Midterm Flashcards
(120 cards)
1
Q
What kind of system is our health care?
A
Single tiered, meaning that even though some of our healthcare is provided by private sectors, it is paid for through public funding.
2
Q
What are P3s?
A
Public Private Partnerships. Introduced by premier McGuinty, the private sector would be responsible for building the hospital and owned it, but the public sector operated and provided care under OHIP. This ensures up-to-date tech and good infrastructure, plus things got done fast. Problem was that in order to make it cost-efficient, housekeeping and food remained with the private sector and weren’t always up to standard.
3
Q
What is the Cahoulli decision?
A
It was a lawsuit brought by Quebec doctors on behalf of his patients who had to wait months for a ship replacement. The court rules that long waiting lists imperilled patients rights to the security of the person. Many claimed this opened the doors to private delivery and financing of HC. Quebec gave money to private sector to develop their version of OHIP.
4
Q
Describe private clinics in Canada.
A
Ex. Coleman Clinics. Pay an annual membership fee for non-insured services but also bill OHIP for services covered by the government. Essentially paying for timely access to doctors, nurses, and sports therapists (queue jumping) which people didn’t like. Charging for things already covered (aka membership fee) was illegal, so government cracked down on these. Now the debate surrounds for profit blood plasma clinics.
5
Q
What are some cons to the private parallel system?
A
It will drain health profiles from public system and allows the doctors in the system to pick and chose their patients, potentially resulting in them doing easy stuff then shipping cases back to the public system when things go wrong. It will also drain personal from the private system.
6
Q
What are the primary objectives of Health Canada at the different levels?
A
Municipal: provides many local recreation facilities
Provincial: deliver health care and hospital maintenance
Federal: provides most of the funding and therefore uses it as leverage.
7
Q
What is the mandate of Health Canada?
A
Maintaining and improving the health of Canadians
8
Q
What select populations was the federal government responsible for under the BNA act?
A
Inuit and First Nations' health RCMP Armed forces veterans Correctional services employees Immigrant and refugee claimants
9
Q
What happened when the fed. government threatened to decrease refugee claimant coverage?
A
The doctors stood up for them and said they need healthcare, especially those needing prenatal care.
10
Q
What occurred in the 1920s as a result of the TB outbreak?
A
When TB became prominent people believed it was spread by the Indian population and the whites wanted segregated hospitals. The government obliged and between 1920 and 1970, there were racially segregated indian hospitals.
11
Q
What is cystitis?
A
TB often hit children but the hospitals were ill-prepared to take care of them, so there were records of doctors putting casts on children to prevent them from running around.
12
Q
What does the federal government do with health Canada?
A
Conducts research, produces national healthcare campaigns, health promotion and disease prevention, and oversees PHAC, Canadian Institutes of Health Research, Hazardous Material Information Review Commission, Patented Medicine Prices Review Board, and Assisted Human Reproduction Canada.
13
Q
What are the different branches of Health Canada?
A
Health Products and Food Branch (HPFB) Healthy Environments and Consumer Safety Branch Canadian Institutes of Health Research Patented Medicines Prices Review Board Public Health Agency of Canada (PHAC)
14
Q
What does HPFB do?
A
Oversees/reviews health related risks and benefits of drugs, vaccines, medical devices, national food products, food, and vets drugs.
15
Q
What does the Healthy Environments and Consumer Safety Branch do?
A
Drug Strategy and Controlled Substances Program: regulates the use and distribution of narcotics and other controlled drugs in Canada ex. medical marijuana.
Tobacco Control Program: regulates the manufacture and sale of tobacco products ex. packaging
16
Q
What does the Canadian Institutes of Health Research (CIHR) do?
A
Funds 13 research institutes across Canada through a multi-million dollar budget
17
Q
What does Patented Medicines Prices Review Board do?
A
It is a watch agency monitoring prices of patented drugs.
18
Q
What is the PHAC?
A
Created in 2004 following SARS and headed by Canada’s Chief Public Helath Officer, it has a mandate to promote health and prevent disease by responding to health emergencies and infectious disease outbreaks.
19
Q
Why do we not have a national pharmacare program?
A
Many of the really poor and elderly are already covered provincially and most of the rest are covered through some work health plan so although it is more cost effective to have a federal program, it is hard to get everyone together and just not work it.
20
Q
What are some international health agencies that work with health care?
A
Organization for Economic Co-operation and Development (OECD)
WHO
21
Q
What is OECD?
A
An international health agency composed of 30 member countries that measures the quality of medical care in member countries and rates health outcomes.
22
Q
What is WHO?
A
Composed of 194 member countries, it provides health leadership globally through health research, monitoring health trends, providing statistics, recommending policy and actions regarding population health, and issuing alerts regarding health epidemics and pandemics.
23
Q
Why are people in some countries hesitant of vaccine campaigns? Give an example.
A
When the americans were looking for Osama Bin Laden in Pakistan, they sent CIA people door-to-door staged as public health vaccinators, looking for him. When people found out, they accused the US of misusing a vital public health service through political means and caused many of the people who were actually giving the vaccines to be killed and the eradication of the diseases were put in jeopardy because people lost trust.
24
Q
What are dog whistle politics?
A
It is coded language that quietly puts blame on people that the public won’t pick up on, resulting in prejudice.
25
Who was blamed for the black death?
The jewish community were blamed in germany.
26
Describe the plague.
Between 1347-53 alone it killed 25 million people in Europe, approximately 1/3rd of the population. It was caused by a bacterial infection that was transmitted to humans via fleas of infected rodents. The sick were incarcerated in their homes and doors were marked with a red X. During the Great Plague of London (1665-66), 1/5th-1/th of the population of the city were killed. Was a class issue.
27
How did Hurricane Katrina illustrate the saying "flee early, flee far, return late"?
Those who could afford to leave prior to the store did, leaving the poor trapped in the city when the levis broke during the storm, forcing them to seek shelter in the stadium. It really showed who had options and who didn't.
28
What are some bacterial infections that resulted in epidemics?
The plague, leprosy, syphilis, typhus, cholera, typhoid, tuberculosis
29
What are some viral infections that resulted in epidemics?
Small pox, yellow fever, rabis, influenza, AIDS, measles, ebola, polio, dengue fever, SARS
30
What level of government is responsible for mosquito control?
All levels.
31
What is influenza?
Commonly referred to as the flu, it is a highly infectious viral disease that affects the respiratory tract. Called influenza because was thought a heavenly influence must be at work to cause so many cases.
32
What is the spanish flu?
It was a pandemic in 1918-1919 that killed over 20 million people. It was called the spanish flu because spain was one of the only countries without a media blackout during the war and therefore projected images of the illness worldwide.
33
What is adding to the rate of disease transmission?
The world is shrinking as our ability to travel more and easier increases.
34
What is SARS?
SARS was a pandemis in 2003 that infected over 8000 people in 29 countries, 800 dying, 44 of them canadians. It was a mysterious pneumonia like disease that spread via airborne droplets. It hit Canada particularly hard.
35
How did SARS change the canadian health care system?
It revealed Canada was not prepared for an epidemic. In a review conducted by Justice Archie Campbell in 2007, he said that the HC system was not prepared and coordinated, that the different levels are needed to work together. Resulted in many cities now having an emergency preparedness plan and the creation of PHAC and Public safety canada.
36
What are PHAC's key goals?
```
Public Awareness
Ongoing Surveillance
Early Detection
Prompt action to contain viruses
Effective CMN across HC system
Collaboration amongst HC providers, orgs, agencies at all levels of government.
```
37
What is H1N1?
A strain of influenza virus that in the past usually only affected pigs but in the spring of 2009, it emerged in people in Mexico. Our lack of natural immunity allows it to spread and cause serious widespread illness.
38
Who was the first case of Swine flu?
A mexican person who acted as a door-to-door census taker in an industrial town in mexico called La Gloria.
39
How have we advanced our outbreak management plans?
We now have emergency preparedness training and teams. Precautions taken for H1N1 actually reduced the normal incidence of other conditions that year.
40
What is Legionaire's disease?
Named after an outbreak at convention of legion member in 1976 in philidelphia, it is caused by a strain of bacteria now called legionella. There was another outbreak in summer/fall of 2012 in Quebec city, 13 dying after it was incubated in the air conditioning units of tall buildings.
41
What is shrek syndrome?
If it is far, far away, we tend not to care that much. For example, ebola was not relevant in north america until a doctor came back sick.
42
Describe the ebola virus.
The disease first appeared in 1976 in two outbreaks simultaneously, one of which occurred near the ebola river. It is now an epidemic is Wes Africa that exhibits race and class issues due to the lack of money for containment efforts. It is spread through bodily fluids and has killed over 11315 out of 28000 cases. People now fear a mutation that will result in it being airborne.
43
Who was severely affected by the ebola virus?
Health care workers were particularly hard hit, with a 50% fatality rate.
44
What was found to be aiding the spread of ebola?
Religious culture practices aided in the spread as when someone died, the family would come and clean and wrap the body, returning it to the home village and allowing transmission to occur.
45
Why don't we have a vaccine for ebola?
Families began losing faith in medical experts and went back to their home villages, spreading the disease. The main reason for the lack of vaccine is where the outbreak occurred, developed countries weren't effected so there was no monetary incentive to develop a vaccine. There was also a severe lack of doctors, with only 225 for a country of 6 million, who would need a steady supply of electricity to heat and clothe blood samples.
46
Who delivery health care in Canada?
1) Health Care Practitioners
2) CAM
3) Informal workers
4) Care by family, friends, and volunteers
47
Define practice setting.
The contest and the environment in which hc is delivered. Now shifting more towards community based care. ex. Ford government is around integrating and coordinating care
48
What is the oaks and what do they specialize in?
The Oaks is a homeless shelter that specializes in harm reduction. They are known to give homeless alcoholics access to small amounts of alcohol. This relieves their addiction seeking behaviours as they know where their next fix is coming from, and allows stability, which can lead to finding housing and a job.
49
What are the principles of harm reduction?
```
Meet the client where they are at
Non-judgemental
Reduce harm
Not necessarily cure
Various practice settings
Examples include needle exchange, methadone maintenance program
```
50
What is a hospice facility?
A facility that provides supportive and compassionate care to individuals who are in the final stages of terminal illness and their loved ones. Do not provide restorative care, instead ensures quality of life until the end of life.
51
Why are barbershops becoming more related to health care?
The barbershop is a place of connection, loyalty, and trust that allows more open conversations about health and especially high blood pressure.
52
What is the Sorrentino Compassion Health?
It is a house in Edmonton that houses women coming from more distant locations to receive chemotherapy. The house not only serves as housing but also as psychosocial support for the women as they can talk with women going through the same thing. Heading into the future, it is likely that more pressure will be put on the government to support these types of places.
53
What is the epidemic of loneliness and why is this a problem?
Of those 80 and above, 80% feel lonely. Loneliness causes your immunity to drop and causes you to use the health care system. It is more harmful that obesity and diabetes as a predictor of early death, and is the same as smoking 15 cigarettes a day.
54
What is a cancer coach?
Often retire nurses, these people help you navigate the cancer world, help you understand the medical jargon around cancer, what your next steps are, and all the things the surgeons and doctors don't have time to tell you.
55
What is a patient navigator?
Similar to a cancer coach but for more general population. Explain where to get what services, who to contact, and what is going to happen when you do.
56
How is doug ford changing Ontario health care?
Aiming to make patient focused, integrated and coordinated care.
57
What is the Men's Shed?
Designed to help reduce loneliness after retirement, it is a program that aims to bring older men together in familiar and comfortable environment. Allows the men to work side by side in a woodworking shop. Now found in Australia, the UK, and Canada.
58
What is social prescribing?
The act of doctors prescribing an activity or life style change such as going to yoga to reduce stress as opposed to prescribing pills.
59
Describe the state of women in health care.
92% of RNs in Canada are women. Of over 1000 midwives in Canada, only one is male. The number of women in health care is increasing each year (approx. 80% of paid HC workers) but the presence of gendered professions (such as nursing) can devalue women's work. Women provide most unpaid health care within the home.
60
Who was Dr. Noni MacDonald?
1st woman to be named a dean of Medicine @ Dalhousie in 1999.
61
Who is Joy Milne?
She was a 65 year-old britich women who's husband developed parkinson. When he got sick, she asked if people could smell parkinson's and was laughed at. However, after he got sick, they got her to smell 12 t-shirt and she correctly identified 11/12 shirts and a year later the 12th person developed parkinson's as well. Later discovered that the illness triggers a change in a persons chemical signature in their oil, leaving to a change in odor.
62
What is the patriarchy?
It is a social organization in which the father is the head of the family and ancestry and inheritance are traced in the male line. It is also a belief system that predisposes the dominance or hegemony of certain groups of men and the disproportionately large share of social and political power men have. Royal family overhauled this by ruling the first child can take the thorn not the first son.
63
Why do nurses dislike the nursing costume?
Women's healthcare skills and expertise are often undermined by the persistent sexist stereotypes, causing midwives credentials to be questioned. It portrays nurses in a light that made them feel as if they were only there to be caring towards the patient, not provide actual healthcare.
64
Describe women as healers in the early 1400s.
Even before written records, people knew of the healing properties of plants, with herbal mendicants playing a significant role in the late middle ages. Women were often healer and became a target. They were cast as enemies of society and devalued to witches during the renaissance and early modern periods. Women's knowledge was usurped later by professional men and pharmaceuticals.
65
What occurred during the witch hunts between the 14th and 17th centuries in Europe?
Women healers, wise women, and folk healers were seen as a challenge to the church as they hearted without the confession of sin. As a result, somewhere between 50-100,000 were killed as witches after being tortured into confessing and naming others. Ultimately, witches represented a political, religious, and sexual threat to the church.
66
Give some examples of things used by folk healers.
Belladonna: used to stop contractions
Digitalis: from purple foxglove plant and used as a heart drug (still today)
Ergot: controlled doses were used to induce abortion and stop maternal bleeding after child birth
67
What occurred in the 13th century to alter the stance of women in health care?
With the introduction of med schools, women were forced out of healing practices. By introducing new licensing laws that prevented practicing within university training, and only teaching in latin, women were blocked from medical training.
68
What were the different crimes witches were accused of?
1. Sexual crimes against men (accused of female sexuality, lust, and conception)
2. Organized into a secret society
3. Having magical powers
69
Who was Susan Nells?
She was a nurse at Sick Kids that was charged with 4 counts of 1st degree murder after 43 babies fell sick. The deaths were ruled murder by the heart drug digoxin. During the investigation, only nurses were looked at and because she showed no emotion and asked for a lawyer, Nells was charged with the murders, despite a lack of proof. Later, it was found that the deaths were caused by MBT, a chemical compound in the rubber seal on IVs and syringes.
70
What is the rest cure?
Women suffering from PPD were told to go to bed and not to excite yourself as it was all in your head. Described int the book "The Yellow Wallpaper" by Charlotte Gilman.
71
When birth control was first introduced, who was it given to?
Married women
72
What were Magdalen Asylums?
They were institutions in Ireland that unmarried girls who got pregnant or who were deemed promiscuous were sent to. There, they would work away their sins doing laundry, essentially using the girls as free labour.
73
What are comfort women?
They were women who were forced into sexual slavery in Japan during world war I. Often women from other countries, they were forced to provide sexual favours to the military man.
74
What is the assumption underlying comfort women?
Men have a sexual appetite that needs to be addressed (never said about women)
75
As doctors rose to prominence, what views came about?
Doctors were given a gatekeeper role. They were the ones that said whether or not you were crazy, was was normal and abnormal, and caused society to adopt a view that doctors know best. This is evident in the medical model that appears and the medicalization of women's lives (birth).
76
What was one of the issues with doctors being moral gatekeepers?
At the time, most doctors were male and were the ones in charge of deciding which women get birth control. At the time, usually only married women got the pill. It was believed that the pill would be taken advantage of by unmarried women and that it would turn them into strumpets.
77
What are the three categories of health care providers?
1. Core healthcare providers: doctors, nurses, psychiatrists, etc.
2. Allied health professionals: osteopaths, optometrists, psychologists
3. CAM practitioners: aboriginal healers, massage therapists, chiropractors
78
Define health care provider.
A person who has graduated from a health-related college or uni program and is accredited by a regulating or professional body, often requiring a license by the provincial government.
79
Define allied health professional.
A health care provider other than a nurse, doctor, or according to some sources, pharmacist, or dentist who provides supportive health care, including direct patient care, therapeutic care, and supportive services.
80
Who regulates doctors? Nurses?
Doctors: The Royal College of Physicians and Surgeons of Canada
Nurses: College of Nurses of Ontario
Both self regulating professions
81
Why does the public sometimes dislike self-regulating professions?
It is sometimes seen that even when they deserve it, these professionals don't always receive proper punishment.
Ex. doctor who was filming women and was allowed to continue practicing
82
What are some different types of nurses?
Registered Nurse
Registered Psychiatric Nurses
Licensed practical nurses (Also called Registed Practical Nurses in ON)
Nurse practitioner
83
Describe the debate around pharmacology companies funding doctor's educations.
Research has shown that doctors are often influenced by drug companies. These companies often fund extravagant education trips for doctors. People often feel that they should not have as much input as they do.
84
What is the CMA?
Canadian Medical Association. It is an advocacy group which supports the interests of Canadian physicians and provides advice and guidance, lobbying for support for physicians and patient interests.
85
Describe the state of doctors in Canada.
We have more than 84 000 physicians in Cananda (230 per 100 000 people) with payments to them totalling over $26.4 million/year. The gross clinical payment per physician in 2015-2016 was found to be $342 000.
86
When more women were entering the physician field, what issue became apparent?
They were accepted to help reduce the doctor shortage but many of the HR reps forgot to account for women having babies and leaving on maternity leave. Since, women have been found to take more time off and work less hours than their male counter parts .
87
What is a family physician?
Also called a general practitioner or primary care physician, they have a wide knowledge base.
88
What are emergentologists?
They are physicians that practise full-time emergency medicine, commonly being hired in place of staffing the ER with on-call physicians.
89
What is a geriatrician?
They are a physical that focuses on the care of older people, specifically those over 65. This time-consuming speciality is typically paid less than other specialties. Commonly work in a private practice, team-oriented practices, or health care facilities.
90
What is a cardiologist?
A physician specializing in conditions of the heart
91
What is a gynaecologist?
Diagnose and treat disorders of the gynaecological and reproductive systems.
92
What is an obstetricians?
Focus on the care of pregnant women and the delivery of their babies in both normal and high-risk situations.
Usually undertaken with gynaecologist.
93
What is an internist?
Typically diagnose and render non-surgical treatment for disease of a person's internal organs, often referring patients to other specialists who deal with specific organs.
94
What is a hospitalist?
A physician who oversees the medical care of patients in the hospital, usually those who do not have a family doctor with admitting privileges to the hospital.
95
What is a neurologist?
Treats conditions of the nervous system but does not perform surgery
96
What is an ophthalmologist?
Specializes in diseases of the eye and can carry out both medical and surgical procedures. Can perform refractions and prescribe glasses though these have been largely taken over by optometrists.
97
What is an oncologist?
Specializes in the care and treatment of people with cancer. Usually practise in large hospitals or medical centres specializing in cancer treatments, they provide ongoing treatment for patients in hospices and related facilities as well.
98
What is a psychiatrist?
Specialize in mental illness and emotional disorders. They can order lab and diagnostic tests and prescribe medicine, but do not perform surgical procedures.
99
What is a physiatrics?
A medical doctor specializing in physical and rehabilitative medicine. Examples of patients would include stroke, accident victims, and post-surgical patients. They aim to restore the patient to their maximum level of function.
100
What is a radiologist?
A physician with additional training in the use and interpretation of imaging techniques to diagnose and treat disease. Acts primarily as a consultant for other physicians in large diagnostic centres.
101
What is a repirologist?
A medical doctor who further specializes in the diagnosis and treatment of lung diseases (asthma, emphysema, and pneumonia). They generally perform tests to check breathing and may use procedures to diagnose a problem
102
What is a surgeon?
Complete their surgical residency in their field of choice, usually over a period of 4 or more years after completing medical school.
103
What is a register nurse?
Nurses that assumes the most complex components of nursing care as well as administrative and case management responsibilities. Require a bachelors degree in nursing (not in Quebec).
104
What is a nurse practitioner?
A RN with extended training and skills. They are authorized to independently carry out specified controlled acts and activities, such as diagnosing and treating disease, ordering lab tests, and prescribing medication. Requires a post baccalaureate certificate or a graduate degree then pass an entry-to-practice examination.
105
What is a registered psychiatric nurse?
Generally recognized as separate health professionals in Western Canada, they form the largest body of mental health professionals providing services in western Canada. Working with other health care providers and community organizations, they focus on mental, developmental, and physical components of health within the context of overall health and life situations.
106
What is a licensed practical nurse?
These nurses collaborate with registered nurses and other members of the team to render patient care. Requiring a 2 year diploma program and a pass of the Canadian Practical Nurse Registration Examination, the skill set and scope have expanded dramatically over the years, now assuming many of the skills and responsibilities formally limited to registered nurses.
107
What is a physician's assistant?
An academically prepared health care provider that works directly with or under the direction of the physician. Responsibilities are usually outlined in the contract but range from interviewing patients and health teaching to performing physicals and selecting diagnostic tests. Require a two-year Canadian Medical Association Accredited Program and an entry-to-practice examination.
108
What is a pharmacist?
A pharmacist dispenses medication and provides members of the health care team information about them. It requires a bachelor's degree in pharmacy, an internship, and successfully passing the national board examination through the Pharmacy Examining Board of Canada.
109
What is the role of a midwife?
Provide prenatal care before the baby's birth, deliver the baby, and provide postpartum and newborn care for up to 6 weeks after. They are licensed in most Canadian jurisdictions.
110
What is the role of an Optometrist?
Prescribing contacts and glasses to those who need them along with selected medications to treat a variety of eye conditions. Requires an undergraduate degree and a 4-year optometry program.
111
What is the role of an Optician?
They can fill prescriptions for eyeglasses or contact lenses, fit glasses, help patients select frames, organize the grinding and polishing of lenses, and cut and edge lenses so they fit selected frames. Requires a 2-3 year college program sometimes with a practical component.
112
What is an osteopathic physician?
They are physicians with specialized training in osteopathic medicine. Aim to apply the knowledge of anatomy and physiology to all diseases, disorders, and dysfunctions. They use hands on, holistic, or manual approaches to identify and correct problems. Can order all imaging studies, lab tests, and pharmaceuticals.
113
What is a podiatrist?
A doctor that specializes in the diagnosis, assessment, and treatment of foot disorders such as sports injuries, deformities, infections, and general conditions. They can perform specific surgical procedures, administer injections, and prescribe medications. This is only offered at the Michener Institute in Toronto.
114
What is a personal support worker?
A person who provides basic care and carries out auxiliary duties for the patient. They work closely with patients providing care, psychological comfort, and assistance with daily activities. Although it is not considered a health profession and not regulated, formal training is required ranging from 3 months to a year.
115
What is a psychologist?
They work with individuals and families to treat emotional and mental disorders, mainly through counselling, clinical and written tests (all noninvasive). It requires a degree from a university at the bachelor, master, or doctoral level and licensing from the regulatory body where they work. Cannot prescribe medication, perform medical procedures, or order lab and diagnostic tests.
116
What is a speech-language pathologist?
They are experts in disorders of human communication, helping assess and manage persons with a wide variety of related conditions. Requires a master's degree.
117
What is an audiologist?
They work with patients with problems relating to sound, deafness, and balance, providing ongoing education and diagnostic services and creating and managing treatment plans. They can also prescribe and fit hearing aids and other hearing devices. Requires a master;s degree.
118
What is a respiratory therapist?
Someone with expertise in several areas of respiratory care and can perform cardiorespiratory health-related functions. They help manage advanced life support patients and area able to intubate people and initiate the use of respirators (vital in the ER). It requires the completion of an RT program accredited by the Council on Accreditation of Respiratoy Therapy Education.
119
What is a physiotherapist?
They work with individual patients to limit and improve upon physical impairments and disabilities and to prevent and manage pain. Requires a master's and pass a national exam to enter professional practice.
120
What is an occupational therapist?
Someone that helps people learn or relearn to manage important everyday activities, including care for themselves or others, maintaining their home, participating in paid or unpaid work, and engaging in leisure activate. Often work with accident victims, disabilities, disease, emotional or developmental problems or aging. Does not require a referral. Education includes a baccalaureate degree in occupational therapy and provincial college registration.
