Good morning

1. Good morning pedagogue by drpraveenjodalli

2. Levels of Prevention pedagogue by dr praveen jodalli

3. contents • Definition of Prevention • Introduction • Goals of Medicine • Objective of Prevention • Levels of Prevention • Primordial prevention • Primary prevention • Secondary prevention • Tertiary Prevention pedagogue by dr praveen jodalli

4. Modes of intervention • Health Promotion • Specific Protection • Early Diagnosis and Treatment • Disability Limitation • Rehabilitation • References pedagogue by dr praveen jodalli

5. Definition • Learell and Clark defines “Prevention” as interception of disease process pedagogue by dr praveen jodalli

6. LEVELS : Grades or categories • PREVENTION:Interception or Oppose or Blockade or Restrict pedagogue by dr praveen jodalli

7. Concept of prevention pedagogue by dr praveen jodalli

8. Successful prevention pedagogue by dr praveen jodalli

9. Objectives of Prevention • To ‘Intercept’ or ‘Oppose’ the cause and there by disease process • This can be done at various levels in the course of natural history of disease, in this regard various levels of prevention have been recognized. • This epidemiological concept permits inclusion of treatment as one ‘mode of intervention’. pedagogue by dr praveen jodalli

10. Levels of prevention- the concept is broad-based pedagogue by dr praveen jodalli

11. Primordial prevention • Primary prevention in purest sense. • New concept receiving special attention in prevention of chronic diseases. • Prevention of emergence or development of risk factorsin countries or population groups in which they have not yet appeared. pedagogue by dr praveen jodalli

12. Eg.: • Prevention of obesity and hypertension: Regular exercise , Sensible diet ,Avoidance of smoking, alcohol • Dental caries : Sensible diet • Oral cancer: By legislation MAIN INTERVENTION – Individual and Mass Education pedagogue by dr praveen jodalli

13. Primary prevention • Defined as “Action taken prior to onset of disease which removes the possibility that a disease will ever occur” • Phase of intervention:PRE-PATHOGENESIS PHASE • Specific causal factors (Risk factors) are already present . pedagogue by dr praveen jodalli

14. Modes of intervention for primary prevention pedagogue by dr praveen jodalli

15. W.H.O. approaches for primary prevention of chronic diseases pedagogue by dr praveen jodalli

16. Population (Mass) Strategy • Directed at the whole population irrespective of individual risk levels. • Aims at socio-economic ,behavioral and lifestyle changes. Eg.- A small reduction in the average blood pressure of a population would produce a large reduction in cardiovascular disease. - Health education to improve oral hygiene practices. pedagogue by dr praveen jodalli

17. High –risk stratergy • Aims to bring preventive care to individuals at special risk. • Requires detection of individuals at high risk by the optimum use of clinical methods. • Eg: Topical fluoride application for those with high risk. pedagogue by dr praveen jodalli

18. Secondary prevention • Defined as “Action which halts the progress of disease in its incipient stage and prevent complications.” • PATHOGENESIS PHASE Health programmes - Initiated by government are at this level. pedagogue by dr praveen jodalli

19. Modes of intervention for secondary prevention EARLY DIAGNOSIS AND PROMPT TREATMENT pedagogue by dr praveen jodalli

20. Tertiary prevention • Defined as “All measures available to reduce or limit impairments and disabilities, minimize suffering caused by existing departures from good health to promote patients adjustment to irremediable conditions”. • LATE PATHOGENESIS PHASE pedagogue by dr praveen jodalli

21. Modes of intervention for tertiary prevention pedagogue by dr praveen jodalli

22. Modes of intervention Intervention is - Any attempt to intervene or interrupt the usual sequence in the development of disease in man. • Health promotion • Specific protection • Early diagnosis and prompt treatment • Disability limitation • Rehabilitation. pedagogue by dr praveen jodalli

23. Health promotion • Defined as a process of enabling people to increase control over and to improve health. • It involves “organizational , political , social and economic interventions designed to facilitate environment and behavioral adaptations that will improve or protect health.” pedagogue by dr praveen jodalli

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25. Health education • One of most cost-effective intervention. • Adequate information about diseases and encouraging people to take necessary precautions in time. • Target group for educational efforts include General public, patients, high risk groups, community leaders , decision makers , health providers. pedagogue by dr praveen jodalli

26. Environmental modifications • The history of medicine – many infectious diseases have been successfully controlled in western countries through this intervention. • Non- clinical and do not involve the physician. • Examples: * Provision of safe drinking water • * Installation of sanitary latrines • * Improvement of housing • * Control of insects and rodents • * Community water fluoridation pedagogue by dr praveen jodalli

27. Nutritional interventions • Examples: * Food distribution & nutrition improvement of vulnerable groups * Child feeding programmes * Dietary counseling pedagogue by dr praveen jodalli

28. Lifestyle and behavioural changes • Examples: Motivating people to avoid smoking, pan-chewing and drinking alcohol. pedagogue by dr praveen jodalli

29. Specific protection • To avoid disease altogether is the ideal but this is possible only in limited number of cases. pedagogue by dr praveen jodalli

30. Health protection • Covers a wider range than specific protection. • Defined as “The provision of conditions for normal mental and physical functioning of the human being individually and in the group. It includes the promotion of health , the prevention of sickness and curative and restorative medicine in all its aspects”. pedagogue by dr praveen jodalli

31. Early diagnosis and prompt treatment • WHO Expert Committee – defined early detection as The detection of disturbances of homeostatic and compensatory mechanism while biochemical , morphological and functional changes are still reversible. pedagogue by dr praveen jodalli

32. Early diagnosis and prompt treatment • In order to prevent overt disease or disablement , the criteria of diagnosis if possible be based on early biochemical , morphological and functional changes that precede the occurrence of manifest signs and symptoms. • The earlier a disease is diagnosed , the better it is from the point of view of prognosis and preventing the occurrence of further cases or any long term disability. • eg: Oral cancer screening, hypertension, leprosy, tuberculosis • AIDS pedagogue by dr praveen jodalli

33. Masstreatment pedagogue by dr praveen jodalli

34. Disability limitation • Disability is defined as any restriction or lack of ability to perform an activity in the manner or within the range considered normal for a human being. • The objective of this intervention is to prevent or halt the transition of the disease process from impairment to handicap. pedagogue by dr praveen jodalli

35. Concept of disability DISEASE pedagogue by dr praveen jodalli

36. Concept of disability pedagogue by dr praveen jodalli

37. Rehabilitation • has been defined as- “Combined and coordinated use of medical, social, vocational and educational measures for training and retraining the individual to highest level of functional ability.” pedagogue by dr praveen jodalli

38. Examples: • Medical rehabilitation Restoration of function – Prosthesis Speech therapy • Vocational rehabilitation Restoration of capacity to earn livelihood • Social rehabilitation Restoration of family and social relationships • Psychological rehabilitation Restoration of personal dignity and confidence pedagogue by dr praveen jodalli

39. references • Park K. Textbook of preventive and social medicine, 19thedn. BanarasidasBhanot publication 36-40. • Mahajan BK Textbook of preventive and social medicine, 3rdedn. Jaypee publication • Soben peter. Textbook of essentials of preventive and community dentistry 2nd edition rya publication. 262,445,827, pedagogue by dr praveen jodalli