complex nature of health systems(including health care systems) posted a new challenge for the system development at all levels. PAC addresses the challenge using the perspective of complex adaptive system and participatory action for change.
6. Societal policies and processes influencing the population prevalence of obesity
COMMUNITY
LOCALITY
Public
Transport
Public
Safety
Health
Care
Sanitation
Manufactured/
Imported
Food
Agriculture/
Gardens/
Local markets
POPULATION
%
OBESE
AND
OVER--
WEIGHT
WORK/SCHOOL/H
OME
Leisure
Activity/
Facilities
Labour
Infections
Worksite
Food &
Activity
Family &
Home
School
Food &
Activity
INDIVIDUAL
Energy
Expenditure
Food
intake :
Nutrient
density
NATIONAL/
REGIONAL
Transport
Urbanization
Health
Social security
Media &
Culture
Education
Food &
Nutrition
INTERNATIONALFA
CTORS
Globalization
of
markets
Development
Media
programs
& advertising
National
perspective
Modified from Ritenbaugh C, Kumanyika S, Morabia A, Jeffery R, Antipatis V. IOTF website 1999: http://www.iotf.org
6
19. 1.4000 medical and surgical procedures,
2.6000 drugs
3. 40% of coronary heart disease patients receive
incomplete care, and 60% of pneumonia
patients.
4. Two million people walk into hospital and get
infection they didn’t have because someone
forgot to wash their hands.
Atul Gawande at TED2012 19
20. 80,000 catheter-related bloodstream
infections
28,000 deaths
$2.3 billion annually
1.8 to 5.2 per 1000 catheter-days
178 actions per days
http://www.newyorker.com/magazine/2007/12/10/the-checklist
20
21. (1)wash their hands with soap,
(2)clean the patient’s skin with chlorhexidine
antiseptic,
(3) put sterile drapes over the entire patient,
(4) wear a sterile mask, hat, gown, and gloves,
(5) put a sterile dressing over the catheter site once
the line is in.
21