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    Science and Technology for Disease Control: Past, Present, and Future

    As we move into the new millennium it is becoming increasingly clear that the biomedical sciences are entering the most exciting phase of their development. Paradoxically, medical practice is also passing through a phase of increasing uncertainty, in both industrial and developing countries. Industrial countries have not been able to solve the problem of the spiraling costs of health care resulting from technological development, public expectations, and—in particular—the rapidly increasing size of their elderly populations. The people of many developing countries are still living in dire poverty with dysfunctional health care systems and extremely limited access to basic medical care.

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    Disease Control Priorities in Developing Countries. 2nd edition.

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    Chapter 5Science and Technology for Disease Control: Past, Present, and Future

    David Weatherall, Brian Greenwood, Heng Leng Chee, and Prawase Wasi.

    As we move into the new millennium it is becoming increasingly clear that the biomedical sciences are entering the most exciting phase of their development. Paradoxically, medical practice is also passing through a phase of increasing uncertainty, in both industrial and developing countries. Industrial countries have not been able to solve the problem of the spiraling costs of health care resulting from technological development, public expectations, and—in particular—the rapidly increasing size of their elderly populations. The people of many developing countries are still living in dire poverty with dysfunctional health care systems and extremely limited access to basic medical care.

    Against this complex background, this chapter examines the role of science and technology for disease control in the past and present and assesses the potential of the remarkable developments in the basic biomedical sciences for global health care.

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    Medicine Before the 20th Century

    From the earliest documentary evidence surviving from the ancient civilizations of Babylonia, China, Egypt, and India, it is clear that longevity, disease, and death are among humanity's oldest preoccupations. From ancient times to the Renaissance, knowledge of the living world changed little, the distinction between animate and inanimate objects was blurred, and speculations about living things were based on prevailing ideas about the nature of matter.

    Advances in science and philosophy throughout the 16th and 17th centuries led to equally momentous changes in medical sciences. The elegant anatomical dissections of Andreas Vesalius swept away centuries of misconceptions about the relationship between structure and function of the human body; the work of Isaac Newton, Robert Boyle, and Robert Hooke disposed of the basic Aristotelian elements of earth, air, fire, and water; and Hooke, through his development of the microscope, showed a hitherto invisible world to explore. In 1628, William Harvey described the circulation of the blood, a discovery that, because it was based on careful experiments and measurement, signaled the beginnings of modern scientific medicine.

    After steady progress during the 18th century, the biological and medical sciences began to advance at a remarkable rate during the 19th century, which saw the genuine beginnings of modern scientific medicine. Charles Darwin changed the whole course of biological thinking, and Gregor Mendel laid the ground for the new science of genetics, which was used later to describe how Darwinian evolution came about. Louis Pasteur and Robert Koch founded modern microbiology, and Claude Bernard and his followers enunciated the seminal principle of the constancy of the internal environment of the body, a notion that profoundly influenced the development of physiology and biochemistry. With the birth of cell theory, modern pathology was established. These advances in the biological sciences were accompanied by practical developments at the bedside, including the invention of the stethoscope and an instrument for measuring blood pressure, the first use of x-rays, the development of anesthesia, and early attempts at the classification of psychiatric disease as well as a more humane approach to its management. The early development of the use of statistics for analyzing data obtained in medical practice also occurred in the 19th century, and the slow evolution of public health and preventive medicine began.

    Significant advances in public health occurred on both sides of the Atlantic. After the cholera epidemics of the mid 19th century, public health boards were established in many European and American cities. The Public Health Act, passed in the United Kingdom in 1848, provided for the improvement of streets, construction of drains and sewers, collection of refuse, and procurement of clean domestic water supplies. Equally important, the first attempts were made to record basic health statistics. For example, the first recorded figures for the United States showed that life expectancy at birth for those who lived in Massachusetts in 1870 was 43 years; the number of deaths per 1,000 live births in the same population was 188. At the same time, because it was becoming increasingly clear that communicable diseases were greatly depleting the workforce required to generate the potential rewards of colonization, considerable efforts were channeled into controlling infectious diseases, particularly hookworm and malaria, in many countries under colonial domination.

    However, until the 19th century, curative medical technology had little effect on the health of society, and many of the improvements over the centuries resulted from higher standards of living, improved nutrition, better hygiene, and other environmental modifications. The groundwork was laid for a dramatic change during the second half of the 20th century, although considerable controversy remains over how much we owe to the effect of scientific medicine and how much to continued improvements in our environment (Porter 1997).

    Source : www.ncbi.nlm.nih.gov

    10 Health Advances That Changed the World

    10 Health Advances That Changed the World

    From vaccines to clean water, health advances have changed the world.

    ByDan Childs and Susan Kansagra, M.d.abc News Medical Unit

    Sept. 20, 2007 — -- Whether it's the technology that allows us to peer deep into the body or medicines that extend the lives of those with chronic diseases, it's easy to see how advances in health and medicine have touched the lives of nearly every person on the planet.

    Yet considering the ubiquitous nature of these developments, it is easy to see how many people take for granted the technologies and practices that, at one point or another, almost certainly saved their own lives or the lives of people they've loved.

    The list below encompasses 10 advances in health and medical practices that have changed -- and in many ways continue to change -- the world today.

    Throughout history, communicable diseases have had a tremendous impact on human history. So too, then, has the development of one of the most effective ways to defend against rampant viral infection -- vaccination.

    Dr. Edward Jenner first introduced the idea of vaccinations in 1796, when he successfully prevented a young English boy from getting smallpox.

    The concept of vaccination was propelled further by scientists such as Louis Pasteur, and in the modern era, when large groups of soldiers were successfully vaccinated in World War I and II against such diseases as tetanus, diphtheria and typhus.

    "Polio vaccine is one that people think of because it had such an impact," said Dr. Jeffrey Baker, director of the history of medicine program at the Duke University School of Medicine.

    But from the global health standpoint, Baker said Jenner's introduction of the smallpox vaccine may have had an even more significant impact in terms of lives saved.

    Without a doubt, surgery used to be a much graver proposition than it is today. One of the chief reasons for this is that before the middle of the 19th century, anesthetic simply wasn't an option.

    That changed Oct. 16, 1846, when William T.G. Morton demonstrated the mysterious wonder of ether -- a substance powerful enough to dull the pain and agony that had long been associated with surgery.

    But while anesthetic was a great advance in and of itself, another advance that occurred at roughly the same time may have been even more beneficial -- antisepsis, or the creation of a sterile surgical environment.

    "Anesthetic made it possible to operate on a patient without pain," Baker notes, "but without antisepsis they'd die anyway."

    Put them beside surgical advances and other cutting-edge technologies, and public health measures don't look so sexy. But the fact is that clean water and sanitation have likely saved millions -- perhaps billions -- of lives since they were widely implemented in the 19th and 20th centuries.

    "It's something that's so important around the world and in America," Baker said. "It used to be that 15 percent of infants would die, and the biggest reason for this was diarrhea brought about by unclean water and milk."

    Clean water and public health measures dramatically cut down the incidence of such deadly water-borne diseases as cholera and improved sanitation, drastically lowering the health impacts of parasitic infections and other health conditions related to the environment.

    As with vaccination, the advent of antibiotics hailed a new era in the treatment of communicable disease.

    Interesting, then, that the concept of antibiotics may have been uncovered accidentally. In 1928, Sir Alexander Fleming left a petri dish of Staphylococci bacteria uncovered and later noted that the bacteria had been killed by a mold.

    Upon further studying the mold, he discovered it was from a family called Penicillium notatum. Others soon saw the potential uses of what later came to be known as penicillin.

    Today, antibiotics are used to treat a plethora of bacterial illnesses. And today, researchers are developing antivirals -- most notably, the AIDS-fighting antiviral AZT -- to deal with a host of viral illnesses as well.

    Arguably, few developments have had as profound a social impact as the introduction of the birth control pill -- though its path to widespread use has been a rocky one.

    Although the Federal Drug Administration approved contraception as safe in the early 1960s, it only became legal for married couples in 1965 and for unmarried couples in 1972.

    But because of the Pill, countless women have been given control over their own fertility -- a concept that created a social revolution.

    "Thinking about how it has transformed women's lives, in terms of family planning and the entry of women into the work force, its impact has been significant indeed," Baker said. "It was the first-ever lifestyle drug. It's not treating a disease, but it was making life better for women."

    Heart disease remains at the top of the list of the country's killers. Despite this, numerous important advances in its treatment have made a considerable impact, extending and improving the lives of its sufferers.

    Not the least of these advancements is surgeons' ability to operate on and repair the heart -- without putting the patient at an unreasonable amount of risk.

    "Maybe the breakthrough moment was the rise of the heart-lung bypass, which made it possible to operate on the heart for more than just a few minutes at a time," Baker said. "This was followed by coronary artery bypass grafting, which is, I believe, a most important procedure."

    Source : abcnews.go.com

    PH: Risk of Infectious and Communicable Diseases Flashcards

    Start studying PH: Risk of Infectious and Communicable Diseases. Learn vocabulary, terms, and more with flashcards, games, and other study tools.

    PH: Risk of Infectious and Communicable Diseases

    Carrier

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    a person or animal that harbors an infectious organism and transmits the organism to others, although having no symptoms of the disease

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    Colonization

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    the presence and multiplication of infectious organisms without invading or causing damage to tissue

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    Terms in this set (143)

    Carrier

    a person or animal that harbors an infectious organism and transmits the organism to others, although having no symptoms of the disease

    Colonization

    the presence and multiplication of infectious organisms without invading or causing damage to tissue

    Common Source Outbreak

    an outbreak characterized by exposure to a common, harmful substance

    Contagious

    communicable by direct or indirect contact

    Endemic

    the constant or usual prevalence of a specific disease or infectious agent within a population or geographic area

    Epidemic

    significant increase in the number of new cases of a disease than past experience would have predicted for the place, time, or population; an increase in incidence beyond that which is expected

    Healthcare-Associated Infection

    originating in a healthcare facility; formerly called nosocomial infection

    Incubation Period

    time period between initial contact with the infectious agent and the appearance of the first signs or symptoms of the disease

    Infectious Disease

    presence and replication of an infectious agent in the tissues of a host, with manifestation of signs and symptoms

    Pathogenicity

    ability of the agent to produce an infectious disease in a susceptible host

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