[merged] Public Health: PART 1-5

Public Heath

It is a societal effort to protect, promote, and restore the public’s health

Public Health

It is a combination of sciences, skills, and beliefs that are directed to the prevention, maintenance, and improvement of the health of all the people through collective or social actions

Public Health

It is a collection of programs, services, and institution involved emphasize the prevention of disease and the health needs of the population as a whole

to reduce:

1. the amount of disease

2. premature death

3. disease-produced discomfort

4. disability in the population

Public health activities change with changing technology and socialvalues, but the goals remain the same: _________________

Public Health

Is thus a social institution, a discipline, and a practice

1. Promote health

2. Prevent disease

3. Prolong life

Three major goals of Public Health

1. The Planning Level

2. The Implementation Level

Levels of Public Health

Macro level

The Planning Level is also known as?

Planning Level

• Focus on the well-being of the population as whole

• Emphasize the assessment and prioritization of a community’s health-related needs as well as planning to address those needs

1. Identifying: health-related community problems

2. Setting community health priorities

3. Formulating community health programs and policies

4. Managing, advertising, and educating community health- promotion programs

5. Educating the community in ways that promote public health

6. Researching, presenting, and publishing information about public health activities

Planning level includes working with community representatives in:

Micro or Provider Level

The Implementation Level is also known as?

Implementation Level

• Include all the activities required to implement public health initiatives

• Performed on a:

  • Provider-to-patient

  • Program-to-population

1. Disease screening

2. Immunization

3. Counselling for at-risk populations/patient counselling

4. Tobacco-cessation programs

5. Health screening and referral

6. Health education

7. Monitoring and responding to adverse drug events

Examples of Micro Level services include:

1. Primary Prevention

2. Secondary Prevention

3. Tertiary Prevention

Three types of Disease Prevention

Primary Prevention

• Helping people maintain their health

• Improve the quality of their lives through a healthy lifestyle

• Reduce the actual the actual incidence and occurrence of disease, injury, and disability

• Example:

  • Control of infections through immunization

  • Adopting healthy lifestyle practices may lead to increase longetivity

Secondary Prevention

• The early diagnosis and treatment of an already existing disease

• Decreasing the severity or progression of the disease, injury, and disability

• Example:

  • Treatment of a streptococcal infection with Penicillin to prevent the onset of Rheumatic Fever

  • DM - monitor blood glucose levels within the limits to prevent Diabetic Retinopathy and non-healing wounds

Tertiary Prevention

• Largely consists of rehabilitation

• Treatment or rehabilitation to return the disease, injury, or disability to the initial or baseline state)

• Example:

  • Most chronic diseases cannot be cured

Pharmacists

________________ who practice in hospital and health systems play a vital role in maintaining and promoting public health

1. Providing population-based care

2. Developing disease prevention and control programs

3. Developing health-education policies and programs

4. Public health policy

5. Advocating for sound legislation, regulations, and public policies regarding disease prevention and management

6. Engaging in population-based research and initiating campaigns to disseminate new knowledge

What are the roles of Pharmacists in Public Health?

1. Epidemiologic and pharmacoeconomic data

2. Medication use criteria

3. Medication use review

4. Risk reduction strategies

One of the core competencies of Pharmacists: develop population-specific, evidence based disease management programs and protocols based on analysis of:

Medication safety programs in their institutions and communities

In developing disease prevention and control programs, it includes what?

1. Check immunization status

2. Identify undiagnosed medical conditions

3. Reducing the number of hospital admissions resulting from drug therapy mismanagement

4. Fostering programs to intercept counterfeit medications

5. Medication reconciliation programs

Pharmacists help develop institutional screening programs to:

1. Safe and effective medication use

2. Other public health-related topics:

   1. Tobacco cessation

   2. Exercise and healthy nutrition

3. Support the education and training of the population at an early age, such as:

   1. School health programs

   2. Help children develop good health behaviors that can continue until adulthood

4. Educate:

   1. Health care colleagues about safe and effective medication use

   2. Community leaders about and involve them in public health initiatives

Developing health-education policies and programs include:

Public Health Policy

• Address local and regional health care needs

• Include environmental hazard and emergency preparedness programs

• Health policy, especially policy directed at chronic disease

  • Better understanding of the relationship of drug therapy to the many other factors that affect disease outcomes

• To provide prophylaxis and treatment to communities during emergencies

  • Accommodation of supplies: Antibiotics, Antidotes (needed in the initial 24 hrs following a crisis)

  • Community-based planning efforts: Mass immunization, prophylaxis, and treatment

  • Pandemic response to chemical, biological, radiological or explosive agents

Roles of Pharmacists during Emergency Planning

1. Applicable laws

2. Best management practices in the proper handling and disposal of hazardous drugs

Pharmacists should also work with health-system administrators to develop policies and initiatives that heighten awareness of the _________________ and ______________________________________________ _________________ and _________________ of hazardous drugs

1. Research methodology

2. Pharmacoepidemiology

3. Statistics

Health-system pharmacists need to be proficient in _________________, _________________, and _________________ and their applications to public health decision making

Clinical studies

Pharmacists must have to have knowledge and experience in the design, conduct, and interpretation of ____________________

Invasiveness

The ability of a microorganism to enter a host, grow, reproduce and spread throughout its body

Pathogenicity

The ability of a microorganism to cause disease by overcoming the defenses of a host

Virulence

Degree of pathogenicity

Toxigenicity

The capacity of an organism to produce a toxin

Infection

Invasion or colonization of the body by pathogenic microorganisms An infection may exist in the absence of detectable disease

Disease

• Occurs when an infection results in any change

• From a state of health

• Is an abnormal state in which part or all of the body is not properly adjusted or incapable of performing its normal functions

Isolation

• Separation of sick people with a contagious disease from people who are not sick

• Intends to treat and monitor suspect, probable, and confirmed cases

Quarantine

• Refers to the separation and movement restrictions of people who were exposed to a contagious disease to see if they become sick

• Intends to keep individuals under observation to see if they will develop COVID19 signs or symptoms or if they will test positive for COVID-19

Epidemiology

The science that studies when and where diseases occur and how they are transmitted in populations

Epidemiology

The study of the determinants and distribution of health-related states or events in specified populations, and the application of this study to the control of health problems

Pathology

Scientific study of disease

Etiology

Pathology is first concerned with the cause of disease

Pathogenesis

Manner in which a disease develops

Normal microbiota or Normal flora

Microorganisms that establish more or less permanent residence (colonize) but that do not produce disease under normal conditions

Symbiosis

Relationship between the normal microbiota and the host

Commensalism

• A relationship between two organisms in which at least one organism is dependent on the other

• Example: Normal Flora

Mutualism

• Type of symbiosis that benefits both organisms

• Example: the large intestine contains bacteria, such as E. coli, that synthesize vitamin K and some B vitamins

Parasitism

One organism benefits by deriving nutrients at the expense of the other

Infectious disease

• Diseases caused by pathogenic microorganisms

• Examples:

  • Bacteria

  • Fungi

  • Protozoa

  • Helminths

  • Virus

1. Communicable disease

2. Contagious disease

3. Non-communicable disease

4. Zoonotic disease

5. Nosocomial disease

Classification of Infectious Disease

Communicable disease

• Disease that spreads from one host to another, either directly or indirectly

• Example:

  • Chickenpox

  • Measles

  • Genital herpes

  • Typhoid fever

  • Tuberculosis

Contagious disease

• Diseases that are easily spread from one person to another

• Example: Influenza

Non-communicable disease

• Do not spread from one host to another. These diseases are caused by microorganisms that:

  • Normally inhabit the body and only occasionally produce disease

  • By microorganisms that reside outside the body and produce disease only when introduced into the body

• Example: Tetanus

Zoonotic disease

Infectious disease which can be transferred from an animal reservoir to a human host

Example: Anthrax - Cattles

Nosocomial disease

• Aka: Health care association infection (HAI)

• An infection acquired from hospital setting

• Example: Ventilator Associated Pneumonia

Bacteremia

Presence of bacteria in the blood

Toxemia

Presence of toxins in the blood

Viremia

Refers to the presence of viruses in blood

Sepsis

Toxic inflammatory condition arising from the spread of microbes, especially bacteria or their toxins, from a focus of infection

Septicemia

• Aka: BLOOD POISONING

• Systemic infection arising from the multiplication of pathogens in the blood

• The proliferation of pathogens in the blood, accompanied by fever; sometimes causes organ damage

Reservoir

Continual source of pathogens

• Living organism

• Inanimate objects

that provides a pathogen with adequate conditions for:

• Survival

• Multiplication

• Opportunity for transmission

1. Human reservoirs

2. Animal reservoirs

3. Non-living reservoirs

Reservoirs of Infection

Human reservoirs

• Principal living reservoir of human disease is the human body itself

  • Symptomatic Patients

  • Asymptomatic Patients (Asymptomatic carriers)

    • Harbor pathogens and transmit them to others w w/o exhibiting signs of illness

Animal reservoirs

Both wild and domesticated animals are living reservoirs of microorganisms that can cause human diseases

Zoonotic

Diseases that occur primarily in wild and domestic animals and can be transmitted to humans

Non-living reservoirs

Major examples:

• Soil

  • Tetanus

  • Fungi

  • Helminths

• Water

  • E. coli

  • V. cholerae

  • S. typhi

• Food

  • E. coli

  • S. aureus

Host

An organism infected by a pathogen

1. Definitive hosts

2. Intermediate hosts

3. Reservoir hosts

4. Carrier hosts

Types of Hosts

Definitive hosts

• An organism that harbors the adult, sexually mature form of a parasite

• Example: Anopheles mosquito - vector of Plasmodium

Intermediate hosts

• An organism that harbors the larval or asexual stage of a helminth or protozoan

• Example: Humans - Plasmodium

Reservoir hosts

• Hosts that harbour a parasite of another host without itself getting affected, but act a source of infection for the original host

• Example: Game animals - T. gambiense

Carrier hosts

Hosts that have a residual population of the parasite and acts as a source of infection for the same type of host

1. Contact Transmission

2. Vehicle Transmission

3. Vector Transmission

Different ways of Disease Transmission

1. Direct Contact Transmission

2. Indirect Contact Transmission

3. Droplet Transmission

Types of Contact Transmission

Person to Person Transmission

Direct Contact Transmission is also known as?

Direct Contact Transmission

• The direct transmission of an agent by physical contact between its source and a susceptible host

• No intermediate object is required

• Example:

  • Kissing

  • Touching

  • Sexual intercourse

Indirect Contact Transmission

Occurs when the agent of disease is transmitted from its reservoir to a susceptible host by means of a non living object

Fomite

Nonliving/inanimate object involved in the spread of an infection

Droplet Transmission

• Microbes are spread in droplet nuclei (mucus droplets) that travel only short distances host - 6 feet or ½ meters

• One sneeze may produce 20,000 droplets

1. Waterborne Transmission

2. Foodborne Transmission

3. Airborne Transmission

Types of Vehicle Transmission

Waterborne Transmission

• Water contaminated with untreated or poorly treated sewage

• Example: Boracay Water: fecal coliforms

Foodborne Transmission

Generally transmitted in food that are:

• Incompletely cooked

• Poorly refrigerated and storage

• Prepared under unsanitary conditions

Airborne Transmission

• Spread of agents of infection by droplet nuclei (5µm or smaller) or dust particles

• Remain suspended in air

• Example: TB

Vector

Animal that carry pathogens from one host to another

1. Mechanical Transmission

2. Biological Transmission

Types of Vector Transmission

Mechanical Transmission

• Passively transport of the pathogens on the insect’s feet or other body parts

• Example: Flies - food

Biological Transmission

• The transmission of a pathogen from one host to another when the pathogen replicates in the vector

• Example: Anopheles - Plasmodium

Predisposing Factor

• Factors which make the body more susceptible to a disease and may alter the course of the disease

• Example:

  • Climate

  • Temperature

  • Nutrition

  • Smoking

  • Disease

  • Drugs

• Once a microorganism overcomes the defenses of the host, development of the disease follows a certain sequence that tends to be similar whether the disease is acute or chronic

Exposure

Target tissue is exposed to a causative agent

Incubation period

A latent stage in which no signs or symptoms are apparent (pathogen numbers are low)

Prodromal period

• Signs and symptoms are usually mild and non specific (pathogen numbers building)

• Not all diseases has this stage

Acute/illness, clinical, invasive period

• Disease process reach their peak

• Fully developed signs or symptoms

Acme

• Highest point of the disease

• The critical stage or crisis of a disease

• Signs and symptoms at their strongest/peak - most severe

Decline

• The body gradually returns to normal

• Immune response and products: peak

Convalescence period

A rehabilitation stage when the patient progresses towards recovery after the termination of the disease

Recovery period

In this stage the patient regains normal health - no signs or symptoms of disease are evident

Remission period

Some diseases may have a latent phase within the disease progression before a second acute clinical period

1. Measures of Disease Frequency

2. Frequency and Geographic Distribution

Occurrence of Disease

Incidence

Number of people in a population who develop a disease during a particular time period

Incidence

Occurrence of new cases of disease or injury in population over a specified period of time

Incidence

Indicator of the spread of the disease

Prevalence

• The total number of people in a population who develop a disease at a specified time, regardless of when it first appeared

• Takes into account both new and old cases

• It’s an indicator of:

  • how serious

  • how long

    • a disease affects a population