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BLOCK CBPBLOCK CBP

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SEMESTER I

1. Stadium Generale and Humaniora

2. Medical Communication

3. The Cell as Biochemical Machinery

4. Groth and !e"elo#ment $renatal and

$ostnatal

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SEMESTER II

1. Medical $ro%essionalism

2. Community&Based $ractice

3. Health System&Based $ractice

4. E"idence&Based Medical $ractice

'. S#ecial To#ic(. Electi"e Study 1

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SEMESTER III

1. The Hematolo)ic System and !isorders

and Clinical *ncolo)y

2. Immune System and !isorders

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SEMESTER I+

1. The Musculos,eletal System and

Connecti"e tissue !isorders

2. -euroscience and -eurolo)ical !isorders

3. Beha"ior Chan)e and !isorders

4. The +isual System and !isorders

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SEMESTER +

1. The limentary and He#ato/iliary System

and !isorders

2. The Endocrine System0 Meta/olism0 and

!isorders

3. Clinical -utrition and !isorders

4. S#ecial To#ic

'. Electi"e Study 2

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SEMESTER +I

1. The Res#iratory System and !isorders

2. The Cardio"ascular System and !isorders

3. The rinary System and !isorders

4. The Re#roducti"e System and !isorders

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SEMESTER +II

1. Medical Emer)ency

2. S#ecial To#ic Tra"el Medicine

3. Electi"e Study 3

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Tahun lalu dilakukan perdebatan di Stasiun TV

Swasta Nasional dalam acara Indonesia Lawyers

Club (ILC) yang membahas UU embatasan

enggunaan Tembakau antara kelompok yang anti

dan yang pro

!ampir semua kelompok anti UU mengemukakan

alasan sbb" Ah, tidak benar merokok ada

kaitannya dengan kanker paru-paru. Buktinya,

saya dan teman-teman saya adalah perokok berat,

dan sudah merokok selama 30 tahun, toh sampaisaat ini tetap sehat-sehat saja.

Pertanyaan:sebagai calon dokter apa

komentar Sdr# dengan mengacu pada prinsip$

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APPROCHES OF

CBPPrevention (not

curative)Community

(not individual)

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Susceptible

(at risk)

Primary prevention

!ealth promotion

Speci&ic protection

Presym-

tomaticstage

Secondary prev.

'arly detection

prompt

treatment

Clinical

stage

Stageof

dis-

ability

Tertiary prev.

isability

limitation

*ehabilitation

Genetic

Environment

e!avior

"ealt! Services

P!ysical

Social# culturaliological# economical

Determinants

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1 Selama !ulia"HP dimati!an (#u!an

silent)

$A$A $ER$%B

& Dalam 'leno 'ai #ila terlam#at 1* menit(+am di dindin ruan !ulia")

ma"asis,a tida!

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B-OC. CBP(Community$based +edical ractice)

,# ! harus dimatikan selama kuliah dan S-

.# Study -uide dan semua re&erences agar selalu

dibawa saat kuliah/ S-/ indi0idual learning

1# 2ehadiran dan keakti&an saat S- dinilai

(34 dari nilai u5ian) IN-6T 6%S'N

7# 2ehadiran saat kuliah dan &eedback dihitung

(bila lebih dari .34 tidak ikut) tidak bisa u5ian

*UL'8*'-UL6TI9NS

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3# ada saat plenary mahasiswa presentasi

:# ;akil mahasiswa yang presentasi harus dipilih pada saat S- dan bukan di ruang kuliah

# Narasumber akan memberi &eedback

pada presentasi mahasiswa

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REFERE/CES 0 A/2A-

Study 3uide 0 Anne4es

Re5erence 167

anualPlease re5er to eac" daysession8module

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DA9 1 & ;: OD2-E61

C2RR%C2-2 S$2D9 32%DE1< OD2-ES

-EAR/%/3 A$ER%A-S:Re5erence 1 and & movie videocli' ,e#sites (it is advice to do,nload materials5rom t"e ,e#sites #e5ore t"e lecture)

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Learning 9utcomes"

a) escribe se0eral determinants(models)o& diseases and death occurring in the

population

b) '?plain the applications o&

understanding diseases and death

determinants (models)

c) Identi&y the strengths and weaknesseso&

diseases models

d) raw &igure o& the natural historyo& a

certain disease

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e) '?plain the applicationso& the natural

history o& a disease &or pre0ention

&) '?plain the se0erity o& diseasesin a

population and its implication to

pre0ention

g) escribe the le0el o& disease pre0ention

based on determinants and natural

history

h) '?plain the Ice %erg henomenomand

its implication in diseases pre0ention

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-EAR/%/3 SCHED2-E(time ta#le)

*=**6*>**: %ntroductory

lecture

S$2D9 32%DE PA3E < (C-ASS B)

*>**611**: %nde'endentlearninRe5erence 1 0 &-earnin tas!s 'ae1=6&1

11**61;**: S3D1?**61@**: Student 'resentation 05eed#ac!

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-EAR/%/3 SCHED2-E(time ta#le)

*>**61***: %ntroductory

lecture

S$2D9 32%DE PA3E 11 (C-ASS A)

1***61&**: %nde'endentlearninRe5erence 1 0 &-earnin tas!61 0 & 'ae 1=6&1

1;**61@**: S3D1@**617**: Student 'resentation 05eed#ac!

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APPROCHES OF

CBPPrevention (not

curative)Community

(not individual)

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Some of the people need health care

some of the time

BUT

All of the people need public health allof the time."

C. Everett $oop# %&

former '.S. Surgeon General

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Determinants o5 mor#idity and mortality in a

'o'ulation

/atural "istory o5 t"e

disease

Diseases 'revention

MODULE-1

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& *

Determinants o5

mor#idity andmortality in a'o'ulation

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$"e E'idemioloic $riad8 $rianle

($eori Sei $ia) 'ae &7 ;;

"eel odel ($eori Roda) 'ae ;@6;>e# odel ($eori Saran -a#a6la#a)'ae ;;odel Blum

Several models8conce't used toanalyed determinants o5

mor#idity and mortality in a'o'ulation

odel osley

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"+ST (intrinsic)(age# se,# genotype# be!aviour# nutritional

status)

GET(biologic# p!ysic# mec!anical#

c!emical# nutrient)

E/0+%ET(P!ysical# iological# Social)

odel Seitia (The 'pidemiologic Triad8Triangle)

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Triad e#idemiolo)i,

AGENTBiological, chemical, physicalMechanical, Nutrient

HUMAN HOSTAge, race, sex, habitGenetic, personalityDefense mechanism

ENVIRONMENTBiological, chemical, physicalMechanical, nutrient, social, psychologic

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Homeostatic Balance

E

H

t e1uilibriumSteady rate

E

H

T!e proportion of susceptibles

in population decreases

Environmental c!anges t!at

favor t!e agent

E

H

Environmental c!anges t!at

favor t!e !ost

EH

E

H

gent becomes more pat!ogenic

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Genetic

"+ST

'@T'*N6L (e?trinsic)

INT'*N6L

(intrinsic)

$hysical En"ironment

Social

#olitic0

economicculture

Biolo)ical

En"iron&ment

odel Roda ("eelodel)

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C t h ti I/;'% +9'L (S6*6N- L6%6 L6%6)

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Contoh asus ematian I/u

Modifikasi dari: FA Moeloek, 2010

;'% +9'L (S6*6N- L6%6$L6%6)

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B-2 ODE-

or#idity andmortality ina 'o'ulation

Environmental 5actors(#ioloical '"ysical social economical

'olitic)

Healt"services

3enetic

Be"avior

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C9NC'T (T!'9*A/ +9'L)INT*9UC' %A

*# +9SL'A;!IC! '@L6IN'

'T'*+IN6NTS 9B +9*%IITA 6N+9*T6LITA 9B C!IL*'N 6-'

UN'* 3 A'6*S IN 6 9UL6TI9N

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Socioeconomic determinants

+aternal

&actors

'n0ironmental

Contamination

Nutrient

de&iciencyIn5ury

!ealthy

ersonal

Illness

control

Sick

-rowth

&altering+ortality

PreventionTreatment

S9CI6L 'T'*+IN6NTS 9B !'6LT!

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S9CI6L 'T'*+IN6NTS 9B !'6LT!

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2"+ CS&" t l f k

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2"+- CS&" conceptual frame3ork

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-!ERST-!I-G

CS5IT6

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4our types of Causal relations!ips

1.-ecessary and Su%%icient2.-ecessary /ut not Su%%icient

3.Su%%icient /ut not -ecessary

4.-either Su%%icient nor -ecessary

-ecessary 7 ithout that %actor disease ne"erde"elo#s

Su%%icient 7 in the #resence o% that %actor disease alays

de"elo#s

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*. ecessary and Sufficient

&irect5

4actor &isease

/ndirect5

4actor Step* Step6 &isease

rarely !appens

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6. ecessary but not Sufficient

4actor

7

4actor &isease 7

4actor C

%ultiple factors re1uired5 initiator 8 promoter

(cancer# T)

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9. Sufficient but not ecessary

4actor

or

4actor &isease or

4actor C

:eukemia ; E,posure to radiation +0 ben

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=. eit!er sufficient nor necessary

(contributory causes)

4actor 7 4actor

or4actor C 7 4actor & &isease

or

4actor E 7 4actor 4

Most accurately re#resents causal relationshi#s in most

chronic diseases

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END OF DA !

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$lenary day 1

$lease re%er to the #lenary day 1 slides

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Determinants o5 mor#idity and mortality in a

'o'ulation

/atural "istory o5 t"e

diseaseDiseases 'revention

MODULE-1

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& 6

/atural "istory o5 t"e

diseaseDisease 'revention

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-atural History o% !isease

-atural history o% disease#ro)ression o% disease in an

indi"idual o"er time 8ITH*Tany inter"ention.

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/A$2RA- H%S$OR9 OF $HED%SEASE

Pae 76> re5erence &

Four staes

Stae o5 susce'ti#ility ('o'ulation atris!)Stae o5 're sym'tomatic (asym'tomatic) diseaseStae o5 clinical (sym'tomatic)

diseaseStae o5 disa#ility

Every disease "as dierencenatural

"istory (e4am'le: H%8A%DS DHF)

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$er9alanan lamiah $enya,it ':

PREPATOGENESIS PAT G N SIS

)en Host ;ase ,linis

Sem/uh

Cacat

5in),un)an ;ase #enyem/uhan Mati

ronis

;ase susce#ti/le ;ase su/,linis

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-atural history o% disease

Susceptible

!ost

T/%E

/ncubationperiod

&eat!

0ecovery

E,posure +nset

:atent /nfectious on-infectious

/nfection

o infection

Clinical disease

N6TU*6L !IST9*A ('*6L6N6N

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%eninggal

$!ronis

Carrier

Sembu!

dengan cacat

Sembu!tanpa cacat

6symptomatic

stage

Symptomatic

stage

N6TU*6L !IST9*A ('*6L6N6N

'NA62IT)

Contoh"hepatitis

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>>

6>>6>>

*>>>*>>>

> * 6 9 = ? * 6 9 = ? @ A> * 6 9 = ? * 6 9 = ? @ A

3340::: emer)encyroom "isits

> 1303(: hos#itali@ations

> 2: deaths

T!' V6*I6TI9N 9B SA+T9+6TIC

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T!' V6*I6TI9N 9B SA+T9+6TIC

IS'6S'S S'V'*ITA

,FF C6S'S

+ild (ringan) +oderateSe0ere

Batal

$"e lm 'resentation

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$"e lm 'resentations"o,ed to you

Contri#ution ('eran) o5: scienti&ic&oundations/ clinical skill/ communication

skill/ in&ormation management/ critical

thinking/ pro&essional 0alues and attitudes/community health

eneliti !ausa suatu 'enya!it(A%DS) dan 'encea"annya

D%FFERE/CES BE$EE/

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D%FFERE/CES BE$EE/

*. 4ocus5 population

6. 0esponsibilities5

all #eo#le in certain)eo)ra#hical area0 health andsic,0 those ho come andthose ho do not come to

health %acilities. They mustacti"ely #ro"ide diseases#re"ention to all #eo#le hoare at ris,

*. 4ocus5 individual

6. 0esponsibilities5all #eo#le ho come

to the health %acilities.They usually #assi"e.

P2B-%C HEA-$H

DOC$OR

C-%/%CA-

DOC$OR

P2B-%C HEA-$H C-%/%CA-

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P2B-%C HEA-$HDOC$OR

C-%/%CA-DOC$OR

9. 4unction5to mobili

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P2B-%C HEA-$HDOC$OR

C-%/%CA- DOC$OR

?. &iagnostic tools5

epidemiology#statistics# demograp!y

?. &iagnostic tools5

stet!oscope# ECG# labe,aminations kits # CTScan# etc

@. &iseasesmeasurements in t!ecommunity5

proportion# prevalence#incidence# ratio

@. &iseasesmeasurements forindividual patient5level

of blood pressure# bloodsugar# level of!emoglobin# etc

P2B-%C HEA-$H C-%/%CA-

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P2B-%C HEA-$HDOC$OR

C-%/%CA-DOC$OR

A. Treatment at t!ecommunity level(prevention)5public!ealt! program suc! as

education program#immuni

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P2B-%C HEA-$HDOC$OR

C-%/%CA-DOC$OR

D. /ndicators forevaluating community!ealt! program5percentdecrease of under

nutrition# percentincrease of contraceptiveuse for family planning#

etc

D. /ndicators for

evaluating t!e resultof patientstreatments5

decrease of bloodpressure of t!eindividual patient#increase of

!emoglobin

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GF%E S$ARS DOC$OR

(HO I orld Healt"Oraniation)Care 'rovider (clinical dr)

Communicator (clinical 0 PHdr)anaer (PH dr)

Community leader (PH dr)Decision ma!er (clinical 0 PHdr)

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S96L$S96L

'+6N6S6NS'%'LU+ UI6N

As sown in te -ilm And The Band Played n

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As sown in te -ilm And The Band Played n

wic was !resented to yo&$ tere were several

sciences involved in investi#ation te ca&se o- AI0S1

Tose sciences are.

A1 Social$ economic$ !olitic$ e!idemiolo#y$ statistic$

virolo#y$ clinical medicine

21 Social$ !olitic$ e!idemiolo#y$ statistic$ virolo#y$

clinical medicine$ ealt ed&cation

C1 Social$ e!idemiolo#y$ statistic$ virolo#y$

clinical medicine$ ealt ed&cation

01 Clinical medicine$ e!idemiolo#y$ statistic$ social$ !olitic

E1 Social science$ e!idemiolo#y$ statistic$

virolo#y$ clinical medicine

! l %il d 9 d l A d Th B d #l d

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!alam %ilm den)an 9udul And The Band #la$ed

On yan) telah Sdr. sa,si,an #ada a,tu

#ertemuan #ertama Blo, Community&Based$ractice0 ada /e/era#a metode yan) di#er)una,an

untu, men)un),a#an #enye/a/ I!S0 yaitu

1. Contact tracin)

2. Cohort

3. Case&control

4. Cross&sectional

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Bila dilihat dari a,tunya0 urutan ca/an)

ilmu yan) mem/antu men)un),a#an#enye/a/ I!S0 yaitu

. $alin) aal "irolo)i0 lalu e#idemiolo)i dan tera,hir ilmu ,lini,

B. $alin) aal ilmu ,lini,0 lalu "irolo)i dan tera,hir e#idemiolo)i

C. $alin) aal ilmu ,lini,0 e#idemiolo)iAstatisti,Ailmu sosial0 lalu

"irolo)i

!. $alin) aal "irolo)i0 statisti,Ae#idemiolo)i lalu ilmu ,lini,E. $alin) aal statisti,Ae#idemiolo)i0 ilmu ,lini, lalu "irolo)i

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$ada Gam/ar&1 /eri,ut ini adalah ,om#etensi

,emam#uan yan) harus di,uasai oleh seoran)do,ter. om#etensi untu, memahami statisti,

,asus&,asus I!S dalam %ilm den)an 9udul

And The Band #la$ed OnD termasu,

1. Scienti%ic %oundations

2. In%ormation mana)ement

3. $ro%essional "alues

4. $o#ulation health

Cli i l

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Critical

t!inking

/nformation

management

Communication

skill

Community

"ealt!(Pu-blic

"ealt!)

Clinical

skill

Professional#

values#

attitudes

Scientific

foundations

CBP

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Sala! seorang ma!asis3a (inisial F) yang kulia! di

fakultas non-kese!atan mengatakan sebagai berikut5

Ah% tida& benar mero&o& ada &aitann$a den'an

&an&er paru(paru. Bu&tin$a% paman sa$a adalah

pero&o& berat% dan sudah mero&o& selama )* tahun%

toh sampai saat ini dia sehat(sehat sa+a.

Pertanyaan:#eri!an !omentar Sdrter"ada' 'ernyataan ma"asis,a GJse'erti 'ada soal di atas(dengan mengacupada prinsip-prinsip epidemiologi).

&alam suatu program interaktif yang

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,ho% &enapa pelacur $an' sudah +elas(+elasdi+umpai-/0tida& di&arantina. 1ere&a ..&an

den'an bebas masih menular&an -/(n$a pada

oran' lain. 2enapa pada saat ter+adi 3abahSA4S% $an' dicuri'ai sa+a sudah lan'sun'

diisolasi5

&alam suatu program interaktif yang

memba!as topik 3aba! "/B/&S di sebua!

stasiun radio di ali# banyak pendengar

dengan berapi-api mengatakan melalui

telepon sebagai berikut5

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An##ota 0PR0 Provinsi 2ali ta&n lal& men#ata"an

se,a#ai ,eri"&t. !ami sudah mengalokasikan

dana APB" yang #ukup besar untukpenanggulangan $%&'A%"( di Bali. !enapa jumlah

orang yang $%&)'A%"( kok terus bertambah

banyak. $arusnya kan berkurang. !alau begitu

per#uma dana yang kami alokasikan tersebut.

PERTAN(AAN. Seandainya Sdr1 men%adi !etas

"eseatan$ ,a#aimana Sdr1 men%awa, !ernyataanan##ota 0PR0 terse,&t

Pertanyaan 'endenar

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$em'at tidur 'asien demam

#erdara" yan dira,at di ruma"sa!it !o! tida! 'a!ai !elam#uK.alau 'asien diiit nyamu! Aedes

!an #isa menular!an 'enya!itnya!e'ada 'etuas di RS atau !e'ada'asien lainK

Pertanyaan 'endenardalam 'roram intera!ti5 di

se#ua" stasiun radio di Bali