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Clinical Medicine: Prevention

Most important determinant of prevention Continuous evaluation and development of procedures (follow up)
Most common causes of morbidity and mortality in the US are Preventable chronic disease
1 out of the top 10 causes of mortality and morbidity are NOT preventable...which one? 1) Alzheimers disease
The extent of harm of a disease or injury with an individual burden and societal burden Morbidity
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.
Ideal setting for preventative care? Why? Primary care! Best patient contact and interviewing/best relationships w/patients
T/F: We stratify patients into risk categories to modify or eliminate risk factors True; Age Gender Race Economic status Employment Genetics Geographic location
What is a QALY? Quality Adjusted Life Year; based on number of years of life that would be added by intervention
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
Intervention that helps a person who is healthy avoid disease and injury Primary prevention
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
action which halts progress of a disease at incipient stage and prevents complications Secondary prevention
2 categories of secondary prevention 1) Screening to ID risk factors 2) Screening high risk populations to detect disease early
all the measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustment to irremediable conditions Tertiary prevention
Next 6 slides: ID Primary, Secondary or Tertiary
Bicycle/ motorcycle helmet laws primary
IV Antibiotics for a person with pneumonia 3tiary
Rx Atorvastatin for a patient w/ a history of MI 3tiary
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.
Gait training in a stroke patient 3tiary
Safe sex counseling primary
T/F: Most prevention programs only provide primary prevention. False; most combined primary and secondary prevention
Ongoing operations aimed at reducing 1) incidence 2) duration 3) effects of infection 4) and financial burden of disease Disease Control
Between control and eradication, an intermediate goal has been described, called "regional: elimination"
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
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)
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
Studies that may also be carried out to generate information for other purposes Evaluation of control
3 core componenets of a public health system 1) Assessment 2) Policy Development 3) Assurance
Exposure/factor that may adversely affect health Hazard (Qualitative)
probability that an event will occur or the probability of an unfavorable outcome Risk (Quantitative)
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
4 sources of environmental disease 1) water 2) air 3) soil 4) rocks
Ex of point source smokestacks, pipes to waterways
Ex of area source agricultural runoff, automobile exhaust (mobile sources), parking lots
Infectious diseases that can be controlled by manipulating the environment are classified as environmental health concerns
Probability of infection is dose-dependent (higher dose gives higher probability of infx and illness
Difference between inapparent (subclinical) infxs and latent infxs Agent is not shed in latent, is in subclinical
The interval between the time of contact and/or entry of the agent and onset of illness (also called the latency period) Incubation Period
Incubation period depends on what 3 things: 1) Dosage of infectious agent 2) Portal of entry 3) Immune response to host
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
What do we do with ill infected persons with contagious disease? Isolation
Not ill but believed exposed to infection? Quarantine
Increased risk for individuals not compromised: Crowded living conditions, medically underserved, risk-takers, poor hygiene
What is the "body burden" content of heavy metals in our bodies
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
Biomagnification as food change progresses, concentration of toxin becomes greater.
dB that causes hearing loss 80 dB
process of determining potential adverse environmental health effects to people exposed to pollutants and potentially toxic materials risk assessment
4 steps of risk assessment 1 Identification of the hazard 2 Dose–response assessment (ex: sound) 3 Exposure assessment 4 Risk characterization
Created by: crward88