Learning outcomes of the course unit
In line with the guidelines of the "Institute for International Medical Education (IIME), Task force for Assessment" and, at the national level, of the Schools of Medicine Presidents’ Permanent Conference, the student must know and understand the main issues of hygiene and public health, health indicators and the health situation of our country in the context of the global health situation. At the end of the course the student must be able to frame the most important determinants of health and illness and to understand the importance of protecting and promoting health at the community level. He will also have to be able to apply epidemiological skills in order to read and interpret the scientific literature and health organization competences in order to appreciate the characteristics of health services and systems.
The student must acquire the ability to integrate the knowledge of the different areas of hygiene and public health in order to critically analyze the problems and the ability to communicate the content of his reflections to specialist and non-specialist interlocutors. At the end of the course, the student will also have acquired a learning and study methodology transferable to other educational fields as well as to the professional sphere.
Semeiotics and Microbiology
Course contents summary
The integrated course in HYGIENE, PUBLIC HEALTH AND HEALTH POLICIES is organized in the following modules:
• General and applied concepts of hygiene, Preventive Medicine and Public health
• Epidemiological methods
• Healthcare management, National Health Service and primary care
• Business economics
• Ethics and bioethics
The course is structured into subsequent themes (some of them covered in the Semeiotics course).
The first theme (**) is on the epidemiology and the general prophylaxis of communicable diseases. In particular, students will learn about direct and indirect prophylaxis, immunoprophylaxis end chemioprophylaxis.
The second theme is on health assessments. In particular, students will be taught epidemiologic methods and will learn about health indicators and surveillance systems.
The third theme is on health policy and management, health economics and primary care organization. In particular, students will learn about the National Health Service, public health and law, healthcare organization and ethics.
The fourth theme is on the determinants of health. In particular, students will learn about the epidemiology of diseases at high-socioeconomic impact, modifiable and non-modifiable risk factors, preventive medicine, predictive medicine, screening, health education, health promotion and public health strategies.
The fifth theme is on vaccine-preventable diseases. In particular, students will learn about vaccine-preventable childhood diseases, vaccine preventable diseases in older adults, the National Immunization Program schedule and vaccines-preventable cancers. In addition, students will be taught about immunization strategies and vaccine calendars guidelines.
The sixth theme in on surveillance and the control of health risk factors. In particular, students will learn about non-vaccine preventable diseases, food-borne outbreaks, international travels and heath, health emergencies, public health and disasters, injury prevention, behavioral disorders and addictions.
The seventh theme is on environmental health. In particular, students will learn about environmental risk factors and sustainable development. In addition, students will be taught about the integrated water cycle and health-related elements in architecture and city planning (eg concept of healthy buildings.)
(**) covered in the Semeiotics course
General concepts of hygiene, health, and health education.
General health status of population, healthcare and health promotion.
Different types of prevention (primary, secondary, tertiary prevention).
Health education: planning, management and intervention evaluation.
Health legislation. Globalisation and health.
Health planning and organization - Health economy and management.
International health management (role of WHO).
Organization of Italian Health System and Regional Health settings: from Law 833/1978 to devolution of NHS.
Hospital and local organization of NHS (Aziende, Dip. prevenzione, distretti).
Principal components of health scheduling: national and regional health programmes.
Introduction to health economics and health organization: how to organize, production benefits and costs.
Health economics: efficiency and efficacy, equity, healthcare and health policy.
Organization: systemic analysis, organization variables, organization planning, clinical autonomy, tailor-made performances.
Health coordination process: local health enterprise budget, main planning tools, budget estimation.
History and application of epidemiology. Sources of statistical-epidemiological data.
Descriptive epidemiological measures: crude rate, specific and standardized rate.
Epidemiological risk measures, cause-effect interpretation.
Ecological studies, cohort studies, case-control studies, case series studies.
Experimental studies and preventive trials. Validation of new drugs and vaccines.
Study design, data collection, ethical and privacy issues.
Classification and data analysis. Quality evaluation of data, epidemiological biases.
Epidemiology of general prevention of infectious diseases: host-guest relationship, infection sources and reservoirs, transmission mode.
Notification, default measures, diagnosis of infectious diseases.
Sterilization, disinfection and disinfestation.
Vaccine preventable diseases. Types of vaccines, strategies and vaccine schedules, passive immunoprophylaxis and chemoprophylaxis.
Immunization policies and schedules for infants, adolescents and adults and the elderly.
Epidemiology and specific prevention of infectious diseases.
Epidemiology and prevention of airborne diseases.
Epidemiology and prevention of sexually transmitted disease and parenteral transmission.
Epidemiology and prevention of faecal-oral transmitted diseases.
Epidemiology and prevention of vector borne diseases and zoonoses.
Epidemiology and prevention of vertical-transmitted diseases.
Emerging and remerging infectious diseases.
Travel medicine and Bioterrorism.
Epidemiology and prevention of nosocomial and opportunistic infections.
Non infectious diseases: epidemiology and prevention.
Major risk factors of chronic diseases and their prevention.
Screening: theoretical concepts and their application.
Epidemiology and prevention of cardiovascular diseases.
Epidemiology and prevention of malignant tumours.
Epidemiology and prevention of other most important non infectious diseases.
Epidemiology and prevention of alcohol and substance abuse.
Epidemiology and prevention of road and domestic.
Environment and Health.
Environmental policies in relation to sustainable development.
Air, climate and atmospheric pollution: health effects.
Indoor environment: microclimate, indoor air pollution, noise, light quality.
Solid waste management: classification, collection and disposal.
Soil and water hygiene: water demand, supply and safety.
Water: safety plan and risk management, sanitation.
Wastewater: collection, disposal and safe wastewater use.
Food safety and Nutrition.
Food as vehicle of infections: foodborne diseases, food poisoning, foodborne outbreaks.
Conservation and manipulation methods, microbiological control methods of food.
Nutrition: food need and nutrition disorders.
General notions of bioethics.
Elements of professional ethics.
General practise evolution in Italy.
Barbuti S, Bellelli E, Fara GM, Giammanco G. Igiene e medicina preventiva (4° ediz). Monduzzi, Bologna, 2014.
Signorelli C: Igiene, epidemiologia e sanità pubblica (Secrets, VI EDIZIONE). SEU, Roma, 2017.
Tarsitani G, Signorelli C, Mastroeni I. Igiene, Epidemiologia e Sanità Pubblica. 5000 Quesiti a scelta multipla (V EDIZIONE). SEU Roma, 2012
Course materials (slides and lecture notes) from instructors.
The course will be taught through frontal lectures as well as through case reports and interactive sessions that allow students to be faced with real word challenges and to understand how epidemiology and public health instruments are relevant and powerful across-the-board in health.
Assessment methods and criteria
The course includes a single final exam (written and oral).
The written test will assess the knowledge and skills acquired by the students during the course. The oral exam will serve to verify the connection, learning, critical analysis and communication skills acquired by the students at the end of the course.