REGULATIONS

BLOCK CBP
(Community-base Medical Practice)
1. HP harus dimatikan selama kuliah dan SGD
2. Study Guide dan semua references agar selalu
dibawa saat kuliah, SGD, individual learning
3. Kehadiran dan keaktifan saat SGD dinilai
(5% dari nilai ujian)
4. Kehadiran saat kuliah dan feedback dihitung
(bila lebih dari 25% tidak ikut) tidak bisa ujian
5. Pada saat feedback mahasiswa presentasi
dengan memakai OHP
6. Wakil mahasiswa yang presentasi harus dipilih
pada saat SGD dan bukan di ruang kuliah
7. Wakil mahasiswa yang presentasi harus bergilir
(tidak boleh sama pada setiap feedback)
8. Sesaat sebelum feedback dimulai, wakil
masing-masing kelompok yang akan presentasi
langsung duduk didepan
9. Nara sumber akan memberi feedback
pada presentasi mahasiswa
APPROCHES OF CBP
Prevention
Community
(not individual)
REFERENCES & HANDOUTS
Study Guide
Reference Books No. 1
Reference Books No. 2
Sudigdo (Bahasa Indonesia)
Handout (Bahasa Indonesia)
OPTIONAL
HARI 1, 2, 3: CONTENT-1
CURRICULUM CONTENTS (STUDY
GUIDE): 5 CONTENTS
LEARNING MATERIALS:
REFERENCE NO. 1 PAGES 1 41
OR HANDOUT BHS INDONESIA
CURRICULUM CONTENT-1
1. Apply diseases prevention in the
community based on determinants of
morbidity and mortality and their
natural history
a) Describe several models of diseases and death
determinants occurring in the population and their
strengths and weaknesses
b) Correlate natural history of diseases and
appropriate prevention in the community
LEARNING SCHEDULE
(time table)
08.00-09.30: Introductory lecture
STUDY GUIDE PAGE (CLASS A)
09.30-12.00: Film presentation
12.00 - Independent learning
Reference book pages 1-41
Learning task (task-1 and 2 for SGD-1,
and task-3 for SGD-2) pages .
12.00-13.30: Introductory lecture
TIME TABLE CLASS B: STUDY GUIDE PAGE
13.30-15.30: Film presentation
Reference book pages 1-41
Learning task (task-1 and 2 for SGD-1,
and task-3 for SGD-2) pages 25, 26, 28
Afternoon: individual learning
Critical
thingking
Information
management
Communication
skill
Population
Health
(Public
Health)
Clinical
skill
Professional,
values,
attitudes
Scientific
foundations
Five contents
page 1 3
Study Guide
Dalam film presentation
akan ditunjukkan
Kontribusi (peran): scientific foundations,
clinical skill, communication skill, informa-
tion management, critical thinking, profes-
sional values and attitudes, community
health
Meneliti kausa suatu penyakit (AIDS)
dan pencegahannya
DIFFERENCES BETWEEN
1. Responsibilities:
all people in certain
geographical area, health
and sick, those who come
and those who do not come
to health facilities. They
must actively provide
diseases prevention to all
people who are at risk
1. Responsibilities:
all people who come
to the health
facilities. They
usually passive.
PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
2. Function: to mobilize all
stakeholders and using
management principles to
plan, implement and
evaluate primary,
secondary, tertiary
preventions
2. Function:
to cure and to
increase the
patients quality
of life
3. Place of works: health
centre, heath department,
community clinics, etc
3. Place of works:
private practices,
hospitals, etc
PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
4. Diagnostic tools:
epidemiology, statistics,
demography
4. Diagnostic tools:
stethoscope, ECG, lab
examinations kits , CT
Scan, etc
5. Diseases
measurements in the
community:
proportion, prevalence,
incidence, ratio
5. Diseases
measurements for
individual patient: level
of blood pressure, blood
sugar, level of
hemoglobin, etc
PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
6. Treatment at the
community level: public
health program such as
education program,
immunization program,
nutrition program,
family planning
program, etc
6. Treatment for
individual
patient:
medical
treatments,
surgery,
radiation,
physiotherapy,
etc
PUBLIC HEALTH DOCTOR CLINICAL DOCTOR
7. Indicators for
evaluating community
health program: percent
decrease of under
nutrition, percent
increase of contraceptive
use for family planning,
etc
7. Indicators for
evaluating the result
of patients
treatments:
decrease of blood
pressure of the
individual patient,
increase of
hemoglobin
FIVE STARS DOCTOR
(WHO = World Health Organization)
Care provider (clnical dr)
Communicator (clinical & PH dr)
Manager (PH dr)
Community leader (PH dr)
Decision maker (clinical & PH dr)
Critical
thinking
Information
management
Communication
skill
Community
Health (Pu-
blic Health)
Clinical
skill
Professional,
values,
attitudes
Scientific
foundations
FIVE
STARS
DOCTOR
POINT-POINT FILM DAN
PENJELASAN TAMBAHAN
Film ini adalah kisah nyata tentang penelusuran
wabah AIDS pada awal tahun 1980-an. Yang
ditonjolkan adalah aspek sosial, ekonomi, politik,
etika, baik ketika meneliti penyebab AIDS
maupun upaya pencegahannya
Terlihat pula peran berbagai disiplin ilmu dalam
penelitian wabah AIDS (clinical science, virology,
epidemiology, statistics, sosial sience, dll, dll)
Kisah yang mirip dengan film juga diuraikan di
Buku Greenberg halaman 1 - 7
Dr. Don Francis pernah diminta oleh WHO untuk
meneliti wabah Ebola di Sungai Ebola (Afrika)
Jumlah pasien dan kematian terus meroket. CDC
(Bagian dari Depkes Amerika yang menangani
penyakit penular) kebingungan karena
penyebabnya tidak diketahui
Pada awal thn 1980 muncul banyak pasien
dengan gejala-gejala kekebalan tubuh yang rusak
di Eropa lalu banyak pula di Amerika terutama
pada kalangan gay
CDC lalu minta bantuan Dr. Don Francis untuk
mengungkapkan misteri tersebut, bergabung
dengan ahli virologi, ahli penyakit kelamin, pakar
imu sosial, dll
Banyak kendala yang dihadapi oleh Dr. Don
Francis dkk antara lain: masalah politik
(persetujuan biaya oleh pemerintah), masalah
sosial (stigma dan diskriminasi pada gay), dll.
Demikian pula untuk prevention-nya. Dijumpai
penolakan PMI untuk screening darah karena
masalah ekonomi, politik. Penolakan penutupan
tempat-tempat permandian kalangan gay, dll.
Terakhir: masalah etika dalam pengakuan
penemu HIV. HIV diketemukan sekitar thn 1984
dan Hadiah Nobel baru diberikan tahun 2008
kepada Luc Montagnier
Contact tracing atau penelusuran kontak adalah
salah satu cara untuk mencari sumber penularan
suatu penyakit yang ditularkan melalui kontak
langsung termasuk kontak seksual
Richard Gere yang juga sebagai pemain dalam
film ini berperan sebagai seorang selebritis yang
juga kena penyakit misterius tersebut. Seperti
kita ketahui, saat ini dia menyumbangkan seba-
gian kekayaannya untuk penanggulangan AIDS
Presiden Reagan berasal dari Partai Republik.
Partai Republik lebih konservatif dibanding Partai
Demokrat. Komunitas gay di Amerika lebih
terdiskriminasi bila P. Republik yang berkuasa
Populasi komunitas gay di Negara Bagian
California paling tinggi di Amerika
Dokter di salah satu negara di Eropa dipanggil
dan ditegur oleh direkturnya karena banyak
merawat pasien AIDS. Direktur mengatakan citra
RS-nya tercoreng. Si dokter menjawab: Saya
tetap akan merawat mereka, dimanapun saya
mendapat tempat.
Robert Gallo adalah salah seorang ilmuwan
terkemuka di Amerika
Luc Montagnier adalah ilmuwan dan peneliti
di Lembaga Pasteur di Perancis
LIHAT LEARNING TASK-1
(APA YANG DITANYAKAN)
SELAMAT
MENYAKSIKAN
dan
Determinants of morbidity
and mortality in a population
Natural history of the
disease
Diseases prevention
CONTENT-1
The Epidemiologic Triangle
(Teori Segi Tiga) page 26 33)
Wheel Model (Teori Roda) page 35-39
Web Model (Teori Sarang Laba-laba) page 33
Model Blum not available in ref 1 & 2
Several models/concept used to
analyzed determinants of morbidity
and mortality in a population
Model Mosley not available in ref 1 & 2
MODEL BLUM
Morbidity and
mortality in
a population
Environmental factors
(biological, physical, social, economical, politic)
Health
services
Genetic
Behavior
Susceptible
(at risk)
Primary prevention
Health promotion
Specific protection
Presym-
tomatic
stage
Secondary prev.
Early detection
& prompt
treatment
Clinical
stage
Stage
of
dis-
ability
Tertiary prev.
Disability
limitation
Rehabilitation
Genetic
Environment
Behavior
Health Services
Physical
Social, cultural
Biological, economical
Dengan memakai Model Blum
NATURAL HISTORY OF THE
DISEASE
Page 6-9 reference book
Four stages
Stage of susceptibility
Stage of pre symptomatic disease
Stage of clinical disease
Stage of disability
Every disease has difference natural
history (example: HIV/AIDS, DHF)
Prevention can be done when
determinants and natural history of
the disease are understood
LEVEL OF PREVENTIONS IN BROAD
CONCEPT
Primary prevention
Health promotion
Behavior change education
Policy/regulation
Specific protection
(specific to a certain disease)
Secondary prevention
Early detection and
prompt treatment/action
Tertiary prevention
Disability limitation
Rehabilitation
Medical
Psychological
Social
Economical
Prolonging
life/increase
quality of life
Susceptible
(at risk)
Primary prevention
Health promotion
Specific protection
Presym-
tomatic
stage
Secondary prev.
Early detection
& prompt
treatment
Clinical
stage
Stage
of
dis-
ability
Tertiary prev.
Disability
limitation
Rehabilitation
Genetic
Environment
Behavior
Health Services
Physical
Social, cultural
Biological, economical
Using Blum Model/Concept
USING ABOVE CHART
(DETERMINANTS, NATURAL
HISTORY OF DISEASE, AND
LEVEL OF PREVENTION)
DISCUSS AT SMALL GROUP (SGD)
TASK 2 AND 3