care plan
- Home care package
- DNACPR
- Palliative care
- Competence and capacitiy
How to determine if a patient is in a palliative stage
Palliative performance scale (goes down in 10% incriments higher it is the better youre doing)
When do you know someone requires palliative care
- Life-limitting diagnosis
- Unable to ambulate
- Majority of the day fatgued sitting
- Assistance to walk, bed -bound, paralysed
- Unable to feed themselves
