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Health and Society > B9 H+S > Flashcards

B9 H+S Flashcards

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1
Q

What does EBDM involve? (4)

A

Patient preferences, resources, research evidence, clinical expertise

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2
Q

what is a cohort study used for?

A

prognosis, cause

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3
Q

case- control studies are used for?

A

cause

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4
Q

what makes a case in a case- control study?

A

those with the disease already, these are compared to those without the disease.

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5
Q

risk is another name for?

A

probability

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6
Q

risk ratio is calculated by?

A

risk of event in questionable group/ risk of event in the control group.

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7
Q

risk ratio can also be called?

A

relative risk

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8
Q

the odds of an event is?

A

the number of events/ number of non- events

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9
Q

odds ratio calculation?

A

odds of event in questionable group/ odds of event in the control group

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10
Q

Odds ratio vs risk ratio

A

Odds ratio: (a/b)/(c/d) whereas RR: (a/a+b)/(c/c+d)

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11
Q

when is a case- control study better than a cohort study?

A

when the population is large and ill- defined, and when the disease outcome is uncommon. (as look at those with disease and compare their exposures)

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12
Q

when is a cohort study better than a case- control study?

A

dealing with outbreaks in small- well defined source population. (As 2 groups will be more similar in size).

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13
Q

RCT’s are used in?

A

treatment intervention, benefits and harm, cost effectiveness.

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14
Q

1st step in smoking cessation

A
  1. Health education and general information to enhance motivation (light smokers) eg: TV ads
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15
Q

2nd step in smoking cessation

A
  1. brief advice from health professional (light smokers) Eg: stop smoking week at GP
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16
Q

3rd step in smoking cessation

A

advice, nictotine replacement, follow up by specialist (moderately motivated, medium dependency)

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17
Q

4th step in smoking cessation

A

specialised counselling rooms and agencies working with group sessions (high dependent smokers)

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18
Q

2 reasons for widespread use of antibiotics

A

increase in global availability

uncontrolled sale in low/ middle income countries

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19
Q

Some causes of antibiotic resistance?

A

use in livestock, releasing into environment, volume prescribed, missing doses, inappropriate prescribing

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20
Q

how antibiotic resistance can be prevented?

A

only when prescribed, complete full prescription, never share, only prescribe when needed, right antibiotic for illness

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21
Q

what is surveillance?

A

systematic collection, collation and analysis of date and dissemination of the results so appropriate control measures can be taken.

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22
Q

purpose of surveillance?

A

early warning sign for public health emergency, documents impact of intervention or goals, monitors and clarifies epidemiology.

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23
Q

3 infectious diseases becoming more common?

A

MRSA, STIs, mumps

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24
Q

Mandatory infectious surveillance in hospitals for what?

A

MRSA

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25
what is the 90/10 gap and where was it mentioned?
commission on health research for development- 1990, less than 10% resources put towards 90% of all preventable deaths. `
26
WHO's health definition of environment?
All physical, chemical, biological factors external to a person and all related behaviours. Preventing and controlling disease, injury, disability by interaction management.
27
what is an outbreak?
increase in occurrence where disease never experienced before
28
epidemic?
group of illness similar in nature from a common source
29
How to prevent an epidemic?
insure poor countries against threat of pandemic, funds where outbreaks occur, vaccines, planned response, monitor disease for future.
30
What does WHO do in public health?
provide leadership, shape research agenda, setting norms and promoting standards, provide technical support and monitor health situations and trends
31
some ways to intervene with HIV/AIDS
blood donor screening, condoms at affordable prices, peer education (high risk groups), safe sexual behaviour, treatment of STD's, increased testing
32
3 determinants of effective outcomes of intervention
economics- most developing countries spend little money on healthcare priorities- what is cost- effective? setting- depending on political openness
33
2 most effective developments in population protection?
clean drinking water, vaccines
34
3 things required for a disease to be eradicated using vaccination?
Human= only resorvoir consequence of infection is very high scientific and political prioritisation.
35
2 main diseases eradicated
smallpox, polio
36
herd immunity facts (3)
protects whole population only applies human-human disease may be eradicated even if some susceptible.
37
what is R0?
basic reproduction rate | average number of individuals directly infected by 1 invective case in TOTALLY SUSCEPTIBLE POPULATION
38
factors affecting R0?
rate of contacts in host populations probability of infection being transmitted infective duration
39
what is effective reproduction rate (R)?
estimation of average number of secondary cases per infectious case in a population of both susceptible and non- susceptible.
40
how to calculate effective reproductive rate (R)?
R= R0x X (number susceptible to disease)
41
what does R value mean?
below 1, cases decreases (needs to be maintained) 1= epidemic threshold more than 1, cases increasing
42
equation for herd immunity?
H= (R0-1)/R0
43
WHO's role in vaccination?
makes recommendations on policy. | supports less able countries with strategy implementation
44
3 international immunization programs?
EPI- expanded programme on immunizisation GPEI- global polio eradication initiative GAVI- global alliance for vaccines and immunisation
45
what is the population vs individual interest debate? (vaccines)
individual- protection by herd immunity is safest option | population- avoidance of vaccine leads to diminishing herd immunity
46
2 websites for travel vaccine info?
NHS fit for travel | National travel and health network and centre
47
3 diseases for private vaccination?
Hep B, Japanese encephalitis, yellow fever, TB
48
5 most common cancers (incidence) in UK
``` 1. Breast/ prostate 2, lung 3. bowel 4. melanoma 5. Non- hodgkin lymphoma ```
49
5 most common cancer mortalities in UK
1. lung 2. bowel 3. prostate/ breast 4. pancreas 5. oesophagus
50
Most common cancer in children
leukaemias
51
cancer mortality UK compared to 3rd world
UK= 29%- higher than developing
52
ABCDE method of bad news?
``` Advanced preparation building relationships communicating well dealing with patient reactions encourage and validate emotions ```
53
SPIKES method of breaking bad news?
``` Setting up perceptions invitation knowledge emotions strategy and summary ```
54
2 conclusions and consequences of Eurocare II report?
cancer survival in 80s and 90s UK were one of worst in Europe Expert advisory group formed generating the calman- Hine report
55
what were the conclusions of the Calman- Hine report?
examined cancer cervices and restructured services to achieve more equitable access all patients have uniform high quality care earlier symptom spotting and should be patient centred
56
The Calman- Hine solution?
3 levels of care- primary cancer units in district general (2), common cancers, diagnostic procedures cancer centres (3) rare cancers, radio and chemo
57
what is a national service framework?
national standards and define service model. Put in programs to promote this and give timescales for change
58
Main aims of NHS cancer plan (2000)
save more lives, ensure right professional support, tackle health inequality, build for the future (research)
59
6 key areas for the cancer reform strategy
``` prevention- smoking, obesity etc diagnosis early ensure better treatment living with and beyond cancer reducing cancer inequalities delivering care in most appropriate setting (local) ```
60
3 cancers that can be screened for?
cervical, breast, bowel
61
4 main outcomes for improving outcomes: a strategy for cancer
prevention and early diagnosis QoL and patient experience better treatments reducing inequality
62
Outcomes form the independent cancer taskforce?
spearhead radical upgrade in prevention | nation ambition for early diagnosis
63
what is a biographical distribution?
chronic illness leads to loss of confidence in the body | from this follows a loss of confidence in social interaction/ self identity
64
3 ethical theories?
consequentalism- correct moral response related to outcome deontology- rules virtue ethics- moral characters
65
why may an argument be invalid?
different premises may express different concepts confusing necessary with sufficient insensitive to the way in which claims are qulified
66
why may argument be unsound?
argument is invalid valid argument but a premise is false (opinion/ claim) does not mean unsound conclusion
67
What is straw man fallacy?
ignoring persons position and substituting it for a misinterpreted version
68
Ab hominenms meaning?
directed against a person rather then position maintaining
69
what is a deductive argument?
purely logic, "this means this, therefore this means this" (maths)
70
moral argument?
seek to support a moral claim, argument need not succeed but must provide supporting reasons (ethics)
71
what is an inductive argument
making argument based on observation, more probably conclusions (may not have seen everything however) (physics)

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