Public Health Flashcards

1
Q

What is horizontal equity?

A

Individuals with the same disease should all be treated the same

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2
Q

What is vertical equity?

A

People with different needs require different treatment for the same disease, i.e. unequal needs.

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3
Q

Describe the difference between equality and equity

A

Eqaulity is everyone having the same, equity is what is fair and just

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4
Q

What are the 3 domains of public health?

A
  • Improving and delivering services
  • Health protection
  • Health promotion
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5
Q

List the stages of the health behaviour model (4)

A

Believe they are suspetible
Believe there are serious concequences
Believe the action will reduce the chances
Believe the benefits of the action outweight the costs

Relies on the self belief of the individual, doesnt take into account emotion.
Looks at a cue.

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6
Q

What does the transtheoretical model suggest as the process of behaviour change?

A
Pre contemplation 
Contemplation 
Preperation
Action 
Maintenance
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7
Q

Define need

A

The ability to benefit from an intervention

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8
Q

Define demand

A

What people ask for

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9
Q

Define supply

A

What is provided

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10
Q

Name 4 at risk groups

A
  • Migrants
  • Asymlum seekers
  • Drug users
    • Children
  • Homeless
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11
Q

What are Bradshaws four taxonomy of needs?

A

In order for a need to become a reality, i.e. make a real need possible.

  • Felt
  • Expressed
  • Normative
  • Comparitive

(all overlap)

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12
Q

What is the inverse care law?

A

Those with better health tend to access better health care services, when in fact, it is people in poorer health that should be having greater access to these services

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13
Q

What is donabedians framework and what is it used for?

A

Framework for quality of care

Structure (context in which the care is delivered, e.g. physical facility, equipment, human resources, organisational characteritsitcs such as staff training and pay)

Process (sum of all the actions that make up healthcare, e.g. diagnosis, treatment, preventative care, patient education)

Outcome (the effects of healthcare on patients and populations) - really hard to draw conclusions and links between interventions and outcomes.

framework that can be used for the evaluation of healthcare services, gives infr

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14
Q

What are Maxwells 6 dimensions?

A

Framework for quality of care

3ES and 3AS

access, acceptability, appropriateness
equity, effectiveness, efficacy

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15
Q

What is a confounding variable?

A

A variable that unfluences the dependent and independent variable

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16
Q

Give an example of something that is demanded, and supplied, but not needed

A

Antibitoics for viral illness

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17
Q

Give an example of something that is needed and demanded, but not supplied

A

Cure for cancer
Cure for chronic disease
Better mental health services

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18
Q

Give an example of something that is needed and supplied, but not demanded

A

Smoking cessation

Alcohol Cessation

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19
Q

What is tertiary prevention?

A

Reducing the impacts of a disease and preventing complications

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20
Q

What is donabedians framework and what is it used for?

A

Framework for quality of care

Structure (context in which the care is delivered, e.g. physical facility, equipment, human resources, organisational characteritsitcs such as staff training and pay)

Process (sum of all the actions that make up healthcare, e.g. diagnosis, treatment, preventative care, patient education)

Outcome (the effects of healthcare on patients and populations) - really hard to draw conclusions and links between interventions and outcomes.

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21
Q

What is the prevention paradox?

A

If something brings a lot of benefit to the population, then it provides little benefit to each individual

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22
Q

What is lead time bias?

A

Bias - overestimation of survival.

In the lead, head start.

I.e. Screening detects people earlier even though they have the same outcome.

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23
Q

Name 3 ways you can quantitatively assess a health service

A

m

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24
Q

What are the 3 main biases involved with screening?

A
  • Lead time
  • Length time
  • Selection
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25
Q

What is a confounding variable?

A

An unaccounted for variable which also independently affects the outcome

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26
Q

Give an example of something that is supplied, demanded and needed

A

Free contraception

27
Q

What is the population approach to intervention?

A

Treating the whole population in an attempt to reduce the risk of people developing the disease

28
Q

What are the bradford hill criteria?

A

Provide the minimal conditons for establishing a causal relationship between 2 variables

29
Q

Name 4 / 9 bradford hill criteria

A
  • Strength
  • Plausability
  • Consistency
  • Evidence
  • Dose response
  • Temporarility
  • Study design
  • Reversibility
  • Specificty
30
Q

What are the four stages of a health needs assessment?

A

Needs Assessment
Plan
Implement
Assess

31
Q

Name 1 advantage and 1 disadvantage to the corporate approach

A

Adv: engaging the individuals using the service and running it

Disadv: blur between demands and needs, bias, staekholders opinions

32
Q

Name 1 advantage and 1 disadvantage to the ecological approach

A

Adv: Large amount of data, can study a particular question, addresses a clear problem.

Disadv: Biomedical model, expensive

33
Q

Name 1 advantage and 1 disadvantage to the comparitive approach

A

Adv: can see the evidence of benefit in a population.

Disadvantage: Hard to find completely matched groups

34
Q

What is an ecological study?

A

Observational study, data analysed at population / group level rather than individual level.

35
Q

What is a case control?

A

Two groups with differing outcomes are identified, compared on the basis of a supposed causal atrribute

36
Q

Define incidence

A

The number of new cases of a condition that develop during a specific time period

37
Q

Name the 4 non-causal associations

A
  • Chance
  • Bias
  • Reverse causality
  • Confounding
    (True association)
38
Q

Give an example and explanation of a service that is supplied, but not needed or demanded

A

C-section on women with previous history of C-section

39
Q

Define epidemiological needs assessment

A

Deciding what a population needs based on the incidence and prevalence of
certain diseases

40
Q

Define comparative needs assessment

A

Individuals with similar characteristics to those receiving help, examines
health status, utilization

41
Q

Define corporate needs assessment

A
Getting input from a number of individuals or groups to decide what is
needed most (press, patients, professionals, politicians)
42
Q

Name 2 disadvantages of the theory of planned behaviour

A
  • No account for emotions

- Relies of self-reported behaviour

43
Q

What is the rule of rescue?

A

We help people regardless of the disproportionate investment that helping the person would result in

44
Q

What is the libertarian principle for resource allocation?

A

Patients are in control of their own healthcare, wellbeing anfdfulfillment of life goals

45
Q

Name 3 behavioural interventions for weight loss

A
  • Motivational interviewing
  • Self-help groups
  • Commercial weight loss programme e.g. weight watchers
46
Q

Give four qualitative methods of research for evaluating healthcare

A
  • Interviews
  • Focus groups
  • Observation
  • Case reports
47
Q

What are the three health behaviours?

A
  • Sick role behaviour - actions taken by people recovering from illness
  • Illness behaviour - think you are ill so seek remidy
  • Health behaviour - prevent disease
48
Q

What is maximising resource allocation?

A

Give to those who are most likely to benefit

49
Q

What is libertarian resource allocation?

A

Everyone is responsible for their own health and wellbeing

50
Q

What is egalitarian resource allocation?

A

Provide equal care to everyone

51
Q

In what 3 cases can you break confidentiality?

A
  • Required by law
  • Public interest
  • Patient has consented
52
Q

List some risk factors for health inequalities

A
Place of residence
Race or ethnicity
Occupation 
Gender
Religion 
Education 
Socioeconomic status
Social capita or resources
53
Q

What are the four things involved in Peytons style of teaching?

A

Trainer runs through without commentary

Trainer talks through and trainer does

Learner talks through and trainer does

Learner talks through and learner does

54
Q

List 2 disadvantages of screening

A
  • Puts potentially well individuals at risk of invasive procedures
  • Detection and treatment of diseases that wouldnt have caused any harm
55
Q

List 3 transtion points / times when a person is more likely to make a behaviour change during their life

A

Any major life event really

  • Leaving school
  • Going to uni
  • Becoming unemployed
  • Retiring
  • Having children
  • Post divorce
  • Significant health event
56
Q

What is involved in teh acid test for dols?

A

Looking at whether someone is depirved of their liberty.

Are they free to leave?
Are tey under continous supervision and control
Do they have capacity to consent to this?

57
Q

Describe the key parts of the health belief model

A
  • suspeptible
  • severe concencequences
  • doing action reduces suspebtility
  • benefits outeight the costs
  • Motivation
  • percieved barriers
58
Q

What is bias?

A

A systematic deviation from the true estimation of an association between an exposure and an outcome

59
Q

What is the difference between an eating disorder and disordered eating?

A

disordered eating - enaged in the same behaviour but to less of a degree.

60
Q

What is the boundary model of eating?

A

Deliberate reduction in food intake to maintain or loose weight
Dieters . - takes them longer to feel full as they have a great range between hunger and satiety
They usually stay under a strict limit, however when they increase ther food intake they have to eat more than others to feel full, reasulting in overall weight gain.
Reasons to go over boundary (disinhibition, ‘what the hell’ mentality) include:
- Large portion size, stress, emotions, high energy preload

61
Q

What is the goal conflict model?

A

a social cognitive theory that attributes the difficulty of chronic dieters to a conflict between two incompatible goals: eating enjoyment and weight control. Although chronic dieters are motivated to pursue their weight control goal, most fail in food-rich environments: Surrounded by palatable food cues that activate thoughts of eating enjoyment, incompatible weight control thoughts are inhibited and weight control intentions are “forgotten”. For successful dieters - probably due to past success in exerting self-control - tasty high-calorie food has become associated with weight control thoughts. For them, exposure to palatable food makes weight control thoughts more accessible, enabling them to control their body weight in food-rich environments

62
Q

What is the externality theory?

A

Overweight individuals eat according to external cues, time of day, sensory cues, whereas leener individuals repsond to internal cues –> however this is a very general statement

63
Q

Define malnutrition

A

Deficiences, excesses or imbalances in a persons intake of energy and/or nutrients.

Covers under and over nutrition.