HISTORY AND TRENDS OF HEALTH CARE - Principles of Health Sciences 1 – 1 - ثاني ثانوي

Link to digital lesson www.ien.edu.sa CHAPTER HISTORY AND 1 TRENDS OF HEALTH CARE Case Study Investigation Fatima is a 53-year-old Saudi woman whose blood pressure has begun to rise above normal levels. Fatima is taking care of her ill mother and is still working full time, which makes her stressed. She is looking for ways to help manage her blood pressure, and she would like to find a complementary medicine that might help her. She has heard about roselle tea and wonders if it works. What complementary medicines might you suggest to Fatima? Is there anything else that she might do to help her condition? LEARNING OBJECTIVES After completing this chapter, you should be able to: . • Create a timeline showing what you believe are the most important developments in medicine throughout history. Identify at least five current trends or changes in health care. • Explain how discoveries in health care have led to the advancement of this field. KEY TERMS pandemic telemedicine wellness alternative therapies biotechnology complementary therapies cost containment energy conservation geriatric care holistic health care home health care nanotechnology outpatient services NOTE: To further emphasize the key terms, they appear in color within the chapter. وزارة التعليم Ministry of CHAPTER 1 2022-1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 12 14/10/2022 10:12

1:1 HISTORY OF HEALTH CARE Why is it important to understand the historical significance of health care? Would you believe that some of the treatment methods in use today were also used in ancient times? In the days before drug stores, people used many herbs and plants as both food and medicine. Many of these herbs remain in use today. A common example is a medication called morphine. Morphine is made from the poppy plant and is used to manage pain. As you review each period of history, think about how the discoveries made in that period have helped to improve the health care you receive today. The timeline in Figure 1-1 shows some of the developments in medicine throughout history. ANCIENT EGYPTIANS The earliest people known to maintain accurate health records. Physicians were Egyptian priests who studied medicine and surgery in temple medical schools. ANCIENT GREEKS BCE 4000 2000 Began modern medical science by observing the human body and effects of disease. They were also among the first to stress that a good diet and cleanliness help to prevent disease. 500 CE Very little is known about these times. No real progress was made in understanding and treating diseases. Dissection of the body began to allow a better under- standing of anatomy and physiology. In the 1300s, a major epidemic of bubonic plague killed almost 75 percent of the population of Europe and Asia. Ibn Sina (ca. 980-1037), commonly known in the West as Avicenna, created a system of medicine that today we would call holistic, and in which physical and psychological factors, drugs, and diet were combined in treating patients. His Canon of Medicine is one of most influential books in the history of medicine. Ibn Al-Nafis (1213-1288) was the first person to describeshe pulmonary (lungs) circulation in dieine History De also made several important discoveries in the fields of anatomy and physiology. وزارة التعليم Ministry of Eduction 2022 1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 13 800-900 1500 -1600 3000 1000 EARLIEST TIMES Herbs and plants were used as medicines, and some are still used today. ANCIENT CHINESE Prohibitions against dissection resulted in inadequate knowledge of the structure of the body. They believed in the need to treat the whole body by curing the spirit and nourishing the body. 100-700 THE ROMANS The Romans realized that some diseases were connected to filth, contaminated water, and poor sanitation. They were the first to organize medical care by providing care for injured soldiers. 1000- 1400 Medical universities were created to train physicians how to use the knowledge gained from the Greeks and Romans to treat illness. Arab countries began requiring that physicians pass examinations and obtain licenses. Abu Bakr al-Razi (ca. 865-925), a physician and scientist, first identified hay fever and its cause. He was the first to clinically distinguish between smallpox and measles. Causes of disease were still not known, and many people still died from infections and puerperal (childbirth) fever. Knowledge spread more rapidly, and physicians became more educated. FIGURE 1-1 The development of medicine. HISTORY AND TRENDS OF HEALTH CARE 13 | 14/10/2022 10:12

During this period, physicians gained an increased knowledge of the human body. However, the causes. of many diseases were still unknown, and medical care remained limited. Rapid advancements in health care. Physicians were able to use new machines such as x-rays to view the body. Medicines and vaccines to prevent diseases were developed. Physicians were now able to treat the cause of a disease. Some major threats to health care exist in this century. New viruses can mutate and cause disease in humans. Pandemics, or worldwide epidemics, can occur quickly in our global society because people can travel easily from one country to another. وزارة التعليم Minst 14 CHAPTER 1 2022 1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 14 1800 2000 1700 1900 Major progress occurred because of the development of machines and the wide availability of books. Physicians began to associate the tiny microorganisms seen under the microscope with diseases. Methods to stop the spread of these organisms were developed. Many vaccines and medications were developed. 2100 The potential for major advances in health care in the 21st century is unlimited. Adult stem cells were used in the treatment of disease early in the 2000s. The Human Genome Project to identify all of the approximately 20,000 to 25,000 genes in human DNA was completed in 2003. FIGURE 1-1 The development of medicine (continued). checkpoint 1. What were the contributions of the ancient Greeks and the Romans to the development of medicine? 2. When was the Human Genome Project completed? 1:2 TRENDS IN HEALTH CARE Health care has seen many changes during the past several decades, and many additional changes will occur in the years to come. Robotics and technology have increased the pace of new innovations in the medical field. An awareness of such changes and trends is important for all health care professionals. COST CONTAINMENT Cost containment means trying to control the rising cost of health care and achieve the maximum benefit for every Saudi Riyal spent. Some reasons for high health care costs include: ⚫ Technological advances, such as heart, lung, liver, or kidney transplants, artificial hearts, computers and technology that can examine internal body parts. 14/10/2022 10:12

The aging population, caused by increases in lifespan, has had an effect on the type of health care needed by older people. Some methods of cost containment include: ⚫ Combination of services eliminates duplication. Laboratories, diagnos- tics centers and imaging departments are shared by multiple hospitals, clinics, and other health care providers among a "health cluster". ⚫ Outpatient services, where patients receive care without being admitted to hospitals or other care facilities. ⚫ Mass or bulk purchasing, where equipment and supplies are purchased in larger quantities at reduced prices. . Early intervention and preventive services, such as patient education, immunizations, regular physical examinations to detect problems early, incentives for individuals to participate in preventive activities, and easy access for all individuals to preventive health care services. ⚫ Environmental protection: A major expense is the correct disposal of the toxic waste that health care produces. ⚫ Energy conservation by monitoring the use of energy to control costs and conserve resources and recycling is also a form of energy conservation, and most health care facilities recycle many different materials. These are just a few examples of cost containment. It is important to note that the quality of health care should not be lowered simply to control costs. The Saudi Central Board for Accreditation of Healthcare Institutions (CBAHI) sets unified performance standards for all health care facilities operating in the Kingdom, assessing and granting accreditation to support all health care providers to comply with quality and patient safety standards. In addition, every health care worker must make every effort to provide quality care while doing everything possible to avoid waste and keep expenditures down. Health care consumers must assume more responsibility for their own care, become better informed of all options for health care services, and follow preventive measures to avoid or limit illness and disease. Everyone working together can help control the rising cost of health care. HOME HEALTH CARE Career Home health care is increasing because diagnostic-related groups and shorter hospital stays have created a need for care in the home. Years ago, home care was the usual method of treatment. Doctors made house calls, private duty nurses cared for patients in the patients' homes, babies were delivered at home, and patients died at home. Current trends show a return to some of these practices. Home care is also another form of cost containment because it is usually less expensive to provide this type of care. All aspects of health care can be provided in the home, such as nursing care, وزارة التعليم Ministry of EducTION 2022-1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 15 HISTORY AND TRENDS OF HEALTH CARE 15 | 14/10/2022 10:12

physical and occupational therapy, respiratory therapy, social services, nutri- tional and food services. GERIATRIC CARE Geriatric care, or care for the elderly, is another field that will continue to experience rapid growth in the future. This is caused in part by the Career large number of individuals who have longer life spans because of advances in health care. Many people now enjoy life spans of 80 years or more. Years ago, very few people lived to be 100 years old, but this experi- ence is becoming more and more common. TELEMEDICINE Telemedicine involves the use of video, audio, and computer systems to pro- vide medical and/or health care services (Figure 1-2). New technology now allows interactive services between health care providers even though they may be in different locations. Telemedicine allows medical professionals to diagnose and treat patients without unnecessary exposure to disease for either provider or patient. Practitioners can also spread information and take care of noncritical patients in a home setting. EHR Electronic health records (EHRS), also called electronic medical records (EMRs), help with rapid transmission of patient information. When physician offices, hospitals, and other health care providers have access to EMRs, a doctor, or anyone else who has permission, can obtain hos- pital laboratory results, radiology reports, and EHRs at any location. Patients can also access their EHRs to obtain information about their medical care. The use of satellite and video technology also enhances medical care. Surgeons using a computer can guide a remote-controlled robotic arm to per- form surgery on a patient many miles away. In other instances, one surgeon can direct the work of another surgeon by watching the procedure on video beamed by a satellite system. FIGURE 1-2 Telemedicine allows medical profes- signals to diagnose and treat patients remotely. وزارة التعليم 16 CHAPTER 1 Mins 2022 1444 Telephone apps enable patients to test their own blood sugar levels, oxygen levels, blood pressure measurements, and other vital signs and send the results to a health care provider. They can also monitor pacemakers, use online courses to learn how to manage their condition(s), schedule an appointment to talk with a health care provider, receive electronic reminders to take medications or perform diagnostic tests, and receive answers to specific health questions. In rural areas, where spe- cialty care is often limited, telemedicine can pro- vide a patient with access to specialists thousands of miles away. Telemedicine is an important way to deliver health care. GE44.PATHWAYS.G02 S2.HLTH.SB.indb 16 14/10/2022 10:12

WELLNESS Wellness is the state of being in optimum health with a balanced rela- tionship between physical, mental, and social health. People are more Career aware of the need to maintain health and prevent disease because dis- ease prevention improves their quality of life and saves costs. More individuals are recognizing the importance of exercise, good nutrition, weight control, and healthy living habits (Figure 1-3). This trend has led to the estab- lishment of wellness centers, weight-control facilities, health food stores, nutrition services, stress reduction counseling, and habit cessation management. Wellness is determined by the lifestyle choices made by an individual and involves many factors. Some of the factors and ways to promote wellness include: • Physical wellness: promoted by a well-bal- anced diet; regular exercise; routine physical examinations and immunizations; regular dental and vision examinations; and avoidance of environmental contaminants, and unhealthy habits such as tobacco smoking. FIGURE 1-3 Individuals are recognizing the impor- tance of exercise and healthy living habits. ⚫ Emotional wellness: promoted by understand ing personal feelings and expressing them appropriately, accepting one's limitations, adjusting to change, coping with stress, enjoying life, and maintaining an optimistic outlook. . Social wellness: promoted by showing concern, fairness, affection, tol- erance, and respect for others; communicating and interacting well with others; sharing ideas and thoughts; and practicing honesty and loyalty. ⚫ Mental and intellectual wellness: promoted by being creative, logical, curious, and open-minded; using common sense; continually learning; questioning and evaluating information and situations; learning from life experiences; and using flexibility and creativity to solve problems. Spiritual wellness: promoted by the teachings and values of Islamic eth- ics, morals, and practices to find meaning, direction, and purpose in life. The trend toward wellness has led to holistic health care, or care that pro- motes physical, emotional, social, intellectual, and spiritual well-being by treating the whole body, mind, and spirit. Each patient is recognized as a unique person with different needs. وزارة التعليم Minister EducTION 2022-1444 GE44.PATHWAYS.G02 S2.HLTH SB.indb 17 HISTORY AND TRENDS OF HEALTH CARE 17 | 14/10/2022 10:12

FIGURE 1-4 Cupping. وزارة التعليم Min 18 CHAPTER 1 2022-1444 COMPLEMENTARY AND ALTERNATIVE METHODS OF HEALTH CARE There is a trend toward the use of complemen- tary and alternative (CAM) health care therapies as part of an integrative medicine approach. Complementary therapies are methods of treat- ment that are used in conjunction with conven- tional medical therapies. Alternative therapies are methods of treatment that are used in place of biomedical therapies. Even though the two terms are different, the term alternative is usually applied whether or not the therapy is used in place of, or in conjunction with, conventional medical therapies. The National Center for Complementary and Alternative Medicine (NCCAM) serves as a national regulatory entity in all matters related to com- plementary and alternative medicine activities. The interest in holistic health care has increased the use of CAM therapies. There are five CAM practices approved and licensed by the NCCAM. One of these is cupping (Hijama) (Figure 1-4). Heated cups are placed on the surface of the skin to create a local vacuum and draw fluids to the area. More information about complementary therapies is available on the NCCAM website. PANDEMIC A pandemic exists when the outbreak of a disease occurs over a wide geo- graphic area and affects a high proportion of the population. A major concern today is that worldwide pandemics will become more and more frequent as individuals can travel rapidly throughout the world. The World Health Organization (WHO) is concerned about influenza pan- demics occurring in the near future. Pandemics have happened throughout history. ⚫The "Spanish flu" pandemic of 1918, which killed 40 million people; the same virus (called HINI) causes bird flu today. ⚫ Middle East respiratory syndrome (MERS) was identified in 2012 and has killed approximately 35% of people with the virus, which lives in drome- dary camels. ⚫ Ebola virus was first discovered in 1976. It caused a widespread outbreak of disease in West African countries in 2014, when more than 70% of people who caught the virus dies of the disease. . In 2019, a new coronavirus that causes the disease COVID-19 spread from China to the rest of the world. WHO declared an international public health emergency and subsequently a pandemic. The first case in Saudi GE44.PATHWAYS.G02 S2.HLTH SB.indb 18 14/10/2022 10:12

Arabia was identified in the Eastern region. The Kingdom quickly imple- mented measures to limit the spread of the disease. The region was put into lockdown and gatherings were prohibited. Social distancing, hand washing, and mask wearing were advised. As the disease spread, travel and large gatherings were limited across the Kingdom. Many governments are creating pandemic influenza plans to protect their populations in the future. Components of most plans include the following: ⚫ Education: Information about the pandemic and ways to avoid its spread must be given to the entire population. ⚫ Vaccine production: In 2018, newly developed vaccines were freeze-dried for ease of transportation to remote areas. Patients may eventually be vaccinated not just by injection but also intranasally, orally, or in a patch. ⚫ Antiviral drugs: Drugs that are currently available must be stockpiled so they will be ready for immediate use. ⚫ Development of protective public health measures: Influenza and other viruses like COVID-19 must be diagnosed rapidly and accurately, strict infection control methods must be implemented to limit the spread of the virus, first responders and health care personnel must be immunized so they will be able to care for infected individuals, and quarantine measures must be used if necessary to control the spread of the disease. ⚫ International cooperation: Countries must be willing to work with each other to create an international plan that will limit the spread of lethal viruses and decrease the severity of a pandemic. In the near future, much effort will be directed toward identifying and lim- iting the effect of any organism that could lead to a pandemic. Health care providers must stay informed and be prepared to deal with the consequences of a pandemic. Cooperation to prevent pandemics must be a global effort. WHO and the governments of all countries must constantly be alert to the dangers that pandemics can present and be ready to act when one occurs. BIOTECHNOLOGIES Biotechnology is the use of the genetic and biochemical processes of living systems and organisms to develop or modify useful products. Science Some of these developments include genomics, stem cell research, and nanotechnology. . Genomics is the study of all the genes in the human genome, or the com- plete set of DNA within a single cell of an organism. . Genomic (genetic) testing is the use of specific tests to check for the pres- ence of inherited genes known to cause disease. These tests allow preventive methods and/or early diagnosis to eliminate or decrease the effects of the disease. Approved genetic tests are available وزارة التعليم Minstrel EducTION 2022-1444 HISTORY AND TRENDS OF HEALTH CARE 19 | GE44.PATHWAYS.G02 S2.HLTH SB.indb 19 14/10/2022 10:12

FIGURE 1-5 A group of microscopic nano robots could be programed to kill cancer cells. for cancers such as breast and colorectal cancer, and for diseases such as Parkinson's disease, and hereditary hemochromatosis. In addition, prenatal screening tests can be performed for diseases such as cystic fibrosis. . Stem cell research studies stem cells, or cells that are capable of becoming specialized cells in the body such as skin, muscle, or nerve cells. ⚫ Nanotechnology uses a wide range of tech- niques to manipulate atoms and molecules to create new materials and devices. Nanomedicine is the use of nanotechnology for medical appli- cations. A nanometer (nm) is a very small struc- ture, 1 one-billionth of a meter. To visualize this size, think of a nanometer as a marble; a meter would be the size of the Earth. Research using these small particles has led to the development of nanodevices that can deliver drugs in precise amounts to targeted body cells, such as the deliv- ery of cancer drugs directly to a brain tumor (Figure 1-5). This decreases the side effects of drugs and damage to other body cells. Biotechnologies will have a major impact on the future of medicine. The opportunities in this field are unlimited, and many new health care careers will develop as research continues. However, it is important to note that bio- technology research has also created bioethical concerns. For example, should an animal being be cloned using biotechnology? Solving bioethical issues is a major concern as science advances. checkpoint Identify five current trends in health care and what medical advances made each possible. وزارة التعليم Min 20 CHAPTER 1 2022 1444 GE44.PATHWAYS.G02 S2.HLTH.SB.indb 20 Case Study Investigation Conclusion Research is currently insufficient to recommend using roselle (hibiscus) tea for controlling or lowering blood pressure. There are many modern medicines which have been found to treat high blood pressure. Should Fatima also consult her family doctor? 14/10/2022 10:12