1) mortality and morbidity
TRANSCRIPT
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REGULATIONS
BLOCK CBP (Community-base Medical Practice)
1. HP harus dimatikan selama kuliah dan SGD
2. Study Guide dan semua references agar selalu
dibawa saat kuliah, SGD, individual learning
3. Kehadiran dan keaktifan saat SGD dinilai
(5% dari nilai ujian)
4. Kehadiran saat kuliah dan feedback dihitung
(bila lebih dari 25% tidak ikut) tidak bisa ujian
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5. Pada saat feedback mahasiswa presentasi
dengan memakai OHP
6. Wakil mahasiswa yang presentasi harus dipilihpada saat SGD dan bukan di ruang kuliah
7. Wakil mahasiswa yang presentasi harus bergilir
(tidak boleh sama pada setiap feedback)
8. Sesaat sebelum feedback dimulai, wakil
masing-masing kelompok yang akan presentasi
langsung duduk didepan 9. Nara sumber akan memberi feedback
pada presentasi mahasiswa
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APPROCHES OF CBP
Prevention
Community(not individual)
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REFERENCES & HANDOUTS
• Study Guide
• Reference Books No. 1
• Reference Books No. 2
• Sudigdo (Bahasa Indonesia)
• Handout (Bahasa Indonesia)
OPTIONAL
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HARI 1, 2, 3: CONTENT-1
CURRICULUM CONTENTS (STUDYGUIDE): 5 CONTENTS
LEARNING MATERIALS:REFERENCE NO. 1 PAGES 1 – 41OR HANDOUT BHS INDONESIA
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CURRICULUM CONTENT-1
1. Apply diseases prevention in thecommunity based on determinants of
morbidity and mortality and their
natural history
a) Describe several models of diseases and death
determinants occurring in the population and their
strengths and weaknesses
b) Correlate natural history of diseases and
appropriate prevention in the community
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LEARNING SCHEDULE
(time table)
• 08.00-09.30: Introductory lecture
• STUDY GUIDE PAGE … (CLASS A)
• 09.30-12.00: Film presentation
• 12.00 - Independent learning
Reference book pages 1-41 Learning task (task-1 and 2 for SGD-1,
and task-3 for SGD-2) pages ….
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• 12.00-13.30: Introductory lecture
• TIME TABLE CLASS B: STUDY GUIDE PAGE …
• 13.30-15.30: Film presentation
Reference book pages 1-41
Learning task (task-1 and 2 for SGD-1,
and task-3 for SGD-2) pages 25, 26, 28
•
Afternoon: individual learning
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Critical
thingking
Information
management
Communication
skill
Population
Health(Public
Health)
Clinical
skill
Professional,
values,
attitudes
Scientificfoundations
Five contentspage 1 – 3Study Guide
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Dalam film presentationakan ditunjukkan
Kontribusi (peran): scientific foundations,
clinical skill, communication skill, informa-
tion management, critical thinking, profes-
sional values and attitudes, community
health
Meneliti kausa suatu penyakit (AIDS)dan pencegahannya
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PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
2. Function: to mobilize allstakeholders and using
management principles to
plan, implement and
evaluate primary,
secondary, tertiary
preventions
2. Function: to cure and to
increase the
patient’s qualityof life
3. Place of works: health
centre, heath department,
community clinics, etc
3. Place of works:
private practices,
hospitals, etc
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PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
4. Diagnostic tools: epidemiology, statistics,
demography
4. Diagnostic tools: stethoscope, ECG, lab
examinations kits , CT
Scan, etc
5. Diseases
measurements in the
community:
proportion, prevalence,
incidence, ratio
5. Diseases
measurements for
individual patient: level
of blood pressure, blood
sugar, level of
hemoglobin, etc
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PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
6. Treatment at thecommunity level: public
health program such as
education program,immunization program,
nutrition program,
family planningprogram, etc
6. Treatment forindividual
patient:
medicaltreatments,
surgery,
radiation,physiotherapy,
etc
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PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
7. Indicators forevaluating community
health program: percent
decrease of undernutrition, percent
increase of contraceptive
use for family planning,etc
7. Indicators forevaluating the result
of patient’s
treatments:
decrease of blood
pressure of the
individual patient,
increase ofhemoglobin
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“FIVE STARS DOCTOR”
(WHO = World Health Organization) Care provider (clnical dr)
Communicator (clinical & PH dr)
Manager (PH dr)
Community leader (PH dr)
Decision maker (clinical & PH dr)
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Critical
thinking
Information
management
Communication
skill
Community
Health (Pu-
blic Health)
Clinical
skill
Professional,
values,
attitudes
Scientific
foundations
FIVESTARS
DOCTOR
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POINT-POINT FILM DANPENJELASAN TAMBAHAN
• Film ini adalah kisah nyata tentang penelusuranwabah AIDS pada awal tahun 1980-an. Yang
ditonjolkan adalah aspek sosial, ekonomi, politik,
etika, baik ketika meneliti penyebab AIDS
maupun upaya pencegahannya
• Terlihat pula peran berbagai disiplin ilmu dalam
penelitian wabah AIDS (clinical science, virology,
epidemiology, statistics, sosial sience, dll, dll)
• Kisah yang mirip dengan film juga diuraikan di
Buku Greenberg halaman 1 - 7
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• Dr. Don Francis pernah diminta oleh WHO untuk
meneliti wabah Ebola di Sungai Ebola (Afrika)
• Jumlah pasien dan kematian terus meroket. CDC(Bagian dari Depkes Amerika yang menangani
penyakit penular) kebingungan karena
penyebabnya tidak diketahui
• Pada awal thn 1980 muncul banyak pasien
dengan gejala-gejala kekebalan tubuh yang rusak
di Eropa lalu banyak pula di Amerika terutama
pada kalangan gay
• CDC lalu minta bantuan Dr. Don Francis untuk
mengungkapkan misteri tersebut, bergabung
dengan ahli virologi, ahli penyakit kelamin, pakar
imu sosial, dll
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• Banyak kendala yang dihadapi oleh Dr. Don
Francis dkk antara lain: masalah politik
(persetujuan biaya oleh pemerintah), masalah
sosial (stigma dan diskriminasi pada gay), dll.
• Demikian pula untuk prevention-nya. Dijumpai
penolakan PMI untuk screening darah karena
masalah ekonomi, politik. Penolakan penutupan
tempat-tempat permandian kalangan gay, dll.
•
Terakhir: masalah etika dalam pengakuanpenemu HIV. HIV diketemukan sekitar thn 1984
dan Hadiah Nobel baru diberikan tahun 2008
kepada Luc Montagnier
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• Contact tracing atau penelusuran kontak adalah
salah satu cara untuk mencari sumber penularan
suatu penyakit yang ditularkan melalui kontak
langsung termasuk kontak seksual • Richard Gere yang juga sebagai pemain dalam
film ini berperan sebagai seorang selebritis yang
juga “kena” penyakit misterius tersebut. Sepertikita ketahui, saat ini dia menyumbangkan seba-
gian kekayaannya untuk penanggulangan AIDS • Presiden Reagan berasal dari Partai Republik.Partai Republik lebih konservatif dibanding Partai
Demokrat. Komunitas gay di Amerika lebih
terdiskriminasi bila P. Republik yang berkuasa
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LIHAT LEARNING TASK-1
(APA YANG DITANYAKAN)
SELAMAT
MENYAKSIKAN
dan
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• Determinants of morbidityand mortality in a population
• Natural history of thedisease
• Diseases prevention
CONTENT-1
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The Epidemiologic Triangle(Teori Segi Tiga) page 26 – 33)
Wheel Model (Teori Roda) page 35-39
Web Model (Teori Sarang Laba-laba) page 33
Model Blum not available in ref 1 & 2
Several models/concept used toanalyzed determinants of morbidity
and mortality in a population
Model Mosley not available in ref 1 & 2
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MODEL BLUM
Morbidity andmortality ina population
Environmental factors (biological, physical, social, economical, politic)
Healthservices
Genetic
Behavior
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Prevention can be done whendeterminants and natural history of
the disease are understood
LEVEL OF PREVENTIONS IN BROAD
CONCEPT
Primary prevention
Health promotion
Behavior change education
Policy/regulation
Specific protection
(specific to a certain disease)
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Secondary prevention
Early detection andprompt treatment/action
Tertiary prevention
Disability limitation
Rehabilitation
Medical
Psychological
Social
Economical
Prolonging
life/increasequality of life
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Susceptible
(at risk)
Primary prevention
• Health promotion
• Specific protection
Presym-
tomaticstage
Secondary prev.• Early detection
& prompt
treatment
Clinical
stage
Stageof
dis-
ability
Tertiary prev.
• Disability
limitation
• Rehabilitation
Genetic
Environment
Behavior
Health Services
Physical
Social, culturalBiological, economical
Using Blum Model/Concept
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