CPHMLS-MMFC (4).pptx

MINDANAO MEDICAL FOUNDATION COLLEGE BACHELOR OF SCIENCE IN MEDICAL TECHNOLOGY / BACHELOR OF SCIENCE IN MEDICAL LABORATORY SCIENCE P. Villanueva St., Agdao, Davao City COMMUNIT Y AND ERICK BERNARD R. JAMELARIN COLLEGE INSTRUCTOR | CLINICAL INSTRUCTOR SUMMER CL...

MINDANAO MEDICAL FOUNDATION COLLEGE BACHELOR OF SCIENCE IN MEDICAL TECHNOLOGY / BACHELOR OF SCIENCE IN MEDICAL LABORATORY SCIENCE P. Villanueva St., Agdao, Davao City COMMUNIT Y AND ERICK BERNARD R. JAMELARIN COLLEGE INSTRUCTOR | CLINICAL INSTRUCTOR SUMMER CLASS - A.Y. 2023 - 2024  UNIT I - FOUNDATIO NS OF  UNIT I - LESSON 1 THE MEDICAL TECHNOLOGIST History of Community and Public Health : During the ROMAN TIMES, it was already implicit that human waste was to be properly disposed of. Around 1000BC, a process called VARIOLATION was practiced by the Chinese, though it was only during the early 1700s that this is documented. In this practice, dried crusts that formed on the lesions of smallpox infected individuals are thought to provide some degree of immunity to the disease when inhaled. During the 14th century, the Miasma theory came about when Black Death in Europe was finally obliterated by burning certain parts of the cities, instead of simply removing the bodies of the dead. History of Community and Public Health : This theory has taught the importance of sanitation in the prevention of diseases. During the 1820s, vaccination became prevalent with the work of Edward Jenner on the treatment of Smallpox. Towards the middle of the 1800s, a milestone was conquered by John Snow for his discovery of the cause of the cholera outbreak in London. Moving onwards with the history of community and public health, the 20th century put more focus on chronic diseases such as CANCER and HEART DISEASE, bringing about the emphasis on Exercise. Notable findings in the said study include of the ff : Cigarette smoking increases the risk of heart disease, Elevated Blood pressure increases the risk of heart disease. History of Community and Public Health : High levels of High Density Lipoprotein (HDL) reduces the risk of heart disease. Here and now, in the 21st century “emerging diseases have become a much larger menace in a world characterized by high mobility and the close interdepence economies” according to Dr. Margaret-Chan, Director General of the World Health Organization in a lecture on April 03, 2007 during her visit at Yong Loo Lin School of Medicine, National University of Singapore. A major concern is that infectious agents could possibly be used as an armament in wars. Indeed bioterrorisms is the scare of the century but we can mitigate and so far we are quite successful in this, by simply being aware of what is going on in the environment and how perilous situations can be prevented. The Role of Medical Technologists in Community and Public Health : Hence, the role of the medical technologist in the primary level of prevention is epidemiological by nature as he/she exerts efforts towards determining such causations. Developments came about during the 19th century like the HDL Level and the serum aldosterone level. These analytes can be determined using clinical laboratory analysis which is the work of the medical technologists.  UNIT I - LESSON 2 GENERAL Three Broad Categories in Studying Community Health : Primary Health Care - refers to intervention that focus on the individual or family such as hand-washing, immunization, circumcision and use of condoms, etc. Secondary Health Care - refers to those activities which focus on the environment such as draining puddles af water near the houses, cleaning bushes and spraying insecticides to control vectors like mosquitos. Tertiary Health Care - refers to those interventions that take place in a hospital settings such as intravenous rehydration and surgery. Health Care Access Pyramid : It is a model that is being used widely in health care planning among government and non government agencies worldwide. It illustrates the position of the health care services in the pyramid. Special needs are addressed at the higher level but the proportion of these patients with special needs referred at this level is lesser as shown in the pyramid. Diffucult cases are fewer and these are the ones referred to the third higher level of the pyramid. Developing a Community Road Map to Health : Community Action and Innovation : It requires a systematic process of determining specific problems of the community through community health assessment, planning for the community based on the identified problems, implementing the projects as planned and evaluating the impact of each other. Community Based Participatory Research (CBPC) is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strenghts that each brings. Developing a Community Road Map to Health : Centralization vs. Decentralization : CENTRALIZATION DECENTRALIZATION More Hierarchical Levels Lesser Hierarchical levels Those at the bottom have little Those at the bottom are or no power for decision empowered to make decisions making Those at the bottom have no Those at the bottom have or little accountability more accountabilities Example : Funds for health Funds for health care services care services come from the come from the local national government government Ethics of Community Health : In going to communities, the community health worker or educator is not immune to ethical concerns by virtue of their job. It must be remembered that certain restrictions in asking questions or even in doing observations are inevitable. One must be careful to respect the rights of individuals as the goal of the community and public health is to be attained though community health research and the promotion of health through health education programs. Ethical Concerns regarding Community Health Research : Underlying ethical principle behind research remains to be its basic form : The principle of beneficence, non-maleficience, utilitarianism and autonomy. We do not do Community research just for the sake of doing it. It is supposed to be benefit not just to the researcher but the ultimate goal is to promote community health for the benefit of the public. Finally, the importance of informed consent must not be understated. Ethics of Health Promotion and Disease Prevention : Aside from the Responsible Parenthood and Reproductive Health Act of 2012 (Republic Act 10354) of the Phils. the following cases given by Bayer (N.d.) may prove useful for reflections: 1. Health Communication Campaigns and the Censorship of Advertising - Using the case of tobacco highlights the tension between robust conceptions of freedom of expressions and the claims that the protection of the public health requires bans or restrictions on advertising that may stimulate the consumption of tobacco products. 2. Taxes, Consumption and the Public Health - Increasing taxes on cigarettes to limited consumption highlights the tension between the claims that individuals have a right to purchase products that give them pleasure even if they produce illness and the public health claim that there is no obligations to inhibit behaviors that can predictably be the cause of morbidity and mortality. Ethics of Health Promotion and Disease Prevention : Aside from the Responsible Parenthood and Reprodcutive Health Act of 2012 (Republic Act 10354) of the Phils. the following cases given by Bayer (N.d.) may prove useful for reflections: 3. Mandatory Motorcycle Helmet Laws - This case places into bold relief the assertion that the protection of the public health, as represented in decreases in morbidity and mortality, may justify the imposition of outright prohibitions designed to protect individuals from their foolish choices, choices that incidentally may be produce burdens on society.  UNIT II - THE HOST  UNIT II - LESSON 3 MODELS OF Human Biology : includes all those aspects of health, both physical and mental, which are developed within human body as a consequence of the basic biology of man and the organic make up of the individual. Processes of maturation and aging. Complex internal system in the body. Contibutes to all kinds of ill health and mortality, including many chronic diseases (Arthritis, Diabetes, Atherosclerosis, Cancer) and others (Genetic Disorders, Congenital malformation and mental retardation). Environment : Includes all those material related to health which are external to the human body and over which the individual has little or no control. Foods, drugs, cosmetics, devices, water supply, etc. Control of health hazards of air, water and noise pollution. Prevention of the spread of communicable diseases. Effective garbage and sewage disposal. Lifestyle : Consists of the aggregation of decisions by individuals which affect their health and over which they more or less have control. Health Care Organization : Generally defined as the Health Care System. It includes medical practice, nursing, hospitals, medical drugs, public and community health care services, ambulances, dental treatment and other treatment such as optometry, chiropractics. A Model of Health and the Community Eco-System : It is just one of the ecological models of health that addresses the effect of environment on community health. The health and community eco-system model proposes that the community must be : 1. Convivial (Have social support networks) 2. Livable (provide a viable human environment) 3. Equitable (Treat all with fairness and justice) The Iceberg Theory of Disease : This theory explains that in studing the nature and history of diseases. What is usually seen and consideres by the health care providers is just the tip of the iceberg which represent only a small portion of the entire problem or disease. The Epidemiological Triad of Disease : Talks about the factors associated with increased risk of human disease. The factors are categorized as the host, the agents and the environment. The host pertains to the intrinsic factors in the human host such as his/her age, gender, ethnicity, religion, occupation, marital status, family background, and previous diseases. Environment refers to the extrinsic factors which include temperature, humidity, altitude, housing , neighborhood, water, milk , radiation, air pollution and noise. The agents refers to biological (bacteria, fungi, protozoans, etc.), chemicals (poison, alcohol,smoke) physical (auto, radiations, fire) or nutrition (lack or excess) factors.  UNIT II - LESSON 4 HUMAN An Ecological Perspective of Human Health and Disease : The term ecology originated from the term OIKIOS which means HOME and LOGUS which means TO REASON or TO STUDY. Ecology refers to the study of the relationship between organisms, relationship with each other and with their environment. Such alterations include global climate change, stratospheric ozone depletion , pervasive land use changes, toxification of the biosphere, infectious disease, invasion of alien species and loss of biodiversity and numerous interactions. Demographic Variables : Population Size - the number of individuals that make up the gene pool ; increases through births and immigrations ; decreases through deaths and emigrations. Population Density - the number of individuals per unit per area or per unit volume. Population Distribution - refers to the general pattern of dispersion through the habitat. Other Demographic factors : Age structure - characterizes the population according to the number of individuals in each of several age categories. The age structure is an important factor to consider in profiling communities. Sex Ratio - characterizes the population according to the number of males compared to the number of females. This ratio may also provide valuable insights on the communities needs. Lifestyle - refers to the set of attitudes, habits or possessions associated with a particular group or person. An unhealthy lifestyle through not involving infectious agents could be passed on to the other members of a community, from parents to children or from neighboor to youth, from one person to another due to peer pressure. Nature of Growth : Exponential Growth - represents a doubling of the population in specified time ; occurs in populations when circumstances of abundance for resources arise or when an important constraint has been removed. - This type of growth can be visualized as a J-Shaped growth factor. Biotic Potential - Suppose members of a population have plenty of food, living space and other resources. - This can be represented as an S-Shaped growth curve. There are limits to population growth such as food, micronutrients , refuge from predators, living space, and pollution free environment. Epidemiologic Terms : Endemic - when an infectious disease is habitually present in an environment. (either a group or population) Epidemic - refers to the occurence in a community or a region of cases of an illness, specific health related behavior or other health related events clearly in excess of normal expectancy. Pandemic - is an epidemic occuring worldwide or over a very wide area, crossing international boundaries, and usually affecting large number of people. Epidemiologic Measures and Measures of Disease Occurence : Counts - refers to the number of cases of a disease or other health phenomenon being studied. Incident - refers to the occurence of a new disease or mortality within a defined period of observation. Prevalence - refers to the number of existing cases of a disease or health condition or deaths in a population at some designated time. Crude rate - is a type of rate that has not been modified to take account of any of the factors such as demographic makeup of the population that may affect the observed rate. Epidemiologic Measures and Measures of Disease Occurence : Case Fatality Rate - refers to the number of deaths due to a disease that occur among persons who are afflicted with that disease. Cause Specific Rate - measures that refers to mortality divided by the population size at the midpoint of a time period times a multiplier. Life Expectancy - refers to the numbers of years that a person is expected to live at any particular year. Infant Mortality Rate - numbers of infant deaths among infant aged 0 - 365 days during a year divided by the number of live births during the same year. Fetal Mortality - defined as a death of the fetus when it is in the uterus and before it has been delivered. Crude Birth Rate - refers to the number of live births during a specific period such as year per the resident population at the midpoint of the year.  UNIT II - LESSON 5 HUMAN Health Education : Health education is the most important tool in public health. According to Debnath (2006) “in the end, public health is just health education and every community health worker is a health educator.” Health Education can be accomplished in three levels:  Individual Level, the approach is more specific to the needs of an individual like counselling.  Small Group, one might need to be more creative in order to catch the attention of the target audience.  The most difficult to address is the public / mass level.  UNIT III - THE AGENT  UNIT III - LESSON 6 NATURE OF Nature of Infectious and Non Infectious Diseases : Infectious Diseases - refers to diseases whereby a specific pathogen is associated with its occurence, known as a causative agent. Non Infectious Diseases - are diseases in which no specific pathogen can be attributed to it. Communicable Disease - is one that can be transmitted from one person to another. Contagious Disease - is one that can easily be transmitted from one person to the other. Infectious Disease : Respiratory Disease - Disease of the respiratory system can be divided into Upper Respiratory Tract (URT) and Lower Respiratory Tract (LRT) Infections.  Pneumonia - refers to the inflammation of the bronchial linings and the lungs. Alvine Discharge Diseases - The contents of the stools are called the alvine discharge. Viral Hepatitis - Inflammation of the liver brought about by infection with any of the hepatitis viruses. Infectious Disease : Vector Borne Disease -requires an intermediate, the vector, in the transfer of infectious agent from one person to the other. Mechanical vectors merely picked up the parasite from point A and drop it off at point B whereas a Biological vector is an arthropod in whose body the pathogen multiplies or matures before viable stage of the infectious agent is transferred. Open lesion Disease - The skin is our first line of defense. Many disease causing agents are unable to penetrate the skin. It become a very accesible portal of entry when there is a cut or lesion. Infectious Disease : Sexually Transmitted Diseases - formerly called as Venereal Disease include any of the infectious transmitted via sexual activities. Non Infectious Disease : Lifestyle Diseases - are generally chronic, non communicable diseases. However when health is viewed from the multi sectoral approach, even lifestyle disease can become communicable as individuals directly or indirectly by their environment like the social structure and the physical environment. Genetic Diseases - as term would imply genetic diseases are diseases that are caused by a malfunction or a defect in the DNA sequence. The defect could affect both somatic and reproductive cells.  UNIT III - LESSON 7 PREVENTION AND CONTROL  BIOLOGICAL HAZARDS - Expotentially harmful microorganisms. ex. Biologic (Infectious Agents), Sharps, Chemical, Radioactive, Electrical, Fire/Explosives and Physical. CHAIN OF INFECTION : - Transmission of Microorganisms. - Essential in Preventing the Spread if Infection. - Requires a continuous link between : SOURCE MODE OF TRANSMISSION SUSCEPTIBLE HOST Note : “ When Hands are VISIBLY SOILED wash hands with SOAP AND WATER. However, if Hands are NOT VISIBLY SOILED, apply Alcohol Based Hand Rub (Ex. Sanitizer). “ HANDWASHING PROCEDURE : 1. Wet hands with warm water. 2. Apply antimicrobial soap. 3. Rub to form a Lather, create FRICTION and loosen debris. 4. Thoroughly clean between fingers, including thumbs, under fingernails and rings and up to the wrist for atleast 15-20 SECONDS. 5. Rinse hands in a DOWNWARD position. 6. Dry with a Paper towel. 7. Turn off faucets with a clean paper towel to prevent RECONTAMINATION. 8. Don’t forget the Handwashing Song in a 2x Manner. Sharp Hazard : - Sharp Objects like Needles, Lancets and Broken Glasses. - Disposed of in PRC “Punctured Proof (Resistant) Container.” Chemical Hazard : CHEMICAL SPILLS - Best first Aid : Flush the Area with amounts of water for atleast 15 minutes then seek medical attention. - DO NOT EVER NEUTRALIZE CHEMICALS that come in contact with the Skin. If the Chemical is spilled on the floor then NEUTRALIZE it with a Base Solution (ex. Sodium Hydroxide, Calcium Carbonate and Potassium Oxide). CHEMICAL HANDLING - ALWAYS Add Acid to Water  To Avoid Sudden Splashing  and Explosion can occur if water is added to acid FIRE HAZARD : TYPES OF FIRE AND FIRE EXTINGUISHER Fire Type Type of Hazard Type of Extinguisher A Ordinary Combustibles : papers,cloths, rubbish, Water, Dry Chemical, Loaded Steam plastic, wood B Flammable Liquids : Grease, Gasoline, Paints and Dry Chemical, Carbon Dioxide, Halon Foam Oil C Electrical Equipment and motor switches Dry Chemical, Carbon Dioxide, Halon Foam D Flammable Metals : Mercury, Magnesium, Sodium Metal X, Sand : Fought by fire fighers only and Lithium E Detonation (Arsenal Fire) Allowed to burn out and nearby materals protected K Cooking Media : Grease, oil, Fats Liquid designed to prevent splashing and cool the fire Water (A) | Dry Chemicals (ABC) | Carbon Dioxide (BC) | Halon (BC) Breaking the Chain of Infection : ELEMENTS IN THE CHAIN OF INFECTION POSSIBLE WAYS OF BREAKING THE CHAIN OF INFECTION Rapid and Accurate Diagnosis Infectious Agent Environmental Sanitation ; Disinfection and Reservoir Sanitation ; Institutional Wellness programs Portal of Exit PPE ; Handwashing, Proper waste disposal Handwashing, Isolation, Air flow control, Proper food Mode of Transmission handling Portal of Entry Handwashing, Aseptic technique, Proper Wound care Immunization, Early Identification of those at risk; Susceptible Host Proper treatment and management of cases Measuring Progress: Control, Elimination and Eradication The World Health Organization porvides the following definitions in measuring the progress as to the prevention and control of diseases: Control : ongoing operations or programs aimed to reducing the incident and / or prevalence of that disease. Elimination : reduction of case transmission to a predetermined very low level. Eradication : achieving a status where no further cases of that disease occur anywhere and where continued control measures are unnecessary.  UNIT IV - THE ENVIRONME  UNIT III - LESSON 8 COMMUNITY Sources of Water : There are many sources of water which nature has provided. These water sources may be tapped but care must be taken to ensure the safety of its users. Secondly, communities must also consider the sustainability of these resources.  Protected Springs - where underground water flows to the surface. Springs can make very good water supplies provided that they are protected againts contamination.  Dug wells - are usually shallow well dug by hand, although some may be quite deep and they are often lined with bricks.  Boreholes - are narrow holes drilled into the ground that tap into groundwater.  Piped Water Supply - are often small and rely on community management and many use untreated groundwater sources.  Rainwater harvesting - is usually collected by households for their own use. If the rainwater is to be used for drinking it is better to collect it from a roof rather than from a ground catchment where it may become contaminated. Sources of Water :  Ponds, Lakes and water treatment - traditionally been used as sources of drinking water. However, domestic water drawn from ponds and lakes must always be treated before consumption. Quality of Water : The microbial and chemical quality of water must be regularly checked to ensure safe water supplies. The principal method of assessing the microbial quality of water is to test for bacteria whose presence indicates that faeces may be in water. Water is of good quality when it is free from pathogenic organisms and unwanted chemicals. An analysis of water quality usually also includes sanitary inspection. This is visual assessment of the water supply using standard forms to record information to see whether faecal pollution exists and whether such pollution could reach the water source. (Howard, 2000) Regulation of Water Supplies : In the Philippines, though it is true that we are surrrounded by bodies of water, many filipinos have felt the impinging effect of water shortage. Republic Act No. 9275, otherwise known as as the Philippine Clean water act of 2004 has been promulgated. It provides for a comprehensive and integrated strategy to prevent and minimize pollution through multi-sectoral and participatory approach involving all stakeholders.  Preventing Over-Pumping of ground water - Sinking too many tube wells for irrigation may cause serious depletion of water held underground and even cause water sources to dry up. Community members must therefore be actively involved in evaluating the risks.  Water conservation - Most piped water systems leak and need to be checked regularly and repaired as soon as faults are discovered. Taps should be turned off immediately after use and children should be discourage from playing with taps. Regulation of Water Supplies :  Managing Water for Agriculture - The introduction or expansion of irrigated agriculture will cause important changes in the local hydrology, land use patterns and ecology. Such changes may introduce new health risks into the area.  UNIT III - LESSON 9 COMMUNITY WASTE : IT’S Waste Classification : The beginning of proper waste management can only be achieve if waste is appropriately identified to determine the most effective an efficient means of managing them. For simplicity, Engr. Fangonon, the patent holder of the Eco- Composting Receptacle (ECR) suggests simply classifying community waste as Biodegradable (nabubulok) or Non-Biodegradable (Di-nabubulok). Biodegradable waste can simply be disposed in an eco-composting receptacle Non-biodegrable waste can be cleaned , stored in a materials recycling facility and processed or recycled or sold to recycling companis or agencies. A provision under the Republic Act No. 9003 is the putting up a materials recycling facility (MRF) for a every distinct where recyclables are temporarily stored before a recycling agency collects them. Excreta and Sewage Disposal : Human excreta are carriers of disease agents. Hence, Its proper disposal is a necessity in order to prevent the spread of disease in communities.  Cartage - basic form of excreta disposal - faeces are collected in a container and disposed of daily.  Pit Latrine Systems - Faecal matter is stored in a pit and left to decomposed.  Septic Tank - form of an onsite sanitation that provides the convenience of a sewerage system. It is usually linked to flush toilets and can received domestic wastewater.  Aquaprivy - similar to septic tank ; it can be connected to flush toilets and take most household wastewater. Consists of a large tank with a water seal formed by a simple down pipe into the tank to prevent odor and fly problems.  Sewerage Systems - are designed to collect excreta and domestic wastewater and transport them away from homes into a treatment and/or disposal point. Solid Waste Management and Chemical Safety : In the Philippines provisions on solid waste management is embodied under Republic Act 9003 otherwise known as “Ecological Solid Waste Management Act of 2000”. Refers to the systematic administration of activities which provide for segregation at source, segregated transportation, storage, transfer, processing, treatment and disposal of solid waste and all other waste management activities which do not harm the environment. Health care wastes are not only the hospital or clinic concern. Even households may produce health care wastes such as bandages and these are classified as Special waste.  UNIT III - LESSON 10 COMMUNITY Principles of Healthful housing : Given that health is approached in a multi-sectoral way, healthful housing covers severe needs. Selected suggestions from the CDC Housing Reference Manual which may be applicable in the Philippines are listed here :  Physiological needs : Protection from the elements.  Psychologic needs : adequate privacy of the individuals.  Protection againts Disease : Provide a safe and sanitary water supply.  Protection againts injury : Provide minimum standards for the protection of life, property, environment and the safety and welfare of the consumer, general public and the owners and occupants of residential buildings.  Protection againts fire : using only the fuel designated by the manufacturer of the appliance. Building Regulation : Housing codes are distinguished from building codes in that they cover houses, not buildings in general. In the Philippines PD 1096, the Revised National Building Code (Republic Act No. 6541) stipulate requirements for housing and building.  The provisions of this code shall apply to the design, location, sitting, construction, alteration, repair, conversion, use, occupancy, maintenance, moving, demolition and etc. Occupational Health : refers to the health and wellbeing of the workers in a given work environment. It is concerned with the prevention of illnesses, injuries, accidents and fatalities in a work setting. The Occupational Safety and Health Center (OSHC) of the Philippines, which is under the Department of Labor and Employment was created under the Executive Order 307 on November 1987. The OSHC has a dual mandate of protecting Filipino Workers againts accidents and illnesses and promoting workers welfare through effective programs that enchance productivity, workers well-being and afford social protection to its Client sector. Occupational Health : Epidemiology of Occupational Illness / Occupational Hazard - The epidemiology of occupational illnesses or occupational hazards mainly aims to identify work place illness and hazards in order to prevent these. Some diseases are associated with certain jobs. Hazard Prevention and Occupational Health Promotion - The OSHC has provided the Occupational Safety and Health standards in the Philippines “ to protect every workingman against the dangers / injury, sickness and death through safe and healthful working conditions, thereby assuring the conservation of valuable manpower resources and the prevention of loss or damage to lives and properties. Recreation and Health : Hazard of Smoking in Public Places - The effects of smoking on health cannot be understated. It is not just the smoker’s health that is compromised but it has been proven that the effect could be worse for secondary smoking or those who do not smoke but are in contact with smokers. A Myriad of diseases associated with Republic Act 9211 or the “Tobacco Regulation Act of 2003” was instituted in the Philippines for a Balanced policy whereby the use, sale, and advertisement of tobacco products shall be regulated in order to promote healthful environment and protect the citizens from the hazards of tobacco smoke. Recreation and Health : Hazard in Swimming Areas and other Recreational Facilities - Certain hazards may be associated with recreational facilities like nausea, vomiting, physical injuries, microbial infections and chemical poisoning. Hazards identified by the WHO in recreational waters facilities included :  Drowing - Death arising from impairment of respiratory functions as a result of immersion in liquid, is a major cause death worldwide.  Microbial Hazard - The risk of illnesses or infections associated with swimming pools and similar recreational water environments is primarily associated with faecal contamination of the water. Swimming pool-related outbreaks of illnesses are relatively infrequent, but have been linked to viruses, bacteria, protozoa and fungi.  Chemical Hazard - Chemicals found in swimming pool water can be derived from a number of sources, namely the source water, deliberate additions such as disinfectants and pool users themselves (these include sweat, urine, soap residues, cosmetics.)  Three main route of Exposure to chemicals in swimming pools and similar environment : 1. Direct ingestion of Water 2. Inhalation of volatile or aerosolized solutes 3. Dermal contact and absoprtion through the skin. Air Quality and Air Pollution Control : Air normally consists of  78.09 % Nitrogen  20.94 % Oxygen  0.93 % Inert Gases  0.02 % Carbon Dioxide Air quality is affected by an imbalance of these components. Air pollution results from the “ Physical and Chemical alterations of the properties of air which is harmful to human health, vegetation and animals (Lee and Anes, 2010). Common Air Pollutants :  Carbon Dioxide and Carbon Monoxide (CDCM) - Carbon Oxides  Sulfur Dioxide and Sulfur Trioxide (SDST) - Sulfur Oxides  Nitric Oxide and Nitrogen Oxide (NONO) - Nitrogen Oxides  Butane, Ethylene, Formaldehyde and Chloroform (BEFC) - Volatile Organic Compounds  Dust, Asbestos, Lead, Chromium and Arsenic (DALCA) - Suspended Particulate Matter Based on the 2006 Natl. Emission Inventory, the transport sector is the major source of air pollution in many regions of the Country “ The Philippines. “  The Clean Air Act of 1999 (Republic Act 8749) Radiation Pollution : Radiation pollution refer to the increase in the natural radiation levels due to human activities. Radiation exposure comes from severe sources such as isotope therapy, X-ray diagnosis and therapy, Fallout from testing of nuclear weapons, radiation pollution from nuclear reactors and radioactive substances and wastes. Other forms of radiation can be form home lighting system, cellular phones, microwave and radiowave, etc. High energy radiation like gamma rays is the one that could actually lead to diseases like cancer. Ionizing radiation is radiation with enough energy so that during an interaction with an atom, it can remove tightly bound electrons from the orbit of an atom, it can remove tightly bound electrons from the orbit of an atom, causing the atom to become charged or ionized. (World Health Organization (WHO), 2012) Article 2 Section 33 of Republic Act 8749 or the Clean Air Act of 1999. Noise Pollution and Control : is a new kind of pollution which consists of pressure waves that travel through the air and are perceived as unwanted or unpleasant, irritating sounds beyond the tolerance of Human Ear. (Lee and Anes, 2000) The effects of noise pollution can be mild such as inability to appreciate conversations and other forms of interactions or serious such as the permanent loss of hearing or hearing disability. Control and Prevention of noise pollution is promulgated under the Chapter XX Section 87.d of the Sanitation Code of the Philippines (PD 856)  UNIT III - LESSON 11 NATIONAL AND Department of Health (DOH) : Holds the overall technical authority on health as it is a national health policy maker and regulatory institution. Basically, DOH has 3 Major roles in the health sector : 1. Leadership in Health 2. Enabler and Capacity Builder 3. Administrator of Specific services Aside from being the regulator of all health services and products, the DOH is the provider of all special tertiary health care services and technical assistance to health providers and stakeholders. World Health Organization (WHO) : Is the directing and coordinating authority for health within the United Nations Systems. It is responsible for providing leadership on global health matters, shaping the health research agenda, settings norms and standards, articulating evidence-based policy options, providing technical support to countries and monitoring and assessing health trends. WHO’s constitution came into force on April 07, 1948 - date we now celebrate every year as World Health Day. Center for Disease Control and Prevention (CDC) : On July 01, 1946. The Communicable Disease Control (CDC) came into being on one floor of a small building in Atlanta, Georgia CDC works with state and other partners to provide a system of health surveillance to monitor and prevent disease outbreaks (Including Bioterrorisms), Implement disease prevention strategies and maintaine national health statistics. Implementing measures to decrease leading causes of death, strengthening surveillance and epidemiology and reforming health policies. ADDITIONA L NOTES FOR Abraham Maslow’s Hierarchy of Needs : A need is somethng that is essential to the emotional and physiological health and survival of humans. All humans strive to meet basic needs ; at any given time an individual’s need may be met, partially met or unmet. Maslow arranges basic human needs in hierarchy, in which certain needs are more basic than others. Although all the needs are present, the individual stives to meet certain of the need at least to the minimal level before attending to the others. The 5 (Five) level of basic needs are : 1. Self-actualization Needs 2. Self-Esteem Needs 3. Love and Belonging Needs 4. Safety and Security Needs 5. Physiologic Needs Abraham Maslow’s Hierarchy of Needs : Physiologic Needs - are physical needs inherent in all human beings ; among them are the needs : Physiologic Needs are sometimes referred to as basic Needs. Below the level of subsistence, DEATH occurs. Safety Needs - Safety is both physiologic and psychologic. We need not only a safe physical environment, a shelter but the feeling of psycological safety. To feel safe we need regular contact with people we trust and feel close to. Love and Belonging Needs - The security we gain from love and belonging enhances the feeling of safety. Our feeling of structure and security is reinforced when we know where we stand in relation to others, and who we are to them. We all need mutually meaningful relationships with other people. Abraham Maslow’s Hierarchy of Needs : Self-Esteem Needs - is derived largely from the feeling that we are valued by those around us. We feel good about ourselves when the people who are important to us express acceptance and approval. Both personal and professional and that others hold one in high regard. Self-Actualization Needs - The need to reach one’s potential through development of one’s unique capabilities. In general, each lower level of need must be met in some degrees before this need can be satisfied. The process of self actualization is one that continues throughout life. Human Rights : Civil and Political Rights : 1. Right to equal protection of the Law. 2. Right to the presumption of innocence until guilt has been proven. 3. Right to freedom of opinion and expression. 4. Right to nationality. 5. Right to equal access to public service in one’s country. Economic, Social and Cultural Rights : 1. Right to work and free choice of employment. 2. Right to equal pay for equal work. 3. Right to rest and leisure. 4. Right to standard living adequate for health and well-being. Levels of Prevention : Primary Prevention - Providing specific protection against diseases to prevent its occurence is the most desirable form of prevention. Primary preventive efforts spare the clients cost, discomfort and the threat to the quality of life. Preventive measures consists of counselling, education and adoption of specific health practices or changes in life style. Example : Mandatory immunization of children belonging to the age range of 0-59 months old to control acute infectious diseases. Secondary Prevention - It consists if organized, direct screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability. Example : Screening programs for hypertension, diabetes, uterine cancer (Pap smear), breast cancer (examination and mammography), glaucoma and sexually transmitted diseases. Levels of Prevention : Tertiary Prevention - It begins early in the period of recovery from illness and consists of such activities as consistent and appropriate administration of medications to optimize therapeutic effects, moving and positioning and prevent complications of immobility and passive and active exercise to prevent disability. (Pender, 1987) The National Health Situation : Positive Aspects : 1. The Filipino nation is healthier today than in the 1960’s. 2. Life expectancy at birth has risen from 57 years in 1960 to 65 years in 1990. 3. Certain diseases like polio and neonatal tetanus are nearing eradication due to wider coverage of immunization programs. 4. Heightened awareness of families and communities on health and disease prevention. 5. Maternal mortality rate has constantly decreased over tthe years. 6. Use of herbal medicine is slowly gaining ground and herbal. Processing plants have been operational in selected regions. 7. Increasing access to safe water supply and sanitary toilet facilities. 8. Fast growing number of health facilities and initiatives to solve inequitable distribution of health facilities and human resources. The National Health Situation : Negative Aspects : 1. Still, a fast growing population. 2. Death related to pregnancy and childbirth remains to be a leading cause of female deaths in the country. 3. Continued high levels of malnutrition especially among female children. 4. Malaria, Schistosomiasis and goiter persists to be highly endemic in selected areas. 5. The incident of HIV infection and AIDS is slowly multiplying , affecting not only males and females of reproductive age but also infants and children. 6. Poor environmental sanitation and new threats from environmental degredation. 7. Low coverage and support level existing compulsory national health insurance systems. 8. Rising and Prohibitive cost of drugs and hospitalization limiting to access of marginalized families to quality and affordable health care. Ten leading causes of MORBIDITY : - Philippines (1991) 1. Diarrheal Diseases 2. Bronchitis 3. Influenza 4. Pneumonia 5. Tuberculosis 6. Accidents 7. Diseases of the Heart 8. Malaria 9. Varicella 10. Measles Ten leading causes of MORTALITY: - Philippines (1991) 1. Diseases of the Heart 2. Pneumonia 3. Diseases of the Vascular System 4. Tuberculosis 5. Malignant Neoplasms 6. Accidents 7. Septicemia 8. Diarrheal Diseases 9. Nephritis, Nephrosis and Nephrotic Syndrome 10. Respiratory Conditions of Fetus and Newborn. Five leading causes of MATERNAL MORTALITY: - Philippines (1991) 1. Postpartum Hemorrhage 2. Hypertension complicating pregnancy, childbirth and puerperium. 3. Normal delivery and other complications related to pregnancy occuring during labor, delivery and puerperium. 4. Pregnancy with abortive outcome. 5. Hemorrhage related to pregnancy. FINAL COVER Concept of a Family : The FAMILY is the basic unit of society. Families exist in all sizes and configuration and are essential to the whole. The role of the family is to meet the needs of society (Taylor, et al, 1989) The family is a unity of interacting persons related by ties of marriage, birth and adoption, whole central purpose is to create and maintain a common culture which promotes the physical, mental, emotional and social development of each of it’s members. (Duval, 1971) The family provides a set of functions important to the needs of the individual members and to society as a whole. The following are the 4 (four) functions of the family : 1. Physical Function - is carried out by providing a safe, comfortable environment necessary to growth, development and rest. 2. Economic Function - provide financial aid for members as well as meeting monetary needs of society. 3. Reproductive Function - It is met by the birth of children. 4. Socialization Function - This is of major importance and includes teaching, transmitting beliefs, values, attitudes and coping mechanisms, providing feedbacks and guiding problem solving. Family Structure :  Traditional Family : composed of a father, mother and their children. These people, married and living together in one house make up the nuclear family. Relatives such as aunt, uncles, cousins and grandparents. This family group usually live in close geographic proximity to members of the extended family, who provided a sense of stability and belonging.  Single-Parent Families : Single parents may be never married, separated, divorced or widowed. Most often, the single parent is divorces or widowed, but increasing numbers or never married men and women are choosing to become parents.  Alternate Family Structure : A. Cohabitating Families ; It includes those individuals who choose to live together for a variety of reasons ; relationships, financial needs and changing values. B. Although the single person is not living with others, he or she is a part of a family of origin. Majority of single adults living adult who has achieved independence and enters the work force and the elderly person, left alone through death of a spouse. Definition of Terms :  Health - state the complete physical, mental and social well being and not merely the absence of disease. (World Health Organization, 1947)  Wellness - An integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable. It requires that the individual maintain a continuum of balance and purposeful direction within the environment where he is functioning. (Halbert Dunn).  Illness - Is a state in which someone’s need are not sufficiently met to allow the individuals to have a sense of physical and psycho-social well being. Major Strategies of Primary Health Care : A. Elevating Health to a Comprehensive and Sustained National Effort - Empowerment of parents, families and communities to make decisions on their health is really a desired outcome. Advocacy must be directed to national and local policy makes to elicit support and commitment to major health concerns through legislations, budgeting and logistical considerations. B. Promoting and Supporting Community-Managed Health Care - The Department of Health (DOH) in promoting community managed care as a cornerstone to health , must manifest support to community organizing and organizations, established sustainable mechanisms for community-managed financial schemes and identify and develop indigenous heallth resources. C. Increasing Efficiencies in the Health Sector - Using appropriate technology will make the services and the resources required for their delivery effective, affordable, accesible and culturally acceptable. The DOH will continue to provide support and assitance to both public and private institutions particularly in faculty development, enhancement of relevant curricula and development of standard teaching materials. Major Strategies of Primary Health Care : D. Advancing Essential National Research - is an integrated strategy for organizing and managing research during intersectoral, multi disciplinary and scientific approach to health programming and delivery. Primary Health Care : E-L-E-M-E-N-T-S E - Education for Health : Health Education is one of the potent methodology for information dissemination. It is a means of improving the health of people by employing various method of scientific procedures to show the most healthful ways of living. (National League of Government Nurses, Inc., 1995) L - Locally Endemic Disease Control : The control for locally endemic diseases focuses on the prevention of the occurence of this diseases. Endemic diseases may have a low morbidity rate since it is continuosly present in the community. Example : Malaria Control E - Expanded Program on Immunization : This program exist in control the occurence of preventable illnesses especially of children. Immunizations on Poliomyelitis, measles, tetanus, diptheria and other deadly but preventable diseases are given for free by the government and an on going program of the DOH. Primary Health Care : E-L-E-M-E-N-T-S M - Maternal and Child Health : The mother and the child are the most delicate members of the community. Therefore, the maternal and infant mortality and morbidity rates are among the indicators of health of a particular community, so the protection of the mother and child to illnesses and other risks would ensure a good health for the community. E - Essential Drugs : This focuses on the information campaign on the proper utilization and acquisition of the drugs. In response to this campaign, The Generic Act of 1988 of the Philippines (Republic Act No. 6675). N - Nutrition : One of the basic needs of a family is food. And if food is properly prepared then one may be assured of a healthy family. There are many food resources found in our communities, but because of faulty preparation and lack of knowledge regarding proper food planning, malnutrition is one of the problems that we have in the country. Primary Health Care : E-L-E-M-E-N-T-S T - Treatment of Communicable Diseases : The disease spread by direct contact pose to a great risk to those who can be infected. Tuberculosis, which is one of the communicable diseases, continuously occupies the top ten causes of death. Most communicable diseases that affects the country are also preventable. Thus, the government focus on the prevention, control and treatment of this illnesses. S - Safe Water and Sanitation : Environmental Sanitation is still a health problem in the country. Water is the basic need for life and one of the factors in man’s environment. In our daily activities. Safe water and sanitation is necessary for the basic promotion of health. Communication : - The process of sharing information of the process of generating and transmitting meanings. Social interactions among people are necessary to fulfill some of their most elemental psychosocial needs such as love, affection and recognition. Elements of the Communication Process : 1. Referent - motivates a person to communicate with another. It may be an object, emotion, idea or act. 2. Sender - also called the encoder, is the person who initiates the interpersonal communication or message. 3. Message - is the information that is sent or expressed by the sender. 4. Channels - are means of conveying messages such as through visual, auditory and tactille senses. 5. Receiver - also called the decoder, is the person to whom the message is sent. 6. Feedback - helps to reveal whether the meaning of the message is received. Communication : Modes of Communication : 1. Verbal Communication - involves spoken or written words. Words are tools or symbols used to express ideas or feelings, arouse emotional responses or describe objects, observations, memories and interferences. 2. Non-Verbal Communication - is transmission of messages without the use of words. We continuosly communicate non-verbally in every face-to-face encounter. Gestures impart meanings that are more powerful than words.