CONCEPT OF EPIDEMIOLOGY

By: Andi Agus Mumang, S.KM

Based on "An Epidemiological Model for Health Policy Analysis" by G.E. Alan Dever, in his book "Social Indicators Research 2" 1976 page 455. Explain that:

Concept “Epidemiological models used in the analysis of health policy” consists of:

Human Biology

• Maturation and Aging
• Complex internal systems
• Genetic inheritance

Environment

• Physical environment
• Social environment
• Psychological environment

Lifestyle

• Employment Participation and Occupational Risk
• Consumption pattern
• Leisure activity risks

System Health Care Organizations

• Preventive
• Curative
• Restorative

Some epidemiological concepts are:

Concept  “Health Field Concept” by Lalonde (1974) :

• Environment
• Life style
• Biology
• Health care delivery system

Concept “Achieving Health for All” by Epp 1986 :

Aim

Health Challanges :

• Reduction inequalitie
• Increasing prevention
• Enchanging copin

Health Promotion mechanisms

• Self Care
• Mutual Aid
• Healthy Environments

Implementation Strategis

• Fostering public participations
• Strengthening community health services
• Coordinating healthy public policy

Concept “Determinants of Health Model” by Evvan and Stoddart (1990) :

• Individual response include behaviour and Biology
• Social environment
• Physical environment
• Genetic endowment
• Prosperity
• Well-being includes health and function, disease, and health care

Concept “Community Oriented Health System” by Rohree (1999) :

• Needs assessment
• System design
• System performance
• Organizational performance assessment

Concept “Seven Patters Health Community” by Norris and Pittman (2000) :

• Healthy Environment
• Vital Economy
• Personal well-being includes mind, body and spirit
• Participation in civil life includes practices ongoing dialogue, Embraces diversity, Shapes its future, Cultivates leadership ever-where, Create a sense of community, Connects people and resources, and Knows itself

Concept “Healthy People ini Healthy Community” by Healthy People (2000) :

• Determinats of health
• Policies and interventions includes social environment, biology, behaviour, physical environment
• Access to quality care
• Health status

Concept “Framework for Health Care System Development” by GRDC (2001) :

• Health Care Policy
• Stable local health care systems includes regional/rural partnership, community participation
• Access to primary care includes health insurance, support services
• Improved health status include monitoring/surveillance of epidemiological data

CONCEPT OF SPECTRUM EPIDEMIOLOGY: SPECTRUM OF DISEASE

By: Andi Agus Mumang, S.KM

The concept of epidemiology spectrum is divided into two major groups namely:

• Clinical focus is a phase that requires treatment measures undertaken by medical personnel (medical area)
• Subclinical focus is a phase that requires preventive measures carried out by epidemiologists (area epidemiology).

The role of epidemiology is very dependent on people's perceptions of pain so it more inclined to identification risk factors for people's health status. This stage is called stage pre-pathogenesis and pathogenesis. Furthermore, is the stage of clinical response Identification of risk factors through the efforts of early diagnosis, this stage also focused on efforts to impede the progress of a disease, The most important thing here is the detection of high-risk factors that significantly. As it is a highly qualified competence for an epidemiologist.

Spectrum Disease Overview 

No

Spektrum Penyakit

Clinical

Subclinical

1

Awal Penyakit (Disease Inception)

Prepatogenesis (Prepathogenesis)

Patogenesis (Pathogenesis)

Progress Patologi (Pathological Progression)

2

Respon Klinis (Clinical Response)

Ringan (Mild)

Sedang (Moderate)

Berat (Several)

3

Gejala Sisa (Squelae)

Penyembuhan (Convalenscene)

Remisi/Kekambuhan (Remission/Recurance)

Perkembangan tak terhenti (Unremitting Progression)

4

Kematian (Death)

                                          Spectrum Disease Modification Overview

Exposure to Etiological agent	Pathologis changes			Symptoms	Usual time of diagnosis		Death
Subclinic manifestations					Clinical Illness
Health optimal		Healthsuboptimal			short-range sick	long-range sick
Epidemiology area					Clinical area

PUBLIC HEALTH : LEVELS OF PREVENTION

 By: Andi Agus Mumang, S.KM

Initially, the concept of health (treatment) includes four components include:

• Health promotion
• Disease prevention
• Restoration Disease
• Rehabilitation

This concept is expressed by Sigerist. Furthermore, this concept was adopted by Leavell and Clark and then modified into several stages which they refer to as levels of prevention:

Primary Prevention is a precautionary measure which precedes disorder / health problem by continuing to put forward the principle of "flexible lines of defense" that seeks to prevent and reduce any risk factors that allow triggering nuisance / health issues. The form of primary prevention described in the following forms:

• Promotion of Health (Health Promotion)
• Specific Protection (Specific Protection)

Secondary Prevention is a precautionary measures do when it has symptoms / health problems that arise with always adhered to the principle of "internal lines of resistance" which seeks to reduce risk factors through improved resistance factors. The main form of secondary prevention is:

• Early diagnosis and prompt treatment

Tertiary Prevention is a precautionary measures do after experiencing the event of illness / health problems to reduce / limit the occurrence of illness / impact of the occurrence of illness and restore it to its original state by continuing to maintain stability and also the optimization of health. Prevention of this form include:

• Restrictions on Disability (Disabality Limitation)
• Rehabilitation (Rehabilitation)

PRINCIPLES IN EPIDEMIOLOGY OF PUBLIC HEALTH: PART 1

By: Andi Agus Mumang, S.KM

Epidemiology as a branch of sciences in public health has a principle as a tool to identify the determinants of a disease, the natural history of a disease, and the classification of disease. Epidemiology basically it not only be applied to a case of disease, but also can be applied in a variety of health problems from the aspect of health itself or in terms of non-health aspects (social, economic, political and policy). Furthermore, Epidemiology will conduct planning and evaluation of health programs.

Here is a description of the application of the principles of epidemiology:

Identify Risk Factors or Determinants

An epidemiology expert clearly and plainly should know about the risk factors for a disease / health problems ranging from phase exposed till phase of handling cases. Such phases have been described in the first node of the node management of epidemiology. In These stages used to identify the risk factors as root causes and then formulated in a developing hypotheses to prove there is relationship or not on the incidence of disease. Read more

Trip Disease History

(Continued ...)

Knowing Classification of Diseases

(Continued ...)

Evaluation of Health Programs

(Continued ...)

References:

Hadisaputro S, M Nizar, Suwando A. 2011. Managerial Epidemiology, Theory and Applications. Semarang: BP Diponegoro University of Semarang.

PRINCIPLE IN EPIDEMIOLOGY: IDENTIFICATION OF RISK FACTORS OR DETERMINANTS

By: Andi Agus Mumang, S.KM

An epidemiology expert clearly and plainly should know about the risk factors for a disease / health problems ranging from phase exposed till phase of handling cases. Such phases have been described in the first node of the node management of epidemiology. In These stages used to identify the risk factors as root causes and then formulated in a developing hypotheses to prove there is relationship or not on the incidence of disease.

Methods in identifying risk factors are presented in the form of epidemiological design and frequency distribution by the place, people and time at each node epidemiology. So that would make it easier to identify the cause of the dominant (dominant risk factor). Next, perform the stages of development of a hypothesis to know the presence or absence of linkages between suspected risk factors on the incidence of the disease (the significance of risk factors).

As an example:

Case: TB by Mycrobacterium tuberculosis

In a study of medical microbiology, Mycro.tuberculosis is the strongest factor that cause of TB cases. Someone who found tubercle bacilli in his/her bodies (susceptible), means that person is identified had TB. Until the process can develop into subclinical (there is pathological changes to the appearance of symptoms) until the event of sickness (clinical phase). All these stages are starting from TB bacterial infection on the person. On the other hand, an epidemiologist trying to examine more deeply what causes until the exposure occurred, where and when the course of the exposure (the principle of epidemiological studies on people, places and times).

So is then pushed the epidemiologist to make identification. The supposition which allow exposure to a disease is called a risk factor. Other epidemiological principle used that multicausal factor is definitely. That is, the occurrence of a disease followed by various causes. Not is only the main cause, but also other causes. This is then assessed in the identification of risk factors. In the case of TB, some of the risk factors is nutritional and immune status, population density, household contact history, housing conditions and behaviors.

Identification of the risk factors in disease diagnosis phase can be done. For example, in the case of TB, a factor involved in diagnosis is the selection of populations and strategies, taking sputum, making preparations to the test laboratory. Likewise, recovery phase (treatment /healing). It could allow a risk factor is compliance with treatment, drugs, PMO, motivation and commitment of officers, etc.

Here's the thing done by an epidemiologist in tackling a health problem. Many factors must be considered as well as the many factors that must to be identified whose purpose is to obtain accuracy to the study of a disease or health problem

THE USE OF EPIDEMIOLOGY IN PUBLIC HEALTH

by : Andi Agus Mumang, S.KM

Generally, epidemiology helpful in explaining the various health phenomenon that occurs around. In more detail the benefits of epidemiology are as follows:

1. Epidemiology helpful in assessing the public
2. Epidemiology helpful in making decisions individually
3. Epidemiology helpful in completing the basic determination of diagnosis
4. Epidemiology helpful in finding cases

In addition, by MacMahon and Pugh, 1970, epidemiology used for:

1. Develop hypotheses in explaining the pattern of development and spread of the disease specific
2. Test the design of epidemiological
3. Test the truth of the concept of illness
4. Classifying the exposed group to determine and identify the factors that cause

Reference : 

• Hadisaputro S, Nizar M, Suwando A. 2011.  Epidemiologi Manajerial, Teori dan Aplikasi. Semarang: BP Univesitas Diponegoro Semarang.

EVENTS ACTION SUPER OF PEACE 212 MAKASSAR, A SUPER PEACEFUL ACTION DESERVE TO PRAISED

By: Andi Agus Mumang, S.KM

02/12/2016 13:00 pm.  After doing of the Friday prayers held at Masjid Al Markas Al Islami, the super of peaceful demonstrators flocked out of the mosque toward the rallying point of the yard of the mosque to immediately went to the location that would later become the focal point of implementation action super of peace in Karebosi Field Makassar. A number of banners and attribute the action started to be worn by participants of the action ranging from posters, flyers, headband, organizations flag, red and white flag, and other attributes.

It appears the atmosphere at that time showed a very high enthusiasm of all participants in the action super peaceful since the morning had alert looking forward to today's action. They all shout out loudly by saying "Penjarakan Ahok". Since the action of peace 411 yesterday, a single demand that continues shouted and desired by them is enforce the law with justice in Indonesia by imprisoning Ahok the blasphemer. Takbir voice was shouted by the demonstrators of super peaceful. Not long after, finally participants of action also took to the streets to go to Karebosi field.

The ambiance street filled with tens of thousands of people instantly flooded roads that become rute of participants. The white clothing worn by participants of the action indicate the shady situation which is so powerful. The action was motivated by the action of super peaceful, really shows the spirit of peace along the road which it looked like a sea of people. Plus the super peaceful demonstrators who take action to greet the public at that time who watching the action along the way. Besides, the ants army in the behind are standing by picking up the garbage  remnants  of the demonstrators super peaceful. Some of the medical team with ambulance is on standby for demonstrators when they need medical assistance. Seen also the participants of the action in cooperation with the security forces to curb traffic. No less interesting and remarkable is the number of food logistics provided free along the road ranging from drinking water and most of the food was donated by the community simpatan.

Arriving in Karebosi , the demonstrators entered the area of the field in an orderly manner in accordance with the instructions. In that afternoon, Karebosi field is really packed with dozens of thousands people. there tablig akbar is held by ulama and umara. Ulama who attended the meetings come from the various Islamic organizations. Umara' who was present and also gives oration, they are the Governor of South Sulawesi, Makassar's mayor, police chief and military commander of VII Wirabuana Makassar. It appears that the action is implemented peacefully and reaping super strong support of the scholars and umara. All of them support the importance of maintaining the integrity of the safety of the nation through the efforts of law enforcement without indiscriminately. 

The support was warmly welcomed by Takbir echoes the demonstrators were very enthusiastic. Additionally, through a representative of the protesters from the Islamic People's Forum Unite also delivered manifesto to demands a single, abbreviated as "Matutu" which was then handed over to the Governor of South Sulawesi, which was witnessed by other regional leaders and also by the security forces and all participants of super peaceful's action  which contains the affirmation to punish Ahok and memenjarakanya in accordance with applicable law. The super peaceful's action 212 was closed with Asr prayer in congregation and prayer together. A super peaceful action that ends very, very super that deserve to be commended. *)

THE SECONDS AHEAD OF "ACTION SUPER OF PEACE 212" IN MAKASSAR

By: Andi Agus Mumang, S.KM

02/12/2016 11:00 pm. ABI (action of defend islam ) chapter III  today took place in the city of Makassar, which is one of the cities that participated in their fair law enforcement efforts related to cases of religion defamation committed by Basuki Cahya Purnama who also known as Ahok. According to national headline about action of defend islam chapter III known as Action Super of Peace 212, which is held in the third time as the really of super action if compared by the implementation of the  action peaceful 411 which we have been knowing as peaceful demonstration which also has proven in its implementation. This action simultaneously confirms to all elements of society that this action is not the action of treason or action is ridden by a particular political scenario. Action super of peace 212 in Makassar is held with acts of prayer and sajadah degree with a view to the safety of the nation. In addition, some slogan that became a hastag on this action in Makassar as "Damai Indonesiaku" and "Penjarakan Ahok". Besides, the theme was "Enforce the law in my country, to make peace in Indonesia with Law Enforcement.

As planned that this time the action will bring approximately 10,000 Muslims who gathered as the United Muslim Forum (FUIB) Makassar derived from group of cadre organizations and the general public (non-cadre organizations). This activity will be held after Friday prayers at around 13:00 pm until 16:30 pm. Implementation of the Friday prayers will be focused on the Masjid Al Markas Al Islami which will also being starting point of the participants of peaceful action. The plan, participants of a peaceful protest along the route will pass through Bawakaraeng's street to the Kartini's street towards Karebosi Field. There will be held takbir akbar by ulama and umara. The security forces had been alerted as a combined of military and police. The plan of Friday prayer will be attended by police chief and military commander of VII Wirabuana also there will be a briefing from them before the action takes place. *)

CONTENT OF PUBLIC HEALTH IS...

By : Andi Agus Mumang, S.KM

Public Health has multidisciplinary science coverage. That is, public health science consists of several disciplines, among others, includes the science of biology, medicine, chemistry, physics, environmental science, sociology, anthropology, psychology, science education, and so on. Based on some of the above disciplines, community health sciences in general in scope as follows:

Epidemiology

Epidemiology comes from the Greek, namely (Epid = on, Demos = people, logos = science), thereby epidemiology is the study of matters relating to the community. Besides, epidemiology can also be interpreted as a study of the frequency and spread of health problems in a group of humans and the factors that influence health problems (Azrul Azwar).

Biostatistics / Health Statistics

Statistics used in health problems, include in the plan, application, evaluation, and monitoring.  Statistics are important because each recording health problems needed to make improvements. Additionally, biostatistics can be defined as a set of concepts and methods used to collect and interpret data on the health sector and draw conclusions in a situation where there is uncertainty and variation.

Environmental Health

The study of the study on the state of the environment and the efforts made to create a healthy environment. Environmental health can also be defined as the science and art of helping people make their optimal healthy lifestyle. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual. This is not just changing lifestyles, but berkairan with changing environment is expected to be more supportive in making healthy decisions (HAKLI)

Public Health Administration

Public health administration is the science in the form of activities carried out jointly by utilizing the organization and management processes in its efforts to achieve the goal of health care as well as possible in order to reach the degree of public health as high.

Community Nutrition

Nutritional science is the study or review that is associated with health food. The science of nutrition covers ranging from procurement, selection, processing and presentation. Community nutrition dealing with malnutrition in the community where the community has a wide aspect, and should be treated as  a multisectoral.

Occupational Health

Occupational health in public health settings often associated with safety. So it has known as K3 (Occupational Health and Safety). K3 is a condition that occurs in a person in relation to the world or the place where he/she worked.  Such, an interruption of work due to a noisy workplace condition, skeletal muscle injury, fire hazards, and so on.

Health Promotion and Behavioral Sciences

Science and art of helping people make their optimal healthy lifestyle. Optimal health is defined as a balance of physical, emotional, social, spiritual, and intellectual. This is not just changing lifestyles, but it’s included by changing environment is expected to be more supportive in making healthy decisions.

  

Management of Hospital Administration (MARS)

Management of the hospital administration is the study of coordination between the various resources (management elements) through the process of planning, organizing, controlling the ability to achieve the purpose of the hospital. 

See also : Health and Healthy Concept, How to keep healthy living

ADVERSITY IS THE BEGINNING OF A SUCCESS

By: Andi Agus Mumang, S.KM

People today may be underestimated you. Because you

visible low in your status. But it does not mean that you suddenly turned into a pessimist. When, you do not have something to be proud. Perhaps, it is only for this time.  Not that you no longer have any hope to proud.

Adversity is the beginning of a success. Someone who ever felt the bitterness of adversity, they will hasten to reap success. Adversity is not a disgrace but a move that would motivate a person to move forward toward success. Adversity gives lessons to succeed. Basic adversity is very dark and smelled foul. Who will hold linger in pools? His/her eyes immediately alert, immediately raced stride, despite being forced to crawl up with both hands, he/she will hasten his/her self probably to out of the slump valley. Here is the beginning of success.

Someone might fall limp in helplessness when he/she was sinking in his/herself.  Even, weeping as signaling the end of his life. When the downturn has worsened much drown you, then remember that the bitter taste was very sick. What should be the next step?. Haste to assemble your success’s boat, make every veins of this slump as frame of your boat. Glue the boat with expectations. Run it by machines motivation which will spur you to develop success screen.

Surrender is not a wise word for those who dream of success. To be success, it may ever make you in an adversity. However, when you stop it will make you worse off. This then will summon the voices of those who love underestimate and patronize. Finally, the soul is mourning in grief pessimistic. Is it appropriate at this time to yourself grieve?

Success is not for those who are cowards, not for those who are happy with the title or nickname lowly. When there is nothing you are proud of, you should have determination. Motivation is in yours, that the success started of your spirit to wake from dreams that make you worse.

Thus, it will realize you, that, "Adversity is not the end of success however, it is the beginning of your success" 

MOTIVATION OF DOING GOODNESS

Goodness is not easy, but special. Everyone has the potential to do good. However, how much the potential of goodness it depends on how much a person's beliefs on that issue. Not an easy thing, by no means difficult, if anyones basically been awarded the goodness to themselves, certainly make it happen will not be too difficult. Especially, when it was a matter of potential in a person. It's special, because goodness is the realization of one's purity and sincerity of his soul. Goodness becomes a mirror of motion and attitude. So that makes the owner created as special masterpiece.

By : Andi Agus Mumang, S.KM

Goodness will bring benefits and appreciation. The benefit come from the trust of  those who feel that goodness. In addition, also in the form of reply kindness to the perpetrators of kindness by the recipient of goodness (the reciprocal relationship / simbiosi mutualism). Appreciation is a form of reward which embedded in the hearts of each person who feel that goodness and it will imprint in their memory forever. Likewise with a real appreciation will be obtained in the form of honor and exaltation to the perpetrators of goodness.

Kindness is not something that is forced, but sometimes have to be forced. When doing a favor do so with sincerity and sincere encouragement from the heart. Not a result of coercion. Because it would hardly to be a kindness if it is forced to do. In fact, sometimes just going to be the motive unrequited, that it is difficult to feel the power of kindness. However an another case, the kindness sometimes should be forced. When we feel that goodness is difficult, it should be forced in the early. Because, sometimes that's where the lessons and experience will be very instrumental goodness deliver it to the degree of sincerity ...

Again, let's motivate yourself to always do good. Because goodness is beautiful.

UTILIZATION FACTORS OF HEALTH SERVICES

By : Andi Agus Mumang, S.KM

In the utilization of health services, there are several factors that cause a person to make decisions on the utilization of health services. The factors are as follows:

1. Factors Enabling  are the factors that describe the condition of a person who makes it able to take action to meet their needs for health services. Consisting of family resources include income, insurance participation and the ability to buy services. Furthermore, community resources include faskes, medical practitioners, health human resources, the availability of medicines, etc.
2. Factors Predisposition is a factor describing the state of a person before the person is experiencing pain. These factors are divided into two, namely the factors that can be changed (mutable) such as lifestyle, education, socio-economic status, knowledge, culture, etc. Factors that can not be changed (immutable): sex, age, etc.
3. Factors Need are factors that affect a person's need to utilize health services. This factor divided by pain and needs. Based in pain, needs halved the perceived need (state of health is perceived by the individual) and evaluated need (doctor's judgment on people's health). Furthermore, based on the needs are divided into four categories namely undetectable need (need not be detected, where sickness has been there but can not be detected by medical technology), detectable need (the opposite of undetectable need), felt need (perceived needs, when someone has sick), and the absolute need (requirement at the beginning when the disease has not been detected and the needs of the post-disease is detected).

PUBLIC HEALTH IS...

By: Andi Agus Mumang, S.KM

PUBLIC HEALTH according Winslow is the science and art of preventing disease, prolonging life, improve physical and mental health, and efficiency through the business community is organized to improve environmental sanitation, control of infection in the community, education of individuals about personal hygiene, the organization of medical services and care, to early diagnosis, prevention of diseases and the development of social aspects, which will support so that every person in the community has a strong standard of living to maintain their health. (Leavel and Clark, 1958).

Explanation:

Public Health is not just talking the issue of science course (theory) but also speak related art (which modificate application strategy, innovative and creative) in the health effort. Mentioned in the above definition of health efforts such as:

1. Prevention of disease. In terms of public health sciences most priority in disease prevention efforts are the health or disease prevention. Disease preventions strategies in sphere of public health are community-based prevention strategies to always pay attention to the elements that make up the community (individuals, families, etc.)
2. Enterprises prolong life. Public health in its application seeks their health efforts are comprehensive and organized in order to increase the "value of life" both in terms of quantity and quality.
3. Enterprises improve the physical and mental health. Regulate public health strategies for improving mental and physical health by good quality health services.
4. The efficiency of health. Public health also regulates health strategy that is efficient in terms of health measures seek to maximize all potential health resources economically to obtain a satisfactory achievement.

This is done through community organizing efforts (involving community participation in health measures) with the goal of improving all the variables that affect the achievement of the health status include:

1. Environmental sanitation is an attempt to rescue the environment as an important factor that plays a role in the chain of public health
2. Control of infection in the community is an effort to suppress the rate of prevalence of infections that occur in society.
3. Individual health education is a form of health protection to every individual as the smallest part in a community through health education.
4. Organization of medical services and treatments are performed with the aim of early diagnosis and prevention of disease
5. The development of the social aspects of health development efforts in terms of social aspects directed to the community as a target in order to empower public health.

The purpose of their public health efforts is to support that everyone in society has a strong standard of living to maintain their health. Content of public health is click here   

See also health and healthy concept here !

How to keep healthy living ?