PH

Question 1

What is health

Answer 1

A state of complete mental, physical and social wellbeing - not merely the absence of disease or infirmity

Question 2

What is public health

Answer 2

The science and art of...
preventing disease
prolonging life
promoting health
through the organised efforts of society

Question 3

What determines population health

Answer 3

The extend of income division
rather than
the mean income

Question 4

Inverse care law

Answer 4

The need for good medical care tend to vary inversely with its availability

Question 5

Social class is a measure of…

Answer 5

occupation, stratification, social position and access to power and resources

Question 6

Examples of screening

Answer 6

Breast, cervical, bowel cancer, newborn hearing screening

Question 7

Screening criteria

Answer 7

I mportant problem
U nderstand the natural history of the disease
S uitable test
C ontinuous process
R
E xpenses low
E early or latent identification available
N diagNosis and treatment should be available

Question 8

Health domains

Answer 8

Health Protection
Health improvements
Improve services

Question 9

Sensitivity

Answer 9

The proportion of people with the disease who were correctly identified by the screening test

Question 10

Specificity

Answer 10

The proportion of people without the disease who were correctly excluded by the screening test

Question 11

PPV

Answer 11

The proportion of people with a positive result who actually have the disease

Question 12

NPV

Answer 12

The proportion of people with a negative results who don’t actually have the disease

Question 13

Stages of change model

Answer 13

Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Relapse/Continuing

Question 14

Primary prevention

Answer 14

Prevent disease onset

Question 15

Secondary Prevention

Answer 15

Slow or halt disease in the early stages after detection

Question 16

Tertiary Prevention

Answer 16

reduce complication
OR severity of a disease
by offering appropriate treatment or intervention

Question 17

Why does a high risk approach favour the rich and affluent over a population approach

Answer 17

More likely to engage in health services
More likely comply with treatment
More likely to have the necessary means to change their lifestyle

Question 18

Compliance

Answer 18

The extent to which a patients behaviour coincides with medical advice

:( assumes doctor knows best
:( doesn’t look at patients ability to manage their health/illness

Question 19

Adherence

Answer 19

The extent to which the patients behaviour matches the agreed recommendations

:) acknowledges the importance of the patients belief

Question 20

Concordance

Answer 20

Shared decision making between patient and professionals

Question 21

Utilitarianism

Answer 21

An action is evaluated solely in terms of its consequences

MAXIMISE GOOD - you shoot one person to save them killing lots

Question 22

Deontology

Answer 22

The features of the action itself determines worthiness

Question 23

5 focal virtues (an action can only be virtuous if it is performed by a person in the right state of mind - they meant to do it)

Answer 23

Compassion
Trustworthiness
Discernment
Integrity
Concientiousness

Question 24

4 ethical principles

Answer 24

Autonomy - allowing the patient to make a rational and informed decision
Beneficence - doing the right thing, to benefit the other
Non-malificence - do no harm
Justice - treating everyone as equal

Question 25

What is evidence based medicine

Answer 25

Asking focused questions
Finding the evidence
Critical Appraisal
 Making a decision
Evaluating performance

Question 26

How do we ask a focused question in EBM

Answer 26

P - population (who to test)
I - intervention (what will you do)
C - comparison (is it better than existing treatment)
O - outcome (what do you expect will happen)

Question 27

Critical Appraisal

Answer 27

The process of carefully and systematically examining research to judge its
trustworthiness
value
and relevance
in a particular context