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Phase 3a > Public Health > Flashcards

Public Health Flashcards

1
Q

3 ways Domestic abuse can impact on a patient’s health

A

Trauma
Psychological eg. PTSD
Somatic issues eg. headaches

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2
Q

How old do you need to be to be a victim of domestic abuse?

A

> 16

With someone who is/have been intimate partners

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3
Q

What are the 3 levels of risk of Domestic abuse?

A

Standard- unlikely
Medium
High- imminent risk of serious harm

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4
Q

How is low/ medium risk of domestic abuse managed?

A

Domestic abuse helplines eg. Helpline, National Helpline

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5
Q

How to manage someone at high risk of domestic abuse?

A

Refer to MARAC (Multi agency risk assessment conference)

Get an IDVA (Independent Domestic Violence Advocacy)

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6
Q

What does MARAC stand for?

A

Multi agency risk assessment conference

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7
Q

Name 4 determinants of health

A

Genetics
Environment
Lifestyle
Access to healthcare

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8
Q

Define equity

A

What is fair and just

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9
Q

Define horizontal equity

A

Equal treatment for equal need

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10
Q

Define vertical equity

A

Unequal treatment for unequal need

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11
Q

What are the two dimensions of health equity

A

Spatial (geographical)

Social (age. gender/ class/ ethnicity)

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12
Q

What are the 3 domains of public health?

A

Protection- eg. prevent infectious disease
Promotion- eg. Change 4life
Improving services

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13
Q

What 3 levels can a public health intervention be implemented

A

Individual
Community
Population

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14
Q

What are primary, secondary and tertiary intervention

A

Primary: Prevent from getting the disease
Secondary: Detect a disease early and stop it getting worse
Tertiary: Prevent complications of disease

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15
Q

What are the 3 types of health behaviour

A

Health behaviour- prevent disease
Sick role behaviour- aimed at getting better
Illness behaviour- aimed at seeking remedy

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16
Q

What is unrealistic optimism?

A

Practice health damaging behaviour due to inaccurate perceptions of risk and susceptibility eg. smoking and lung cancer

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17
Q

What are the 4 ways that Bradshaw described need?

A

Felt need- individual wants
Expressed need- vocalised need, what services are popular
Normative- Need set by experts eg. vaccination
Comparative- need in one location may be similar to that of others

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18
Q

What is a health needs assessment

A

A systematic method for reviewing health issues facing a population

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19
Q

What is the planning cycle involved in improving healthcare?

A

Needs assessment
planning
implementation
Evaluation

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20
Q

3 approaches to a health needs assessment

A

Epidemiological- look at the population- what’s the problem
Comparative- Compare services in different populations
Corporate- Input of professionals, patients, politicians

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21
Q

Negative of a epidemiological health needs assessment?

A

Lack of data
Poor data quality
Doesn’t include felt need

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22
Q

Negative of a comparative health needs assessment?

A

Lack of data

Difficult to find a comparable population

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23
Q

Negative of a corporate health needs assessment?

A

Vested interests
Political agenda
Can’t distinguish need and demand

24
Q

Levels of Maslow’s hierarchy of need

A 
Physical
Safety
Love and belonging
Esteem
Self acctualisation
25
Q

4 barriers to healthcare

A

Access
Knowledge
Lack of integration of primary care and other services eg. prison
Not a priority

26
Q

What is a refugee

A

A person who has been granted refugee status

27
Q

What rights do refugees have?

A

Same as UK citizens

28
Q

What is family reunion for refugees?

A

1 spouse and any child <18 can come to UK

29
Q

What are asylum seekers entitled to?

A

£35 per week
NHS
Housing
If <18 then school

30
Q

What can’t asylum seekers do?

A

Claim other benefit

Work

31
Q

Methods to counteract loneliness in the elderly

A

Dementia friends

Age UK

32
Q

Give 3 models of behaviour change

A 
Health belief model
Theory of planned behaviour
Transtheoretical model
Social norms theory
Motivational interviewing
Nudging
Financial incentives
33
Q

What 4 things are key to the health belief model of behavioural change?

A

Believe susceptible to disease
The disease has serious consequences
Action reduces susceptibility
The benefits of action outweighs the costs

34
Q

Compare external and internal queues to change

A

Internal: from within eg. feel unwell
External: eg. GP told you to

35
Q

What is the theory of planned behaviour

A

Best predictor of behaviour is intention

Determined by: 
Attitude
Subjective norms
Perceived behavioural control
Self efficacy
36
Q

What makes up the evaluation of health services framework?

A

Structure- what is there eg. no. staff
Process- what is done eg. no. patients seen
Outcome- what is the result eg. 5 D’s- death, disease, disability, discomfort, dissatisfaction

37
Q

What are 6 of Maxwell’s dimensions of quality?

A 
Effectiveness
Efficiency
Equity
Acceptability
Accessibility
Appropriateness
38
Q

What is the prevention paradox?

A

Preventative measure, large benefit to population, small to the individual
eg. wearing seatbelt, statins

Statins: Over 5 years, 100 needs to take them to prevent 1 having a heart attack

39
Q

How does cocaine work?

A

Blocks reuptake of mood enhancing neurotransmitters at the synapse (serotinin, dopamine)

40
Q

3 causes of visual loss?

A

Cataracts, age related macular degeneration (Black spot in middle of image), glaucoma (tunnel vision), diabetic retinopathy (loose spots of vision), hemianopia

41
Q

Give 5 types of medical error

A 
Sloth- didn’t bother
Fixation
Loss of perspective
Communication breakdown
Poor teamwork
Playing the odds- choose common over rare condition
Bravado- working beyond your competence
Ignorance
Lack of skill- not properly trained in role
Mistriage
System error
42
Q

What is intuitive thinking? Give some errors of it

A

Intutive thinking= fast, automatic, no conscious reasoning
Error of over-attachment eg. to a particular diagnosis
Error due to inherited thinking eg. if at back of triage queue they are less important
Failure to consider alternative error- don’t consider other tests
Error in prevalence perception eg. think something is rarer than it is

43
Q

What are heuristics?

A

Cognitive shortcuts

Prone to bias

44
Q

What is dual process theory?

A

Use intuitive + analytical thinking

45
Q

Define epigenetics

A

Non genetic influences on gene expression/ interaction of genes and environment

46
Q

Define allostasis

A

Stablility through change

47
Q

Define allostatic load

A

Accumulation of stresses of everyday life

48
Q

Risk assessment tool for domestic abuse

A

DASH
Domestic Abuse, Stalking, Harassment and Honour based abuse
Standard/medium/high
Qs such as are you frightened

49
Q

Principles of the NHS

A

Free at point of use, meet needs of everyone, based on clinical need not ability to pay

50
Q

3 transition points where interventions are more effective?

A

Leaving school
Entering the workforce
Becoming a parent

51
Q

Why may breast milk prevent obesity/ overfeeding?

A

It contains leptin

52
Q

What is Heinrich’s triangle theory?

A 
Unsafe acts
Near misses
Minor injury
Lost time injury
1 fatality
53
Q

What is lack of candour?

A

Hiding mistakes, altering records

54
Q

What is Medical negligence?

A

Decided by a court case
Doctor is found LIABLE not guilty
Claim for damages eg. money

55
Q

How to decide if there was medical negligence?

A

Was there a duty of care? 
eg. advice given

Was it breached? dereliction (negligence or deviation from the standard of care)
 eg. would a reasonable doctor do the same (Bolam test), would it be reasonable of them to do so? (Bolitho)

Did the patient come to harm? Damages

Did the breach cause harm? >50% chance Direct cause

Phase 3a (2 decks)

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