Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Final > PH > Flashcards

PH Flashcards

(98 cards)

Start Studying
1
Q

Causes of associations of outcome in a study

A

1) Bias
2) Chance
3) Confounding
4) Reverse causality
5) True association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a bias

A

Systematic error resulting in deviation from true effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of bias

A

Selection bias (non-response by certain groups, loss to follow up etc)

Allocation bias (Groups with differing traits allocated to diff groups)

Information bias

  • Measurement bias (diff equipment gives diff reading)
  • Observation bias (observers expectations influence
  • Recall bias (memory)
  • Reporting bias (don’t report the truth)

Publication bias (negative results less likely to get published

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bradford Hill criteria (9 things to prove a relationship is causal)

A

Strength of association (high relative risk)

Consistently shown across studies

Temporality

Dose response

Reversibility

Biological plausibility

etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Randomised control trial

2 Pros and 2 Cons

A

Low risk of bias and confounding + can show causality

Time consuming
Expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Case control:

What is it?
2 Pros + 2 Cons

A

Observational study comparing those with disease (case) to those without (control). Looks retrospectively at exposures.

Pro: Quick, good for rare diseases

Cons: difficult finding appropriate controls, Selection and information bias prone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cross sectional study:

Basics
Pros + Cons

A

Collects data from population at a point in time (snapshot)

Pro: large sample size, Provides prevalence data

Cons: Risk of reverse causality (which came first)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is reverse causality?

A

Outcome mau have been caused by exposure

E.g. in depressed people who are obese which caused which

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cohort study

Basic
Pros + Cons

A

Longitudinal study of similar groups getting different Tx/RFs
Follows them over time

Can follow up rare exposures
Allow Rfs to be identified

Takes a long time
High drop out rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

50 cases in 1000 people over ten years. What is the incidence per year?

A

10yrs

= 0.5% per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to calculate the relative risk (ratio)

A

(% with disease in exposed) / (% with disease in control)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to calculate attributable risk of smoking

A

(% with disease in exposed) - (% with disease in control)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to measure number needed to treat (the number which would save 1)

A

1/Attributable risk

%diseaseexposed - %diseaseunexposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Wilson + Jungner screening criteria

A

INASEP

Important disease

Natural Hx under

Acceptable intervention

Simple + Safe

Effective Tx with early detection

Policy of who should get tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Disadvantage of screening

A

Overdetection of subclinical disease

False +ve: worry and exposure to harmful further testing

False -ve: more dangerous as gives false sense of health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Positive predictive value

A

% of positives who are positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Negative predictive value

A

% of negative who are negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sensitivity

A

% of those with the disease who are detected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Specificity

A

% of those without the disease who are negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lead time Vs Length time bias

A

Lead time = false sense of increased survival time due to early detection

Length time = a disease with a slower progression/low aggression more likely to be picked up by screening giving false idea screening is reason for good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PROGRESS mnemonic for health inequality

A

Place of residence

Race/Ethnicity

Occupation

Gender

Religion

Education

Socioeconomic status

Social capital resources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Definition of health:

A

A state of complete physical, mental and social wellbeing. No merely the absence of disease or infirmity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of Errors

A

System Error

  • staffing
  • Equiptment unavailability

Human Error

  • memory
  • skill
  • timing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Types of errors & model

A

Latent (system), Active (human)

Swiss cheese model

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
4 Questions in breach of negligence
1) Was there a responsibility of care 2) Was there a breach of duty 3) Was the patient harmed 4) Was the harm due to breach
26
3 domains of public health
Health Protection Health improvement Delivery of safe & high quality services
27
Aim of Health needs assessment
Systematic review to allow resource allocations which improve health equity and reduce inequalities
28
The 4 types of need (Bradshaw taxonomy)
Felt need (individual perception e.g. back pain need help) Expressed need (Help seeking- going to Dr) Normative need - Profession defines what intervention is needed Comparative need compares the needs of different groups (e.g. diff locations)
29
3 approaches to to Health needs assessment
Epidemiological - defines problem by looking at epidemiological data Comparative - Looks at services/health outcomes and compares to similar area Corporate - Asks local population / Health professionals/gov what needs are
30
Epidemiological HNA Pros and Cons
Uses existing data, Incidence morbidity/mortality, evaluate trends over time Variable data qual, data collected may not be required, doesn't consider felt needs
31
Comparative HNA Pros and Cons
Quick/Cheap, shows if better/worse than other areas Difficult to find comparable
32
Corporate HNA Pros and Cons
Based on felt/expressed need Make use of experience/knowledge Cant establish need from demand, Vested interest, political agendas
33
Types of health behaviour
Health behaviour (prevent disease) Illness behaviour (going to Dr) Sick role behaviour (taking medication)
34
Transtheoretical model behaviour change PCPMAN
Pre-contemplation (not ready yet) Contemplation Preparation Action Maintenance
35
Nudge model behavioural change
Nudge the env for positive change (e.g. fruit near checkout
36
Theory of planned behaviour
Three things lead to intention and subsequent behaviour 1) Attitude to the behaviour 2) Subjective norms (perceived social pressures) 3) Perceived behavioural control
37
What are never events
Serious Largely preventable Compromise in patient safety Would not have occurred if preventative measures in place - wrong site surgery, psych escape, wrong route chemo etc
38
What does egalitarian mean?
All people are equal and deserve equal rights and opportunities.
39
unfits of cohort study
Assessment of multiple RF Assess rare disease RCT can not be used to assess pathological exposures ethically
40
Role on communicable disease control consultant
Surveillance Notification Prevention
41
Causes of homelessness
Relationship breakdown Domestic abuse Dispute with parents Bereavement
42
Barriers to healthcare for travellers
GPs reluctant to register Communication difficulties Lack of permanent site = poor continuity of care Professional mistrust
43
Barriers for healthcare to homeless
Access Lack of trust Dont prioritise health (Maslows hierarchy)
44
Presenting illnesses of Asylum seekers
Common illnesses Injuries from travelling/Malnutrition Untreated Chronic disease Lack of screening/Immunisations Mental health: PTSD, depression, psychosis
45
Error of: - Intention - Action - Outcome - Context
Failure to achieve planned action. Skill/knowledge based Task specific failure (e.g Wrong order / Omission of something in Tx) Near miss/Death Team/Env factors
46
Strategies to reduce errors
Simplification Standardisation of procedures Checklists Practice/Training
47
How is risk identified
Audit DATIX Complaint forms
48
Relative reduction in risk
(Risk exposed - risk unexposed) / Unexposed
49
What can be offered to a Drug abuser
Health check Screen for blood borne viruses Contracepton Smear and immunisation Drug services info: Needle exchange
50
Principles in addiction management
Harm reduction (advise on risky behaviour_ Intervention: Explain risks, effects and advise on controlling use Referral to specialist advice
51
Aims of drug use Tx
Reduce harm to under/family/society Improve health Reduce crime
52
What is domestic abuse?
Any incident/pattern controlling, coercive, threatening behaviour Violence or abuse Between those aged over 16 Have been Intimate partners or family
53
Types of abuse
``` Psychological Physical Sexual Financial Emotional ```
54
Role of doctor in abuse
Healthcare records Give helpline Patient safety Non-Judgemental
55
Domestic abuse levels of risk
Medium: RFs identified. Unlikely to happen without change in circumstance. - give abuse contact details High: risk of imminent harm - Refer to MARAC (multi-agency risk assessment conference)
56
DASH score
Used for risk of domestic abuse Domestic Abusive Stalking Harassment
57
Equity Vs Equality
Equity identifies unequal needs which need proportional help
58
Definition of health need
Ability to benefit from an intervention
59
Positive and Negative conditioning in addiction
Positive: inc intensity of desire to use Negative: Fear of withdrawal stops not quitting
60
Alcohol dependency
``` Tolerance Withdrawal Neglect of other activities Continued use despite negative effects Narrowing repertoire ```
61
Wernickes Triad
Ophthalmoplegia Ataxia Mental confusion GIVE PABRINEX
62
Given to stop alcohol
Disulfram (sick) | Acamprosate (GABA blocker)
63
Emotional needs of elderly
``` Security Attention Autonomy Intimacy Part of community ```
64
``` Maslows hierarchy of needs Pyramid 1 (bottom) to 5 (tip) ```
1) Physiological (food, water, sleep) 2) Safety 3) Belonging and love (intimacy/friendship) 4) Esteem: feeling of accomplishment 5) Self actualisation (reaching full potential,) Need fulfilled 1->5 Some people however to emphasise slightly differently
65
Epigenetics
Env influence on genetic regulation Disease = Genetic predisposition + epigenetic changes
66
Child abuse
Abuse in someone under the age of 16
67
Major RF for domestic abuse
Preg Threats Obsessive
68
Prevention: Primary Secondary Tertiary
Prevent onset of disease (vaccinations) Detect pre-clinical level (screening) Interventions arrest progress of disease e.g. of cervical cancer 1 - HPV vaccine 2 - Screening 3 - Tx of cancer
69
Benefits of equity over equlity
Leads to equal health
70
Horizontal Vs Vertical Equity
H: Those in identical situations should get same Tx V: Those in different situations treated differently
71
3 Domains of PH
Health improvement /Protection at: 1) Indvidual: patient education, immunisations etc 2) Community: Community health groups, green spaces, playgrounds, Vit D for at risk 3) Population: Screening, Sugar and alcohol tax, School meals, Fortified cereals, public smoke ban Alc E.G.: 1) individual consumption levels, 2) Local alc sales/avail, 3) taxation
72
Theory of planned behaviour problem
Doesn't take into account emotions or habit or routine
73
Typical Transition points for health behaviour
``` Leaving school Entering work Becoming parent Unemployment Retirement Bereavement ``` Can be +v or -ve
74
What is a meta analysis
Compiles stats of research in particular field to give one P-Value
75
Reason for risk taking behav
Unrealistic optimism (inaccurate perception of risk)
76
Top down needs management
Population level | Manage end result
77
Bottom up needs management
Individual approach.
78
Supplied, demanded and needed
Contraception, cataract, liability access
79
Types of needs assessment + resource allocation
Population/Subgroup e.g. Hillsborough Condition e.g. COPD Intervention e.g. Smoking cessation
80
5 step approach to HNA
1) Situational analysis (audit current practice) 2) Gap analysis 3) Methods of fixing 4) Implementation 5) Evaluation (re-audit)
81
What is methadone + what used for?
Opioid receptor agonist | Used in drug and alcohol misuse to prevent withdrawal
82
Alcohol issue in GP
Liver/Kidney failure CVD Cacer (2nd after smoking)
83
Alcohol Weekly
14 units (1 unit = 8g alcohol)
84
Alcohol related death
``` Accidents + Violence CVD Malignancies (Head and neck , liver, breast, stomach, pancreas) Cardiomyopathy (dilated) Cirrhosis ```
85
Alcohol in Preg
ESPECIALLY not 1st trimester Underweight Mental retardation Facial appearance (Flat nasal bridge, epicanthic fold, Micrognathia) Cardiac/Renal/Occular abnorm
86
Delirium tremens - Cause - Pres - Tx
Dec alcohol in dependant individual Hallucinations (lilliputian), Marked tremor Supportive: fluids, BZD if fitting, Pabrinex
87
Alcohol screening
GGT Carbohydrate deficient transaminase CAGE
88
Model for healthcare evaluation
Donabedian model
89
Donabedian model sections
Structure (what resources, eg building staff eqpt) Process (how is it done, eg how many patient seen, 2weel wait % etc) Outcome (5Ds: Death, Disese, Disability, Discomfort, Dissatisfaction)
90
Problem with measuring health outcomes of service changes
lots of cofounders | Difficult to link cause and outcomes
91
Maxwells 6 dimensions of quality (EEEAAA)
Effectiveness (desired effect) Efficiency (maximal output) Equity (fair) Acceptable Access (cost, availability) Approp (right Tx to right people)
92
When to notify of disease
One case of a notifiable disease Contaminations (Infections e.g. restaurant, Chemical, Radiological) Significant risk: chicken pox in healthcare worker, SARS
93
Social exclusion in the elderly initiatives
Age UK over 50 club, Dementia Cafes
94
What is the inverse care law
Care is inversely available to those who need it
95
Kordakoffs
Profound memory loss | Confabulation (fabricated, misinterpreted memories)
96
Gillick competence
Allows child under 16 to consent Tx if deemed Gillick competent (Sufficient understanding + intelligence)
97
Fraser guidelines
Allows child with understanding to consent for contraception
98
When to break confidentiality for underage sex
Over 18 | Position of power (e.g teacher, Dr etc)

Final (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions