William Shakespeare was an English poet and playwright from the late 16th and early 17th centuries. He is widely considered the greatest writer in the English language. Shakespeare wrote comedies, histories, and tragedies, including Romeo and Juliet, Hamlet, and Macbeth. Some of his most famous works are listed in the document.

1. CONCEPTS OF
PREVENTION
DR. MAHESWARI JAIKUMAR.
maheswarijaikumar2103@gmail.com

2. • The goal of medicine is to
promote, to preserve, to restore
health when it is impaired & to
minimize suffering & distress.
• These goals are embodied in the
word “prevention”.

3. • Successful prevention depends
upon a knowledge of causation,
dynamics of transmission,
identification of risk factors & risk
groups, availability of prophylactic
or early detection & treatment
measures to appropriate persons,
groups & continuous evaluation of
& development of procedures
applied.

4. • The objective of preventive
medicine is to intercept or
oppose the “cause” & thereby
the disease process.

5. LEVELS OF PREVENTION
• 1. Primordial prevention.
• 2. Primary prevention.
• 3. Secondary prevention.
• 4. Tertiary prevention.

7. PRIMORDIAL PREVENTION
• This primary prevention is purest
in its sense.
• It implies prevention of the
emergence or development of
risk factors in population groups
in which they have not yet
appeared.

8. • The main intervention in
primordial prevention is through
individual & mass education

9. PRIMARY PREVENTION
• Primary prevention can be
defined as “action taken prior to
the onset of disease, which
removes the possibility that a
disease will occur”.

10. • It signifies intervention in the pre
pathogenesis phase of a disease or
health problem.
• Primary prevention may be
accomplished by measures designed
to promote general health & well
being, & quality of life of people or
by specific protective measures.

11. • Primary prevention is far more than
averting the occurrence of a disease
& prolonging life.
• It includes the concept of “positive
health”, a concept that encourages
achievement & maintenance of “an
acceptable level of health that will
enable every individual to lead a
socially & economically productive
life”.

12. • It concerns an individual’s
attitude towards life & health &
the initiative he takes about
positive & responsible measures
for himself, his family & his
community.

13. • The concept of primary
prevention is now applied for
the prevention of chronic
disease such as heart disease,
hypertension & cancer based on
elimination or modification of
“risk factors” of disease.

14. • WHO has recommended the
following approaches for the
primary prevention.
1. Population Strategy ( Mass
strategy)
2. High risk strategy

15. POPULATION STRTEGY
The population strategy is directed at
the whole population irrespective of
individual risk levels.
• E.g., Even a small reduction in the Bp
or serum cholesterol of a population
would produce a large reduction in the
incidence of cardio vascular disease.

16. HIGH RISK STATERGY
• The high risk strategy aims to
bring preventive care to
individuals at special risk.
• This requires detection of
individuals at high risk by the
optimum use of clinical methods.

17. • Primary prevention is a desirable
goal.
• It is worthwhile to recall the fact
that industrialized countries
succeeded in eliminating
communicable diseases by rising
the standard of living (primary
prevention)

18. • In summary, primary prevention
is a holistic approach.
• It relies on measures designed to
promote health or protect
against specific disease “agents ”
& hazards in the environment.

19. • It utilizes the knowledge of the
pre pathogenesis phase of
disease embracing the agent,
host & the environment.

20. • The safety & low cost of primary
prevention justifies its wider
application. Primary prevention
has become increasingly
identifies with “health
education” & the concept of
individual & community
responsibility for health.

21. SECONDARY PREVENTION
• Secondary prevention can be
defined as “action which halts the
progress of a disease at its
incipient stage & prevents
complications”.

22. • The specific interventions are early
diagnosis & prompt treatment.
• Secondary prevention attempts to
arrest the disease process, restore
health by seeking out unrecognized
disease & treating it before irreversible
pathological changes have taken place
& reverse communicability of
infectious diseases.

23. • Secondary prevention is largely
the domain of clinical medicine.
• The health programmes initiated
by the government are at the
level of secondary prevention.

24. • The drawback of secondary
prevention is that the patient
has already been subject to
mental anguish, physical pain &
the community to loss of
productivity.

25. • Secondary prevention is an
imperfect tool in the control of
transmission of disease.
• It is more often expensive & less
effective than primary
prevention.

26. TERTIARY PREVENTION
• When disease process has
advanced beyond its early
stages, it is still possible to
accomplish prevention by what
might be called “tertiary
prevention”.

27. • It signifies intervention in the late
pathogenesis phase.
• Tertiary prevention can be defined as
“all measures available to reduce or
limit impairments & disabilities,
minimize suffering caused by existing
departures from good health & to
promote the patient’s adjustment to
irremediable conditions.

28. • The main interventions include
disability limitation &
rehabilitation.
• Tertiary prevention extends the
concept of prevention into fields
of rehabilitation.

31. THE THREE “C” OF
PREVENTION

32. MODES OF INTERVENTION
• Intervention is defined as any attempt
to intervene or interrupt the usual
sequence in the development of
disease in man.
• Five modes of intervention have been
described depending upon the natural
history of disease.

33. Modes of intervention
1. Health Promotion.
2. Specific protection.
3. Early diagnosis &
treatment.
4. Disability limitation.
5. Rehabilitation.

34. THE ICEBERG PHENOMENON

35. HEALTH PROMOTION
• Health promotion is the process of
enabling people to increase control
over & to improve health. It is not
directed against any particular
disease, but is intended to
strengthen the host through a variety
of approaches (interventions) .

36. •The interventions are :
• 1. Health Education.
• 2. Environmental modifications.
• 3. Nutritional interventions.
• 4. Life style & behavioral changes

37. HEALTH EDUCATION
•Is one of the most cost
effective interventions.

38. • A large number of diseases
could be prevented with little
or no medical intervention if
people were adequately
informed about them & if
they were encouraged to take
necessary precautions in time.

39. ENVIRONMENTAL MODIFICATIONS
• A comprehensive approach to
health promotion requires
environmental modifications
such as provision of safe water,
installation of sanitary latrines,
control of insects & rodents,
improvement of housing etc.

40. • Environmental interventions are
non clinical & does not require
physician.
• History has shown that many
developed countries have made
remarkable progress in health of its
people through environmental
modification.

41. NUTRITIONAL INTERVENTION
• These comprise of food
distribution & nutrition
improvement of vulnerable
groups; child feeding
programmes; food fortification;
nutrition education.

42. LIFE STYLE & BEHAVIOURAL
CHANGES
• The conventional public health
measures or interventions have
not been successful in making
inroads in to lifestyle reforms.

43. • Health education is a basic
element of all health activity,
in changing the views,
behaviors & habits of people.

44. • A well conceived health promotion
programme identifies the target groups
& directs appropriate message to
them.
• It involves organizational, political,
social & economic interventions
designed to facilitate environmental &
behavioural adaptation that will
improve or protect health.

45. SPECIFIC PROTECTION
• The following are some of the
currently available interventions
aimed at the specific protection.
• 1. Immunization.
• 2. Use of specific nutrients.

46. • 3. Chemoprophylaxis.
• 4. Protection against
occupational hazards.
• 5. Protection against accidents.
• 6. Protection from carcinogens

47. • 7. Avoidance of allergens.
• 8. Control of specific hazards.
• 9. Control of consumer product
quality & safety of foods,
drugs, & cosmetics.

48. • It also protects others in the
community from acquiring the
infection & thus provide
secondary prevention for the
infected individuals & primary
prevention for their potential
contacts.

49. • Secondary prevention is largely
the domain of clinical medicine.
• The health programmes initiated
by the governments are usually
at the level of secondary
prevention

50. • Health protection is defined as “the
provision of conditions for normal &
physical functioning of the human
being individually & in the group.
• Health protection is considered as
an integral part of the overall
community development.

51. EARLY DIAGNOSIS &
TREATMENT
• WHO defines early detection as the
detection of disturbances of
homoeostatic & compensatory
mechanism while bio chemical,
morphological & functional changes
are still reversible.

52. • Early detection & treatment are
the main interventions of
disease control.

53. MASS TREATMENT APPROACH
• A mass treatment approach of
used in the control of certain
diseases (yaws, pinta, trachoma,
malaria).

54. • There are many variants in mass
treatment. They are ; total mass
treatment, juvenile mass
treatment; selective mass
treatment; depending upon the
nature & prevalence of disease
in the community.

55. DISABILITY LIMITATION
• The objective of this intervention is
to prevent or halt the transition of
the disease process from
impairment to handicap.

56. CONCEPT OF DISABITLITY
DISEASE IMPAIRMENT DISABILITY HANDICAP
IMPAIRMENT : Any loss or abnormality
of psychological, physiological or
anatomical structure or function.

57. • E.g., loss of foot, defective vision.
• An impairment may be visible or
invisible, temporary or permanent
& may or may not lead to secondary
impairment.
• (In case of leprosy damage to nerves
– primary limitation may lead to
plantar ulcers – secondary
impairment).

58. • DISBILITY : Because of an
impairment the affected person
may be unable to carry out certain
activities considered normal for his
age, sex. Disability has been 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

59. • HANDICAP : As a result of
disability, the person
experiences certain
disadvantages in life & is not
able to discharge the obligations
required of him & play the role
expected of him in the society.

60. • “Handicap” may be defined as a
disadvantage for a given
individual, resulting from an
impairment or a disability, that
limits or prevents the fulfillment
of a role that is normal for that
individual.

61. • Accident------Disease or disorder.
• Loss of foot-----Impairment
(extrinsic or intrinsic)
• Cannot walk-----Disability
(objectified)
• Unemployed----- Handicap
(socialized)

62. DISABILITY PREVENTION
• “Disability prevention” relates to
all levels of prevention.
• Reducing occurrence of
impairment---immunization.

63. • Disability limitation by
appropriate treatment (secondary
prevention).
• Preventing the transition of
disability into handicap (tertiary
Prevention)

64. REHABILITATION
• Rehabilitation has been defined as “
the combined & coordinated use of
medical, social, educational &
vocational measures for training the
individual to the highest possible
level of functional ability.

65. • It includes all measures aimed at
reducing the impact of disabling &
handicapping conditions & at
enabling the disabled &
handicapped to achieve social
integration.
• Rehabilitation has emerged in
recent years as a medical specialty.

66. • The following areas of concern in
rehabilitation have been identified :
• 1. Medical rehabilitation --- Restoration
of function.
• 2. Vocational rehabilitation ---
Restoration of the capacity to Earn a
livelihood.

67. • 3. Social rehabilitation ---
Restoration of family & social
relationships.
• 4. Psychological rehabilitation ---
Restoration of personal
dignity & confidence.

68. THANK YOU

70. William Shakespeare
was an English poet,
playwright, and actor,
widely regarded as the
greatest writer in the
English language and
the world's pre-eminent
dramatist. He is often
called England's
national poet and the
"Bard of Avon".

71. Shakespeare's Works
• COMEDIES
• All's Well That Ends Well
As You Like It
Comedy of Errors
Love's Labour's Lost
Measure for Measure
Merchant of Venice
Merry Wives of Windsor
Midsummer Night's
Dream
Much Ado about
Nothing
Taming of the Shrew
Tempest
Twelfth Night
Two Gentlemen of
Verona
Winter's Tale
HISTORIES
Henry IV, Part I
Henry IV, Part II
Henry V
Henry VI, Part I
Henry VI, Part II
Henry VI, Part III
Henry VIII
King John
Pericles
Richard II
Richard III
TRAGEDIES
Antony and Cleopatra
Coriolanus
Cymbeline
Hamlet
Julius Caesar
King Lear
Macbeth
Othello
Romeo and Juliet
Timon of Athens
Titus Andronicus
Troilus and Cressida