This document discusses the concept of primary health care. It defines primary health care as essential health care that is universally accessible and affordable. The key elements outlined in primary health care are maternal and child health, immunization, disease prevention and control, treatment of common illnesses, and access to essential drugs. The principles of primary health care are equitable distribution of services, community participation, coordination between different sectors, use of appropriate technologies, and focus on prevention. The role of nurses in primary health care involves direct care provision, health education, planning and managing care, guiding and supervising other personnel.
Unit -I : Community Health IntroductionSMVDCoN ,J&K
Special field of nursing that combines the skill of nursing, public health and same phase of social assistance and function as part of the total public health program for the promotion of health, the improvement of the condition in the social & physical environment, rehabilitation of illness & Disability.
Unit -I : Community Health IntroductionSMVDCoN ,J&K
Special field of nursing that combines the skill of nursing, public health and same phase of social assistance and function as part of the total public health program for the promotion of health, the improvement of the condition in the social & physical environment, rehabilitation of illness & Disability.
A home visit is one of the essential parts of the community health services because most of the people are found in a home. Home visit fulfils the needs of individual, family and community in general for nursing service and health counselling. A home visit is considered as the backbone of community health service. A home visit is a family –nurse contact which allows the health worker to assess the home and family situation in order to provide the necessary nursing care and health-related activities.
Family health services are the central point of health services.
It is an important component of “Health for All” goal.
Health of each individual affects the health of other member of family.
MATERNAL & CHILD HEALTH PROGRAMME IN COMMUNITY HEALTH NURSING
According to W.H.O. (1976) Maternal & child health services can be defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the mother & child.” Thus maternal & child health services is an important & essential services related to mother & child’s overall development.
6. Reduce maternal, perinatal, infant & child mortality & morbidity rates. Child survival. Promoting reproductive health or safe motherhood. Ensure birth of healthy child.
7. Prevent malnutrition. Prevent communicable disease. Early diagnosis & treatment of the health problems. Health education & family planning services.
8. The MCH service are rendered through the infrastructure of P.H.C. & sub centers. It is proposed to set up one P.H.C. & sub-centers. It is proposed to set up one P.H.C. for every 30,0000 population, & one sub-centers for every 3000 to 5000 population. Each sub-centers are foundation of national health system. Each sub-sub-center is manned by a team of one male & female health worker. In addition there is a team of one trained Dai & one health guidein every village.
The level of prevention topic will help you to know about how to prevent any particular disease in humans. Level of prevention is categorized into four
Primordial prevention
Primary prevention
Secondary prevention
Tertiary prevention
A home visit is one of the essential parts of the community health services because most of the people are found in a home. Home visit fulfils the needs of individual, family and community in general for nursing service and health counselling. A home visit is considered as the backbone of community health service. A home visit is a family –nurse contact which allows the health worker to assess the home and family situation in order to provide the necessary nursing care and health-related activities.
Family health services are the central point of health services.
It is an important component of “Health for All” goal.
Health of each individual affects the health of other member of family.
MATERNAL & CHILD HEALTH PROGRAMME IN COMMUNITY HEALTH NURSING
According to W.H.O. (1976) Maternal & child health services can be defined as “promoting, preventing, therapeutic or rehabilitation facility or care for the mother & child.” Thus maternal & child health services is an important & essential services related to mother & child’s overall development.
6. Reduce maternal, perinatal, infant & child mortality & morbidity rates. Child survival. Promoting reproductive health or safe motherhood. Ensure birth of healthy child.
7. Prevent malnutrition. Prevent communicable disease. Early diagnosis & treatment of the health problems. Health education & family planning services.
8. The MCH service are rendered through the infrastructure of P.H.C. & sub centers. It is proposed to set up one P.H.C. & sub-centers. It is proposed to set up one P.H.C. for every 30,0000 population, & one sub-centers for every 3000 to 5000 population. Each sub-centers are foundation of national health system. Each sub-sub-center is manned by a team of one male & female health worker. In addition there is a team of one trained Dai & one health guidein every village.
The level of prevention topic will help you to know about how to prevent any particular disease in humans. Level of prevention is categorized into four
Primordial prevention
Primary prevention
Secondary prevention
Tertiary prevention
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Waste management in the center and clinicsKrupa Mathew
community health nursing - Role of community health nurse in waste management in the center and clinics --- for bsc nursing students --- hospital waste management ---biomedical waste management
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
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Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
2. OBJECTIVES
The student will be able to,
define primary health care
list out the elements of primary health care
explain the principles of primary health care
detail the roles and responsibility of community
health nurse in primary health care
3. INTRODUCTION
Primary health care approach had its
inception in the year 1978 following an
international conference at Alma –ATA in
USSR.
Primary health care is equally applicable for
all the countries from most to the least
developed countries have accepted primary
health care as the vital part of the health
system.
3
4. DEFINITION
“Primary Health Care is essential health care
made universally accessible to individuals &
acceptable to them, through their full
participation & at a cost the community &
country can afford ”.
4
5. ELEMENTS OF PRIMARY HEALTH
CARE
The Alma-Ata conference outlined 8 essential components of primary health care.
Education concerning prevailing health problems and the methods of preventing and
controlling them.
1. Education and information concerning prevailing health problems and methods
of preventing and controlling them
2. Promotion of food supply and proper nutrition.
3. An adequate supply of safe water and basic sanitation.
4. Maternal and child health care, including family planning.
5. Immunization against major infectious diseases.
6. Prevention and control of locally endemic diseases.
7. Appropriate treatment of common diseases and injuries.
8. Provision of essential drugs.
5
6. PRINCIPLES OF PRIMARY
HEALTH CARE
1. Equitable distribution.
2. Community participation.
3. Intersectoral coordination.
4. Appropriate technology.
5. Focus on Prevention
6
7. EQUITABLE DISTRIBUTION
The first key principle in the primary health care strategy is equity
or equitable distribution of health services.
Health services must be shared equally by all people irrespective
of their ability to pay, and all must have access to health services.
At present health services are mainly concentrated in the major
towns and cities resulting in inequality of care to the people in
rural areas.
The worst hit are the poor and the needy and vulnerable groups of
the population in rural areas and urban slums.
This has been termed as social injustice.
8. The failure to reach the majority of the people is
due to inaccessibility.
Primary health care aims to redress this
imbalance by shifting the centre of gravity of the
health care system from cities to the rural areas
and bring these services as near people’s homes
as possible.
9. Community participation
Health of the people is not just the responsibility of
central and state government alone.
Involvement of people in the development process
voluntarily and willingly is vital component of
primary health care.
9
10. There must be a continuing effort to
secure meaningful involvement of the
community in planning, implementing &
maintenance of health services, besides
maximum reliance on local resources
such as manpower, money & materials.
10
11. Best example for community participation is
introduction of village Health Guides” & “Trained
Dais” using people from local community. It is an
essential feature of primary health care in India.
• China had set his fore front strategy by
introducing community participation in the from
of “bare foot doctors” .
11
12. INTERSECTORAL COORDINATION
There is an increasing realization of the fact that the components
of primary health care cannot be provided by the health sector
alone.
The declaration of Alma-Ata states, primary health care involves
in addition to the health sector, all related sectors and aspects of
national and community development, in particular agriculture,
animal husbandry, food, industry, education, housing, public
works, communication and other sectors”.
This requires strong political will to translate values into action,
an important element in intersectoral approach is planning –
planning with other sectors to avoid unnecessary duplication of
activities.
13. Appropriate technology
Appropriate technology has been defined as
“technology that is scientifically sound,
adaptable to local needs, & acceptable to
those who apply it & for those whom it is
used & that can be maintained by the people
themselves in keeping with the principles of
self reliance with the resources the
community & country can afford
13
14. Cont..
The term appropriate is emphasized because
in some countries luxurious hospitals that are
totally inappropriate to the local needs, are
built, which absorb a major part of the
national health budget, effectively blocking
many improvement in general health
services.
14
15. Focus on Prevention
Prevention is the core strategy of primary
health care. Community health nurses focus
on health promotion and health maintenance
activities for which they engage in primary
,secondary and tertiary level of preventive
care activities.
15
16. ROLE OF NURSE IN PRIMARY
HEALTH CARE
WHO study group in 1985 highlighted the
following roles and functions of nurses in
primary health care.
1. Direct care provider
The nurse provide direct care to individual,
families and community with reference to 8
elements of primary health care
Ex:MCH Care
16
17. Health educator & teacher
In order to promote health, prevent disease, regain and
maintain health, the nurse educates individuals, families
and community at large about healthful behavior, sanitary
environment, prevention of diseases etc., she educates
family members to take care of the sick in her absence and
also other preventive measures.
As a teacher, she trains other health workers such as
ANMs, health Guides, Village Dais
17
18. Good planner & care manager
The nurse working for primary health care
makes assessment of health needs, health
problems of individuals, families and
community.
The nurses involves individuals, families and
community in planning and implementing of
the care.
She makes referrals when
required.
She maintains the record of care given and
evaluates the effectiveness of the same.
18
19. Guide & supervisor
As a nurse engaged in providing
primary health care, she is expected
to supervise, guide and help other
personnel in providing care, planning
health services for families and for the
community.
19
20. Specific functions-PHC
Assessment of health needs and health problems of
individuals and community.
Provide integrated comprehensive primary health care
service related to 8 essential elements.
Mobilize involvement of individuals, families and
community in providing primary health care.
20
21. Surveillance of locally endemic diseases.
Monitoring and analysis of health condition to determine
the progress in primary health care.
Training and supervision of health workers.
Working in collaboration with other socioeconomic
sectors.
Maintenance of accurate, complete and up-to-date records
of health care services rendered
21
22. REFERENCES
1. Shyamala, D. ( 2018). Text book of community
health nursing –II , 1st edition, CBS Publishers
2. Neelam Kumari,(2011) A textbook of community
health nursing –II First Edition,
S vikas & Company Medical publisher .
3. K.PARK, (2019).Textbook of Preventive and
Social Medicine, 25rd edition , Banarsidas Bhanot
Publishers.
22