Public health Flashcards

1
Q

Define social class

A

A measure of occupation, stratification, social position, access to power and resources. Models = NS-SEC ot Registrar General’s

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2
Q

Define incidence

A

The no. of new cases per unit time

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3
Q

How can incidence be increased?

A

Screening

Increasing risk factors

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4
Q

How can prevalence be increased?

A

Screening
Increasing risk factors
Increasing life expectancy

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5
Q

How can incidence be decreased?

A

Decreased risk factors (primary prevention)

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6
Q

How can prevalence be decreased?

A

Cures

Decreased risk factors

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7
Q

How may someone enter the prevalence pool?

A

Diagnosis

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8
Q

How may someone leave the prevalence pool?

A

Cure

Death

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9
Q

Define sociology

A

It is the study of social relations and social processes

It is a measure of social INTERdependecies

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10
Q

What is the role of a sick person in society?

A

They are exempt from normal social responsibilities
They should focus on getting better
They should seek help from medical professionals

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11
Q

Define global health

A

Issues, concerns, ideas regarding health that transcend national boundaries

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12
Q

State the 3 millennium goals that relate to health

A

Reduce child mortality of under 5’s by 2/3rds
Improve maternal health
Combat AIDS/HIV

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13
Q

Define prevalence

A

The no. of existing cases of a disease at a point in time

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14
Q

Define sensitivity

A

The probability of a person with the disease testing positive
a/a+c

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15
Q

Define positive predictive value

A

The proportion of people with a positive result that actually have the disease
a/a+b

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16
Q

Define specificity

A

The probability of a person without the disease testing negative
b/b+d

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17
Q

Define negative predictive value

A

The proportion of people with a negative result correctly excluded by screening
d/c+d

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18
Q

What effect does screening of a common disease have on PPV and NPV?

A

Increased PPV

Decreases NPV

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19
Q

What effect does screening of a rare disease have on PPV and NPV?

A

Decreases PPV

Increases NPV

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20
Q

State the principles of screening

A

1) Important condition
2) Treatment available
3) Suitable test
4) Recognised latent and early phase of disease
5) Cost of screening balanced with that saved by early diagnosis
6) Known history of disease
7) Policy regarding who to treat
8) Facilities for test available

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21
Q

State the reasons for screening

A

Early diagnosis - better outcome
Early diagnosis - cheaper treatment
Prevention of suffering
Patient satisfaction

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22
Q

State the reasons against screening

A

Screening may have adverse effects on healthy individuals
Damaging effects of wrong diagnosis (hopes up/ fear or later diagnosis)
Personal choice comprimised

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23
Q

State the changing health behaviour models that exist

A

1) Health belief model
2) Stages of change model
3) Nudge theory
4) Financial incentives
5) Motivational interviewing
6) Social marketing
7) Mindspace

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24
Q

Describe health belief model

A

Perceived susceptibility
Perceived barriers
Perceived benefits
Self-efficacy

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25
Q

Describe the stages of change model

A
Pre-contemplation
Contemplation
Preparing
Action
Maintenance
Stable changed lifestyle/replace
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26
Q

Describe the nudge theory model

A

Changing the environment to make the healthiest option the easiest one

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27
Q

Define primary prevention

A

Actions that aim to reduce the risk of a disease becoming ESTABLISHED
e.g. behaviour change/vacinations

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28
Q

Define secondary prevention

A

Action that aim to slow/halt the progression of a disease identified in its early stage

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29
Q

Define tertiary prevention

A

Actions that aim to reduce the complication or severity of a an established, detectable and symptomatic disease using treatments/interventions

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30
Q

What is the prevention paradox?

A

Whether to target many low risk individuals(population approach) or few high risk individuals

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31
Q

What sort of people does the high risk prevention approach target and why?

A
Affluent/well educated individuals
These people are more like to:
-engage with health services
-comply with treatments
-have means to change their lifestyle
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32
Q

What is the advantages of using the population approach to prevention?

A

Reduces social inequalities

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33
Q

State the primary prevention for CHD

A

Smoking cessation
Nutrition improved
Alcohol consumption decreased
Physical activity increased

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34
Q

Give 3 unmodifiable risk factors of CHD

A

Age
Sex
Ethnicity

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35
Q

Give 5 modifiable risk factors of CHD

A
Diet - cholesterol - type 2 diabetes
Blood pressure
Physical activity
Smoking
Alcohol
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36
Q

Give a psychological risk factor of CHD

A

Depression

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37
Q

Which personality type is more at risk of developing CHD

A

Type A personality - competitiveness, hostility, impatient

Under assessed using questionnaires/self report

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38
Q

How does work impact risk of CHD

A

High demand/low control job = stress = increased risk of MI/CHD

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39
Q

How does social support influence health

A

Increased social support = decreased morbidity/mortality

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40
Q

What is the link between smoking and men and women?

A

Men smoke more

But gap is closing

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41
Q

What is the link between smoking and social economic status?

A

People of LES tend to smoke more

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42
Q

What is the age limit for smoking?

A

18

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43
Q

When was smoking banned in public placed in the UK?

A

2007

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44
Q

What are the reasons for smoking

A
Nicotine addition
Coping with stress
Habit
Socialising
Fear of weight gain
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45
Q

What is the daily alcohol limit for a man?

A

3-4 units a day

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46
Q

What is the daily alcohol limit for a women?

A

2-3 units

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47
Q

What is standard unit of alcohol?

A

10ml/8g ethanol

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48
Q

How many units are there roughly in a bottle of wine?

A

10

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49
Q

What percentage of A&E admissions relate to alcohol?

A

55%

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50
Q

What are the social implications related to alcohol consumption

A

Disease
Danger - rape, accidents, violence
Driving offences
Depression

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51
Q

What are the withdrawal symptoms of alcohol

A

Tremor
Hallucinations
High BP/HR

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52
Q

What does CAGE stand for?

A

Have you ever thought about CUTTING down
Have you ever felt ANNOYED by people telling you to cut down
Do you feel GUILTY about how much you drink?
EYE OPENER: ever had a drink first thing in the morning

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53
Q

Define ethics

A

The attempt to arrive at an understanding of the nature of human values, of how we ought to live and what constitutes right conduct

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54
Q

State the rivals to ethics

A

Law
Religion/cultural beliefs
Personal conscience

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55
Q

What is meant by a bottom up inductive ethical argument?

A

Using past medical problems to create new guides for practice

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56
Q

What is meant by a top down deductive ethical argument?

A

Applying one specific ethical principle to all problems

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57
Q

What are the 4 ethical principles

A

Autonomy
Beneficence
Non-maleficence
Justice

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58
Q

What is meant by autonomy?

A

Allowing the patient to make a rational and informed decision

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59
Q

Define beneficence

A

Doing good

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60
Q

Define non-maleficence

A

Preventing harm/reducing harm/doing no harm

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61
Q

Define justice

A

Being fair e.g. distribution of health resources

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62
Q

What is utilitarianism

A

Act evaluated solely in terms of its consequences

Maximising good

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63
Q

Define deontology

A

Doing what you believe is morally right

It is the act itself that determines worthiness

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64
Q

Define virtue ethics

A

Focuses on the character of the person, integrating reason and emotion (person in their right state of mind intending to do the right thing)

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65
Q

State the 5 focal virtues

A
Compassion
Trustworthiness
Conscientiousness
Integrity
Discernment
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66
Q

Which strain of influneza caused pandemics?

A

A

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67
Q

What is the criteria for pandemic spread?

A
Novel virus
Capable of infecting humans
Capable of causing human illness
Large pool of susceptible people
Ready and sustainable transmission from person to person
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68
Q

What are the different phases of a pandemic?

A

1-3 animals mostly
4 human to human transmission sustained
5-6 widespread human infection
Post peak - possibility of recurrent events
Post pandemic - disease returns to seasonal levels

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69
Q

State the changes affecting the risk of pandemics

A
International travel
Larger population
Crowding
------
Improved population health
Interdependency between countries
Changes in animal husbandry
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70
Q

Define patient-centred medicine

A

Medicine involving shift in focus from treatment to care

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71
Q

Define compliance

A

The extent to which a patient’s behaviour coincides with medical/health advice. Professionally rather than patient focused ‘doctor knows best’

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72
Q

Give an example on unintentional non-compliance

A

Forgetting

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73
Q

Give a reason for intentional non-compliance

A

Religion/beliefs/personal preferences

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74
Q

Define adherence

A

Similar to compliance
Acknowledges a patient’s beliefs
Health professional = expert, convey their knowledge, results in increased patient satisfaction, knowledge and adherence

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75
Q

Define concordance

A

Patients as equals in care

Expected patients will take part in treatment decisions

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76
Q

What are the ethical considerations of concordance?

A

Mental capacity
Decision’s detrimental to patients health
Potential threat to the health of others
Children: sufficient understanding, can give consent

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77
Q

Give some examples of public health interventions (regarding influenza/pandemics)

A
Hand washing
Respiratory hygiene
Travel restrictions, Screening those entering UK
Reducing social contact
Restricting mass gatherings
School closures
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78
Q

State the types of transmission of diarrhoeal diseases

A

Direct
Indirect
Airborne

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79
Q

Give 2 examples of bacteria that cause diarrhoea

A

E.coli

Rotavirus

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80
Q

What measures can be taken to reduce the risk of diarrhoea?

A
Hand washing with soap
Safe drinking water
Safe disposal of waste
Breastfeeding infants
Safe handling of food
Control of flies/vectors
Vaccination
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81
Q

Which groups are most at risk of developing diarrhoea?

A

Those with poor hygiene/sanitation
Children at pre-school
Health care and social workers
Those preparing unwrapped/uncooked foods

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82
Q

State the way in which disability can be divided

A

Cognitive V Physical

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83
Q

What subtypes of cognitive/physical disability exist?

A
Congenital
Developmental
Addicents
Diseased of early/mid life
Functional limitation of older people
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84
Q

Why is disability increasing?

A

Healthy life expectancy not increasing as much as life expectancy

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85
Q

Give an example of how disability can be assesed (elderly)

A

Activities of Daily Life scale

MMSE

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86
Q

Define palliative care

A

Care aiming to improve the quality of life of patients and families who face life-threatening illness by providing pain/symptom relief, spiritural, and psychosocial support from diagnosis to end of life and bereavement

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87
Q

What types of palliative care exist?

A

Specialist and generalist

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88
Q

Define specialist palliative care

A

Involves health professionals who specialise in palliative care within a MDT. Delivered in hospitals/care home etc

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89
Q

Define generalist palliative care

A

GPs, hospital doctors, district nurses social workers

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90
Q

Describe the relationship between age and comorbidities

A

Increase in age increase in comorbidity

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91
Q

Describe the relationship between chronic disability and SES

A

Lower SES, increased chronic disability

92
Q

Describe the relationship between poverty/living conditions and age

A

Increase age, increase in poverty/poorer living conditions

93
Q

Why do elderly people require more specialist care need?

A
More comorbidities, more impairment
Greater risk of impairment from treatment complications
Increased social isolation
Increased psychosocial distress
Increased economic hardship
94
Q

Define gerontology

A

The study of changes in the body and mind with age

95
Q

Define geriatrics

A

Diagnosis and treatment of disorders that occur with old age

96
Q

Describe the difference in palliative care between COPD and lung cancer sufferers

A

Lung cancer patients receive more palliative care

COPD patients have a low QOL

97
Q

What does evidence based medicine involve?

A
Asking a focused question
Finding evidence
Critical appraisal
Making a decision
Evaluating performance
98
Q

What are the 4 components of asking a focused question in EBM?

A

Population
Intervention
Comparator
Outcome

99
Q

Define the gold standing in EBM

A

Systematic reviews/meta analysis of multiple RCTs

100
Q

Describe the hierarchy of evidence

A

1a - Systematic reviews/Meta analysis of multiple RCT GOLD STANDARD
1b - at least one RCT
2a - at least one controlled trial without randomisation
2b - at least one type of quasi-experimental study

101
Q

What components should be assessed in critical analysis? And what other factors can affect these?

A
Validity
Reliability
Applicability
---------
Stats
Chance
Bias
Confounding factors
102
Q

Define validity

A

How close to the truth something is

103
Q

Define reliability

A

How consistent results are; same every time experiment repeated

104
Q

Define applicability

A

How relevant a study is to clinal medicine

105
Q

What makes a good study?

A

Randomisation - allocation of intervention
Have outcome measures for at least 80% of the population
Show causation rather than association

106
Q

State the main two categories of study

A

Observational

Experimental/interventional

107
Q

What are the subtypes of observational studies?

A

Descriptive
Descriptive/analytical
Analytical

108
Q

What are the 2 types of descriptive observational studies?

A

Case report

Ecological

109
Q

State the advantages of ecological studies

A

Quick/cheap
Help generate hypotheses
Few ethical issues

110
Q

State the disadvantages of ecological studies

A

Can’t show causation

Diagnostic criteria bias

111
Q

Give an example of a descriptive/analytical study

A

Cross-sectional

112
Q

State the advantages of cross sectional studies

A

Quick cheap
Generate hyp
Few ethical issues

113
Q

State the disadvantages of cross sectional studies

A

Prone to bias e.g. sampling

114
Q

State the types of analytical observational studies

A

Case control

Cohort

115
Q

Give an advantage of a case control trial

A

Quick, inexpensive (don’t have to wait for disease to develop)

116
Q

Give a disadvantage of case control trial

A

Retrospective therefore relies on people’s memories

Can only show association not causation

117
Q

Give an advantage of cohort study

A

Can distinguish causes from associated factors

Can measure more than one outcome for a single exposure

118
Q

Give a disadvantage of cohort study?

A

Long - expensive, drop out rate high

Advances in diagnosis influence results

119
Q

Describe the criteria for an association to be causal

A
Strength of association
Consistency
Coherence with existing theories
Temporal relationship
Dose-response relationship
Specificity
120
Q

What are the 3 types of causes?

A

1) X necessary for disease
2) Exposure of X is sufficient to cause disease
3) X contributes to the disease

121
Q

Define a systematic review

A

A review of a clearly formulated question that uses symptomatic and explicit methods to identify, select and critically appraise relevant research, and to analyse the data from studies included in the review

122
Q

Define meta-analysis

A

Review/analysis of results using STATISTICAL METHODS

123
Q

Why is routine health data collected?

A

1) Monitor changes in health
2) Generate hypotheses of ill health
3) Improve planning of health services
4) Evaluate performance of policies/services

124
Q

What information in collected in routine health data collection?

A

1) Morbidity
2) Mortality
3) Use/quality of health care
4) Individual lifestyle
5) Quality of life
6) Socioeconomical/cultural and environmental conditions

125
Q

Define Ethnograph, and state what type of research it is involved in?

A

Emersing yourself in someone else lifestyle

Qualitative

126
Q

What other types of qualitative research is there?

A

Interviews

Documentary analysis

127
Q

What are the associated problems with qualitative research?

A

Subjective - open to personal interpretation

Not truly understanding what someone means

128
Q

What are the disadvantages of quantitive research?

A

Requires a large population

Expensive

129
Q

Quantitive data can be divided into what two categories?

A

Continuous

Discrete

130
Q

What type of graphs can continuous data be show by

A

Histogram
Stem and leaf
Box and whisker

131
Q

What types of graphs can discrete data be shown by?

A

Pie chart

Bar chart

132
Q

Define normal distribution

A

The AVERAGE DISTANCE of observations from the MEAN value

133
Q

How is a an outlier determined by a box and whisker plot?

A

Outliers more than 1.5 X IQR from the upper/lower ends of the box

134
Q

Describe normal distribution curve

A

Bell shaped
66% data within 1 SD
95% data within in 2 SD

135
Q

Describe the relation ship between the median and mean in normal distribution

A

They are the same

136
Q

If the data is symmetrical what should be used to summarise the data

A

Mean and SD

137
Q

If the data is skew what should be used to summarise the data?

A

Median and IQR

138
Q

Describe the relationship between mean, median and mode in a positive skew

A

Mode is less than Median which is less than Mean

139
Q

Define reference range

A

The limits in which you would expect the majority of your data to fall

140
Q

What is the difference between population and sample

A
Pop = all the people we are interested in
Sample = group within the pop which we will study
141
Q

What is standard error?

A

The SD of all the sample means
SD/ square root of n
Standard error quantifies how good a sample result is likely to be
Estimate of precision

142
Q

What are the different types of random sampling?

A

1) Simple
2) Stratified - divided into groups - sampled w/i groups
3) Cluster - groups of individuals sampled

143
Q

Describe the relationship between sample size and confidence intervals

A

Sq sample size

Half CI

144
Q

What is the role of the confidence intervals?

A

Assesses the sample mean against the population mean

145
Q

Give the stages of hypothesis testing

A
Set null hypothesis H0
Carry out experiment H1
Carry out significance test
Obtain test statistic
Compare to critical value
Obtain P value 
Make a decision e.g. reject null hypothesis if P value less than 0.05
146
Q

Define (absolute risk)

A

Incidence/ population

147
Q

What is absolute risk difference?

A

Absolute additional risk following exposure

Risk in exposed group - risk in unexposed group

148
Q

What is meant in terms of absolute risk value when the confidence intervals include 0

A

No difference

149
Q

Define no. needed to treat

A

The ADDITIONAL no of people you would have to treat to cure one extra person compared to the old treatment

150
Q

Define no. needed to harm

A

The ADDITIONAL no of people who need exposure to the risk in order to have one extra person DEVELOP the disease

151
Q

State the eq for NNT

A

1/absolute risk REDUCTION

152
Q

State the eq for NNH

A

1/absolute risk DIFFERENCE

153
Q

Define odds and give eq

A

The ratio of the probability of an occurrecne compared to the prob of a non-occurrence

Odds=prob/(1-prob)

154
Q

Define odds RATIO

A

Ratio of odds for the exposed group and unexposed groups

155
Q

Give an example of a study that OR is used

A

Case control study (relative risk can’t be used here)

156
Q

Why might OR be used in a cohort study / crossectional study? (where relative risk can be used)

A

Not clear which is IV and DV

157
Q

What is the result of a medical error?

A

Adverse effect or near miss

158
Q

Define adverse effect

A

harm caused to patient that is not a direct result to their illness or due to chance

159
Q

Define error

A

Failure of a planned action to completed as intended, preventable event

160
Q

State the different types of error

A

Error of omission

Error of commission

161
Q

Define error of omission

A

Delayed / not taken action

162
Q

Define error of comission

A

Wrong action taken

163
Q

What are the types of errors of omission/comission?

A

1) Professional negligence - skills not up to standard
2) Skill based error - routine task but distracted
3) Rule base - wrong plan

164
Q

Define violation

A

Deliberate deviations from the practicals and rules

165
Q

Disadvantage of personal error model?

A

Anticipation of blame encourages cover up (could make situation worse)
Dependant on trust

166
Q

Advantages of systematic error model

A

Proactive rather than reactive

Early event stopped than could have late damaging effects

167
Q

Define team

A

A group of of people working together to achieve a common goal

168
Q

Define stress

A

A state of mental, physical or emotional strain causing great worry
Demands > ability to cope

169
Q

Give examples of acute stress

A

Danger
Hunger
Noise
Short term inf

170
Q

Give examples of chronic stressors

A

Relationships
Financial
Work
Lack of friends

171
Q

How can work causes stress?

A

High demand, low control

Bullying/violence

172
Q

Give example of internal stressors

A

Phys - inflammation

Psych - personal expectations/beliefs

173
Q

What are the 5 types of stress

A
Biochemical
Physiological
Behavioural
Cognitive
Emotional
174
Q

State the signs of biochemical stress

A

Increased cortisol

175
Q

State the signs of physiological stress

A

Shallow breathing
Increased HR
Increased acid in stomach

176
Q

State the signs of behavioural stress

A

No sleeping
Not eating well (increased/decreased)
Increased alcohol consumption
Increased smoking

177
Q

State the signs of emotional stress

A
Tearfulness
Mood swings
Aggression
Bored
Apathy (lack of emotion)
178
Q

State the signs of cognitive stress

A

Headaches
Negative thoughts
Loss of concentration

179
Q

What are the 3 ways in which one can respond to stress?

A

1) Fight/flight
2) General adaptation system
3) Interaction model (impact of stressor influenced by coping methods adopted/past experiences with stressors)

180
Q

What are the mediating factors of stress

A
Social support
Beliefs/attitudes
Perception
Personality
Coping strategies
Lifesyle
Gender
181
Q

3 stress management methods

A

1) CBT
2) Exercise
3) Self-help/support

182
Q

Why is public health v imp in neurology?

A

Lack of curative treatment

Need for prevention! And rehabilitation

183
Q

Describe type A personality

A
Impatient 
Competitive
Confident
Achievement orientated
Angry
> risk CHD
184
Q

Define frailty

A

Weak physical and psychological states, low vigour, low resilience, and vulnerability

185
Q

What are the 2 types of aging

A

Intrinsic - natural

Extrinsic - due to external factors - UV/smoking

186
Q

What are the effects of decreasing hospital stay?

A
  • Pts return home w/ higher dependancy
  • Increased pressure on commutity services
  • Increase re-admission rate
187
Q

How can we reduce hospital re-admissions for elderly people?

A

Increased support to discharged patients

Managing chronic disease in the community

188
Q

Why is back pain increasing? What can doctors do to reduce it?

A
Reduced phy activity
Inc obesity
Ageing pop
Education
Advise exercise
189
Q

State factors affecting sexual repro health

A

Decrease age of puberty
Increasing age of first marriage
Media

190
Q

State problems with sexual health education

A

In schools - poor attendance, teachers lack training
Not youth friendly (should involve youth in design)
Fear of judgement

191
Q

State the 1 prevention for STIs

A

Education/awareness

Vaccination

192
Q

State the 2 prevention of STIs

A

Screening

Partner notification

193
Q

State the 3 prevention of STIs

A

Treatment

194
Q

State causes of obesity

A
(Imbalance of energy intake and energy expenditure)
Car use/ decreased activity
Work - long hours/shift/sedentary
Grazing
Consumption increased
Food - high in fat, sugar, low in fibre (calorie dense)
Sugary drinks
Obesogenic lifestyle - watch TV/game
195
Q

3 Diseases associated with obesity

A

Type II diabetes
CVR
Hypertension

196
Q

Eq for BMI (N.B. doesn’t measure adiposity)

A

Kg/m2

197
Q

Normal BMI range

A

18.5-25

198
Q

What are the public health implications of obesity?

A

Disease

Increase pressure on health services

199
Q

Give the risk factors of diabetes type II

A
Age
Gender
Ethnicity
BMI
Waist circumference
Hypertension
Impaired glucose tolerance
200
Q

1 prevention for diabetes

A

Education - promotion exercise, change diet/weight loss

201
Q

2 prevention for diabetes

A

Screening/routine bloods

202
Q

3 prevention for diabetes

A

Management

Treating symptoms

203
Q

Why is it more difficult for someone who it already overweight to lose weight?

A

More difficult to exercise
Low-self esteem/embarrassed/scared
Employment/relationships

204
Q

Describe the run away weight gain train model

A

Obesogenic environment
Ineffective breaks - physiological, prejudice, knowledge
Accelerators - ineffective dieting, low SES, self-esteem

205
Q

Risk factors of CKD

A

Alcohol/drugs
Hypertension
Diabetes

206
Q

What does small birth body size indicate in terms of health in later life?

A
CVR disease
Type II diabetes
Osteoporosis
Schizoprenia
Depression
207
Q

What does large birth body size indicate in terms of health in later life?

A

Cancer

208
Q

What are the 4 key concepts of health economics

A

1) Opportunity cost - sacrifice in terms of benefits forgone by not allocating all the resources to the next best activity
2) Economic efficiency - Quality Adjusted Life Years/max benefit
3) Increments and margins - new vs old
4) Equity - fairness

209
Q

What makes a good team

A
Communication
Clearly identified common goal
Identified team leader
Feeling valued/team dynamic
Appropriate size
210
Q

Benefits/importance of working in a team

A

Efficient
Improves decision making
Reduces medical error

211
Q

Disadvantages of working in a team

A

Difficult to monitor due to involvement of different health professions(different managers)/environmental problems - diff offices/shifts
Feeling of lack of responsibility when problem shared

212
Q

State the 7 steps to pt safety

A

1) Safe culture
2) Lead/support staff
3) Integrate risk management activity
4) Promote reporting
5) Communicate w/ patients/public
6) Learn and share safety lessons
7) Implement solutions to prevent harm

213
Q

What is the SBAR checklist

A
For asking advice from senior e.g. over phone
Situation
Background
Assessment
Recommendation
214
Q

What are the types of violation

A

Routine - cut corners
Necessary
Optimising - personal gain

215
Q

Give an example of a hard defence

A

Engineered safety features

216
Q

Give an example of a soft defence

A

Law, rules, regulations, checklists, handovers

217
Q

Why is safety in healthcare compromised so often

A

Complex environment
Shared responsibilities
Resource intensive
System, patient and practitioner interaction

218
Q

What is heterogeneity

A

Variability of results

219
Q

Homogeneity?

A

Similarity of results

220
Q

Define substance abuse

A

Ingestion of substance affecting the CNS which leaves to behavioural and psychological changes. Implicitly not for therapeutic use

221
Q

RFs for substance abuse

A
FHx
Family conflict
Low SES
Friends (peer pressure)
Academic failure
222
Q

Define addition

A

Physical and psychological dependance on a substance
Physical - w/o = withdrawal symptoms
Psychological - feel like you can’t live w/o, fear, pain, guilt

223
Q

Define an autonomous action

A

An intentional action, done with understanding and w/o controlling influences

224
Q

Define malnutrition

A

A state nutrition in which the excess or deficiency of energy, protein and other nutrients causes measurable adverse effects on the body and clinical outcome

225
Q

Describe the MUST tool

A

BMI
Unexplained weight loss/gain in last 3-6 months
Assess acute disease (e.g. NBM more than 5 days)

226
Q

Define alcohol abuse

A
1 or more in the last 12 months of:
Role failure
Relationship problems
Risk of bodily harm
Problems with the law
227
Q

Define alcohol dependance

A
3 or more in the last 12 month of:
Withdrawal sym
Tolerance
Can't stay w/i limit
Keep drinking despite problems