Clinical Medicine: Prevention
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| Most important determinant of prevention | Continuous evaluation and development of procedures (follow up)
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| Most common causes of morbidity and mortality in the US are | Preventable chronic disease
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| 1 out of the top 10 causes of mortality and morbidity are NOT preventable...which one? | 1) Alzheimers disease
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| The extent of harm of a disease or injury with an individual burden and societal burden | Morbidity
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| T/F: Prevention makes financial sense | True, preventative measures are usually cheaper. There is a price to prevention, so do make sure to compare the cost of prevention with the value of benefit gained.
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| Ideal setting for preventative care? Why? | Primary care! Best patient contact and interviewing/best relationships w/patients
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| T/F: We stratify patients into risk categories to modify or eliminate risk factors | True; Age
Gender
Race
Economic status
Employment
Genetics
Geographic location
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| What is a QALY? | Quality Adjusted Life Year; based on number of years of life that would be added by intervention
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| 3 key steps for prevention in primary care | 1) Know and recognize risk factors in individuals 2) Recognize propensity of population to acquire and observe prevalence in population 3) Interview families to find any additional risk factors
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| Intervention that helps a person who is healthy avoid disease and injury | Primary prevention
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| 1 example of a action to protect against disease and 1 example of preventing injury | Disease: Fluoride in drinking water; Injury: prohibiting texting while driving or mandating seatbelts
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| action which halts progress of a disease at incipient stage and prevents complications | Secondary prevention
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| 2 categories of secondary prevention | 1) Screening to ID risk factors 2) Screening high risk populations to detect disease early
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| all the measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustment to irremediable conditions | Tertiary prevention
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| Next 6 slides: ID Primary, Secondary or Tertiary |
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| Bicycle/ motorcycle helmet laws | primary
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| IV Antibiotics for a person with pneumonia | 3tiary
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| Rx Atorvastatin for a patient w/ a history of MI | 3tiary
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| Screening pregnant women for Rh status during pregnancy | primary Remember: “Is what we are screening for a disorder?” Pregnancy isn’t even though Rh can be a problem.
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| Gait training in a stroke patient | 3tiary
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| Safe sex counseling | primary
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| T/F: Most prevention programs only provide primary prevention. | False; most combined primary and secondary prevention
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| Ongoing operations aimed at reducing 1) incidence 2) duration 3) effects of infection 4) and financial burden of disease | Disease Control
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| Between control and eradication, an intermediate goal has been described, called "regional: | elimination"
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| absolute process, an "all or none" phenomenon, restricted to termination of an infection from the whole world. It implies that disease will no longer occur in a population. | Disease eradication
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| the performance and analysis of routine measurements aimed at detecting changes in the environment or health status of population; examples | Disease monitoring (air pollution, water quality etc)
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| to watch over with great attention, authority and often with suspicion; 3 main objectives | Disease Surveillance; 1) provide info on new/changing trends 2) provide feed-back 3) provide timely warning of PH disasters
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| Studies that may also be carried out to generate information for other purposes | Evaluation of control
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| 3 core componenets of a public health system | 1) Assessment 2) Policy Development 3) Assurance
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| Exposure/factor that may adversely affect health | Hazard (Qualitative)
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| probability that an event will occur or the probability of an unfavorable outcome | Risk (Quantitative)
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| Causes instability, disorder, harm or discomfort to the ecosystem, can take the form of chemical substances or energy such as noise, heat, or light | Pollution
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| 4 sources of environmental disease | 1) water 2) air 3) soil 4) rocks
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| Ex of point source | smokestacks, pipes to waterways
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| Ex of area source | agricultural runoff, automobile exhaust (mobile sources), parking lots
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| Infectious diseases that can be controlled by manipulating the environment are classified as | environmental health concerns
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| Probability of infection is | dose-dependent (higher dose gives higher probability of infx and illness
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| Difference between inapparent (subclinical) infxs and latent infxs | Agent is not shed in latent, is in subclinical
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| The interval between the time of contact and/or entry of the agent and onset of illness (also called the latency period) | Incubation Period
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| Incubation period depends on what 3 things: | 1) Dosage of infectious agent 2) Portal of entry 3) Immune response to host
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| 3 control points of infectious disease | 1) contain/control source (define source, disinfection, vector control, behavior change) 2) Interrupt transmission (hygiene, precautions, expanded precautions, proplylaxis/immunization) 3) Reduce susceptibility of host
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| What do we do with ill infected persons with contagious disease? | Isolation
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| Not ill but believed exposed to infection? | Quarantine
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| Increased risk for individuals not compromised: | Crowded living conditions, medically underserved, risk-takers, poor hygiene
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| What is the "body burden" | content of heavy metals in our bodies
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| Can produce a hazard for decades or hundreds of years. Soluble in fat and likely to accumulate in living tissue. Don't easily break down in environment. | Persistent Organic Pollutants
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| Biomagnification | as food change progresses, concentration of toxin becomes greater.
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| dB that causes hearing loss | 80 dB
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| process of determining potential adverse environmental health effects to people exposed to pollutants and potentially toxic materials | risk assessment
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| 4 steps of risk assessment | 1 Identification of the hazard
2 Dose–response assessment (ex: sound)
3 Exposure assessment
4 Risk characterization
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