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public health Flashcards

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1
Q

what is the Gini coefficient?

A

a statistical representation of nation’s income distribution among its residents - the lower the coefficient the more equality
UK has rather high inequality compared to Scandavian countries

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2
Q

what is proportionate univerasalism?

A

focusing on the disadvantaged only will not help to reduce the inequality, action must be universal but with a scale and intensity proportional to the disadvantage
fair distribution of wealth is important

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3
Q

what are the domains of public health?

A

health protection
improving services
health improvement
addressing wider determinants of health

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4
Q

what does ad hominem mean?

A

responding to arguments by attacking someone’s character

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5
Q

what does begging the question mean?

A

assuming the initial point of the argument

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6
Q

what are motherhoods?

A

inserting a soft statement to disguise the disputable one e.g “all humans are equal”

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7
Q

what does no true scotsman mean?

A

modifying argument
no scotsman would do such thing
but this one did
well, no true Scotsman would

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8
Q

what are the 3 main notifiable diseases?

must be reported to WHO

A

cholera
yellow fever
plague

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9
Q

when can confidentiality be broken?

A

required by law
public at risk
individual in vulnerable to exploitation
patient consent

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10
Q

what is health behavioru?

A

aimed to prevent disease

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11
Q

what is illness behaviour?

A

aimed to seek remedy

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12
Q

what is the sick role behaviour?

A

aimed at getting well

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13
Q

what is the health belief model?

A

individuals must believe theh are suceptible to the condition
must beleive it has serious consequences
must believe takng action reduces their risks
must believe that the benefits of taking action outweigh the costs

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14
Q

what is the transtheoretical model?

A 
1 precontemplation
2 contemplation
3 preparation
4 action
5 maintenance
6 relapse ???
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15
Q

define morality

A

concerned with the distinction between good and evil or right and wrong

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16
Q

define ethics

A

system of moral principles and a branch of philosophy which defines what is good for individuals and society

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17
Q

what is utilitarian/consequentialism?

A

an act is evaluated solely in term of its consequences,

maximising good and minimising bad

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18
Q

what are the 4 principles?

A

autonomy
benevolence
non-maleficence
justice

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19
Q

what are the GMC “duties of a doctor”?

A

protect and promote the health of patients and the public
provide good standard of practice and care
recognise and work within the limits of your competence
work with colleagues in the way that best serves patients interests
treat patients and individuals and respect their dignity

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20
Q

what are the challenges of ageing population?

A 
strains on pension
increasing demand for health care
bigger need for trained health workforce
increasing demand for long term care
pervasive ageism (denying older people the rights and opportunities available for other adults)
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21
Q

what is intrinsic ageing?

A

natural, universal, inevitable

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22
Q

what is extrinsic ageing?

A

dependent on external factors, e.g. UV ray exposure, smoking, air pollution

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23
Q

why do women live longer?

A

20% biological - hormones protect from heart disease

80% environmental - more lifestyle risks

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24
Q

name 5 types of dementia?

A 
alzheimers (most common)
vascular 
mixed alzheimers and vascular
lewy bodies
fronto temporal
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25
what is medicalisation of death?
where death is seen as a failure
26
what is the chain of infection?
susceptible host - low immunity, low white cell count causative micro-organism resevoir - where the spread originates portal of entry/exit mode of transmission: exogenous spread (direct/indirect contact, vector, airbourne) endogenous spread (self spread)
27
how do you break chain of infection?
hand decontamination disposal of clinical waste standard infection control precautions
28
what is the 3As? for patient approach
ask advice assist
29
what is the digital divide?
the difference in access to information
30
what are the 3 leading causes of death in children in developing world?
pneumonia diarrhoea malaria
31
what are key foundations involved in global health?
rockefeller foundation | bill and melinda gates foundation
32
what are some examples of migrants?
asylum seekers, refugees, trafficked people
33
where are alot of asylum seekers from?
pakistan, iran, sri lanka, syria
34
where are alot of economic migrants from?
romania, poland, spain, italy, bulgaria
35
what are the goals of the NHS?
equity of access reducing gap in health equalities providing services for the vulnerable ensuring the services are appropriate and accessible
36
define sustainability?
being able to define the needs of today without compromising the ability of future generations to meet the needs of tomorrow
37
what is the Bradford hill criteria?
a group of minimal conditions necessary to provide adequate evidence for a causal relationship ``` strength consistency specificity temporality biological gradient coherence analogy ```
38
what is primary prevention?
to prevent a disease from occurring
39
what is secondary prevention?
detection of early disease in order to alter the course of the disease and maximise the chances of a complete recovery tertiary prevention
40
what is sensitivity?
the proportion of people with the disease who are correctly identified by the screening test
41
what is specificity?
the number of people without the disease who are correctly excluded by the screening test
42
what is the positive predictive value?
the proportion of people with a positive test result who actually have the disease
43
what is the negative predictive value?
the proportion of people with a negative test result who do not have the disease
44
what is prevalance?
the proportion of a population found to have the disease
45
what is incidence?
the number of new cases within a specified time period divided by the size of the population initially at risk
46
what are the Wilson and Jungner criteria for screening?
``` should be serious health problem facilities for diagnosis and treatment avaliable detectable early accepted treatment no unmanageable extra clinical workload suitable test acceptable test for patients intervals for the test agreed policy on whom to treat cost balanced against the benefits ```
47
what are 3 types of bias?
selection bias lead time length time
48
what is selection bias?
people who choose to participate in screening programmes may be different from those who do not
49
what is lead time bias
screening merely identifies the disease earlier than before and thus gives the impression that survival is prolonged (but is unchanged)
50
what is length time bias?
diseases with longer periods of presentation are more likely to be detected than those with shorter time of presentation
51
what are the 3 human error types?
omission commission negligence
52
what are errors of omission?
required action delayed / not taken
53
what are errors of commission?
wrong action is taken
54
what are errors of negligence?
actions or omissions do not meet the standard of an ordinary, skilled persons professing
55
what are routine violations?
cutting corners
56
what is the SBAR checklist?
``` when reporting a case S - situation B - background A - assessment R - recommendation ```
57
what is the mental health WHO definition?
state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is bale to make a contribution to his or her community
58
what are some common mental health problems?
``` depression anxiety panic disorders phobias OCD PTSD ```
59
why are CMHPs dangerous?
negative impact on quality of life increase risk of physical illness increased mortality from physical illness depression is a major risk factor for suicide
60
what are 4 types of stressors?
acute - noise danger infections injuries hunger chronic - health home finances work family physical - inflammation infection psychological - attitudes believes personal expectations worries
61
what is spleens response to stress?
more RBCs are discharged
62
what is mouths response to stress?
drier as saliva and mucus dry up
63
what is immune systems response to stress?
WBCs redistributed
64
what is skins response to stress?
blood flow directed away to support skeletal muscles and heart
65
what occurs during the general adaptation syndrome?
alarm - when threat/stressor identified adaptation - defensive countermeasures engaged exhaustion - body begins to run out of defensive
66
what are the 5 signs of stress?
``` biochemical physiological behavioural cognitive emotional ```
67
what occurs during physiological stress?
shallow breathing, raised BP, more HCL produced
68
what occurs during behavioural stress?
over-eating, anorexia, insomnia, more alcohol or smoking
69
what occurs during cognitive stress?
negative thoughts, no concentration, worse memory, tension headaches
70
what occurs during emotional stress?
mood swings, irritability, aggression, boredom, apathy, tearfulness
71
what is reactive reactions?
defending NHS rep
72
what is proactive actions?
improving and protecting population health
73
causes of obesity?
car culture americanization of diet and society greater avaliability of energy dense food, cheaper replacing water with sugary drinks
74
genetic cause of obestiy?
prader willi syndrome
75
what is satiation?
what brings an eating episode to an end
76
what is satiety?
inter-meal period
77
what is energy compensation?
the adjustment of energy intake following the ingestion of a particular food energy compensation is lower with liquids than solids (except of soup)
78
what are the 4 main STIs?
chlamydia gonorrhoea (drug resistance) syphilis trichomoniasis
79
what are HIV safety ABC?
abstain be faithful condom use
80
what must sexual and reproductive health eduction do?
involve young people as they are key decision makers provide comprehensive, accurate info address barriers to accessing health services empower adolescents to make life choices that are best for them
81
what does CAM stand for?
complementary and alternative medicine
82
what are the big 5 NHS CAM?
``` acupuncture chiropractic therapy homeopathy herbal medicine osteopathy ```
83
what are major concerns of CAM?
unrealistic expectations delayed conventional care general safety
84
what is equity?
fair distribution of goods and services based on individual need
85
what is equality?
fair distribution of goods and services
86
what is the basic economic problem?
resources are finite desire for good and services is infinite no country treats all treatable ill health choice cannot be avoided
87
what is opportunity cost?
the loss of other alternatives when one alternative is chosen
88
what is economic efficiency?
achieved when resources are allocated between activities in such a ways as to maximise benefit
89
what is economic evaluation?
the method used to see whether economics benefited max
90
what are 3 types of economic evaluation?
cost-effectiveness analysis cost-utility analysis cost-benefit analysis
91
what is cost-effectiveness analysis?
outcomes measured in natural units: incremental cost per life year gained
92
what is cost-utility analysis?
measured in quality adjusted life years: incremental cost per QALY gained
93
what is cost-benefit analysis?
outcomes measured in monetary units: net monetary benefit

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