PPIC, e-Health, SDOH and professionalism Flashcards Preview

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Flashcards in PPIC, e-Health, SDOH and professionalism Deck (31):
1

Different parts to justice

Legal
Rights-based
Morally correct
Social justice (among classes)
Distributive (fair distribution of resources)

2

Human rights governed by

human rights act 1998, can be limited/restricted in some circumstances

3

Principles for human rights in healthcare

Only exercise power/control when justified
Interference must be legitimate, lawful, necessary and proportionate

4

What is discrimination

Unfair treatment of person/group in comparison to others

5

Discrimination types

Direct - person treated less favourably than another in comparable situ
Indirect - not equitable, so a rule applies equally to all but works as disadvantage to some

6

Diversity vs equality

diversity is acceptance of differences between people/groups
equality is about framework that allows access evenly so differential treatment given by taking account of diversity

7

Occupational medicine

Keeping people on optimal condition to work

8

Black report 2008

Evidence that work, health and wellbeing linked and shows importance of safe and healthy work environment

9

Boorman review 2009

10 million working days lost each year to sickness within NHS alone

10

Whitehall study - professor Marmot

Those in lower status jobs have less social support than in higher, inc risk of CVD

11

Fit for work service function

Occupational health assessment and advice to employees/employers
Health assessment done by GP after 4 weeks of sickness absence

12

Work place hazard types

Physical
Biological (infections/animals)
Chemical (latex/drugs)
Mechanical (body position e.g. back pain)
Psychosocial (bullying, harassment)

13

Statement of fitness for work

Necessary only if employee is off sick more than 7 days, outlines possible modifications employer can make to bring back employee

14

Rights and duties of sick person (once Med3 acquired)

Right to be exempt from responsibility
Right to be exempt from normal social role obligations
Duty to recognise that illness is bad and try to recover
Duty to seek help to recover

15

George Engel's biopsychosocial middle of barriers to return to work

Health issue
Belief (fear of event)
Social issue
Work related perceptions
Organisational/legal issues
Co-morbidities

16

Increasing time off work causes

Decrease in probability of return:
4-12 weeks 10-40% likely to be off work in a year
6-12 months 10% chance of returning
2 years more likely to die than return

17

Doctor-patient expectations of each other with regards to occupational health and issue with not meeting these

Patient believes it's doc's duty to sign them off sick
Doc believes patient will tell them the truth

When not met trust breaks down, also exacerbated when incapacity lasts longer than expected/diff to medical norm

18

Classifications of drinking disorders

Hazardous drinking - pattern that brings about risk of physical/psychological harm (harmful drinking makes this likely)
Substance dependence - behavioural/cognitive/physiology issues after repeated abuse

19

CAGE questionnaire

Cut down. annoyed, guilty, eye-opener
Not good at identifying hazardous + harmful use, score >1/4 considered clinically significant

20

AUDIT test

10 q gold-standard for hazardous and harmful drinking, >7/40 is positive result

21

Areas of concern for fitness to practice with drugs/alcohol

drink driving and affecting work
dealing/possession of drugs

22

Fitness to practice procedures

All med schools have one based on GMC models
Dealt with in health/disciplinary pathway to protect patients
Support for student/doctor to regain FtP

23

Clinical documents 1˚ and 2˚ functions

1˚- support patient care through comms with diff providers and to help medics remember how to treat best
2˚- audits/research, policy, teaching, legal doc, billing

24

Proforma and (dis/)advantages over blank space doc

Proforma is pre-printed, fill in blanks
Advantages: standardised, prompts clinician, good for data collection
Disadvantages: may erode professional autonomy, use more paper

25

10Cs of good documentation

Correct
Clear
Complete
Comprehensive
Concise
Collaborative
Consecutive
Contemporary
Confidential
Centred on patient

26

SOAP for documentation

Subjective exam
Objective results
Assessment of patient
Plan

27

Advantages of good documentation

Patient safety
Protect doctors
Identify improvement areas
Requirement by GMC

28

Sustainability issues

Resource consumption increased due to rising pop
Climate change increasing bacterial growth rate, algal bloom, vector-borne disease, ground level ozone

29

Life course epidemiology

Study of biological, behavioural and psychosocial pathways on chronic illness

30

What led life course epidemiology revival

Poor prediction of individual risk from variations, and 1946 birth cohort measured due to decreasing birth rates

31

Discoveries of life course epidemiology

Higher CHD mortality linked to lower birth weight
Higher birth weight links to greater grip strength at 53
Mean chair rise performance linked to age first walked
Better childhood cognition at 8 linked to lower mortality
Adult brain volume linked to infant motor development speed
Breastmilk benefits offspring IQ but effect confounded by maternal IQ