Preventive-Medicine-I.pdf

Preventive Medicine I – Quick Sheet Family Health ƒ Nuclear – married man and woman + children ƒ Extended – parents; children; siblings Æ 3 generations o Unilateral – o Bilateral – ƒ Blended – stepparents; stepchildren ƒ Communal – group of individuals formed for societal purposes. ƒ Circumflex Model (Olson) o Cohesion: Disengaged Æ Separated Æ Connected Æ Enmeshed (DSCE) o Adaptability: Rigid Æ Structured Æ Flexible Æ Chaotic (RSFC) ƒ Family Typologies o Resilient Fragile Pliant Bonded Resilient FP BR o Rhythmic Unpatterned Intentional Structuralized Rhythmic UI SR o Regenerative Vulnerable Secure Durable Regenerative VS DR ƒ Family Triangle o Physician – Patient – Family ƒ ETHNIC o E: Explanation o T: Treatment o H: Healers o N: Negotiate o I: (Agree on) Intervention o C: Collaboration ƒ BELIEF o B: Health beliefs o E: Explanation o L: Learn o I: Impact o E: Empathy o F: Feelings ƒ BATHE o B: Background o A: Affect o T: Trouble o H: Handling o E: Empathy ƒ APGAR – rapid screening for family dysfunction (8-10 highly functional; 4-7 moderate; 0-3 severely dysfunctional) o Adaptation o Partnership o Growth o Affection o Resolve ƒ SCREEM o Social interaction o Cultural pride o Religion o Economic stability o Education o Medical Health ƒ Family Health Care Plan – (DPCR) – diagnostic; preventive; curative; rehabilitative ƒ First order change – mastery and adaptation; no change in family structure; “need to do” ƒ Second order change – transformation of individual states and meaning; “need to be”

Epidemiology ƒ Agent – element, substance, or a force; contact with host; serves as a stimulus to initiate or perpetuate a disease. ƒ Reservoir – where infectious agents live and multiply for survival ƒ Passive Immunity – maternal transfer; inoculation of specific protective antibodies; brief duration ƒ Active Immunity – attained immunity o Natural Immunity - attack of the disease w/o clinical manifestations o Artificial Immunity – inoculation; variant form ƒ Latent Immunity – immunity developed due to small doses for a long period of time ƒ Epidemic – excessive frequency ƒ Endemic – constantly occurring ƒ Pandemic – epidemic occurring within more than one country or territory ƒ Sporadic – occasional or infrequent occurrence ƒ Epizootic – occurring in animals ƒ Zoonotic – diseases in animals transmissible to man ƒ Infectivity – ability of an agent to invade and adapt itself to the human host ƒ Pathogenicity – measure of the ability of an agent to set up a local or general tissue reaction ƒ Virulence - measure of the severity of the reaction produced ƒ Contact transmission – touching the infected reservoir ƒ Vehicle transmission – agent is transported by water, food, milk, serum or plasma ƒ Vector transmission – arthropods or other invertebrates bite or deposit infective material (malaria, typhus, filariasis; fly or mosquito) ƒ Airborne transmission – respiratory inhalation (droplet nuclei, dust) ƒ Portal of entry – respiratory tract; mouth; skin; mucous membrane; conjunctiva; placenta ƒ Incubation Period – interval between the time of entry of the agent and onset of signs and symptoms ƒ Clinical Horizon – after incubation period: fever; rash; jaundice; vomiting ƒ Outcome of disease – chronic; carrier; temporary/permanent disability; death ƒ Period of communicability – period during which the patient is infectious ƒ Levels of Prevention o Primary Prevention – immunization ƒ Alters susceptibility ƒ Reduces known risks o Secondary Prevention – early diagnosis; prompt treatment; control of the patient; disability limitation; screening o Tertiary Prevention – rehabilitation ƒ Herd immunity – state of resistance of a group of individuals to the susceptibles in a community ƒ Point epidemic – single exposure (food-borne disease) ƒ Contact epidemic – peak, regular or irregular, in the oscillating occurrence of a disease which is constantly present in a community ƒ Epidemic Curves o Classical – short ascending and climb ƒ rapid transmission ƒ food-borne diseases o Inverted Curve – long ascending, short descending limb ƒ Transmission is more complex ƒ Long incubation period ƒ Malaria, insect-borne disease o Bell-shaped Curve – rapid ascending and rapid descending limb ƒ Spread is rapid; transmission is simple; rapid elimination ƒ Measles; polio

©Mikey

Community Health ƒ 1973-4 – regional initiatives in PHC o Banzon of Region VIII o Barangay Health Auxiliary Volunteers o Roxas of Bukidnon with the Barangay Volunteers Medics ƒ 1978 – Started research and development in PHC with WHO/DANIDA/SIDA ƒ 1981 – nationwide implementation of PHC ƒ 1985 – PHC working in all barangays

ƒ

Population Pyramid – age/sex structure o Expansive – broad base; high proportion of children; rapid rate of population growth o Constructive – narrow base; rapid decline in fertility o Stationary – narrow base; roughly equal numbers in each age group, slow or zero growth ƒ Natural growth – births / deaths ƒ Total growth – births / deaths/ net migration Natality Rates Name Numerator Denominator K CBR # live births Average 1000 Population GFR # live births # women (151000 44 yrs) Morbidity Rates Incidence # new cases # exposed to 1000 risk Prevalence # all cases Population 1000 Attack Rate # ill with # persons at 100 disease event Mortality Rates CDR # total deaths Average 1000 Population Cause# deaths from Average 1000 specific a cause Population Age specific # deaths; all Average 1000 causes; age population of group age group IMR (infant) # deaths