D. King and C. M. King IJSHIM - Volume 4, Issue 8 (2011), pp.43-72
HEALTH MANAGEMENT: PREVENTION AWARENESS AND WELLNESS EXCEPTIONALISM
David King1 and Christina M. King2
Tennessee State University, USA1 and Kingston University, UK2
ABSTRACT
e primarily analyzed discrepancies in general health systems, and underlined the significance of preventive healthcare information awareness. Secondly, we studied the hallmarks of universal healthcare resources availability. Thirdly, the authors recommend
that, there is a critical need to (A) educate society at large on social healthcare, for example, (A) understanding of the determinants of health disease prevention and treatment and (B) provide opportunities for health resources as well as progress. Fourth, the authors believe that access to preventive healthcare as the golden goal for (1) lifelong growth and (2) biochemistry scholarship. Therefore, we argue that, access to quality primary care and preventive healthcare services in general must remain as the central health promotion method. A methodology map (figure 2) used in the study is based on four categorical hybrid approaches (4-CHA). 1. Medscape allows medical professionals to explore their curiosity and the know-how in medicine, 2. Medline University educates the general public on medicine at no cost, 3. Realage has over the past decade become the most informative healthcare prevention and wellness, and 4. Dr. Oz’s TV broadcast, also provide a viable and excellence in medicinal education, in particular, healthcare prevention and wellness. Keywords: Awareness, Diseases, Health, Prevention, Treatment, Wellness.
INTRODUCTION
Generally, health issues emerges from the attitudes and lifestyles of individuals and groups of people and includes many dimensions such as physical, intellectual, spiritual, financial, emotional, social, sexual, environmental, and cultural wellbeing. In the study, we noted that health represents the overall condition of the body-mind composition and therefore, health is a by-product of the sum of our thoughts, beliefs, emotions, actions, environment and genetic blueprints. As such, it is largely determined by individuals and nonetheless their lifestyle-choices. We recommend herein, and acknowledge that education is the key to healthcare prevention and wellness. This enlightenment can be achieved outside the parameters of primary care medicine, for example, by wellness coaches, holistic healers, and other mind-body practitioners.
W
Full Article Available Online at: Intellectbase and EBSCOhost │ IJSHIM is indexed with Cabell’s, JournalSeek, etc.
International Journal of Social Health Information Management
Journal Homepage: www.intellectbase.org/journals │ ©2011 Published by Intellectbase International Consortium, USA
Health Management: Prevention Awareness and Wellness Exceptionalism
BACKGROUND
Throughout human history, medicine, and medical care has been critical for many civilizations, helping society to be healthier. From the ancient Egyptians with one of the most advanced medical systems, in pharaonic times, keeping their people as one of the healthiest in the ancient times. Also, in those days, first recorded surgeries were executed, and gave birth to several of the actual medical specialties. More so, did the introduction like medicine and concepts likes diagnosis, prognosis, and medical examination. Diagnosis, as known in ancient Greek “διάγνωσις” (discernment) is the identification of nature and cause of anything. Diagnosis is used in many different disciplines with variations in the use of logics, analytics, and experience to determine the cause and effect relationships. In systems engineering and computer science, diagnosis is typically used to determine the causes of symptoms, mitigations for problems, and solutions to issues of the many diseases (Simpson and Sheppard 1994). Prognosis, also descends from the ancient Greek (as “πρόγνωση” literally fore-knowing, foreseeing) is a medical term to describe the likely outcome of an illness. When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because previous research found that this proportion of patients did indeed die. However, it is much harder to translate this into a prognosis for an individual patient: additional information is needed to determine whether a patient belongs to the 45% who will accede, or to the 55% who withstand (Gould 2009). A complete prognosis includes expected time, function, and a description of the disease development such as progressive decline, intermittent crisis, or sudden, and unpredictable crisis. Physical examination or clinical examination is the process by which a doctor investigates the body of a patient for signs of disease. It generally follows the sampling of the medical history - an account of the symptoms as experienced by the patient. Together with the medical history, the physical examination aids in determining the correct diagnosis and devising the treatment plan. This data then becomes part of the medical record.
OBJECTIVE
Disease prevention in a global health care system is primarily, the motivation, concern and objective for the study. In the United States healthy people provide science-based, national goals and objectives with approximately 10-year targets, normally designed to guide national health promotion and disease prevention efforts to improve the health of all people. As commonly practiced, the criterion standard test (CST), also known as “reference test” ultimately decides either there is a presence or absence of a disease. Examples of CST include pathological specimens for malignancies and pulmonary angiography for pulmonary embolism. However, CST routinely has major drawbacks (e.g. usually expensive, less widely available, more invasive, and riskier). These issues usually coerce most physicians to choose other diagnostic tests as alternatives for the CST. For example, in the US, as well as other “western nations”, integrative medicine has evolved out of historical appreciation of the limitations of the dominant medical paradigm. From this perspective the (CDC), together with the US government has established benchmarks to monitored progress over time (See Figure 1 below).
D. King and C. M. King IJSHIM - Volume 4, Issue 8 (2011), pp.43-72
Figure 1: Benchmark for monitoring Health Progress: The Case of US
While pharmaceutical and technological approaches to medicine rely on isolated testing scenarios, which often appear to transform successfully and bring about the healing of real people suffering from complex and multi-faceted conditions, integrative medicine pays attention to forms of medicine that have occurred in other cultural contexts, often attract to the intuitive intelligence of a patient and practitioner, rather than the alleged expertise of a laboratory researcher. Because the nature of integrative medicine is to attempt to merge evidence based medicine with alternative medicine techniques, as well as partially focusing treatment on the "spiritual", it is not without controversy. Consequently, it falls into the same category of criticisms as much of alternative medicines seem to uphold. “Healthy People 2020” contain a substantial amount (1,200) of objectives in about 42 significant topic areas designed to serve as this decade’s framework in attempt to improve the health of all people in the United States (CDC.Gov). For instance, as initiated in this study, our methodology map for health awareness, prevention and treatment (MP-HAPT), a four Categorical Hybrid approach (4-CHA) provides a concrete synopsis of the modern day guide to good health. See figure 2 below.
Identify nationwide health improvement priorities
Increase public awareness and understanding of the determinants of health, disease, and disability
and the opportunities for progress.
Provide measurable objectives and goals that are applicable at
the national, State, and local levels.
Engage multiple sectors to take actions to strengthen policies
and improve practices that are driven by the best available
evidence and knowledge
Identify critical research, evaluation, and data collection
needs.
Health Management: Prevention Awareness and Wellness Exceptionalism
METHODOLOGY MAP
Figure 2: Methodology Map for Health Awareness, Prevention and Treatment (MP-HAPT). A Four Categorical Hybrid approach (4-CHA), http://www.medscape.org, │http://www.medline.com/medline-university, │http://www.realage.com
EPIDEMIOLOGY
The scientific and medical study of the causes and transmission of disease within a population, as well as the origin, and the developmental features of a specific disease is known as epidemiology. In studying diseases, epidemiology faces the challenge of an established definition. Particularly, for poorly understood diseases (see appendices A, B, C and D), various groups in the medical fields use different classifications. Without an agreed-upon definition, innumerable researchers will find very dissimilar numbers of cases and physiognomies of a disease(s). Conversely, it can be argued that, epidemiology is the study of the factors that cause or encourage diseases. Some diseases are more common in certain geographic areas, among people with certain genetic or socioeconomic characteristics, and, or occurrences at different times of the year. Epidemiology is considered as a cornerstone methodology of public health research, and is highly regarded in evidence-based medicine for identifying risk factors for disease. In the study of communicable and non-communicable diseases, the work of epidemiologists ranges from outbreak investigation to study design, data collection and analysis including the development of statistical models to test hypotheses and documentation of results. Epidemiologists also study the interaction of diseases in a population, a condition known as a syndemic. Infact, epidemiologists rely on a number of other scientific disciplines such as biology (to better understand disease processes), biostatistics (the current raw information available), Geographic Information Science (to store data and map disease patterns) and social science disciplines (to better understand proximate and distal risk factors). To create a positive balance on epidemiology, we ensue with a significant study on a healthy balance of the well-being, also characterized as (wellness).
• Medline University provides the basis for medical education
• Medscape allows medical professionals to explore their curiosity and the know-how in medicine
• Also, Dr. OZ, provides a viable alternative in medical education, in particular, healthcare prevention and wellness.
• Realage has over the past decade become the most informative healthcare prevention and wellness
REAL AGE Dr. OZ
BROADCAST
MEDLINE UNIVERSITY
MEDSCAPE
D. King and C. M. King IJSHIM - Volume 4, Issue 8 (2011), pp.43-72
WELLNESS
Wellness is commonly used to mean a healthy balance of the mind, body and spirit that results in an overall feeling of well-being. Also, it has been used in the context of alternative medicine since Halbert L. Dunn, M.D.1, who began using the phrase high level wellness in the 1950s. The modern concept of wellness did not, however, become popular until the 1970s (Zimmer, 2010). The term has been defined by the Wisconsin-based National Wellness Institute (in the United States) as an active process of becoming aware of, and making choices toward a more successful existence (Cherry, March 2006). This is consistent with a shift in focus away from illness in viewing human health, and in positive perspective, where the term wellness is used. In other words, wellness is a view of health that emphasizes the state of the entire being and its ongoing development. The phrase can also be seen as a reference to the medical term "homeostasis". In the study, the term wellness has been applied in many ways. Although, there might be different views on what wellness encompasses, Medscape, Medline, Dr. Oz as well as the National Wellness Institute (along with the help of leaders in health and wellness), shared many interpretations and models of wellness. Indeed, our review indicated that, there appears to be general agreement as depicted, (ABC) in figure 3 below:
Figure 3: The ABC Wellness Indicator (WI)
1 Halbert L. Dunn, M.D. (1896–1975) was the leading figure in establishing a national vital statistics system in the United States and is known
as the "father of the wellness movement. Born in New Paris, Ohio, he attended the University of Minnesota where he earned his M.D. in 1922 and his Ph.D. in 1923. He served as an assistant in medicine at Presbyterian Hospital of New York City 1923-1924 and as fellow in medicine at the Mayo Clinic in Rochester, Minnesota (1924–1925).
AUTHOR’S VIEW: Wellness is an active process through which people become aware of, and make choices toward, a more successful existence and can be described as "the constant,
conscious pursuit of living life to its fullest potential.
Wellness is a conscious, self-directed and evolving process of achieving full potential.
Wellness is multi-dimensional and holistic, encompassing lifestyle, mental and spiritual well-being, and the environment
Wellness is positive and affirming
A
B
C
Health Management: Prevention Awareness and Wellness Exceptionalism
The human condition is the subject of such fields of study as philosophy, theology, sociology, psychology, anthropology, demographics, evolutionary biology, cultural studies, and sociobiology. The philosophical school of existentialism deals with the ongoing search for ultimate meaning in the human condition. In most developed countries, improvements in medicine, education, and public health have brought about quantitative, not necessarily qualitative, marked changes in the human condition over the last few hundred years, with increases in life expectancy . There are several theories which points to the unisons of all human beings. A popular example is that humans search for a purpose is curious and thrive on new information. Certain movements, most prominently trans-humanism, aim to radically change the human condition. Some thinkers, like Enrico Fermi and others, deny that human nature has really changed in any fundamentally meaningful way over time. Despite all of the social and scientific advances that have occurred, humans remain essentially unchanged and have been merely transplanted into progressively more complex environments. Next is self-awareness enlightenment.
SELF-AWARENESS
Self-awareness is the capacity for introspection and the ability to reconcile oneself as an individual separate from the environment and other individuals. Self-awareness, though similar to sentience in concept, includes the experience of the self, and has been argued as implicit to the hard problem of consciousness. lf-Awareness Theory (IAT) states that when individuals focus their attention on themselves, they evaluate and compare their current behavior to their internal standards and values. Frankly, they become self-conscious as objective evaluators of themselves. According to Cohen (1994), self-awareness is indeed different from self-consciousness (SC). In reviewing the concepts, we noted that various emotional states are intensified by self-awareness, and individuals sometimes attempt to escape their inner deeds by consulting to television, video games, drugs, etc. Other concepts revealed that, occasionally certain individuals may seek to increase their self-awareness through addictive outlets. Humans are more likely to align their behavior with their standards when introduced to experience self-awareness. Nevertheless, some group of individuals will also be negatively affected if they are not able to live up to their personal standards. Various environmental cues and situations induce awareness of the self, such as mirrors, an audience, or being videotaped or recorded. As Duval (2001) indicated, these cues also increase accuracy of personal memory. In Demetriou's theory, one of the neo-Piagetian theories of cognitive development, self-awareness develops systematically from birth through life span (Demetriou and Kazi, 2001). This is a major factor for the development of general inferential processes. Moreover, a series of recent studies showed that self-awareness about cognitive processes participates in general intelligence on a par with processing efficiency functions, such as working memory, processing speed, and reasoning . In psychology, the concept of "self-awareness" is used in different ways - As a form of intelligence, self-awareness can be an understanding of one's own knowledge, attitudes, and opinions. Ferrand and Ludovic (2002), Faber, (2003), Nicolas et al. (2007), all pointed out that, Alfred Binet's first attempts to create an intelligence test included items for "auto-critique" – a critical understanding of oneself. Surprisingly, individuals do not have a privileged access to their own opinions and knowledge directly. For instance, if an attempt to enumerate any known conceptual classification, a consequential lack of recognition can be assumed. In our study we found that, Boeree (2006) acknowledged the work of
D. King and C. M. King IJSHIM - Volume 4, Issue 8 (2011), pp.43-72
Albert Bandura who created taxonomy called self-efficacy that builds on our varying degrees of self-awareness. Generally, individual’s inaccuracy about their own abilities, knowledge, and opinions has created many popular phenomena for research such as the better than average effect. For instance, 90% of drivers may believe that they are "better than average" (Swenson, 1981) .This inaccuracy comes from the absence of a clear definable measure of driving ability and their own limited self-awareness; and this of course underlines the importance of objective standards to inform our subjective self-awareness in all domains. Inaccuracy, in individual’s opinion seems particularly disturbing, and can be more personal than opinions. Thus, inconsistency in our opinion is as strong as in our knowledge of facts. For instance, people who call themselves opposite extremes in political observations often do not embrace overlapping political views, but views that are central to the opposite extreme. As indicated by Swenson, (1981), reconciling such differences proves difficult and generally gives rise to Leon Festinger's theory of cognitive dissonance. Next, we discuss an exemplar preventive medicine strategy.
PREVENTION
Many diseases and disorders can be prevented through a variety of procedures (both medical and personal). These include sanitation, proper nutrition, adequate exercise, vaccinations, and other self-care and public health measures. Preventive medicine or preventive care refers to techniques taken to prevent diseases or injuries rather than curing or treating the symptoms (Gordon 1987). The term differs in techniques with curative and palliative medicine, and in scope with public health protocols, which work at the level of population health rather than individual health. Preventive medicine strategies are typically described as taking place at the primary, secondary, tertiary and quaternary prevention levels. In addition, the term "ancient prevention" has been used to describe all measures taken to ensure, for example, “fetal well-being” and impede any long-term health consequences from gestational history and/or disease. The rationale for such efforts is the evidence demonstrating the link between fetal well-being, or "primal health", and adult health. Ancient prevention strategies typically focused on providing future parents with: education regarding the consequences of epigenetic influences on their child, sufficient leave time for both parents, and financial support if required. Simple examples of preventive medicine include hand washing, breastfeeding, and immunizations. Preventive care may include examinations and screening tests tailored to an individual's age, health, and family history. Personal arrogance contributes to the inability to deter most of the unwanted diseases (Sackett, 2004). For example, a person with a family history of certain cancers or other diseases would begin screening at an earlier age and/or more frequently than those with no family history. On the other side of preventive medicine, some non-profit organizations, such as the Northern California Cancer Center, apply epidemiological research towards diseases prevent. See below for details.
Health Management: Prevention Awareness and Wellness Exceptionalism
Prevention levels
Doctor’s side
Disease
absent present
Patient’s side
Illness
absent Primary prevention
(illness absent disease absent) Secondary prevention
(illness absent disease present)
present Quaternary prevention
(illness present disease absent) Tertiary prevention
(illness present disease present)
Level Definition
PRIMARY Prevention
Primary prevention strategies intend to avoid the development of disease. Most population-based health promotion activities are primary preventive measures.
SECONDARY Prevention
Secondary prevention strategies attempt to diagnose and treat an existing disease in its early stages before it results in significant morbidity.
TERTIARY Prevention
These treatments aim to reduce the negative impact of established disease by restoring function and reducing disease-related complications.
QUATERNARY Prevention
This term describes the set of health activities that mitigate or avoid the consequences of unnecessary or excessive interventions in the health system.
Gordon (1987) in the area of disease prevention, and later Kumpfer and Baxley in the area of substance use Kumpfer, and Baxley (1997), proposed a three-tiered preventive intervention classification system: universal, selective, and indicated prevention. Amongst others, this typology has gained favor and is used by the U.S. Institute of Medicine, the NIDA and the European Monitoring Centre for Drugs and Drug Addiction. See below for the 3-Tier Systems.
Tier Definition
UNIVERSAL PREVENTION
addresses the entire population (national, local community, school, district) and aim to prevent or delay the abuse of alcohol, tobacco, and other drugs. All individuals, without screening, are provided with information and skills necessary to prevent the problem.
SELECTIVE PREVENTION
focuses on groups whose risk of developing problems of alcohol abuse or dependence is above average. The subgroups may be distinguished by characteristics such as age, gender, family history, or economic status. For example, drug campaigns in recreational settings.
INDICATED PREVENTION
involves a screening process, and aims to identify individuals who exhibit early signs of substance abuse and other problem behaviors. Identifiers may include falling grades among students, known problem consumption or conduct disorders, alienation from parents, school, and positive peer groups etc.
Environmental prevention is one of the external parameters of the three-tier model. This type of prevention methodologies are typically managed at the regulatory or community level, and focus on interventions to deter drug consumption. For example, prohibiting workplace smoking and alcohol advertising may be viewed as the ultimate environmental restriction. However, in practice
D. King and C. M. King IJSHIM - Volume 4, Issue 8 (2011), pp.43-72
environmental hindrance programs embrace various initiatives at the macro and micro level, from elected and designated governing bodies.
TREATMENTS
Medical therapies or treatments are efforts to cure or improve a disease or other health problem. However, in the medical field, therapy is synonymous with the word "treatment". Among psychologists, the term may refer specifically to psychotherapy or "talk therapy". Also, we found out that common treatments include medications, surgery, medical devices, and self-care. Although, treatments may be provided by an organized health care system, or informally, by the patient or family members, other spiritual (Godly) leaders, friends (social) and neighbors were identified in the study. A prevention or preventive therapy is a way to avoid an injury, sickness, or disease in the first place. A treatment or cure is applied after a medical problem has already started. Nonetheless, a treatment attempts to improve or “remove” a problem, however, treatments may not produce permanent cures, especially in chronic diseases. Despite the fact that cures are a subset of treatments that reverse diseases completely or end medical problems permanently, several medical interpretations have evolved. In spite of uncertainty and elucidations on this issue (“healed”), many diseases that cannot be completely cured are still treatable. Nonetheless, treatment for medical emergencies must be provided promptly, as often, through an emergency department or, in less critical situations, urgent care facilities must normally be available. The following is a synopsis of treatable information grid systems (TIGS).
5-HTP Coenzyme Q-10 Horse chestnut Pyridoxine (Vitamin B6)
Acai Cranberry Horsetail Red clover
Alfalfa Creatine Iodine Red yeast
Aloe Dandelion Iron Riboflavin (Vitamin B2)
Bacillus coagulans Devil's claw Kava Roman chamomile
Belladonna DHEA L-arginine Saccharomyces boulardii
Beta-carotene Dong quai Lactobacillus SAMe
Bifidobacteria Echinacea Lavender Saw palmetto
Bilberry Eucalyptus Licorice Selenium
Biotin Evening primrose oil Lycium Senna
Black psyllium Feverfew Lycopene Shark cartilage
Black tea Fish oil Magnesium St. John's wort
Bladderwrack Flaxseed Manganese Tea tree oil
Blessed thistle Flaxseed oil Melatonin Thiamine (Vitamin B1)
Blond psyllium Folic acid Milk thistle Turmeric
Blue-green algae Garlic Morinda Valerian
Blueberry Ginger Niacin and niacinamide (Vitamin B3) Vitamin A
Boron Ginkgo Pantothenic acid (Vitamin B5) Vitamin B12
Bromelain Ginseng, American Passionflower Vitamin C (Ascorbic acid)
Calcium Ginseng, Panax Pennyroyal Vitamin D
Calendula Ginseng, Siberian Peppermint Vitamin E
Cassia cinnamon Glucosamine hydrochloride Phosphate salts Vitamin K
Grid 1: Samples of Recommended Medi-Cure Intake (RMCI)
Health Management: Prevention Awareness and Wellness Exceptionalism
Chondroitin sulfate Glucosamine sulfate Pomegranate Wild yam
Chromium Goldenseal Propolis Yohimbe
Clove Green tea Pycnogenol Zinc
THERAPEUTIC HEALTH RESOURCES (THR)
Therapeutic health resources (THR) attempts to provide an outline, explicate, delineate and categorize new sources of health information systems in an industry that has been largely driven by the consumer. What is the role of THR, and the new medicine? In the study, we find “metaphors” such as Holistic, Humanistic, Alternative, Complementary, Integrative, and Mind-Body and Self-Transcending used to differentiate this new perspective from the old paradigm. THR, is the practice that emphasizes the importance of collaborative healing partnerships between practitioner and patient, focuses on the “Individual-Being”, and makes use of evidenced-based therapeutic approaches from many healthcare professionals to achieve optimal health and healing. For example, the U.S. National Center for Complementary and Alternative Medicine (NCCAM), conducts and supports research, trains CAM researchers, and provides information about CAM (Nahin, Pecha, Welmerink, et al. 2009). It has been noted that, disease can be conventionally categorized and defined. However, CAM providers often use the term dis-ease to describe this orientation to the broader sphere of health, suggesting an imbalance in the body's ability to optimally function. Illness, or the way the individual lives with or perceives disease, varies for each person. Therefore, we argue that, the role of a public health educator, in particular, at the community level, becomes increasingly essential to assist in distinguishing facts from fiction, and to locate credible community health resources. On many aspects of illness, a healing process also varies for each individual. The healing concept is far less understood than the pathophysiology of disease, and it is open to many levels of interpretation. Healing differs from curing a disease, in that healing comes from within (Nahin, Pecha, Welmerink, et al. 2009). Healing may arise from an interaction or insight that promotes a change in acceptance of the current situation to a measurable improvement in one or more facets of health. Insights such as increased awareness of self and others and adjustments to long held beliefs are often part of the healing process. The healing process can be an opportunity to grow in ways previously undefined by that individual or group. In various ways, healing will enhance the quality of life. Illness and disease are phenomena, that when examined in depth, provoke questions that go beyond medicine to the essence of the human condition in this modern world. The healing process may encourage exploration of the larger questions concerning human suffering, compassion and tolerance for the other. Cultivating a trusting healing partnership to support this process of growth and as reviewed, transformation creates that space for integration of deeper knowing. THR gives new meaning to the art of healing. The subsequent section deals with general diseases literature.
DISEASES
Certainly, all societies have medical beliefs that provide explanations for disease . A disease is an abnormal condition affecting the body of an organism. It is often implied to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune diseases. In humans,
D. King and C. M. King IJSHIM - Volume 4, Issue 8 (2011), pp.43-72
"disease" is often used more broadly to refer to any condition that causes pain, dysfunction, distress, social problems, and/or death to the person afflicted, or similar problems for those in contact with the person. In a broader sense, the term disease persistently includes injuries, disabilities, disorders, syndromes, infections, isolated symptoms, deviant behaviors, and abnormal variations of structure and function, while in other contexts and for other purposes these may be considered discrete. Diseases usually affect individual not only physically, but also emotionally, as contracting and living with many diseases can alter one's perspective on life, and their personality. Death due to disease is called death by natural causes. There are four main types of disease: pathogenic disease, deficiency disease, hereditary disease, and physiological disease. These four types of diseases will not be discussed in this study. However, it will be examined in the next phase (future) of the research. Diseases can also be classified as communicable and non-communicable disease.
THE CALCULATED YEARS METHOD (CYM)
In almost a decade, (around 2004), the World Health Organization (WHO) calculated that, nine hundred and thirty two million (932 million) years of potential life were lost to premature death (Burnet, Jefferies, Benson, Hunt, Treasure, 2005). This is in line with disease encumbrance (DE) which is unquestionably, the effect of a health delinquency in an area measured by monetary cost, mortality, sickness, or other consequential indicators. There are several methods used to quantify the encumbrance imposed by diseases on people. The years of potential life lost (YPLL) is a simple estimate of the number of years that an individual's lifespan was shortened due to a disease(s). For example, if a person deceases at the age of sixty five (65) from a disease, and would probably have lived until eighty years (80 years) of age without that disease, then that disease has caused a loss of fifteen years (15 years) of potential life. YPLL measurements do not account for how incapacitated a person is before passing away, hence the measurement treats a sudden death people and death at the same age after decades of ailment as equal. In the works of Burnet, Jefferies, Benson, Hunt and Treasure (2005), we learned that, the quality-adjusted life year (QALY) and disability-adjusted life year (DALY) metrics are similar, but take into account whether a person was healthy after diagnosis. In addition to the number of years lost due to premature death, these measurements add part of the years lost to being sick. In Contrast to YPYLL, these dimensions show the encumbrance enforced on very sick individual, however lives a normal life. A disease that has high encumbrance, although low mortality, will have a high DALY and a low YPLL. In 2004, the World Health Organization calculated that 1.5 billion disability-adjusted life years were lost to disease and injury Burnet, et al. (2005). Below illustrates the categories and the percentiles of the description in Table 1.
Health Management: Prevention Awareness and Wellness Exceptionalism
Table 1: Years of Potential Life Lost, Association of Public Health Epidemiologists (2008), Adopted
Disease category P
erce
nt
(%)
of
all Y
PL
Ls
lost
, wo
rld
wid
e
Per
cen
t (%
) o
f al
l DA
LY
s
lost
, wo
rld
wid
e
Per
cen
t (%
) o
f al
l YP
LL
s
lost
, Eu
rop
e
Per
cen
t (%
) o
f al
l DA
LY
s
lost
, Eu
rop
e
Per
cen
t (%
) o
f al
l YP
LL
s
lost
, US
an
d C
anad
a
Per
cen
t (%
) o
f al
l DA
LY
s
lost
, US
an
d C
anad
a
Infectious and parasitic diseases, especially lower respiratory tract infections, diarrhea, AIDS, tuberculosis, and malaria
37% 26% 9% 6% 5% 3%
Neuropsychiatric conditions, e.g. depression
2% 13% 3% 19% 5% 28%
Injuries, especially motor vehicle accidents
14% 12% 18% 13% 18% 10%
Cardiovascular diseases, principally heart attacks and stroke
14% 10% 35% 23% 26% 14%
Premature birth and other perinatal deaths
11% 8% 4% 2% 3% 2%
Cancer 8% 5% 19% 11% 25% 13%
In the study, we adopted Years of potential life lost (YPLL) as a computational examination instrument (CEI) for the individual level data or using congregated age data. To compute the years of potential life lost, the researchers established an upper orientation age. The orientation age must correspond to the life expectancy of the population under study. In the advanced nations, this is normally set at age 75, which is fundamentally subjective. Thus, YPLL should be documented with honor in respect to the orientation age used in the calculation: e.g. YPLL[75]. Based on Association of Public Health Epidemiologists (2008), the methodology used for each individual YPLL is calculated by subtracting the person's age at death from the orientation age. If a person is older than the orientation age when he or she dies, that person's YPLL is set to zero (i.e., there are no "negative" YPLLs). In effect, only those who die before the orientation age are incorporated in the calculation. Below is brief orientation:
1. Orientation age = 75; Age at death = 60; YPLL [75] = 75 - 60 = 15 2. Orientation age = 75; Age at death = 6 months; YPLL [75] = 75 - 0.5 = 74.5 3. Orientation age = 75; Age at death = 80; YPLL [75] = 0 (age at death greater than Orientation age)
D. King and C. M. King IJSHIM - Volume 4, Issue 8 (2011), pp.43-72
To compute the YPLL for a certain population in a specific year, the analyst aggregates the individual YPLLs for all individuals in that population who passes away in that year. This can be done for all-cause mortality or for cause-specific mortality. Often, cost-benefit analysis from the perspective of quality care delivery are not emphasized enough as it is the case of the US healthcare system.
MEDI-CARE TRACKING ANALYSIS: USA
National representatives and health researchers have long recognized that the amount and quality of the health care services that Medicare beneficiaries receive vary substantially across different regions of the United States. Much of that variation does not appear to be caused by differences in beneficiaries’ health, and one widely-publicized estimate asserted that as much as thirty percent (30%) of Medicare expenditures may be unnecessary. Tables 2 and 3 display support the study in the below data. Five (5) Synopsis techniques were used by the Policy and Data Analysis Group (PDAG) and further significant analysis were performed by Geographic Variation Public Use File (GV PUF).
1. Study population 2. Geographic variables 3. Disease variables 4. Utilization measures 5. Quality measures
Table 2: Study Population for the GV PUF
Number Percent
Total Medicare beneficiaries in 2008 47,850,425 100.0
BENEFICIARIES EXCLUDED FROM THE ANALYSIS:
Any enrollment in MA 11,010,040 23.0
First eligible after January 2008 2,344,071 4.9
Part A only or Part B only 3,572,468 7.5
Disabled 4,916,123 10.3
ESRD 174,803 0.4
Total excluded beneficiaries 22,017,505 46.0
Study population for the GV PUF 25,832,920 54.0
Beneficiaries in study population that died during 2008 1,365,882 5.3
Reviewed and Endorsed – Source: John Wennberg et al. Tracking the Care of Patients with Severe Chronic Illness – The Dartmouth Atlas of Health Care 2008, The Dartmouth Institute for Health Policy and Clinical Practice.
Note: Itemizations may slightly deviate from expected totals due to mathematical approximation.
Health Management: Prevention Awareness and Wellness Exceptionalism
Table 3: Demographic Information for GV PUF Study Population
Number Percent
Total beneficiaries in study population (2008) 25,832,920 100.0
BY GENDER:
Female 14,953,519 57.9
Male 10,879,401 42.1
Part A only or Part B only 3,572,468 7.5
BY RACE:
White, non-Hispanic 21,829,671 84.5
African-American 1,876,307 7.3
Hispanic 1,285,537 5.0
Asian-American / Pacific Islander 552,432 2.1
American Indian 99,464 0.4
Other 189,509 0.7
Average age 76.5
Percentage eligible for full Medicaid benefits 14.4
Reviewed and Validated – Source: John Wennberg et al. Tracking the Care of Patients with Severe Chronic Illness – The Dartmouth Atlas of Health Care 2008, The Dartmouth Institute for Health Policy and Clinical Practice. Note: Itemizations may slightly deviate from expected totals due to mathematical approximation.
THE HUMAN PHYSIOLOGY (THP)
In the course of examining literatures for the study, it became apparent that general human science was significant to the overall discussion and intellectual contribution. Henceforth, detail description of THP as well as living organs is provided. The human physiology (THP) and biochemistry, is a complementary basic medical science, is primarily the scientific study of the morphology of the human body. Anatomy is subdivided into gross anatomy and microscopic anatomy. Gross anatomy (also called topographical anatomy, regional anatomy, or anthropotomy) is the study of anatomical structures that can be seen by unaided vision. Microscopic anatomy is the study of minute anatomical structures assisted with microscopes, which includes histology (the study of the organization of tissues), and cytology (the study of cells). Anatomy or physiology is the study of function and biochemistry, the study of the chemistry of living structures are complementary basic medical sciences that is applicable to the human body. As such, these subjects are usually taught together (or in tandem with,) to students in the medical sciences. In some of its facets human anatomy is closely related to embryology, comparative anatomy and comparative embryology, through common roots in evolution; for example, much of the human body
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maintains the ancient segmental pattern that is present in all vertebrates with basic units being repeated, which is particularly obvious in the vertebral column and in the ribcage, and can be traced from very early embryos. The human body consists of the next depicted Grid 2 below as sequenced,
The history of anatomy has been characterized, over a long period of time, by a continually developing understanding of the functions of organs and structures in the body. Methods have also advanced dramatically, advancing from examination of animals through dissection of preserved cadavers (dead human bodies) to technologically complex techniques developed in the 20th century. In this study, we uncovered that, the human anatomy is also known as (gr. ἀ νατομία, "dissection", from ἀ νά, "up", and τέμνειν, "cut"). See appendices ABC.
BIO-PEDAGOGY
Biology is concerned with the characteristics, classification and behaviors of organisms, as well as how species were formed and their interactions with each other and the environment. The biological fields of botany, zoology, and medicine date back to early periods of civilization, while microbiology was introduced in the 17th century with the invention of the microscope. However, it was not until the 19th century that biology became a unified science. Once scientists discovered commonalities between all living things, it was decided then that all organisms must be studied as a whole. Some key developments in biology were the discovery of genetics, for example, Darwin's theory of evolution through natural selection; the germ theory of disease and the application of the techniques of chemistry and physics at the level of the cell or organic molecule. This indeed led to modern biology which is divided into sub-disciplines by the type of organism, and by the scale being studied. Equally, molecular biology serves as the fundamental chemistry of life, while cellular biology is the examination of the cell; the basic building block of all life. At a higher level, physiology looks at the internal structure of organism, while ecology looks at how various organisms interrelate. A fragment of DNA, the chemical sequence that contains genetic instructions for the development and functioning of living organisms. This field encompasses a set of disciplines that examines phenomena related to living organisms. The scale of study can range from sub-component biophysics up to complex ecologies. Illustration below (Figure 5) is an exemplar.
BIOLOGICAL SYSTEMS
ORGANS,
TISSUES,
CELLS
CONNECTIVE TISSUE.
Grid 2: Segmented Sequential Human Physiology (SSHP)
Health Management: Prevention Awareness and Wellness Exceptionalism
CONCLUSION, LIMITATIONS AND RECOMMENDATIONS
The authors acknowledge that, whereas this study is reiterating evidence-based health awareness, it is indeed worth reviewing the core concerns of public health, which appears to be ignored at all levels by society at large. We argued herein, and recommend that healthcare awareness through enlightenment is needed and must be well served. Indeed, it must also be recognized that, a significant amount of prevention will be done outside the parameters of primary care practitioner as indicated in the introduction (for example, by wellness coaches, holistic healers, and other mind-body practitioners). The significance of universal health resources availability were underlined, and applicable medical terminologies were examined and highlighted. Also, we uncovered in the study that, in general, health issues emerges from the attitudes and lifestyles of individuals and groups of people which includes many dimensions such as physical, intellectual, spiritual, financial, emotional, social, sexual, environmental, and cultural wellbeing. In the study, we noted that health represents the overall condition of the body-mind composite. Our study pointed out that, health is a by-product of the sum of our thoughts, beliefs, emotions, actions, environment and genetic blueprints. As such, it is largely determined by individuals and nonetheless their lifestyle-choices. Although, other methods could have been used for the study, we recognize our limitations in this research. However, the four categorical hybrid approaches (CHA): Medscape, Medline University, Realage and Dr. Oz’s broadcasts were the most current and appropriate for the study. Respectively, the CHA methodology allows medical professionals to explore their curiosity and the know-how in medicine, provides the basis for medical education, offers the most informative healthcare prevention and wellness and finally, delivers a viable and excellence in medical education, in particular, in the areas of healthcare prevention and wellness. A continuum research on this topic is in the “pipeline”.
Figure 5: Samples of Living organisms.
Phascolarctos cinereus,
Athyrium filix-femina
Amanita muscaria,
Agalychnis callidryas
Brachypelma smithi
Salmonella typhimurium
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REFERENCES
Cohen, A. P (1994) Self-Consciousness: An Alternative Anthropology of Identity, 1994
Association of Public Health Epidemiologists in Ontario (2008) "Calculating Potential Years of Life Lost (PYLL)". http://www.apheo.ca/index.php?pid=190. Retrieved 2008-05-13.
Boeree, C. G. (2006) Personality Theories: Albert Bandura. http://webspace.ship.edu/cgboer/bandura.html (Accessed online September 24, 2011)
Burnet NG, Jefferies SJ, Benson RJ, Hunt DP, Treasure FP (2005). "Years of life lost (YLL) from
cancer is an important measure of population burden--and should be considered when allocating
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Cherry, Rona (March 2006). "Can You Pray Your Pounds Away?" Vegetarian Times: pp. 80–83.
Demetriou, A., & Kazi, S. (2001). Unity and modularity in the mind and the self: Studies on the relationships between self-awareness, personality, and intellectual development from childhood to adolescence. London: Routledge
Gordon, R. (1987), ‘An operational classification of disease prevention’, in Steinberg, J. A. and Silverman, M. M. (eds.), Preventing Mental Disorders, Rockville, MD: U.S. Department of Health and Human Services, 1987.
Gould, SJ, http://www.prognosis.org/what_does_it_mean.php, (Accessed Online August, 2011)
Faber, D. (2003), "Archival note: an inquiry into the relationshp between Alfred Binet and Cyril Burt.", Journal of the history of the behavioral sciences 39 (3): 289–97, doi:10.1002/jhbs.10111, PMID 12891695
Kumpfer, K. L., and Baxley, G. B. (1997), 'Drug abuse prevention: What works?', National Institute on Drug Abuse, Rockville.
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http://www.cdc.gov/nchs/healthy_people.htm (accessed Online – August, 19 2011)
http://www.justanswer.com (Accessed online September 2011)
http://www.hacres.com/media/articles/pray_your_pounds_away_veg_times_Mar06.pdf. (Retrieved 2008-03-08)
http://www.medscape.org (Access July 2011)
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Nicolas, Serge; Ferrand, Ludovic (2002), "Alfred Binet and higher education.", History of psychology 5 (3): 264–83, 2002 Aug, doi:10.1037/1093-4510.5.3.264, PMID 12269336
Nahin, RL, Pecha M., Welmerink D. B, et al. (2009) Concomitant use of prescription drugs and dietary supplements in ambulatory elderly people. Journal of the American Geriatric Society. 2009;57(7):1197–1205
Health Management: Prevention Awareness and Wellness Exceptionalism
Sackett, D. L. (2004) The arrogance of preventive medicine. CMAJ. 2004;167:363-4
Staum, M. S (2007), "Ribot, Binet, and the emergence from the anthropological shadow.", Journal of the history of the behavioral sciences 43 (1): 1–18, doi:10.1002/jhbs.20206, PMID 17205542
Thomas, S. (2001) Duval Self-Awareness and Causal Attribution, p. 1, Springer, 2001 ISBN 978-0792375012
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APPENDIX A
Health Management: Prevention Awareness and Wellness Exceptionalism
APPENDIX B
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APPENDIX C
Health Management: Prevention Awareness and Wellness Exceptionalism
APPENDIX D
This list contains acronyms on diseases (infectious or non-infectious) and medical disorders.
Acronyms Diseases and Disorders AAA Abdominal aortic aneurysm
AAS Aarskog-Scott syndrome
ABCD syndrome albinism, black lock, cell migration disorder
ACC Agenesis of the corpus callosum
ACS Acute coronary syndrome
ACTH deficiency Adrenocorticotropic hormone deficiency
AD Alzheimer's Disease
AD Attachment disorder
ADD Attention Deficit Disorder
ADD-RT Attention Deficit Disorder-Residual Type
ADEM Acute disseminated encephalomyelitis
ADHD Attention Deficit Hyperactivity Disorder
AF Atrial fibrillation
AGS Aicardi-Goutieres syndrome
AHC Alternating hemiplegia of childhood
AIDS Acquired Immune Deficiency Syndrome
ALI Acute lung injury
ALS Amyotrophic Lateral Sclerosis
AMD Age-related Macular Degeneration
AOS Apraxia of speech
APA Aldosterone Producing Adenoma
APS Antiphospholipid syndrome
ARBD Alcohol-Related Birth Defects
ARD Adult Refsum disease
ARDS Acute Respiratory Distress Syndrome
ARND Alcohol-Related Neurodevelopmental Disorder
AS Ankylosing Spondylitis
AS Asperger syndrome
ASDs Autism spectrum disorders
A-T Ataxia-telangiectasia
AVMs Arteriovenous malformations
BBS Bashful Bladder Syndrome (see Paruresis)
BEB Benign essential blepharospasm
BD Binswanger's disease
BEH Behaviorally/Emotionally Handicapped
BH Behaviorally Handicapped
BMD Becker's muscular dystrophy
BPH Benign prostatic hyperplasia
BS Bloom's syndrome
BSE Bovine spongiform encephalopathy
CACH Central Nervous System Hypomyelination
CAD Coronary artery disease
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Acronyms Diseases and Disorders
CADASIL Cerebral Autosomal Dominant Arteriopathy with Sub-cortical Infarcts and Leukoencephalopathy
CAPD Central Auditory Processing Disorder
CCD Considerable Conduct Disorder
CCHF Crimean-Congo haemorrhagic fever
CCHS Congenital Central Hypoventilation Syndrome
CCM Cerebral cavernous malformation
CDG Congenital disorder of glycosylation
CDGS Carbohydrate deficient glycoprotein syndrome
CESD Cholesteryl ester storage disease
CF Cystic Fibrosis
CFIDS Chronic Fatigue Immune Dysfunction Syndrome
CFS Chronic fatigue syndrome
CGBD Corticobasal ganglionic degeneration
CH Cluster headache
CHARGE syndrome Coloboma of the eye, Heart defects, Atresia of the nasal choanae, Retarded growth & or development, Genital abnormalities, Ear abnormalities
CHD Congenital Heart Disease
CHD Congenital hip dysplasia
CHD Coronary heart disease
CHF Congestive heart failure
CIDP Chronic inflammatory demyelinating polyneuropathy
CIPA Congenital insensitivity to pain with anhidrosis
CJD Creutzfeldt-Jakob disease
CMs Chiari malformations
CMT disease Charcot-Marie-Tooth disease
COFS Cerebro-oculo-facio-skeletal syndrome
COPD Chronic Obstructive Pulmonary Disease
CP Cerebral Palsy
CP/CPPS Chronic prostatitis/chronic pelvic pain syndrome
CPDD Calcium pyrophosphate deposition disease
CPM Central pontine myelinolysis
CPPS Chronic Pelvic Pain Syndrome (see UCPPS)
CRF Chronic Renal Failure
CRKP Carbapenem resistant Klebsiella pneumonia
CRPS Complex regional pain syndrome
CSA Central sleep apnea
CSD Cat scratch disease
CVD Cardiovascular disease
DAS Developmental apraxia of speech
DBA Diamond Blackfan anemia
DBMD Duchenne/Becker Muscular Dystrophy
DD Developmental disability
DEF Deaf
DF Dengue Fever
Health Management: Prevention Awareness and Wellness Exceptionalism
Acronyms
Diseases and Disorders
DH Developmentally handicapped
DHF Dengue hemorrhagic fever
DiG DiGeorge syndrome
DLB Dementia with Lewy bodies
DM Diabetes mellitus
DMD Duchenne muscular dystrophy
DRSP disease Drug-resistant Streptococcus pneumoniae disease
DS Down syndrome
DSPS Delayed sleep phase syndrome
DTs Delirium tremens
DVD Developmental verbal dyspraxia
ED Emotionally disturbed
EDS Ehlers-Danlos syndrome
EDS Excessive daytime sleepiness
EEE Eastern equine encephalitis
EHK Epidermolytic hyperkeratosis
EMH Educable mentally handicapped
EMR Educable mentally retarded
ENS Epidermal nevus syndrome
EPM Extrapontine myelinolysis
ESRD End Stage Renal Disease
ESS Empty Sella Syndrome
FAE Fetal Alcohol Effects
FAS Fetal Alcohol Syndrome
FASDs Fetal Alcohol Spectrum Disorders
FFI Fatal familial insomnia
FMA Focal Muscular Atrophies
FMD Fibromuscular dysplasia
FMS Fibromyalgia Syndrome
FSP Familial spastic paraparesis
FTD Frontotemporal dementia
FVS Fetal Valproate Syndrome
FXS Fragile X syndrome
GAD Generalized anxiety disorder
GAN Giant axonal neuropathy
GAS disease Group A Streptococcal disease
GBS Guillain-Barré Syndrome
GBS disease Group B Streptococcal disease
GCE Glycine encephalopathy
GD Gestational diabetes
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Acronyms
Diseases and Disorders
GERD Gastroesophageal reflux disease
GI Gastrointestinal
GIB Gastro-intestinal bleeding
GN Glossopharyngeal neuralgia
GSS disease Gerstmann-Straussler-Scheinker disease
GT/LD Gifted and learning disabled
GVHD Graft-versus-host disease
GWD Guinea worm disease
HAS Holmes-Adie syndrome
HD Huntington's Disease
HDL2 Huntington's disease-like 2
HELLP syndrome Hemolytic anemia, Elevated Liver enzymes and Low Platelet count syndrome
HFA High Functioning Autism
HFMD Hand, foot, and mouth disease
HFRS Hemorrhagic fever with renal syndrome
HI Hearing impaired
HiB disease Haemophilus influenzae type B disease
HMSN Type III Hereditary Motor and Sensory Polyneuropathy Type III (see Dejerine Sottas syndrome)
HOH Hard of hearing
HPN Hypertension
HPRT deficiency hypoxanthine-guanine phosphoribosyl transferase deficiency
HPS Hantavirus pulmonary syndrome
HPV Infection Human Papillomavirus Infection
HSP Hereditary spastic paraplegia
IBD Inflammatory bowel disease
IBIDS syndrome ichthyosis, brittle hair, intellectual impairment, decreased fertility, and short stature syndrome
IBM Inclusion body myositis
IBS Ichthyosis bullosa of Siemens
IBS Irritable bowel syndrome
IC/PBS Interstitial cystitis/painful bladder syndrome
ICF syndrome Immunodeficiency, Centromere instability and Facial anomalies syndrome
IHA Idiopathic Hyperaldosteronism
IED Intermittent Explosive Disorder
IFAP syndrome Ichthyosis follicularis, alopecia, and photophobia syndrome
INAD Infantile neuroaxonal dystrophy
IP Incontinentia pigmenti
IRD Infantile Refsum disease
Health Management: Prevention Awareness and Wellness Exceptionalism
Acronyms Diseases and Disorders
IS Infantile spasm
ITP Idiopathic thrombocytopenic purpura
JAS Juvenile Anklosing Spondylitis
JE Japanese encephalitis
JHD Juvenile Huntington's disease
JRA Juvenile Rheumatoid Arthritis
KS Kawasaki syndrome
KSS Kearns-Sayre syndrome
KTS Klippel-Trenaunay syndrome
KTW Syndrome Klippel-Trenaunay-Weber Syndrome
LCM Lymphocytic choriomeningitis
LD Learning Disabilities/Differences
LD Legionnaires' Disease
LEMS Lambert-Eaton myasthenic syndrome
LFA Low Functioning Autism
LGV Lymphogranuloma venereum
LKS Landau-Kleffner syndrome
LNS Lesch-Nyhan syndrome
LP Lipoid proteinosis
LP Little person/people (see Dwarfism)
MAC Mycobacterium avium complex
MBD Minimal brain dysfunction
MCS Multiple Chemical Sensitivities
MD Muscular dystrophy
MDR TB Multi-drug-resistant tuberculosis
MID Multi-infarct dementia
MJD Machado-Joseph disease
ML mucolipidoses
MLD Metachromatic leukodystrophy
MMA Monomelic amyotrophy
MMR measles, mumps, rubella
MMRV measles, mumps, rubella, varicella
MND motor neuron disease
MOH Medication overuse headaches
MPD Myeloproliferative disorders
MPS I Mucopolysaccharoidosis Type I (see Hurler syndrome)
MPS II Mucopolysaccharoidosis Type II (see Hunter syndrome)
MPS III Mucopolysaccharoidosis Type III (see Sanfilippo syndrome)
MPS IV Mucopolysaccharoidosis Type IV (see Morquio syndrome)
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Acronyms Diseases and Disorders
MPS VI Mucopolysaccharoidosis Type VI (see Maroteaux-Lamy syndrome)
MPS VII Mucopolysaccharoidosis Type VII (see Sly syndrome)
MR/DD Mentally retarded/Developmentally disabled
MSA Multiple system atrophy
MSDD Multi-Sensory Developmental Delays
NAS Neonatal Abstinence Syndrome
NBIA Neurodegeneration with brain iron accumulation
NCL Neuronal Ceroid Lipofuscinosis
NF1 Neurofibromatosis type 1
NF2 Neurofibromatosis type 2
NKH Nonketotic hyperglycinemia
NLD Nonverbal learning disability
NMDs Neuronal migration disorders
NMO Neuromyelitis optica
NMS Neuroleptic malignant syndrome
NP Niemann-Pick disease
NPC1 Niemann-Pick disease, type C1
NPH Normal pressure hydrocephalus
NTD Neural Tube Defect
NTDs Neural tube defects
OA Osteoarthritis
OCD Obsessive-Compulsive Disorder
ODD Oppositional Defiant Disorder
OMA Ocular Motor Apraxia
ON Osteonecrosis
OPC Oropharyngeal Candidiasis
OPCA Olivopontocerebellar atrophy
OSA Obstructive sleep apnea
PBC Primary biliary cirrhosis
PBD Peroxisome biogenesis disorders
PCOS Polycystic ovarian syndrome
PD Parkinson's disease
PDD Pervasive Developmental Disorder
PDD-NOS Pervasive developmental disorder not otherwise specified
PDD/NOS Pervasive developmental disorder not otherwise specified
PKAN Panthothenate kinase-associated neurodegeneration
PLMD Periodic limb movement disorder
PLS Primary lateral sclerosis
Health Management: Prevention Awareness and Wellness Exceptionalism
PMD Pelizaeus-Merzbacher disease
Acronyms Diseases and Disorders
PML Progressive multifocal leukoencephalopathy
PMS Premenstrual Syndrome
POTS Postural orthostatic tachycardia syndrome
PPMA Postpolio Progressive Muscular Atrophy
PPS Post-polio syndrome
PSC Primary sclerosing cholangitis
PSP Progressive supranuclear palsy
PVL Periventricular leukomalacia
PW Port-wine stain
Q fever Query fever
RA Rheumatoid Arthritis
RAD Reactive Airway Disease
RIND Reversible ischemic neurologic deficit
RLF Retrolental fibroplasia
RLS Restless legs syndrome
RMDs Repetitive motion disorders
ROP Retinopathy of prematurity
RS Reye's syndrome
RSD Reflex Sympathetic Dystrophy
RTI Respiratory Tract Infection
SARS Severe Acute Respiratory Syndrome
SB Spina bifida
SBS Shaken Baby Syndrome
SC Sydenham chorea
SD Saint Vitus's dance (see Sydenham chorea)
SIDS Sudden Infant Death Syndrome
SIS Shaken infant syndrome
SLE Systemic lupus erythematosus
SMA Spinal Muscular Atrophy
SMEI Severe myoclonic epilepsy of infancy
SMS Smith-Magenis Syndrome
SOD Septo-optic dysplasia
SPS Stiff person syndrome
SSPE Subacute sclerosing panencephalitis
STEMI ST-elevation myocardial infarction
STD Sexually Transmitted Disease
SUNCT Headache Short-lasting, Unilateral, Neuralgiform headache
SWS Sturge-Weber syndrome
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TAC Trigeminal autonomic cephalgia
Acronyms Diseases and Disorders
TB Tuberculosis
TBI Traumatic brain injury
TCS Tethered cord syndrome
TEF Tracheoesophageal fistula
TIA Transient ischemic attack
TMH Trainable mentally handicapped
TMJ/TMD Temporomandibular joint disorder
TMR Trainable mentally retarded
TN Trigeminal neuralgia
TOS Thoracic Outlet Syndrome
TS Tourette syndrome
TS Tuberous sclerosis
TSC Tuberous sclerosis
TSEs Transmissible spongiform encephalopathies
TSP Tropical spastic paraparesis
TTH Tension type headache
TTP Thrombotic thrombocytopenic purpura
UCPPS Urologic chronic pelvic pain syndrome (IC/PBS + CP/CPPS)
UDA Urticaria-deafness-amyloidosis
UTIs Urinary Tract Infections
VCFS Velo cardio facial syndrome
vCJD variant Creutzfeldt-Jakob disease
VD Venereal disease
VHF Viral Hemorrhagic Fever
VHL Von Hippel-Lindau Disease
VSD Ventricular septal defect
VVC Volvovaginal Candidiasis
VWM disease Vanishing White Matter disease
WAGR syndrome Wilms tumor, Aniridia, Genitourinary anomalies, and mental Retardation syndrome
WD Wilson's disease
WEE Western equine encephalitis
WS Williams Syndrome
XDR TB Extensively drug-resistant tuberculosis
XP Xeroderma pigmentosa
YSS Young Simpson syndrome
YVS Yunis-Varon syndrome
ZBLS Zadik Barak Levin syndrome