public health Flashcards

Question

Relative risk

Answer 1

Risk in one category relative to another

Answer 2

The rate of disease in exposed that may be attributed to the exposure (DIFFERENCE)

Answer 3

Exposed vs unexposed (DIVIDE)

Answer 4

A systematic error which leads to a distortion from the true underlying association

Answer 5

error is in the selection of study participants or the allocation of participants to different groups

Answer 6

error in measurement or classification of exposure or outcome

Answer 7

The situation where a factor is associated with the exposure of interest and independently influences the outcome but DOES NOT lie on the causal pathway

Answer 8

``` Strength of association Dose-response Consistency Temporality Reversibility Biological plausibility ```

Answer 9

``` Genes Environment Lifestyle Healthcare Education Living and working conditions Age Sex Constitutional factors ```

Answer 10

Equity - what is fair and just | Equality - concerned with equal shares

Answer 11

Equal treatment for equal need

Answer 12

Unequal treatment for unequal need

Answer 13

Health improvement Health protection Improving services

Answer 14

Individual Community Ecological (population)

Answer 15

Health behaviour = a behaviour aimed to prevent disease Illness behaviour = a behaviour aimed to seek remedy Sick role behaviour = and activity aimed at getting well Health - eat healthy Illness - go to Dr Sick - take medicine

Answer 16

``` Don't understand why taking meds Side effects Memory loss Reputation Socioeconomic status ```

Answer 17

The process of enabling people to exert control over their determinants of health (POPULATION LEVEL)

Answer 18

Change 4 life, stoptober, movember

Answer 19

Care responsive to INDIVIDUAL needs

Answer 20

``` NO e.g. alcohol individual - consumption local - sales, community crime population - national sales and stats ```

Answer 21

Individuals continue to practice health damaging behaviours due to INACCURATE PERCEPTIONS OF RISK AND SUSCEPTIBILITY

Answer 22

Lack of personal experience with problem Belief that problem is preventable by personal action Belief that if problem not occurred already its unlikely to Belief that problem infrequent

Answer 23

``` Work with patients priorities aim for easy changes over time set and record goals plan coping strategies review regularly ```

Answer 24

``` Patients will change if they believe: they are susceptible to the condition it has serious consequences taking action reduces susceptibility benefits of action outweigh costs ```

Answer 25

doesn't account for emotions impact of behaviour

Answer 26

Best predictor of behaviour is intention

Answer 27

``` Precontemplation Contemplation Preparation Action Maintenance ```

Answer 28

``` Leaving school entering workforce parenthood unemployment retirement bereavement ```

Answer 29

Biomedical: absence of disease Psychosocial: stress and fn Lay views: felt and expressed needs

Answer 30

NEED - ability to benefit from an intervention Demand - what the people want Supply - what is provided

Answer 31

health care need is more specific

Answer 32

Felt need - individual perceptions of variation from normal health Expressed need - individual seeks help to overcome variation Normative need - professional defines intervention Comparative need - comparison between severity, range of interventions and cost

Answer 33

comparative, epidemiological, corporate

Answer 34

Screening, GUM contact tracing, MMR

Answer 35

Treatment of child abusers, some palliative stuff, contraception in some countries

Answer 36

waiting lists

Answer 37

ABx for sore throat, cosmetic surgery

Answer 38

PERFECTION

Answer 39

structure - whats there e.g. equipment staff buildings process - whats done e.g. no of patients seen outcome - mortality, QOL, satisfaction

Answer 40

observations interviews focus groups review of documents

Answer 41

Routinely collected data Review of records Surveys Epidemiological methods

Answer 42

``` High mortality (RABIES) High morbidity (HUS) Highly contagious (influenza) Expensive to Rx (HIV) Effective intervention is available (hep B) ```

Answer 43

``` enceph meningitis polio hepatitis anthrax cholera diptheria HUS food poisining in clusters enteric fever leprosy plague malaraia measles mengingococcal sepsis rabies SARS smallpox tb whooping cough ```

Answer 44

An aggregation of cases | MAY OR MAY NOT BE LINKED

Answer 45

Occurence of more cases of disease than normally expected within a specific place or group 2+ cases linked through common exposure single case of rare or serious disease (polio, rabies)

Answer 46

link confirmed through investigation

Answer 47

``` OD Constipation Injection - DVT, abscess, infection, loss of IVI Viruses Vasoconstriction Dependency - ```

Answer 48

``` craving fear of withdrawal social exclusion guilt imprisonment effects on families financial criminality ```

Answer 49

``` Psychological intervention Referral for allied problems (Hep, STI) Detox - LOFEXIDINE + BUPRENORPHINE Maintenance - MATHADONE (full ag) or BUP (part ag) Relapse prevention - NALTREXONE ```

Answer 50

14 units/ week Spread drinking evenly over 3 days Several drink free days per week

Answer 51

6 pints 6 glasses of wine 14 spirits

Answer 52

8g of ETOH | %xml/1000

Answer 53

``` genetics personality gender religion occupation childhood problems early use of substances depression peers social deprivation ```

Answer 54

``` Accidents Violence Malignancy CVA CHD ```

Answer 55

``` GI cancer Liver - fatty liver, cirrhosis, alcoholic hepatitis, HCC CV - hyperlipidaemia, htn, AF Neuro - stroke MSK Birth defects miscarriage and foetal alcohol syndrome ```

Answer 56

Small underweight babies with slack muscle tone Mental retardation, behavioural and speech problems Characteristics: Thin upper lip, microcephaly, upturned nose, hypoplastic jaw, epicanthic folds, short palpebral fissure

Answer 57

``` Minimum unit pricing Change licensing laws Screening by healthcare workers Increasing price More joined up services ```

Answer 58

Address other health issues Consider vitamin supplementation Assess IHD risk Assess osteoporosis risk

Answer 59

CAGE AUDIT FAST PAT

Answer 60

Disulfiram - causes acute sensitivity to etoh - inhibits acetaldehyde dehydrogenase Acamprosate - gaba blocker Naltrexone - anitcrave

Answer 61

3-5 days toxic confusional state clouding of consciousness, seizures, confusion, hallucinations, tremor Rx - fluids benzo - chlordiazepoxide

Answer 62

b1 deficient Reversible acute confusion, ophthalmoplegia, ataxia Rx IV/IM/PO B1

Answer 63

IRREVERSIBLE Amnesia - short term memory, loss of spontaneity or initiative, apathy, confabulation Dx - CT Rx - Thiamine

Answer 64

``` ID - TB, hep Resp Addiction Psych Malnourishment Sexual health ```

Answer 65

``` Language Stigma Education Inverse care law physical - transport ```

Answer 66

Owing to well founded fear of being persecuted is outside of country of nationality and unable to return

Answer 67

submitted application to be recognised as refugee and waiting for claim to be decided by home office

Answer 68

indefinite leave to remain - HAVE ALL RIGHTS OF UK CITIZEN

Answer 69

money, housing, NHS, u18 education | NOT EMPLOYMENT

Answer 70

NHS founded on requirement to provide all care that is necessary and appropriate to everyone

Answer 71

Criteria that maximise public utility

Answer 72

Each is responsible for their own health, wellbeing and fulfilment of plans

Answer 73

focus on the individual - blame/fault/shame

Answer 74

focus on working conditions - recognise errors and implement defences

Answer 75

``` Incident reporting Complaints and claims Audit External accreditation Active measurement ```

Answer 76

cause harm or death to patients - should never occur if correct protocols followed

Answer 77

``` Wrong site/implant for surgery Wrong drug preparation/route/dose Retained foreign object of surgery Falls from windows Trapped in bed rails Misplaced NG tube Death due to PPH ```

Answer 78

The greater the benefits and lower the likely consequences the more common it is for people to migrate towards working in ways that they know to be wrong or break the rules Over time these ways become integrated into culture and normalised

Answer 79

Behaviours are driven by attitudes, self efficacy, perceived control and subjective norm

Answer 80

Make care of pt first concern Take prompt action if you think patient safety is being compromised Be honest and open and act with integrity

Answer 81

Human error - communication, judgement, omissions, lapses Neglect - necessary care is withheld Poor performance - attitude problem

Answer 82

serious - shipman | minor - rough handling

Answer 83

hiding own or others mistakes, altering records

Answer 84

Expenses, drugs, alcohol, time (pretending you're ill)

Answer 85

Was there a duty of care? Was there a breach in the duty of care? Did the patients come to harm? Was the harm due to the breach?

Answer 86

would a group of reasonable doctors do the same?

Answer 87

would it be reasonable for them to do so?

Answer 88

1. Integrative - psychosexual x physical 2. CBT - Sensate focus // self growth 3. Psychodynamic - past events, attachments 4. systemic - interactions and roles in the relationship

Answer 89

organisational influences, supervision, preconditions, specific acts

Answer 90

``` Fasting BM Testosterone SHBG Albumin FAI PL TSH OESTROGEN FBC ```

Answer 91

Lack or loss of sexual desire - makes initiation less likely Ax: Chronic medical conditions: obesity, dm, cvd Androgen deficiency, highPL, lowTFT, Addisons Psych: low mood, anxiety, body image Rx testosterone replacement Integrative, behavioural, cognitive, CBT, psychodynami Tx

Answer 92

Difficulty in developing or maintaining an erection suitable for satisfactory sexual intercourse ``` Ax- CVD, neuro, DM Drugs - SSRI Prostate surgery Anxiety, Depression Pain Insufficient stimuli Age Substance abuse ``` Rx - sildenafil, alprostadil (inj) Vacuum, ring, pump, implant

Answer 93

``` Failure of genital response - VAG DRY Ax - CVD, DM, NEURO, CONN TISS disorder oestrogen deficiency antidepressants lactation depression anorexia ``` ``` Rx Couples therapy sensate focus CBT Lubricant Eros device ```

Answer 94

``` Orgasm doesn't occur or markedly delayed CVD/DM/Neuro/renal/liver dis Oestrogen, thyroid, androgen def pelvic floor weakness ageing SSRI Rx oestrogen + therapy + meds r/v ```

Answer 95

<1 minute // before they want Ax - genetic, penile hypersensitivity, hyperthyroid, prostatitis, ED, Anxiety, lack of experience Rx- STUD spray, couple pshcosexual therapy, stop/start or kegel excercises

Answer 96

Spasm of pelvic floor muscles causing occlusion of vaginal opening --> penile entry impossible Ax Fear, prev abuse, thrush, FGM, Cong abnormality, Religion, Fear of pregnancy, fear of partner Rx psychosexual therapy Vaginal trainers personal exploration, sexual growth programme

Answer 97

Pain during intercourse attributed to local pathology | Ax - infection, injury, endometriosis, poor lub, adhesions

Answer 98

Get a cohort --> exposure --> f/u over time Good - for rare exposures, can identify RF Bad - expensive and time consuming

Answer 99

did HRT cause it

Answer 100

Observational: collect data at specific point in time GOOD - quick, can still show changes over time BAD - observer bias, reverse causality

Answer 101

Group----- divide to placebo + exposure ---> outcome GOOD - establish causation and comparative BAD - expensive, drop outs, ethical issues

Answer 102

Finite limit to resources

Answer 103

sacrifice in terms of benefits forgone from not allocating resources to next best activity

Answer 104

fairness/justice of distribution of costs and benefits

Answer 105

Comparative study of costs and benefits of interventions

Answer 106

lenght of life x units of quality of life (0-1)

Answer 107

Cost effectiveness - natural units Cost utility - QUALYS Cost benefit - monetary units Cost minimalisation - try to reduce cost for same effectiveness Rx

Answer 108

+ve incremental cost + +ve incremental QALY | <20,000 pounds per QALY gained

Answer 109

Incremental cost effectiveness ratio | = incremental cost / incremental QALYS

public health Flashcards

(133 cards)