HYGIENE, PUBLIC HEALTH AND HEALTH POLICIES
cod. 1010302

Academic year 2023/24
3° year of course - Second semester
Professor responsible for the course unit
PASQUARELLA Cesira Isabella Maria
integrated course unit
11 credits
hub:
course unit
in ITALIAN

Learning objectives

With reference to the specific subjects: knowledge and understanding;
applying knowledge and understanding; making judgements;
communication skills; autonomous learning skills.

Prerequisites

None

Course unit content

The Course "IGIENE, SANITA’ PUBBLICA E POLITICHE DELLA SALUTE" consists of 7 modules: "Igiene generale", "Igiene generale e applicata (interdisciplinare)", "Igiene", "Igiene applicata", "Epidemiologia e organizzazione sanitaria", Economia aziendale", "Il Servizio Sanitario Nazionale, la medicina di famiglia, l'ordine professionale".

Full programme

EPIDEMIOLOGIA E ORGANIZZAZIONE SANITARIA

Elements of National and International Healthcare Organization and Legislation

A Brief History of the Italian Healthcare System. What are the origins and founding principles of the SSN? What is a healthcare system and what are the main types at the international level? What are the most relevant health regulations in Italy? What is the Italian National Health Service (Servizio Sanitario Nazionale, SSN) and how is it organized? What is an ASL (Local Health Unit)? What are the Essential Levels of Assistance (LEA)? The Components of the National Health Service. What are the main State bodies dealing with health? What are the tasks of the Ministry of Health? What are the tasks of the other State bodies dealing with health? How is healthcare organized at the level of Regions and Autonomous Provinces? What are the Health Companies? What is a Hospital? What are the characteristics of Hospital Companies? What is an Emergency Department and How is it organized? What are the management bodies of Health Companies? What are the functions and what are the professional requirements of the General Manager and the Health Director of a Healthcare facility? What are the Health Districts and how is territorial health care organized? What is the role of the General Practitioner? How is hospital-territory integration implemented and with what tools? What is the current territorial health organization? Health planning in Italy. What is health planning? What is the National Health Plan and what are its contents? What are the characteristics of Regional Health Plans? What is the National Prevention Plan and what are the main contents? How is health planning implemented at the local level? What is a Budget Document? What is the International Classification of Diseases (ICD)? What is a SDO (Hospital discharge sheet )? What are DRGs (Diagnostic Related Groups)? Why classify patients? What are "outcomes"? How are hospital performances measured? What does the "accreditation" of a healthcare facility mean? What is the National Health Fund and what is the evolution of healthcare expenditure in Italy? How are the need, demand, and supply in healthcare defined? What is clinical governance? What is Health Technology Assessment? International Health and Global Health. What is meant by globalization and health? What are the main government organizations dealing with health? What are the purposes and structure of the World Health Organization (WHO)?

THE EPIDEMIOLOGICAL METHOD AND ELEMENTS OF DEMOGRAPHY.
Introduction to epidemiology as the study of the distribution and frequency of diseases and health-related events within a population.
The importance of the denominator (demography overview): population status and movement. Life expectancy, life expectancy at birth, aging index, infant mortality rate
Epidemiological data sources.
The main epidemiological frequency and risk measures: proportions and rates, prevalence, and incidence (cumulative and person-time), Odds Ratio, Relative Risk, and Attributable Risk.
Association, secondary, spurious, and causal associations, Bradford-Hill's causality criteria.
Classification of observational epidemiological studies: case reports, current statistics analysis, cross-sectional (the concept of screening and population screening), case-control, cohort studies. Overview of randomized clinical trials.
Systematic reviews and meta-analyses.

IGIENE GENERALE
Concepts of Hygiene, Public Health, Health Policies.
Concepts of "One Health" and "Global Health".
Concept of Health and its evolution.
The ten threats for global health (World Health Organization, 2019)
Levels of prevention: primary, secondary, tertiary, quaternary.
Epidemiology and general prophylaxis of infectious diseases Methods of
Direct prophylaxis and indirect prophylaxis; Direct prophylaxis
(Notification, Diagnostic assessment, Isolation, Cleaning, Disinfection,
Sterilization, Disinfestation, Active and passive immunoprophylaxis
Primary and secondary chemoprophylaxis).
Epidemiology and prevention of healthcare-related infections (HAIs) and antimicrobial-resistance.
The five moments of hand hygiene in healthcare setting.
The five moments of hand hygiene.
Food hygiene: foodborne infections and food poisoning.
The HACCP system and its applications.
Managing an epidemic.

IGIENE

Preventable infectious diseases with vaccinations or public health strategies. Poliomyelitis, diphtheria, tetanus, viral hepatitis B, whooping cough, measles, rubella, mumps, chickenpox, herpes zoster. Invasive bacterial infections, Haemophilus influenzae type b infection, pneumococcal diseases, meningococcal meningitis. HPV infections, influenza virus infections and control strategies, rotavirus, viral hepatitis A, typhoid fever, yellow fever. Other infectious diseases preventable with vaccinations (Covid-19, dengue, cholera, Japanese encephalitis, rabies, tick-borne encephalitis).

IGIENE APPLICATA
Environmental matrices and their effects on health. What is meant by "One Health" and "Health in All Policies". What is meant by environment and what are the most relevant environmental factors that can influence human health. Effects of climate change on human health. Atmospheric pollution and main air pollutants. Main effects on human health of atmospheric pollution: greenhouse effect and ozone hole risks. What are the characteristics of soil and what are the main pollutants. The integrated water cycle: what are the characteristics of water intended for human consumption and how is the distribution of drinking water done. Health risks related to the consumption of polluted waters and what are the main treatments. What are the main hygienic-sanitary aspects related to the use of water for recreational purposes? The integrated waste cycle: how is the removal, disposal, and treatment of sewage done and what are the health risks; how are solid waste classified and what are the main environmental and health problems. What are the systems for collecting and disposing of solid waste and what are the related health risks. What is meant by medical waste and what are the disposal systems. What are the most important international environmental policies. What are the bodies responsible for environmental policies and controls in Italy. What is meant by the precautionary principle. What is meant by Environmental Impact Assessment (EIA), Strategic Environmental Assessment (SEA), and Health Impact Assessment (HIA). What is meant by NIMBY syndrome. What are the tools to increase knowledge and environmental awareness of the population. Urban Health and Indoor Environments What is meant by "Urban Health": what are the characteristics of the "healthy city" and what is meant by sustainable mobility. Main aspects of hygienic-sanitary relevance to consider in urban planning and main sources of pollution in urban contexts.


IGIENE GENERALE E APPLICATA (INTERDISCIPLINARE)
Health education.
Health Promotion.
Ottawa Charter.
The concepts of Empowerment, Health Literacy, Advocacy.
The “Gaining Health” project.
Diet.
Alcohol.
Physical Activity.
Smoke.
Surveillance systems in Public Health.

ECONOMIA AZIENDALE
Health economics, health management. General introduction.


IL SSN, LA MEDICINA DI FAMIGLIA, L’ORDINE PROFESSIONALE
Therapeutic adherence.
PPI deprescription.
Prescriptive appropriateness in the elderly patient.
Empathy in the care relationship.
Primary care in general medicine.
Organizational model of Parma - the Health Houses.
Territorial care for managing chronic and acute conditions: integrated home care and intermediate care.
Diabetes: therapy and integrated management.
Reduction of prescriptive variability and clinical governance.
Hospitalization risk management in the area.

Bibliography

IGIENE, EPIDEMIOLOGIA, ORGANIZZAZIONE SANITARIA
Auxilia F, Pontello M, et al. Igiene, Medicina Preventiva e Salute globale. Padova: Piccin, 2021.
Barbuti S, Fara GM, Giammanco G, et al. Igiene, Medicina, Preventiva, Sanità Pubblica. Napoli: Edises Editore, 2022.
Signorelli C, et al. Igiene e Sanità Pubblica. Roma: Società Editrice Universo, 2021.
Signorelli C, Odone A. Elementi di metodologia epidemiologica. Roma: Società Editrice Universo, 2023.

Materiale didattico (diapositive delle lezioni) e altro materiale fornito dal docente attraverso la piattaforma Elly (https://elly2023.medicina.unipr.it/)


ECONOMIA AZIENDALE
Materiale didattico fornoto dal docente e disponibile sulla piattaforma Elly.

SSN, MEDICINA DI FAMIGLIA, ORDINE PROFESSIONALE
Harrison's Principles of Internal Medicine, XVIII ed. Mc. Graw Hill ed.
Goldman-Cecil Medicina Interna, XXV ed. Edra SPA editor.

Teaching methods

The course will be conducted through traditional frontal lectures, with interactive teaching.
Lessons will be supported by visual aids, and these materials will be made available to students on the Elly platform
(https://elly2023.medicina.unipr.it/).

Assessment methods and criteria

The course includes a single final written exam.
The final evaluation will take place through a multiple-choice qu
conducted on ELLY platform. The test will last 45 minutes and will consist
of 31 multiple-choice questions. The test will cover all the topics covered
in all modules of the course.
One point is assigned to each correct answer, and the minimum score to
pass the test is 18. The test is evaluated on a scale of 0-31. A student
who achieves the maximum score (31) will receive honors.
The questions are designed to assess knowledge, the ability to apply
knowledge, judgment autonomy, and learning capacity.
Students with learning disabilities (DSA/BSE) must contact
University's Center for Accommodation and Inclusion (cai@unipr.it).

Other information

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