Public Health Knowledge And Practices Essay

What are your upcoming week’s specific learning goals and objectives?
What is your upcoming week’s detailed schedule at your community practice experience placement?
Were there any placement items/issues that occurred this week that you feel your instructor should be aware of that are private in nature and are more appropriately shared here than in the discussion board with your classmates?
Give a brief description of an objective you worked on this week. Make sure to cite at least one reference showing how your objective relates to the public health knowledge you’ve studied during this course or the public health course. You may choose to reference your e-text, journal articles, or videos you’ve studied during these courses or you may find an outside reference on your own to further enhance your public health knowledge and practices.Public Health Knowledge And Practices Essay

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Remember, your journal entries are an important aspect of clinical learning as they serve to help you reflect upon and get the most out of your community practice experience. Therefore, your journal entry should include the who, what, where, and when of your community practice experience. Remember, this should simulate a dialogue that would normally take place face-to-face with your community practice experience instructor.Public Health Knowledge And Practices Essay

Section 1: Public Health and Public Health Practices/Investigations Public health is the discipline and skill for preventing diseases and injuries, extending the lifespan and endorsing wellbeing through structured public work, the control of communicable diseases, the union of medical and nursing facilities for the prompt identification and disease prevention, teaching individual health and to make sure a standard of living suitable for the conservation of health (Breslow et al, 2002).. Public health focuses the health of the people completely than the treatment of individuals (Beaglehole et al, 2004). The public health principles are meant for the public and other institutions that have a public health mission. Individuals and…show more content…
Preventing diseases needs various methods at each level. Some consist of education, awareness campaigns, legislation and modifying the surroundings. Disease/injuries need to be addressed at more than one level, and time and again all three. It is essential to recognize which prevention strategies are shown effective in order to have the utmost effect on your chosen program (Christoffel & Gallagher, 2005). Public health should predominantly address the vital causes of disease and necessities for health which in turn aims to avoid adverse health consequences. For instance, the handling of treatable infections is essential to the deterrence of transmission of infection. Public health must reach community health which compliments the rights of those in the public. This Principle recognizes the mutual need in public health to ponder the concerns of the individual and the public. An ethical principle does not exist to deliver an explanation or answer to this constant pressure in public health.Public Health Knowledge And Practices Essay Public health guidelines, programs, and priorities ought to be established and assessed over to guarantee an opening for feedback from the public. The capability for the community to offer this contribution and intellect is dire in the progress and preservation of communal trust in the society. Public health must sponsor and work for the authorizations of subjugated fellows, pointing to make sure that the wealth Public Health Knowledge And Practices Essay

Public health in the United States confronts a dilemma. On the one hand, the advances against health problems for which public health was established in this country are largely taken for granted: safe water, substantial protection against formerly epidemic diseases, an infant death rate only one-tenth as high as in 1900. It is difficult to maintain a sense of urgency about these matters, although continuing vigilance is necessary to preserve the gains that have been won. For example, our country’s progress in reducing infant mortality has actually slipped: throughout the 1970s, infant mortality declined at an average annual rate of 5 to 6 percent, while from 1981 to 1984, the rate of decline slowed to about 3 percent. (Hughes et al., 1986) Infant mortality has actually increased recently in Detroit, Los Angeles, and elsewhere and remains distressingly high in poor communities. Outbreaks of measles, for which effective immunization is available, continue to occur. The rate of syphilis is rising again. (U.S. Department of Commerce, Bureau of the Census, 1986) But warnings about these events by public health officials are sometimes seen as self-serving.Public Health Knowledge And Practices Essay

On the other hand, despite general complacency that the public health job is done, public concern is mounting over new health problems: toxic substances in air, water, and food; cancer and heart disease; drug abuse and teenage pregnancy; AIDS. Excitement about such new health threats often leads to laws, regulations, agencies, and appropriations that bypass the “old” public health. Action is obviously necessary, but the traditional channels are widely regarded as unsuitable.

Thus the dilemma faced by public health is how to take on the new challenges while continuing its work to contain long-existing problems.Public Health Knowledge And Practices Essay

Public health leaders have not succeeded in making clear that both aspects of public health must be tackled vigorously. All too often, political leaders push short-term “solutions” to various health crises without reference to the knowledge base that exists for sound programs. The general public is confused. The result is a hodgepodge of fractionated interests and programs, organizational turmoil among new agencies, and well-intended but unbalanced appropriations—without coherent direction by well-qualified professionals.Public Health Knowledge And Practices Essay

That disarray has stimulated this study and this volume.

The first chapter reflects the committee’s sense as the study began that public health was in trouble, that few people knew and even fewer cared, and that those who did care were divided over the nature of the problem and what to do about it. In conducting the study, committee members set aside temporarily their individual views—although not their shared concern—in order to take a fresh look at public health and to develop a common understanding of it. The aim of the study has been to produce a report that examines the total range of public health activity, not simply an assortment of tax-supported programs. The committee sought to identify a set of functions necessary for the protection and advancement of the public’s health, to assess difficulties in carrying out these functions, and to recommend specific strategies for improvement.Public Health Knowledge And Practices Essay

Judgments about the specific programs that public agencies should undertake or what resources they should command always imply underlying assumptions about the agency’s proper mission, scope of concern, and functions. In Chapter 2, the committee sought to make its own assumptions explicit, so that the logic of the ensuing problem analysis, findings, and recommendations would be clear. The committee’s own deliberations proceeded along these lines, beginning with clarification of the mission and scope of public health. The committee continued by distinguishing functions and responsibilities that only governmental agencies can undertake from those that should be shared with or left to the private sector. Then, weighing its analysis of the existing dilemma of public health, as outlined in Chapters 3, 4, and 5, the committee asked with respect to each issue: Given our definition of public health and what we believe government’s responsibilities ought to be, how should this challenge be addressed?Public Health Knowledge And Practices Essay

This final chapter, setting forth the committee’s recommendations for the future of public health, traces the same path. The committee is making three basic recommendations dealing with:

the mission of public health,
the governmental role in fulfilling the mission, and
the responsibilities unique to each level of government.
The rest of the recommendations are instrumental in implementing the basic recommendations for the future of public health. These instrumental recommendations fall into the following categories: statutory framework; structural and organizational steps; strategies to build the fundamental capacities of public health agencies—technical, political, managerial, programmatic, and fiscal; and education for public health.Public Health Knowledge And Practices Essay

In 1948, WHO defined health as “a state of complete physical, mental and social well-being, and not merely the absence of disease”. Health can be considered in terms of a person’s body structure and function and the presence or absence of disease or signs (health status); their symptoms and what they can and cannot do i.e. the extent to which the condition affects the person’s normal life (quality of life).

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Health care is the prevention, treatment, and management of illness and the preservation of health through the services offered by health care organisations and professionals. It includes all the goods and services designed to promote health, including “preventive, curative and palliative interventions, whether directed to individuals or to populations”.[6]

A) Measures of health status

Health status can be measured using pathological and clinical measures and is usually observed by clinicians or measured using instruments.Public Health Knowledge And Practices Essay

Types of disease measurement include:

Signs – blood pressure, temperature, X-ray, tumour size
Symptoms – disease specific checklists
Co-morbidity – Charlson Index, ICED- index of co-existing disease (looks at both disease severity and functional severity), adverse events – pain, bleeding, readmission, complications (e.g. using Clavien-Dindo Classification of Surgical Complications).
It is always best to use an existing measure which has been tried and tested rather than inventing a new one. Use an existing standardised measure with proven reliability, validity and responsiveness. Criteria which should be applied when evaluating measures include:Public Health Knowledge And Practices Essay

Psychometric criteria

Acceptability – there should be a range across a measure with no floor or ceiling bias
Reliability – test re-test (testing and retesting would give the same score), inter-rater (2 people assessing someone separately would give the same score- measured by the Kappa statistic*), internal consistency (Cronbach’s alpha – when series of questions are used to measure something e.g. the Oxford Hip Score, scores for the answers are often on a scale and added up to give a single total numerical value. Scales must have internal consistency i.e. the items should all measure the same thing. Cronbach’s alpha is a coefficient for assessing internal consistency of a scale. [7])Public Health Knowledge And Practices Essay
Validity – sensitivity (identify those with disease correctly) and specificity (identify those without the disease correctly)
Responsiveness – the degree to which a measure can detect change which is clinically meaningful.
*The kappa statistic measures inter-rate reliability. Kappa = (% observed agreement between observers – % agreement expected by chance alone) / (100% – % agreement expected by chance alone).

Practical criteria

If the measure is intended for routine use as part of clinical practice:Public Health Knowledge And Practices Essay

The measure should be appropriate/relevant
The measure should be brief and simple to administer
Feasible for routine use.
If it is not possible to use an existing measure, the next best thing is to adapt an existing measure, however it must be re-evaluated for reliability, validity and responsiveness in the new circumstances. Otherwise, a new measure needs to be developed and evaluated for reliability, validity and responsiveness.Public Health Knowledge And Practices Essay

Factors that can improve a test’s reliability include:

Training of observers
Clear definitions of terminology, criteria and protocols
Regular observation and review of techniques
Identifying causes of discrepancies and acting on them.
Methods that can increase validity include:

Structured and standardised procedures for collecting clinical information
Standardised protocols for scoring and interpreting
Use of well-constructed instruments (i.e. with documented reliability and validity)
Obtain appropriate reports of information.
Relationship between validity and reliability

What may be valid for a group or a population may not be so for an individual in a clinical setting. When the reliability or repeatability of the test is poor, the validity of the test for a given individual may also be poor.Public Health Knowledge And Practices Essay

B) Measures of quality of life

Quality of life is a measure of the difference between the hopes and expectations of the individual and the individual’s present experience. [8] Health-related quality of life is primarily concerned with those factors which fall within the spheres of influence of health care providers and health care systems.

Health related quality of life can be measured by asking the patient directly or through various instruments.
Measures of health-related quality of life can be applicable across different types of diseases, medical treatments and demographic / cultural groups or they may relate only to specific diseases, interventions or population groups. Population or disease-specific, whilst being very relevant to the population or people with the disease in question, make comparisons with the general population (who do not have the health problem) difficult. If such a comparison is important, a generic tool may be more useful. Generic and specific tools can be used in conjunction with each other.Public Health Knowledge And Practices Essay
HRQoL measures are useful because they can establish the range of problems that affect patients, can pick up any on-going problems that might otherwise be missed, and can be a predictor of treatment success.
HRQoL measures can be combined with measures of time in a particular health state, to form Quality Adjusted Life Years (QALYs) – see health economics section for more details.
Generic tools for measuring HRQoL include:

Short form (SF)-36
WHOQOL
EuroQoL (EQ5D)
Nottingham health profile (NHP)Public Health Knowledge And Practices Essay
Sickness Impact Profile (SIP)
The SF-36 tool is a widely used tool which consists of a 36 item, self-administered questionnaire. It generates a score on 8 health dimensions plus 2 summary scores and is currently accepted as a gold standard measure. It is available in several languages and has been disseminated and adopted world-wide.Public Health Knowledge And Practices Essay