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Public Health Flashcards

1
Q

What are the 9 Bradford-Hill Criteria?

A 
Temporality 
Strength of association 
Consistency 
Dose-response relationship 
Biological plausibility 
Specificity 
Coherence 
Experiment 
Analogy
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2
Q

What is a type 1 error

A

Rejecting the null hypothesis when it is true - saying there is an effect when there isn’t

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3
Q

What is a type 2 error

A

Accepting the null hypothesis when it is false - missing an effect that actually exists

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4
Q

A Pearson’s coefficient of 1 means…

A

Perfect correlation

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5
Q

What are the six steps of CDC Evaluation framework?

A
  1. Engage stakeholders
  2. Describe programme
  3. Design evaluation
  4. Collect data
  5. Justify conclusions
  6. Disseminate findings
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6
Q

6 Kass ethical framework domains i.e. process to work through when initially evaluating

A
  1. Proposed benefits
  2. Proposed programme
  3. Burdens
  4. Mitigation
  5. Distribution of benefits/burdens (equity)
  6. Balance of benefits/burdens (justice process)
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7
Q

4 Kass ethical burdens

A
  1. Privacy/Confidentiality
  2. Autonomy/Liberty
  3. Justice/Equity
  4. Individual health
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8
Q

7 general ethical considerations

A
  1. Producing benefits
  2. Avoiding/preventing harms
  3. Utility
  4. Distributive and procedural justice
  5. Respecting autonomy
  6. Protecting privacy and confidentiality
  7. Trust
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9
Q

5 Principles for resolving ethical conflicts

A
  1. Effectiveness - infringing moral considerations will improve health
  2. Proportionality - benefits must outweigh harms
  3. Necessity
  4. Least infringement - least burdensome alternative
  5. Public justification - explanation and transparency
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10
Q

Health Protection Amendment Act (2016) escalation pathway intervention

A
  1. Scope public health risk
  2. Voluntary measures (informal contact tracing)
  3. Formal contact tracing
  4. Directions and court orders
  5. Urgent public health orders
  6. Prosecution
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11
Q

Beauchamp and Childress Ethical Principles

A
  1. Beneficence
  2. Non-maleficence
  3. Autonomy
  4. Justice
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12
Q

Definition of public health

A

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

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13
Q

WHO Definition of health

A

A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

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14
Q

3 domains of public health

A
  1. Health Improvement
  2. Health Protection
  3. Health Service Delivery and Quality
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15
Q

DPSEEA framework for intervention

A
  1. Driving forces - car dependency
  2. Pressures - daily commuting
  3. State - average energy expenditure
  4. Exposure - individual energy expenditure
  5. Effect - obesity and NCDs
  6. Action - intervention at each level
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16
Q

11 WHO Healthy Cities qualities

A
  1. Clean, safe, high quality physical environment
  2. Stable and sustainable ecosystem
  3. Strong, mutually supportive and non-exploitative community
  4. Citizen participation and control
  5. Basic needs (food, water shelter, employment, income)
  6. Access to experiences and resources
  7. Diverse, vital and innovative economy
  8. Cultural and biological heritage
  9. An urban form that promotes all of the above
  10. Public health and sick care services
  11. High health status
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17
Q

4 purposes of epidemiology

A
  1. Causation
  2. Natural history
  3. Description of health status of population
  4. Evaluation of interventions
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18
Q

Define incidence rate

A

the number of new cases in a given period of person-time

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19
Q

Define cumulative incidence

A

number of people who develop disease during a specified time period, out of the total number of people who were at risk over that period and were free from disease to start with

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20
Q

Define point prevalence

A

proportion of population of people with disease at a specified point in time

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21
Q

Define period prevalence

A

proportion of population with disease at any time within a given period

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22
Q

Define Attributable risk

A

The difference in incidence between what the exposed and unexposed populations experience i.e. the extra burden that is due to the exposure

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23
Q

3 types of causes

A
  1. Sufficient cause - an event or exposure that, having occurred, ensures the outcome will occur
  2. Necessary cause - an event or exposure without which the outcome will not occur
  3. Component cause - an event or exposure which increases the likelihood of the outcome occurring, with an attributable fraction of <1 and >0
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24
Q

Epidemiologic triad

A
  1. Host
  2. Agent
  3. Environment
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25
Q

4 types of prevention

A
  1. Primordial - aims to alter the environments that allow unhealthy exposures to occur
  2. Primary - aims to reduce incidence of disease through exposure reduction
  3. Secondary - aims to cure or manage disease through early diagnosis and treatment
  4. Tertiary - aims to reduce complications or disability due to disease
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26
Q

3 Pros of ecological studies

A

Easy
Cheap
Uses existing datasets

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27
Q

4 Cons of ecological studies

A
  1. Cannot prove causation, can only infer it
  2. Has little explanatory power at the level of the individual
  3. Prone to confounding
  4. Ecological fallacy - inferring things about individuals in a population based on population characteristics e.g. men are more likely to get IHD, thus Tom has a higher risk of IHD than Mary
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28
Q

3 Pros of cross-sectional studies

A
  1. Useful for describing prevalence
  2. Good for qualitative explorations
  3. Quick and cheap
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29
Q

4 Cons of cross-sectional studies

A
  1. Can’t measure incidence as no time component
  2. Can’t establish causation as no temporality
  3. Difficult to use for acute or wax-and-wane disease as they’re less likely to be present at the time you ask
  4. Prone to selection bias
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30
Q

3 Pros of case-controls

A
  1. Relatively quick and cheap
  2. Good for rare diseases - don’t have to have a huge cohort to generate a few rare cases
  3. Can consider multiple risk factors
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31
Q

5 Cons of case-controls

A
  1. Not good for rare exposures
  2. Suffers heavily from recall bias
  3. Can’t calculate an actual risk estimate, or an incidence
  4. Prone to confounding
  5. Timelines unclear so difficult to prove causation
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32
Q

3 Pros of cohort studies

A
  1. As there is a clear timeline, can be used to establish causality, and doesn’t suffer from recall bias so much
  2. Can calculate incidence rate and an actual risk to presently disease-free people
  3. Can look at multiple outcomes - i.e. can determine a number of bad things that happen to smokers vs non-smokers
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33
Q

4 Cons of cohort studies

A
  1. Can be very difficult to retain people in the study - loss-to-followup is a big risk
  2. Can only study one exposure - this is the factor that separates the two groups
  3. Not good for rare diseases - need a really big group to get a few cases
  4. Expensive and time-consuming
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34
Q

2 purposes of randomisation

A
  1. Makes the two groups (intervention and control) as similar as possible at baseline, which is the most effective way to control for confounders (both known and unknown)
  2. Eliminates bias in treatment allocation - doesn’t allow for patient preference or willingness or investigator bias
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35
Q

3 parts of Triple blinding

A
  1. Participants are unaware of group allocation - controls for placebo effect
  2. Investigators are unaware of group allocation - controls for investigator/interviewer bias
  3. Analysts are unaware of group allocation - controls for bias introduced
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36
Q

4 reasons to do intention-to-treat analysis

A
  1. Gives an idea of the real-world performance of the intervention, because these issues occur in the real-world - no treatment is ever done under ideal conditions. I.e. effectiveness rather than efficacy
  2. Preserves the balance of baseline characteristics from randomisation - it may be that e.g. males are more likely to switch groups than females, which if you analysed the groups people ended up in would introduce confounding by gender
  3. Preserves your sample size and thus power - if you excluded dropouts, the sample size would shrink
  4. Prevents conscious and unconscious bias related to outcomes, or loss of data because people drop out
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37
Q

Reason for doing per-protocol analysis

A

Analysing only the people who completed the treatment as specified gives you the efficacy - how well the treatment works in the ideal, cleanest conditions

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38
Q

4 Pros of Community Trials

A
  1. Good for public health interventions where a community or system is the target for intervention rather than individuals
  2. Often more convenient - easier to randomise whole classes of children, rather than individual children in a class as this might be quite disruptive to the real-world functioning of the class
  3. Measures system effects
  4. Usually generalisable as studies whole communities
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39
Q

3 Cons of Community Trials

A
  1. Require long follow-up for public health interventions
  2. Inter-cluster correlation - clusters may be fundamentally different to each other due to differences in the way people associate themselves - need a large enough number of clusters to account for this and good inclusion criteria and work put into recruitment
  3. Often run as open cohorts - people enter and exit the study during the course, due to real-world influences
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40
Q

Steps of meta-analysis

A
  1. Define research question
  2. Systematic search of literature
  3. Quality assessment
  4. Pooling results
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41
Q

6 Limitations of meta-analysis

A
  1. Require homogeneity for pooling of results to be valid - can be very difficult to account for
  2. Dependent on quality of source data - bad inputs create bad output
  3. Can be seen as final word on a research question - doesn’t leave room for nuanced understanding
  4. Vulnerable to publication bias if this is not addressed
  5. Work best with access to primary data rather than just summary estimates and statistics
  6. Controversial to use in study types other than RCT
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42
Q

Criteria for confounding

A
  1. Associated with exposure
  2. Causes outcomes
  3. Not on causal pathway between exposure and outcome
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43
Q

Strategies for addressing confounding

A
  1. Randomisation
  2. Restriction
  3. Matching
  4. Stratification
  5. Standardisation
  6. Regression analysis
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44
Q

Define selection bias

A

Bias that arises from the way participants in a study are selected and from factors that influence participation in the study.

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45
Q

Causes of selection bias

A
  1. Unconcealed randomisation
  2. Volunteer bias
  3. Ascertainment bias - exposed more likely to be diagnosed than control
  4. Healthy worker bias
  5. Loss to followup
  6. Faulty selection criteria
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46
Q

Define measurement bias

A

Bias that arises when measuring tools do not accurately reflect reality

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47
Q

5 Ottawa Charter Actions (in descending order)

A
  1. Build Healthy Public Policy
  2. Create Supportive Environments
  3. Reorient Health Services
  4. Strengthen Community Action
  5. Develop Personal Skills
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48
Q

3 Ottawa Charter strategies

A

Advocate
Enable
Mediate

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49
Q

8 steps of Gosling Advocacy Framework

A
  1. Analyse the situation
  2. Identify advocacy issue
  3. Set goals/objectives
  4. Analyse policy and power
  5. Identify targets and influencers
  6. Develop message
  7. Build added strength
  8. Develop and implement action plan
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50
Q

5 elements of TWTW

A
  1. Taha Wairua - spirituality
  2. Taha Hinengaro - mental fortitude
  3. Taha Tinana - physical development
  4. Taha Whanau - family as basic unit of society
  5. Whenua (unseen) - land and whakapapa
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51
Q

4 stars and 2 pointers of Te Pae Mahutonga

A
  1. Mauriora - access to Te Ao Māori
  2. Toiora - healthy lifestyles
  3. Te Oranga - participation in society
  4. Waiora - environmental protection

Ngā manukura - community leadership
Te Mana Whakahaere - autonomy

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52
Q

5 Kaupapa Maori principles

A
  1. Tino Rangatiratanga
  2. Social Justice
  3. Te Ao Maori
  4. Te Reo
  5. Whanau
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53
Q

Te Tiriti articles related to health

A
  1. Kawangatanga - governance and obligation to citizens
  2. Tino Rangatiratanga - control and self-determination
  3. Oritetanga - equity
54
Q

4 steps of risk assessment

A
  1. Hazard Identification
  2. Dose-Response Information
  3. Exposure Assessment
  4. Risk Characterisation
55
Q

7 rules of risk communication

A
  1. Accept and involve the public as a partner
  2. Plan carefully and evaluate
  3. Listen to the public’s specific concerns
  4. Be honest, frank and open
  5. Work with other credible sources
  6. Meet the needs of the media
  7. Speak clearly and with compassion
56
Q

Definition of surveillance

A

“The ongoing, systematic collection, analysis, interpretation and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health”

57
Q

3 types of surveillance

A
  1. Passive - waiting on reports
  2. Active - periodically collecting reports
  3. Negative - requiring reports even when no cases
58
Q

3 Features of control-focused surveillance

A

Focused on immediate responses
Relies on picking up every case of disease
Universal, prospective and real-time

59
Q

4 Features of strategy-focused surveillance

A

Monitors incidence, distribution and risk factors
Assesses impact of disease and priorities for intervention
Depends on accurate description
Can be retrospective and use samples rather than individual cases

60
Q

7 objectives of outbreak investigation

A
  1. Stop the outbreak and prevent further illness
  2. Prevent future outbreaks from same source or similar circumstances
  3. Address public concerns
  4. Reduce direct and indirect costs
  5. Contribute to scientific understanding about pathogen, transmission mechanisms etc
  6. Satisfy legal or international obligations
  7. Help train public health staff
61
Q

8 Steps of Outbreak Investigation

A
  1. Confirm the existence of an outbreak
  2. Define and identify cases
  3. Descriptive epidemiology: person/place/time
  4. Develop hypotheses
  5. Test hypotheses
  6. Compare epidemiology with environmental and/or microbiologic investigation results
  7. Implement control/prevention measures
  8. Communicate findings
62
Q

7 Requirements for contact tracing

A
  1. Important communicable health problem with a low incidence in general population
  2. Natural history and transmission dynamics well understood
  3. Possible to identify, locate and communicate with contacts in a timely manner - before secondary transmission has occurred
  4. Able to ascertain susceptibility early (i.e. immune testing), or have some possible intervention to offer
  5. Interventions will reduce the R0 below 1
  6. Testing methods are acceptable (blood vs invasive testing)
  7. Population benefits outweigh risks, and costs are reasonable
63
Q

4 Contact tracing interventions

A
  1. Isolation of detected cases
  2. Quarantine of asymptomatic contacts
  3. Prophylaxis/vaccination
  4. Education
64
Q

Define Latent period

A

Time from exposure to development of infectiousness

65
Q

Define Infectious period

A

Time during which an infected host may infect others

66
Q

Define Incubation period

A

Time from exposure to development of symptoms

67
Q

Define Symptomatic period

A

Time during which clinical disease is experienced

68
Q

Define transmission probability

A

The likelihood that an infectious host will pass a disease on to a susceptible host in an instance of contact

69
Q

Transmission probability depends on which 4 factors

A
  1. Infectivity
  2. Type of contact
  3. Vectors
  4. Pathogen factors
70
Q

Define secondary attack rate

A

The number of people who develop disease / number of susceptible people who are exposed during infectious period

71
Q

Define secondary cases

A

Secondary cases are those who develop symptoms in the time period after (primary case onset + min latent period) and before (max infectious period + max latent period)

72
Q

Define R0

A

Basic reproductive number - the number of new cases that arise from a single case in a population naiive to the disease (i.e. without immunity). Not specific to a pathogen, rather to a pathogen within a specific population at a specific time

73
Q

Calculation for R0

A

Number of contacts per unit time * transmission probability per contact * duration of infectiousness

74
Q

Define Effective Reproductive Number (R)

A

The Effective Reproductive Number (R) accounts for immunity within a population (through immunisation, previous disease, breastfeeding or innate factors) - multiply R0 by proportion of population susceptible

75
Q

How to determine vaccine coverage required to halt transmission

A

1 - 1/R0. In the case of measles, 1 - 1/9 = 0.89, so 89% immunity is required

76
Q

5 steps of basic health protection response model

A 
Incident
Investigation
Analysis
Control and prevention
Review
77
Q

Define surveillance

A

The ongoing, systematic collection, analysis, interpretation and dissemination of data regarding a health-related event for use in public health action to reduce morbidity and mortality and to improve health

78
Q

3 types of surveillance

A

Passive - data collector waits for other actors to report
Active - data collector periodically checks with other actors
Negative - reporting required even when no cases occurred

79
Q

Elements of control-focused surveillance

A

Supports efforts to control established risks e.g. typhoid
Allows immediate public health response
Relies on collecting every case of disease
Is universal, continuous and prospective/real-time
Usually uses a dedicated primary data collection system (e.g. notifiable disease)

80
Q

Elements of strategy-focused surveillance

A

Supports efforts to prevent risks e.g. pneumococcal disease
Objectives:
- Monitor incidence and distribution
- Assess impact and determine priorities
- Identify risk factors to address
- Evaluate interventions
- Fulfill statutory and international requirements

Depends on accurate description, can use samples and surveys not focused on individuals

81
Q

7 Types of CD Surveillance in NZ

A
  • Notifiable diseases through practitioners
  • Sentinel - data collected from a representative sample (e.g. GP influenza-like illness system)
  • Virological surveillance - collecting serotype and DNA data to analyse patterns
  • Lab-based surveillance (includes notifiables)
  • Clinic-based - specific clinics where most cases come through regularly report (e.g. HIV notified through sexual health and ID clinics)
  • Syndromic surveillance - collection of non-specific collections of symptoms/signs e.g. flaccid paralysis
  • Web-based surveillance - using online activity to determine disease patterns, either actively (flutracker) or passively (google flu)
82
Q

5 Levels of Integrated Disease Surveillance and Response framework

A 
Community
Health facility
District/state/province
National
WHO Offices (National and Regional)
83
Q

8 Actions of Integrated Disease Surveillance and Response framework

A 
Identify
Report
Analyse and Interpret
Investigate and confirm
Respond
Communicate
Evaluate
Prepare
84
Q

6 Steps in surveillance programme evaluation

A 
Describe the specific objectives of the system
Describe the system
Document how surveillance has been used
Assess quantitative attributes
Assess qualitative attributes
Estimate cost
85
Q

9 Factors in priority assessment for surveillance (Canadian Laboratory for Disease Control)

A
  1. Potential for outbreaks
  2. Public perception of risk
  3. Necessity for immediate public health response
  4. Magnitude
  5. Severity
  6. Morbidity
  7. Premature morbidity
  8. Economic cost
  9. Preventability
86
Q

Define hazard

A

A factor or exposure that may adversely affect health - a qualitative term that expresses the presence of danger

87
Q

Define risk assessment

A

Identification of risk through assessment of hazards and exposure. Ultimately seeking to determine a safe level for a particular hazard where adverse effects are unlikely - most meaningful information to be able to communicate.

88
Q

Define risk management

A

Using information derived from risk assessment as a basis for strategies aimed at reducing harm.

89
Q

4 types of risk

A

Perceived risk - level of risk that the public or individuals believe exists
Calculated risk - expert calculation based on assessment of hazard and exposure and quantitative analysis
Actual risk - considers both perceived and calculated risk
Acceptable risk - what the public or individuals will accept - based on perceived risk and values

90
Q

3 steps of estimating hazard exposure

A
  1. Estimate magnitude, duration and frequency of human exposure, and volumes of people exposed via different pathways
  2. Consider living/working/playing, whether it makes it into water or food chains
  3. Calculate reasonable maximum exposure - the highest level of exposure that could possibly occur from the hazard
91
Q

4 considerations in Annex 2 of IHRs

A
  1. Seriousness of event’s public health impact
  2. Unusual or unexpected nature of event
  3. Significant risk of international spread
  4. Significant risk of international travel or trade restrictions
92
Q

4 mandatory notifiable diseases under IHRs

A
  1. Smallpox
  2. Wild-type poliovirus
  3. New human influenza subtype
  4. SARS
93
Q

3 types of cluster

A
  1. Time
  2. Space
  3. Time-space
94
Q

6 Characteristics of Clusters

A

Definable health event
At least two cases
Perceived closeness of cases within time-space
Potential exposure is suspected, along with connection between exposure and event
Unusual or unexpected
Community requests explanation

95
Q

8 Steps of cluster investigation

A 
Establish that a problem exists
Confirm the homogeneity of events
Collect data on all events
Characterise the epidemiological factors of events
Look for patterns and trends
Formulate hypothesis
Test hypothesis
Write a report and communicate results
96
Q

4 stages of cluster investigation

A

Preliminary evaluation of a report of an alleged cluster
Verification of index case and exposure reports
Full case ascertainment
Ongoing surveillance OR epidemiological study

97
Q

5 strategies for hazard mitigation

A 
Substitute
Isolate
Monitor
Protection
Elimination
98
Q

4 Aims of DWSNZ

A
  1. Set out requirements for compliance
  2. Facilitate consistency of application throughout NZ
  3. Protect public health while reducing unnecessary monitoring
  4. Specify remedial actions required in the event of breaches of standards
99
Q

Names of the Legislation and regulations for drinking water

A
  1. Health (Drinking Water) Amendment Act 2007

2. Drinking Water Standards for New Zealand 2005 (revised 2008)

100
Q

5 air contaminants of concern

A
  1. PM10
  2. Carbon Monoxide
  3. Sulfur Dioxide
  4. Ozone
  5. Nitrogen Dioxide
101
Q

Maximum occupational noise exposure

A

85 decibels over 8 hours

102
Q

6 steps in HIA

A
  1. Screening (identifying plan, project, or policy decisions for which an HIA would be useful).
  2. Scoping (planning the HIA and identifying what health risks and benefits to consider).
  3. Assessment (identifying affected populations and quantifying health impacts of the decision).
  4. Recommendations (suggesting practical actions to promote positive health effects and minimize negative health effects).
  5. Reporting (presenting results to decision makers, affected communities, and other stakeholders).
  6. Monitoring and evaluation (determining the HIA’s impact on the decision and health status).
103
Q

4 Rs of Emergency Management

A
  1. Reduction
  2. Readiness
  3. Response
  4. Recovery
104
Q

4 main strategies of Reduction

A
  1. Surveillance and intervention
  2. Business continuity management
  3. Building organisational resilience to hazards
  4. Responding to incidents to prevent escalation to emergency
105
Q

4 main health sector actions in Response

A
  1. Coordinate a national, regional and local health service response to emergencies
  2. Develop and disseminate health messages
  3. Support welfare activity
  4. Support CDEM groups including local authorities
106
Q

4 key objectives for Recovery

A
  1. Minimising the escalation of consequences of an emergency
  2. Regenerating the cultural, social, emotional and physical wellbeing of individuals and communities
  3. Taking opportunities to adapt to meet the future needs of the community
  4. Reducing future exposure to hazards and their associated risks
107
Q

6 stages of Pandemic Influenza Plan

A
  1. Plan for It (planning and preparedness)
  2. Keep It Out (border management)
  3. Stamp It Out (cluster control/eradication)
  4. Manage It (pandemic management)
  5. Manage It (post-peak)
  6. Recover From It (expediting recovery)
108
Q

5 ethical considerations in emergencies

A
  1. Allocation of resources
  2. Equitable access to resources
  3. Restriction of freedoms (isolation/quarantine/forced treatment)
  4. Obligations of health workers
  5. Obligations of agencies and states to each other
109
Q

7 domains of HSQC quality framework

A 
1. Partnerships with consumers/
patients and their families/
whānau
2. Quality and safety culture
3. Leadership for improvement
and change
4. Systems thinking
5. Teamwork and communication
6. Improvement and innovation
7. Quality improvement and
patient safety knowledge
and skills
110
Q

6 aspects of quality

A
  1. Effective
  2. Efficient
  3. Accessible
  4. Acceptable/patient-centred
  5. Equitable
  6. Safe
111
Q

7 WHO Quality Improvement Activities

A
  1. Stakeholder involvement
  2. Situational analysis
  3. Confirmation of health goals
  4. Quality goals
  5. Choosing intervention for quality
  6. Implementation process
  7. Monitoring progress
112
Q

8 NSU screening programme criteria

A
  1. The condition is suitable for screening
  2. There is a suitable test
  3. There is an effective and accessible treatment or intervention for the condition
  4. There is high-quality evidence that a screening programme is effective in reducing death and illness
  5. The potential benefit of the test should outweigh potential harm
  6. The health sector should be capable of supporting diagnosis, follow-up and programme evaluation
  7. There is consideration of social and ethical issues
  8. There is consideration of cost-benefit issues
113
Q

5 components of a screening programme

A
  1. Education
  2. Testing
  3. Clinical services
  4. Programme management
  5. Quality assurance
114
Q

4 types of bias in screening studies

A
  1. Lead-time bias (early detection makes survival look better)
  2. Length bias (screening programmes more likely to detect good prognosis, slow growing disease)
  3. Over-diagnosis bias (for certain conditions, screening programmes increase diagnosed disease incidence without improving mortality)
  4. Selection bias (low-risk people more likely to volunteer to participate in screening programmes - makes survival look good)
115
Q

4 WHO Mental Health Action Plan Objectives

A
  1. To strengthen effective leadership and governance for
    mental health
  2. To provide comprehensive, integrated and responsive
    mental health and social care services in communitybased
    settings
  3. To implement strategies for promotion and
    prevention in mental health
  4. To strengthen information systems, evidence and
    research for mental health
116
Q

6 WHO Mental Health Action Plan Principles

A
  1. Universal health coverage
  2. Human rights
  3. Evidence based practice
  4. Life course approach
  5. Multi-sectoral approach
  6. Empowerment of persons with mental disorders and
    psychosocial disabilities
117
Q

3 Pathways in Draft Suicide Prevention Plan

A
  1. Building positive wellbeing throughout people’s lives
  2. Recognising and appropriately supporting people in mental distress
  3. Relieving the impact of suicide on people’s lives
118
Q

3 VicHealth key determinants of mental health

A
  1. Social inclusion
  2. Freedom from discrimination and violence
  3. Economic participation
119
Q

Definition of primary health care

A
  1. Essential health care care based on practical, scientifically sound and socially acceptable
    approach methods and technology
  2. Made universally accessible to individuals and
    families in the community through their full participation
  3. At a cost that the community and country can afford to maintain at every stage of their development in the spirit of self-reliance and self determination
  4. The first level of contact of individuals, the family, and the community with the national health system, bringing health care as close as possible to where people live
    and work, and constitutes the first element of a continuing health care process.
120
Q

10 Characteristics of High-Performing Chronic Care Systems

A
  1. Universal coverage
  2. Care is free (or low cost ) at point of use
  3. A focus on prevention as well as treatment
  4. Priority for patients to self-manage
  5. Priority to primary health care – multi-disciplinary teams led by nurses
  6. Stratify those with long term conditions by clinical risk – support them commensurately needed
  7. Care should be integrated to enable primary
    health care teams to access specialist advice and support when needed
  8. Good use of IT to improve chronic care (improve communication between professionals, improved care of patients at home)
  9. Effective coordination of care – particularly those with multiple conditions – employing Care Co-ordinators
  10. The above are linked as part of a strategic approach
121
Q

Health Equity Assessment Tool (HEAT) Questions

A
  1. What inequalities exist in relation to the health issue under consideration?
  2. Who is most advantaged and how?
  3. How did the inequalities occur? What are the mechanisms by which the inequalities were created, maintained or increased?
  4. Where/how will you intervene to tackle this issue?
  5. How will you improve Māori health outcomes and reduce health inequalities experienced by Māori?
  6. How could this intervention affect health inequalities?
  7. Who will benefit most?
  8. What might the unintended consequences be?
  9. What will you do to make sure the intervention does reduce inequalities?
  10. How will you know if inequalities have been reduced?
122
Q

Application of Tiriti principles in health

A
  1. Partnership - working together with iwi, hapū, whanau and Māori communities to develop strategies for Māori health gain and appropriate health and disability services
  2. Participation - Involving Māori at all levels of the sector, in decision-making, planning, development and delivery of health and disability services
  3. Protection - Working to ensure Māori have at least the same level of health as non-Māori, and safeguarding Māori cultural concepts, values and practices
123
Q

6 priorities for Child Wellbeing

A
  1. Child poverty is reduced, in line with the Government’s intermediate and ten-year targets
  2. Children experience optimal development in their first 1000 days: safe and positive pregnancy, birth and parenting (conception to around two years)
  3. Children are thriving socially, emotionally and developmentally in the early years (two to six years)
  4. Children are safe and nurtured, in their whānau and their homes
  5. Children’s mental wellbeing is supported
  6. Children are free from racism, discrimination and stigma
124
Q

4 types of economic analysis

A
  1. Cost minimisation - same consequences, lowest cost
  2. Cost-effectiveness - outcomes directly comparable
  3. Cost-utility - outcomes not directly comparable so uses measure such as QALY
  4. Cost-benefit - takes into account and attempts to quantify whole-system effects e.g. lost productivity, work absence
125
Q

3 phases of prioritisation

A
  1. Identification - arises from needs assessment, planning, monitoring and stakeholder feedback
  2. Analysis - gathering evidence to inform prioritisation decisions
  3. Decision - taking analyses as inputs as well as political, ethical, acceptability and equity considerations into account
126
Q

5 focus areas of Healthy Aging Strategy

A
  1. Ageing well
  2. Acute and restorative care
  3. Living well with long-term conditions
  4. Support for high and complex needs
  5. Respectful end-of-life care
127
Q

6 messages in emergency communications

A
  1. Expression of empathy
  2. Facts (Who/What/Where/When/Why/How)
  3. What we don’t know
  4. Process to get answers
  5. Statement of commitment
  6. Referrals/contacts (who to talk to if concerned)
128
Q

4 reasons for apparent association in studies

A
  1. Chance
  2. Bias (selection and information)
  3. Confounding
  4. Actual relationship
129
Q

6 principles of Drinking Water Supply

A
  1. High standard of care must be embraced
  2. Protection of source water is of paramount importance
  3. Maintain multiple barriers against contamination
  4. Change precedes contamination
  5. Suppliers must own the safety of drinking water
  6. Apply a preventive risk management approach
130
Q

4 Pathways of He Korowai Oranga

A
  1. Whānau/hapū/iwi/community development
  2. Māori participation
  3. Effective service delivery
  4. Working across sectors
131
Q

6 Te Mana Raraunga approaches

A
  1. Asserting Māori rights and interests in relation to data
  2. Ensuring data for and about Māori can be safeguarded and protected
  3. Requiring the quality and integrity of Maori data and its collection
  4. Advocating for Māori involvement in the governance of data repositories
  5. Supporting the development of Māori data infrastructure and security systems
  6. Supporting the development of sustainable Māori digital businesses and innovations

Public Health (1 decks)

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