PUBLIC HEALTH Flashcards

Question

What is a cross-sectional study?

Answer 1

Provide a 'snapshot', sometimes called prevalence studies Provide weak evidence of cause and effect

Answer 2

The number of patients who need to receive a treamtment in **Order for one person to benefit** worked out as 1/absolute risk reduction say a drug reduced risk of MI from 10% to 5% absolute risk reduction would be 0.05 (5%) 1/0.05 = 20 so 20 people would needed to take drug to prevent one person having a heart attack

Answer 3

**Attitude towards the behavior**: this refers to an individual's positive or negative evaluation of performing the behavior **Subjective norm**: this reflects the perceived social pressure to engage or not engage in the behavior. It involves the influence of important others (e.g., family, peers, society) and their expectations or approval of the behavior (e.g., "Do people who matter to me think I should do this?"). **Perceived behavioral control (PBC)**: This refers to the individual's perception of their ability to perform the behavior, influenced by both internal factors (e.g., self-confidence, skills) and external factors (e.g., availability of resources, opportunities). It is similar to the concept of self-efficacy. The more control a person believes they have over performing a behavior, the more likely they are to intend to do it.

Answer 4

Attitude: Beliefs about the behavior → Evaluation of outcomes (positive/negative) Subjective Norm: Normative beliefs (perceptions of others' expectations) → Motivation to comply Perceived Behavioral Control: Control beliefs (resources, opportunities) → Confidence in ability to perform the behavior Intention: The likelihood of engaging in the behavior Behavior: The actual action or decision **ASP**

Answer 5

Strengths: It provides a comprehensive framework that includes both individual (attitude, perceived control) and social (subjective norm) factors. It has been empirically supported in many domains, especially health psychology and consumer behavior. Limitations: TPB assumes that people are rational decision-makers, which doesn't always align with real-world, emotional, or impulsive behaviors. It can be hard to measure some of the constructs, especially perceived behavioral control, which is often subjective. The model primarily focuses on individual-level factors and might not fully account for systemic or structural barriers.

Answer 6

A Health Needs Assessment (HNA) identifies the health needs of a population to prioritize and allocate resources effectively. It evaluates gaps in services and helps plan interventions to improve public health. 1. epidemiological 2. Corporate 3. Comparative

Answer 7

Epidemiological Approach: Focuses on data and statistics. Analyzes the prevalence, incidence, and distribution of diseases. Uses evidence from studies to identify health problems.

Answer 8

Advantages: - Uses existing data - Provides data on disease - Incidence - Can evaluate services by trends over time Disadvantages: - Quality of data variable - Data collected may not be the data required - Does not consider the felt needs or opinions/experiences of the people affected

Answer 9

- Ask the population what their needs are - Use focus groups meetings etc - Engages stakeholders (e.g., community groups, healthcare providers).

Answer 10

Advantages: - Based on the felt and expressed needs of the population in question - Recognises the knowledge of those in the population - Takes into account a wide range of views Disadvantages: - Difficult to distinguish need from demand - Groups may have vested interest - May be influenced by political agendas

Answer 11

Compares services or health outcomes across populations (e.g., regions or countries). Highlights inequalities and areas needing improvement. Identifies "best practices" for replication.

Answer 12

Adv: - Quick and cheap - Gives a measure of relative performance Dis: - May be difficult to find comparable population - Data may not be available/high quality - May not yield what the most appropriate level (e.g. of provision or utilisation) should be

Answer 13

Bradshaw's 4 Types of Health Needs provide a framework to understand different perspectives on health needs: Normative Need: Felt Need: Expressed Need: Comparative Need: Summary: Bradshaw's framework distinguishes between needs defined by experts, individuals, and comparisons to ensure a comprehensive approach to addressing health needs.

Answer 14

Normative Need: Defined by professionals or experts based on standards or guidelines. Example: A doctor recommends vaccinations to reduce disease risk. Felt Need: What individuals feel they need, based on personal experiences. Example: A person reports feeling anxious and seeks mental health support.

Answer 15

Expressed Need: A felt need that has been acted upon or expressed as a demand. Example: Long waiting lists for physiotherapy reflect expressed demand for the service. Comparative Need: Identified by comparing one group to another with similar characteristics. Example: One area has fewer healthcare facilities than a neighboring area with the same population size.

Answer 16

Perceived Susceptibility Perceived Severity Perceived Benefits Perceived Barriers Cue to action Self-Efficacy Social and Environmental Factors

Answer 17

An individual’s belief about the likelihood of getting a disease or condition. For example, someone who believes they are at high risk of developing diabetes is more likely to take preventive measures (such as dieting or exercising).

Answer 18

An individual’s belief about the seriousness of a health issue and its consequences. If someone believes that a condition like lung cancer will have severe consequences, they may be more motivated to stop smoking.

Answer 19

The belief that taking a specific action will reduce the threat of a health problem. For instance, if an individual believes that wearing a seatbelt significantly reduces the risk of injury in a car accident, they are more likely to wear one.

Answer 20

The perceived obstacles or costs associated with taking the recommended health action. Even if an individual believes that exercise will improve their health, they may avoid it due to perceived barriers like lack of time or energy.

Answer 21

A trigger that motivates a person to take action. This could be an internal cue, such as feeling unwell, or an external cue, such as a health campaign or a doctor's recommendation.

Answer 22

Added later by Becker and others, this refers to the belief in one’s ability to successfully carry out the recommended health behavior. The higher one's self-efficacy, the more likely they are to take action. This concept emphasizes confidence in personal ability to make health changes.

Answer 23

Health promotion campaigns: It can be used to design interventions that target specific beliefs (e.g., promoting awareness about the risks of smoking). Chronic illness management: For people managing long-term conditions, understanding perceived barriers and benefits (e.g., taking medication regularly) can help improve adherence. Public health initiatives: The model is used to tailor messages about vaccines, screenings, or health behaviors by addressing individuals’ concerns and motivations.

Answer 24

- Should be an important health problem (IH) - Should be an accepted treatment (AT) - Facilities and treatment should be available (FT) - Should be a recognizable latent or early symptomatic stage. (RE) - Suitable test or examination (ST) - Natural history of the condition, should be understood (HU) - Should be an agreed policy on whom to treat. (AP) - Costs of the screening program (including diagnosis and treatment) should be balanced against the benefits. (CB) - Case-finding should be a continuing process (CP) I Ate Fitty strawberries, hungry asain-pakistani cabbies copulate

Answer 25

- Strength - Consistency: same result from various studies - Dose-response - Temporality: Exposure occurs prior to outcome - Plausibility: Reasonable biological mechanism - Reversibility: Intervention to reduce/remove exposure eliminates/reduces outcome - Analogy: Similarity with other established cause-effect relationships - Specificity: Relationship specific to outcome of interest

Answer 26

- studies when the detection of a disease or condition is more likely to occur in individuals with a slower progression of the disease, leading to an overestimation of survival rates or the effectiveness of a treatment

Answer 27

detecting the presence of disease earlier, screening can appear to increase length of survival even if it has no impact on the course of the disease.

Answer 28

Pre-contemplation Contemplation Preparation Action Maintenance relapse can occur at any stage

Answer 29

Belief they are susceptible to the condition, Belief in serious consequences, Belief that taking action reduces susceptibility, Belief that the benefits of action outweigh the costs

Answer 30

**Normative Needs**: These are health needs based on objective, expert-defined criteria, typically related to health standards or guidelines. For example, a health need that is defined by medical experts, such as the need for a specific vaccination or health screening based on age or risk factors. **Felt Needs**: These are health needs that individuals or communities perceive and feel. Felt needs are subjective and based on personal experiences or self-reported symptoms. For example, a person may feel they need support for stress or mental health, even if there is no clear medical diagnosis. **Expressed Needs**: These are health needs that are articulated by individuals or communities through their behaviour, such as seeking medical treatment, making appointments, or using healthcare services. Expressed needs are needs that people actively try to address by accessing health services. **Comparative Needs**: These are health needs identified by comparing different populations or groups. Comparative needs look at disparities between groups, such as differences in health outcomes, health service access, or health behaviours. For example, comparing the incidence of heart disease in one community versus another may reveal differences in health needs.

Answer 31

- Fever above 38 - Tonsilar exudates - under 15 - No cough - Tender lymph nodes

Answer 32

Lost developmental milestones Not able to hold an object at 5 months Not sitting unsupported at 12 months Not standing independently at 18 months Not walking independently at 2 years Not running at 2.5 years No words at 18 months No interest in others at 18 months

Answer 33

Age > 35 Amenorrhoea or oligomenorrhea Previous abdo/pelvic surgery Previous STI/PID Previous urogenital surgery Previous STI Varicocele Two abnormal semen results.

Answer 34

Staggered overdose is defined as the first and last paracetamol ingested being more than 1 hour apart.

Answer 35

1. Socio-Economic Status (SES) 2. Education 3. Housing Conditions 4. Access to Healthcare 5. Nutrition and Diet 6. Lifestyle and Behavioural Factors 7. Work Environment 8. Environmental Factors 9. Intergenerational Disadvantage Some evil scientists experimented, hurting children and hiding nasty diseases, letting big weapnes end everyones future in diaster

Answer 36

Social Determinants of Health: It emphasized that health inequalities were largely shaped by social and economic factors, such as poverty, poor housing, and limited access to education and healthcare, rather than biological or genetic factors alone. Class-Based Health Inequalities: People in lower social classes had worse health outcomes across nearly all measures, and this disparity was particularly pronounced in mortality rates. Health Inequality Persistence: The report concluded that inequalities in health were persistent over time and not simply the result of lifestyle choices or differences in healthcare access.

Answer 37

Headache, which is present in 90% of cases Weakness or impaired control of one or both sides of the body Difficulty speaking or understanding language Blurred or double vision Seizures Nausea and vomiting Fainting or loss of consciousness Coma Eye pain or swelling of one or both eyes Rash that looks like small bruises or bleeding under the skin

Answer 38

Giving people what they need to achieve equal outcomes

Answer 39

Odds ratios are the usual reported measure in case-control studies. It approximates to relative risk if the outcome of interest is rare. Odds in treatment group/odds in placebo

Answer 40

Giving everyone the same rights, opportunities and resources

Answer 41

Equal treatment for people with the equal health care needs

Answer 42

Unequal treatment for unequal health care needs

Answer 43

Availability of health care tends to vary inversely with its need

Answer 44

P- Place of residence R- Race O- occupation G- gender R- Religion E- Education S- Socio economic S- Social capital

Answer 45

- Health improvement - Health protection - Improving services

Answer 46

- Maxwell's dimensions of quality of healthcare - Donabedian’s

Answer 47

Structure - What is there (buildings, staff, equipment available) Process - What's actually done (number of pts seen, operations performed) , **output** - either separate or included In process Outcome - Different ways to classify outcomes, such as 1. 5Ds - Death, disease, disability, discomfort, dissatisfaction 2. Mortality 3. Morbidy (complication rate) 4. Quality of life/ Patient-reported outcomes 5. Patient satisfaction **SPO**

Answer 48

3 A's and 3 E's - Acceptability - Accessibility - Appropriateness - Effectiveness - Efficiency - Equity

Answer 49

Egalitarian Maximising Libertarian

Answer 50

Provide ALL care that is necessary and required for everyone Good: equal Bad: expensive

Answer 51

Act is evaluated solely in terms of its consequences Good: Resources are allocated to those most likely to benefit from it Bad: Those who don't make the cut receive nothing

Answer 52

Each is responsible for their own health Good: promotes positive engagement Bad: most diseases are not self-inflicted

Answer 53

Primary Prevention: Preventing the disease from occurring in the first place e.g. vaccine Secondary Prevention: Early identification of the disease to alter disease course e.g. screening Tertiary Prevention: Limit consequences of established disease e.g. Limit consequences of established disease e.g. preventing worsening renal function in CKD

Answer 54

Population approach: Prevention approach delivered to everyone to shift the risk factor distribution curve e.g. dietary salt reductions through legislation High risk approach: Identify individuals above a chosen cut off and treat them e.g. screening people for high blood pressure and treat them Prevention paradox: “A preventative measure which brings much benefit to the population often offers little impact to each participating individual.” e.g. mass immunisation

Answer 55

- HIV, syphilis, Hepatitis B - Sickle cell and thalassaemia screening 10-13 weeks if parents are carriers, via CVS, or by aminocentesis in 15-20 weeks - Foetal anomaly screening, including Downs Syndrome

Answer 56

- NIPE - New-born Hearing Screening Programme (permanent childhood hearing impairment). Otoacoustic hearing test, down around 4-5 weeks, - New-born blood spot screening test

Answer 57

AAA screening programme Bowel Cancer Screening - 60-74 years, every 2 years, FIT test Breast Cancer Screening Cervical Screening Diabetic Eye Screening

Answer 58

**Knowledge of Disease** Important Disease understood Recognisable stage **Treatment** Accepted treatment Enough facilities Agreed policies on who to treat **The Screening Test** Suitable test Accepted by public **Organisation and Cost** Cost of case findings balance out to possible expenditure Ongoing process I(Important disease)n E(effective treatment available)am S(simple and safe)eason NAP (Natural history, Acceptable, Policy agreed) In Exam Season NAP

Answer 59

To work out odds, you divide the probability of an event occurring by the probability of the event not occurring

Answer 60

Absolute Risk (AR) = the number of events (good or bad) in a treated (exposed) or control (non-exposed) group, divided by the total number of people in that group - Absolute Risk Reduction (ARR) = the AR of events in the control group (ARc) - the AR of events in the treatment group (ARt) - Relative Risk (RR) = AR(Treatment) / AR(Control) (Doesn’t take into account baseline risk) Relative risk reduction = (EER - CER) / CER

Answer 61

The Number Needed to Harm (NNH) is a statistical measure used in clinical research to quantify **how many patients need to be exposed to a specific intervention or treatment** over a certain period to cause harm in one additional person **compared to a control group**. = 1 / (ARt – ARc) ARt = Attributable risk in treatment group ARc = Attributable risk in control gourp Example: If a new drug causes an adverse event in 10% of the treatment group (ARt = 0.10) and in 5% of the control group (ARc = 0.05): NNH = 1/(0.1-0.05) =1/0.05 = 20 people

Answer 62

Measurement bias Different equipment measuring differently Observer bias Observers expectations influence reporting Recall bias Past events not recalled correctly Reporting bias People don’t tell the truth because of shame/ judgement

Answer 63

Selection bias Bias in recruiting for a study, and some may be lost to follow up Publication bias Trials with negative results less likely to be published

Answer 64

Health Behaviour - aimed to prevent disease E.g. regular exercise Illness behaviour - aimed to seek remedy E.g. going to the doctor Sick Role Behaviour - aimed at getting well E.g. taking medication

Answer 65

Cravings – very strong desire to drink Drinking despite negative consequences: On their physical health, On their mental health, On their social / work life Tolerance – this is said to occur when the individual has to drink larger amount of alcohol to obtain a similar effect. Loss of control Narrowing of repertoire (start to drink only one type of drink in one place) wIthdrawal symptoms Primacy (put drinking before other activities) – neglecting other activities

Answer 66

Availability (affordability) of food Access – economic and physical Utilisation – opportunity to prepare food Stability of the three dimensions over time

Answer 67

Would a reasonable doctor do the same

Answer 68

Would that be reasonable?

Answer 69

Sloth error: being lazy, not bothering to check results/information for accuracy. Lack of skill: lack of appropriate skills or teaching in practice Communication breakdown: unclear instructions or plans and not listening to others System failure: machine/equipment stopped working Human factors: bravado, timidity Judgement failure Neglect Poor performance Misconduct

Answer 70

hazard ratio is typically used when analysing survival over time

Answer 71

Point prevalence = number of cases in a defined population / number of people in a defined population at the same time

Answer 72

Hawthorne effect - describes a group changing it's behaviour due to the knowledge that it is being studied

Answer 73

Swiss cheese model Three-bucket model

Answer 74

- Grunting - Resp rate over 60 - Seizures - bulging fontanelle - temp over 38 under 3 months - Cyanosis - Mottled skin - Difficult to rouse - Moderate or severe recessions - Non-blanching rash

PUBLIC HEALTH Flashcards

(98 cards)