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Golden Lecture of Prevention. Building a Global Prevention Network to Share Knowledge and Wisdom Updated November 2009. Life Expectancy Map. From Wikipedia. Hygeia In Greek mythology The goddess of health. Hygiene –The science that deals with the preservation & promotion of health. .

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Golden Lecture of Prevention

Building a Global Prevention Network to Share Knowledge and Wisdom

Updated November 2009


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Life Expectancy Map

From Wikipedia


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Hygeia

In Greek mythology The goddess of health.

Hygiene –The science that deals with the preservation & promotion of health.

Importance of Hippocrates’ Teaching for public health and medicine of today

This lecture is dedicated to a man who is currently recognized as the “father” of medicine. It’s because of his work, healers became doctors instead of sorcerers. Hippocratic oath is administered during the graduation ceremonies of all modern medical schools.


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Objectives

  • To define prevention and highlight its importance in global health.

    2. To discuss the importance of network in the context of the Supercourse and to begin to organize the internet based globalization for prevention

    3. To further distribute the golden lecture to faculty, students and professionals all over the world


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Definition of Prevention

“Actions aimed at eradicating, eliminating, or minimizing the impact of disease and disability. The concept of prevention is best defined in the context of levels, traditionally called primary, secondary, and tertiary prevention”

A Dictionary of Epidemiology, Fourth Edition

Edited by John M. Last


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Public Health and Sanitation

Achievements of the 20th century:

  • Improvements in hygiene practices

  • Improvements in food handling (refrigeration)

  • Improvement in Water and sewage treatment

  • Vaccination practices


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Rising Life Expectancy

Source: United Nations (U.N.) Population Division, Demographic Indicators, 1950-2050 (The 1996 Revision) (U.N., New York, 1996).



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Death rate for Tuberculosis, 1860-1960, United States, Source: US Bureau of the Census, Historical Statictics of the United States; Colonial Times to 1970 (Washington, D.C.:Government Printing Office, 1975), Part 1 pp58,63.  Note: Data between 1860 and 1900 for Massachusetts only.

Koch

identified

tubercle

bacillus

Streptomycin

introduced

Vaccination

available


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The Sanitary Revolution and the Ascendancy of Public Health Source: US Bureau of the Census, Historical

1. The sanitary revolution produced the greatest transformation in the pattern of disease that the world had known since nomadic hunter-gatherers settled in permanent villages, and ultimately developed modern urban industrial communities


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Death Rates for Measles in Children Under Age 15, England and Wales, 1850-1970

Source: Thomas McKeown, The Modern Rise of Population (Academic Press, San Francisco, 1976), pp. 93, 96.




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Example of successful prevention program in Cuba and Wales, 1850-1970VACCINATION PROGRAM RESULT

POLIO ELIMINATED SINCE 1962

DIPHTHERIA ELIMINATED SINCE 1969

NEWBORN TETANUS ELIMINATED SINCE 1972

CONGENITAL RUBELLA ELIMINATED SINCE 1989

MENINGITIS POST MUMPS ELIMINATED SINCE 1989

MEASLES ELIMINATED SINCE 1993

WHOOPING COUGHTRANSMISSION INTERRUPTED SINCE 1994

RUBELLATRANSMISSION INTERRUPTEDSINCE 1995

MUMPS TRANSMISSION INTERRUPTEDSINCE 1995

MORBIDITY

MENINGOCOCCICAL DISEASE REDUCTION 93%

TYFHOID FEVER REDUCTION 75%

B HEPATITIS REDUCTION 52%



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Death Rates for Coronary Heart Disease by Country Men Ages 35-74, 1970 and 1993 (Rate/100,000)

750

FIN

USA

AUST

SCOT

NZ

CAN

500

SING

USSR

250

ITY

SPN

FRAN

JPN

HK

CHN

0


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Advances in Cancer Care and Cancer Prevention will Arise From

  • Genetics, genomics, proteomics

  • Cell biology and immunology

  • Molecular Epidemiology/biomarkers

  • Bioinformatics

  • Behavioral Sciences


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Lifestyle Factors From

“Genes load the gun.Lifestyle pulls the trigger”

Dr. Elliot Joslin


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Relation Between CHD Events and FromLDL-C in Recent Statin Trials

4S-PI

30

2° Prevention

25

4S-Rx

20

% with

LIPID-Rx

15

LIPID-PI

1° Prevention

CHD event

CARE-Rx

CARE-PI

WOSCOPS-PI

10

AFCAPS/TexCAPS-PI

5

WOSCOPS-Rx

AFCAPS/TexCAPS-Rx

0

90

110

130

150

170

190

210

Mean LDL-C level at follow-up (mg/dL)

PI=placebo; Rx=treatment

.


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Teacher in Alexandria From

Teacher in UAE- Sharjah

Teacher in Pittsburgh

Teacher in Tanzania

Teacher in Paris

Teacher in Moscow

Methods: Supercourse model



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Conclusions From

Increased life expectancy in the past century was achieved through the improvement of sanitation and prevention

Successful prevention in the past and in the future needs to be rooted in the networking of health professionals around the world to share their knowledge

Internet based Information sharing is the key to prevention and a “golden” world


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What is the future of prevention? From

  • Globalization of Prevention

  • Networking of people in prevention

  • Sharing of data, knowledge and wisdom

Please forward the Golden Lecture to faculty, students and health professionals in your country


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Review Questions (Developed by the Supercourse team) From

  • What caused the dramatic shift in life expectancy over the course of the 20th century?

  • What are the major levels of prevention?

  • Give an example of successful prevention activity that had a big influence on increasing life expectancy.


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