HYGIENE AND EPIDEMIOLOGY
Learning outcomes of the course unit
Allow students to know and understand the tools and the basic methodology to develop and use practical concepts of the hygiene and the epidemiology in the prevention of infectious and chronic degenerative diseases in healthcare facilities as well in the territorial settings.
The main educational goal of the course is to providing students with the basic knowledge to understand the concepts of risk factors and determinants of health / disease.
Among the acquired skills, students will be able to:
-recognize individual and environmental risk factors and assumed causal inference with diseases of interest;
- participate in the application of guidelines and protocols for the proper management of patients as well the healthcare workers;
-build simple epidemiological analysis in their discipline (for example, studies on the prevalence of hospital infections, application of protocols to reduce the risk of infection);
-to read and comment critically the literature or ad hoc surveys.
Course contents summary
The first part of the course allow the students to frame the Hygiene discipline as part of Public Health and Preventive Medicine, referring to the concepts of health status and disease status. The course continues with a discussion of the burden of disease, with a national and international level.
The epidemiological methods are discussed in the prospective of hygiene and public health discipline with reference to the key measures of frequency and association, to the concepts of causal inference and causal risk factors and the classification of epidemiological studies.
The second part of the course concerns more specifically Contenuti: Hygiene, Public Health, Epidemiology and Preventive Medicine the hygiene as a discipline, with in-depth discussion of the concepts of primary, secondary and tertiary prevention and related operational tools
Part 1 EPIDEMIOLOGY
definition of health and determinants of health/disease
evolution of the definitions of health
The continuum health-disease
The importance of measuring health thought health-indicators
The Burden of Disease
Definition of epidemiology and fields of study of the epidemiology Fields of study of the demography, census, the population pyramid, Fundamental parameters of populations: general mortality, infant mortality, life expectancy at birth
Measures in epidemiology: prevalence and incidence rate, relation between incidence and prevalence
Epidemiological measures of risk association
characteristics of the association causal
the causal factors and risk factors
the relative risk (RR) -how does it work
odds ratio (OR) how does it work
Classification of epidemiological studies:
observational studies and experimental studies
case-control studies (odds ratio)
cohort studies (relative risk)
clinical trials ( what it means to randomize)
Definition of screening, characteristics of a screening campaign
sensitivity, specificity, predictive values
examples of screening (eg, neonatal, cancer)
Part II HYGIENE
General epidemiology of infectious diseases
The micro-organisms (saprophytes, commensals and pathogens), and host-parasite relationships, infection and disease, infectiousness, diffusivity, pathogenicity, virulence;
Reservoirs and sources, sick and infected individuals (healthy carriers, early, convalescent and chronic);
mechanisms (ways) of direct transmission, semi-direct, indirect, vehicles and carriers.
Elements of general epidemiology of non-infectious diseases
The "levels of prevention": primary, secondary, tertiary.
Prevention of infectious diseases (notification, diagnostic tests, insulation)
Disinfection: main disinfectants
Sterilization main methods of sterilization (critical tools, semi-critical and non-critical)
Asepsis (maintaining sterility)
Antisepsis or handwashing (felling and removal pathogens)
Immunoprophylaxis: what are the vaccines, main categories, general theory of active immunization. Vaccination of Childhood
Special prevention of infectious diseases: overview of etiology, epidemiology, pathogenesis, clinical, prevention of the following diseases: tuberculosis, influenza, meningitis. hepatitis a hepatitis b, hepatitis c and AIDS
Health care-associated infections: definition, epidemiology, risk factors, preventive measures.
Special prevention of chronic diseases: neoplastic disease, diabetes, cardiovascular disease
Environmental: hygiene: water (pollution and potability requirements'), waste management, special hospital waste.
Barbuti, Fara, Giammamco et al. “IGIENE” terza edizione, Monduzzi Editore, 2011.
The course is structured in lectures in which the teacher, after a broad introductory reading, proposes to students some case studies from the literature and clinical practice. Students will be provided from time to time teaching materials (online references) to deepen the topics covered.
Assessment methods and criteria
The evaluation is divided into two moments;
• Immediately after the end of the first nucleus of lessons (1 CFU, 10 hours of class) will be proposed a written test “in itinere” on the topics covered in epidemiological methodology. The test consists of 15 questions (some of which open answer). This test is considered to have been passed if the correct answers are at least 10.
• Students who pass this test access to the final evaluation which consists in an oral examination designed to assess the understanding of the topics covered in the second part of the course (4 credits), through 2 general questions structured in such a way as to allow connections between the topics in question.