CPHMLS-MMFC.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.