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Igiene 1 anno infermieristica
Università degli Studi di MILANO-BICOCCA infermieristica (abilitante alla professione sanitaria di infermiere) 2020
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- Hygiene's Purpose: To defend and improve individual and collective health, preventing diseases and promoting physical, mental, and social well-being through a holistic, multifactorial approach.
- Key Actions: Inducing well-being via protective factors and preventing risks from harmful factors (diseases, disabilities).
- Epidemiology: The core discipline studying disease frequency, distribution, and determinants in populations, not just individuals. It uses a scientific method involving observation, hypothesis, study design, data analysis, and conclusion formulation.
- Epidemiological Triad: Disease (especially infectious) results from the interaction of an Agent (e.g., microorganism, chemical), a Host (e.g., human with specific characteristics), and the Environment (e.g., climate, living conditions).
- Iceberg Phenomenon: Most diseases have a subclinical or latent phase ("invisible part of the iceberg"), meaning studying only symptomatic cases is insufficient for understanding public health impact.
- Historical Contributions:
- Semmelweis: Demonstrated the importance of hand hygiene in preventing puerperal fever by identifying "cadaveric particles" transmission.
- John Snow: Pioneered modern epidemiology by tracing cholera outbreaks to contaminated water pumps in London, challenging the "miasma" theory and advocating for intervention.
- Data and Statistics: Epidemiology relies on numerical data from various sources (ISTAT, hospital records, registries) and uses statistics for objective analysis and interpretation, acknowledging inherent uncertainty in scientific findings.
- Measures of Frequency:
- Incidence: Measures new cases of a disease in a population at risk over a period, useful for acute events.
- Prevalence: Measures existing cases at a specific moment, useful for chronic diseases.
- Rates: (Mortality, Natality, Infant Mortality, Perinatal Mortality, Case Fatality, Survival) quantify health events in relation to population size and time.
- Risk Measures: Absolute Risk, Relative Risk, and Odds Ratio are used to quantify associations between risk factors and disease.
- Types of Epidemiological Studies:
- Descriptive: Observational studies (What, Who, When, Where) that describe disease patterns (e.g., using census data).
- Analytical: Investigate disease causes (Why) through cross-sectional, case-control (retrospective, good for rare diseases), and cohort (longitudinal, good for risk factors) studies.
- Experimental: Involve direct intervention by researchers, often with blinding and randomization, to test therapeutic or preventive strategies.
- Prevention Levels (WHO):
- Primary: Aims to reduce disease incidence (e.g., vaccinations, healthy lifestyles).
- Secondary: Aims to reduce disease prevalence (e.g., early diagnosis and treatment like mammography).
- Tertiary: Aims to reduce severity and complications of incurable diseases (e.g., rehabilitation).
- Non-Infectious Diseases: Multifactorial conditions like cardiovascular diseases (ischemic cardiopathy, cerebral ischemias), cancers, and diabetes mellitus are major causes of death in industrialized countries. Prevention focuses on modifying risk factors (diet, exercise, smoking, hypertension) and early screening.
- Infectious Diseases: Require an infectious agent, a reservoir/source, and a susceptible host. Transmission can be direct contact, indirect (via vehicles/vectors), droplets, or airborne. Examples discussed include Legionellosis (waterborne), Salmonellosis (foodborne), Botulism (foodborne toxin), and Staphylococcal food poisoning. Prevention involves hygiene, food safety (HACCP), and understanding contagion chains (Swiss Cheese Model).
- Disease Patterns in Population: Can manifest as sporadic cases, epidemics (localized outbreaks), or pandemics (widespread global outbreaks), influenced by individual and environmental factors.