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Phase 4 > Phase 4 Public Health > Flashcards

Phase 4 Public Health Flashcards

1
Q

Utilitarian

A

Maximise benefit and consider all beings equal

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2
Q

Deontology

A

Action is right or wrong

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3
Q

Consequentialist

A

Consequences are right are wrong e.g. white lies

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4
Q

Virtue

A

Character traits - mind, character, honesty

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5
Q

Libertarianism

A

Maximise freedom, autonomy and choice

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6
Q

Which allocation theory is the NHS founded on

A

egalitarian

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7
Q

3 allocation theories and their definitions

A

Egalitarian - equal access, equity
Maximising
Libertarian - autonomy and responsibility

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8
Q

rule of rescue

A

duty to save a life even if that money could prevent more deaths elsewhere

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9
Q

public health

A

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

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10
Q

3 domains of public health and examples

A

health improvement - education, housing
health protection - ID, environmental hazards and emergency response
improving services - clinical governance, service planning

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11
Q

Lalonde determinants of health

A

E - environment (physical, social, economic)
F - lifestyle
G - genes
H - health care

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12
Q

6 measurements of equity

A 
supply
access
utilisation
outcomes
health status
allocation
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13
Q

dimensions of equity

A

spatial - geographic

social - age, gender, class, socioeconomic, ethinicity

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14
Q

levels of health interventions

A

individual
community
population

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15
Q

levels of health preventions

A

high risk - cut off the curve

population - shift the curve

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16
Q

prevention paradox

A

prevention measure bringing great benefit to the population offers little to each participating individual

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17
Q

2 major types of screening

A

population based e.g. smear

opportunistic e.g. chlamydia

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18
Q

10 Wilson and Jugner criteria

A 
important problem
history understood
latent phase
effective treatment
policy on who to treat
facilities
acceptable test
suitable test
economic 
ongoing process
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19
Q

first in S/S

A

disease

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20
Q

first in NPV/PPV

A

test

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21
Q

impact of prevalence on S/S/NPV/PPV

A

no impact on S/S

impact on NPV/PPV

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22
Q

lead time bias

A

survival looks longer because it was noticed sooner

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23
Q

length time bias

A

aggressive disease is missed

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24
Q

3 descriptive studies

A

case reports
ecological studies
cross sectional

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25
Q

3 analytical studies

A

cohort
case control
cross sectional

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26
Q

retrospective study

A

case control - shows RF

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27
Q

why is prospective important

A

can show causation

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28
Q

study for rare exposures

A

cohort

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29
Q

study for rare diseases

A

case control

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30
Q

odds formula

A

with exposure/#without exposure

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31
Q

odds ratio formula

A

(#controls exposed/#controls unexposed)

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32
Q

when must an odds ratio be used

A

case control

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33
Q

when may an odds ratio be used

A

cross sectional
cohort
(where IV/DV is unclear)

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34
Q

how to state odds ratio

A

individuals with [DISEASE] are x5 more likely to be exposed to [EXPOSURE]

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35
Q

when is incidence rate useful

A

when Ps are followed up for varying lengths of time (denominator is person-time)

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36
Q

what does relative risk show

A

strength of association

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37
Q

reasons for association

A 
BRACC
bias
chance
confounders
reverse
causal
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38
Q

bias

A

systematic deviation form the true estimation of the association

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39
Q

3 types of bias

A

selection
information - observer, P, instrument
publication

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40
Q

Bradford Hill criteria for causal link

A 
strenght of assocaition
dose response
consistency
temporality
reversibility
biological plausibility
coherence
analogy
specificity
41
Q

health needs assessment

A

a systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities

42
Q

4 parts of health needs assessment

A

needs assessment
planning
implementation
evaluation

43
Q

define need

A

ability to benefit

44
Q

health need vs healthcare need

A

health - wider social and environmental determinants of health e.g. housing and education
healthcare - ability to benefit from healthcare e.g. health education, diagnosis, rehab

45
Q

an intervention must be directed at

A

a population and a condition

46
Q

3 health needs assessment approaches

A

epidemiological
comparative
corporate

47
Q

advantages and disadvantages of epidemiological approach

A

+: uses existing data, provides data, evaulate over time

-: variable data quality, data collected may not be data required, ignores felt needs

48
Q

describe epidemiological approach

A

SMEAR
S - size of problem - incidence, prevelance
M - models of care
E - evidence base
A - available services - unmet and overmet need
R - recommendations

49
Q

advantages and disadvantages of comparative approach

A

+: quick and cheap. shows relative performance

-:incomparable population, low quality data, doesn’t show whats right

50
Q

advantages and disadvantages of corporate approach

A

+: felt and expressed needs, range of views

-: difficult to distinguish need from demand, vested interests, politics, dominant voices

51
Q

define evaluation

A

assessment of whether a service achieves its objectives with regard to relevance, effectiveness and impact

52
Q

Framework for service evaluation

A

Structure
Process
Outcome

53
Q

6 dimensions of quality

A 
effective
efficient
equity
acceptable
accessible
appropriate
54
Q

3 qualitative approaches of health outcome measures

A

observation
interview
focus group

55
Q

health, illness and sick role behaviours

A

health - prevent disease
illness - seek remedy
sick role - getting well

56
Q

unrealistic optimism components

A

HIPPy

H - hasn’t happened yet
I - infrequent
P - preventable by personal action
P -personal experience lacking

57
Q

health belief model components

A

4 beliefs - susceptible, serious consequences, taking action reduces risk, benefits outweigh costs

cues to action

perceived barrier (most important)

58
Q

critique of health belief model

A

ignored impact of emotions on behaviour
doesn’t differentiate first and repeat behaviours
no temporal element

59
Q

critique of theory of planned behaviour

A

ignores impact of emotions
no temporal element
bridging the gap

60
Q

stages of change

A 
precontemplation
contemplation
preparation
action
maintenance
61
Q

Theory of planned behaviour. 50% of intenders fail to change behaviour. Give 5 bridging methods.

A 
perceived control
anticipated regret
preparatory actions divided into chunks
If-then plans (implementation intention)
relevence to self
62
Q

aim of motivational interveiwing

A

resolve ambivalence

63
Q

4 types of undernutrition

A

stunting (height for age)
wasting (weight for height)
underweight (weight for age)
insufficiency

64
Q

3 early influences on eating behaviour

A

maternal diet
breastfeeding
parenting practices

65
Q

4 tips for parents on healthy eating

A

responsive feeding
provide variety
avoid pressure to eat
don’t usee food as a reward

66
Q

3 main components of restraint theory

A

dieters rely on conscious control to regulate intake
dieters have greater hunger-satiety gap
what the hell effect if cognitive boundary is broken

67
Q

3 eating behaviour models

A

Restraint theory
Externality
Goal conflict

68
Q

6 services for newly presenting IVDU

A 
BB virus screen
Immunisations
Smear and STI screen
Drug service signposting
General Health check
Needle exchange
69
Q

5 domains of social exlcusion

A 
material
civic activities
basic services
neighbourhood
social relationships
70
Q

what is an asylum seeker and what rules must they live by

A

application for refugee status in progress

Not allowed to work
£35 a week, housing, 70% income support
Full NHS access
Full education and social care access if <18yo
NASS support package
71
Q

NHS care for rejected asylum seekers

A 
primary care
A&E
communicable diseases and STI
family planning
treatment of trauma problems
72
Q

rights of ILR

A

all UK citizen rights

family reunion

73
Q

maslows hierarchy

A

so everyone loves stupid pyramids

self actualisation
esteem
love and belonging
safety
physiological
74
Q

epigenetics

A

the expression of a gene is dependent on its environement

75
Q

allostasis and allostatic loas

A

allostasis is stability through time and allostatic load is the physiolocial burden of acheiving this

76
Q

how does major life change affect us

A

radical change of working model

77
Q

percent of female injuries caused by domestic abuse

A

25%

78
Q

domestic abuse tool and levels

A

DASH

standard - serious harm unlikely
medium - potential to cause serious harm is circumstances change
high - potential to cause serious harm imminently

79
Q

2 referrals for high risk domestic abuse

A

MARAC - multi agency risk assessment conference

IDVA - independent domestic abuse advocate

80
Q

Process after murder by domestic abuse

A

domestic homicide review

81
Q

1,2,3 wound healing

A 
1 = apposed edges e.g. sutures
2 = unopposed edges, allow granulation and epithelialisation
3 = open, close later
82
Q

5 local factors influencing wound healing

A 
site
infection
oedema
vascular insufficiency
previous RT
83
Q

hydrogel

A

rehydrate dry wounds

84
Q

alginate

A

highly exudative wounds

85
Q

hydrocolloid

A

sloughy, moderately exudative wounds

86
Q

non adherent

A

low exudate, delicate wounds

87
Q

slips

A

attentional error causing observable action

e.g. pushing the patient buzzer instead of emergency alarm

88
Q

lapse

A

internal event, memory, action based

e.g. forgetting to flush a cannula

89
Q

mistake

A

action is carried out according to plan but the plan is wrong

90
Q

two types of mistake and describe

A

rule based - wrong rule or bad rule, e.g. treating an MI as pneumonia
knowledge based - novel and cognitively effortful situation, e.g. suturing using random stitches because you don’t know how to do it

91
Q

3 types of violations

A

routine - cutting corners
necessary - no other option
optimising - personal gain

92
Q

individual factors of error

A

IM SAFE

Illness
medication
stress
alcohol
fatigue
emotion
93
Q

situation factors of error

A

SIT REP

S - situation misunderstood
I - inadequate checking
T - time pressures
R - regular teams missing (unfamiliar)
E - experience lacking
P - poor procedures e.g. staffing and training
94
Q

ways to learn from error

A

incident reporting - identify error traps and culture

root cause analysis

95
Q

learning theories and describe

A

behaviourism - learning through reinforcement e.g. clinical skills, lectures
cognitivism - learning through processing e.g mindmaps, discussions, flipped lectures
constructivism - learning through safe experience e.g placement

96
Q

features of effective small group session

A

clarify roles and purpose
active, specific and reflective
safe environment promotes discussion
safe questioning identify edge of knowledge

Problems: silent group, alpha student, tangents, lack of prep

97
Q

leadership vs management

A

leader - influence and engage, create a vision and culture, work in the future

manager - specific technical skills and expertise, follow a vision and culture, work in the present

98
Q

standard of proof for medical negligence

A

balance of probabilities (>50%), not beyond reasonable doubt

Phase 4 (7 decks)

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