Ateneo - UPO

THE CONTEXT OF PUBLIC HEALTH IN ITALY
- international and national factors affecting public health in Italy;
- Organization System.
- Fundamentals of organization design.
- Systems Information.
- Human Resource Management.
- Healthcare system and healthcare organizations.
- Human Resource Management in health care sector.
HEALTH NEEDS ANALYSIS
- main elements of health needs analysis of a population;
- stages of the analysis of the health needs of a population based on current health data;
- epidemiological tools to define the health status of a community;
- main sources of health data available in Italy, useful for the analysis of the health needs of a population;
- nature and characteristics of priority health problems;
RISK ANALYSIS
- concept of risk, at the individual and population level;
- main risk factors of Non Communicable Diseases;
- information sources for the identification and assessment of a risk;
- epidemiological tools to identify the risks to which a population is exposed;
- critical appraisal of scientific literature in order to identify health risks;
- risk of infectious diseases;
PREVENTION INTERVENTIONS
- type of prevention interventions: primary and secondary prevention, universal, selective and indicated prevention
-primary prevention of Non Communicable Diseases;
- primary prevention of Communicable diseases;
- vaccines and the Italian vaccine programme;
- sources of information for the identification of prevention interventions;
EPIDEMIOLOGY AND PREVENTION OF COMMUNICABLE DISEASES
ENVIRONMENTAL RISKS FOR HUMAN HEALTH
NUTRITIONAL HEALTH
NOSOCOMIAL INFECTIONS
PRINCIPLES OF EBM:
- to define questions for the search of information on effectiveness of interventions in scientific databases, starting from a clinical case or a public health problem;
- to identify biomedical databases possibly containing answers to the questions;
- to elaborate and apply a sensitive and specific search strategy to identify the information necessary to answer questions;
- to critically read and assess scientific reports and extract useful information to answer questions;
- to describe the characteristics, the opportunities and the limits of Guidelines;
- to carry out a search of Guidelines on the main biomedical websites.
Introduction to Evidence Based Medicine (EBM), with focus on statistical methods and study design

Bonanni, Bonaccorsi, Maciocco. Manuale di igiene e sanità pubblica. Carocci, 2021
Faggiano, Donato, Barbone (curatori). Manuale di epidemiologia per la Sanità pubblica. Centro Scientifico Editore, 2005
Wilkinson R, Marmot M. et al. Social determinants of health: the solid facts. 2nd edition. WHO Europe 2003.
Costa G., Giubitta P., Pittino D., Organizzazione aziendale, McGraw-Hill, 2014.
Reading papers provided
- Straus S, Glasziou P, Richardson WS, Haynes RB. Evidence-Based Medicine. 4th Edition. How to Practice and Teach It. Churchill Livingstone, 2010http://www.euro.who.int/__data/assets/pdf_file/0005/98438/e81384.pdf
- Other suggested reading:
Maggi G. Sistema di Controllo di Gestione nelle Aziende Sanitarie, Giuffrè, 2003

- to assess the health needs of a population.
- to identify the priorities for intervention
- to measure the health risks to which the population being treated is subjected
- to choose prevention interventions based on scientific evidence of efficacy
- to define priorities in the pevention and control of infectious diseases
- to list main environmental risks for human health
- to discuss the most important risks for human health of a uncurrect nutrition
- causes and interventions to control hospital infections
- To apply the tools of Evidence-Based Medicine in the selection of effective health interventions: in particular, to search, select, assess and use the results of scientific research for solving clinical and public health problems.
- Knowledge of the main methods for experimental study in medicine and meta-analyzes.
- Understanding of the statistical aspects related to the analysis of survival and the conduct of meta-analyses
- comprehend how to use the key elements of organization design to create effective organizations;
- to recognize the influence of culture on members' bahaviour.

The exam of “Quantitative Science” should be passed as required by the didactic regulations of the medical course
Bases of medical statistics; advanced kwowledge of epidemiologic study designs (primary and secondary)

Lectures,exercises; small group work; literature search; critical reading of scientific papers; PP presentation; plenary discussions.
Some course contents will be conveyed through reading of texts and discussions

The course is associated with the internship of "Field Medicine"
The material used in class will be made available on the DIR platform

Articulated written exam on the assessment of the various skills of the various disciplines. The exam consists of a single written exam, with reading of a scientific article and questions to verify the understanding of the content and the topics covered in class and open questions on small group work. Multiple choice questions based on the overall program and on the presentation of short cases. The final grade comes from the sum of the scores obtained in the individual disciplines. At the end the results are normalized according to a coefficient resulting from the highest score obtained in the first exam cohort, which is compared to 30 cum laude. In subsequent cohorts the coefficient is kept unchanged.

- factors influencing public health context;
- demography and economy;
- ethics, industry, citizens;
- technologies.
- epidemiologic indicators of health: incidence, prevalence, YPLL, YLD, DALY;
- methodologies for needs analysis: cross-sectional studies;
- Global Burden of Disease project;
- health priorities and Italian tendencies.
- indicators of association in etiologic epidemiology: RR and OR;
- indicators of attributable risk; AR, AF, NNT;
- Main risk factors for Non Communicable Diseases and their tendencies;
- distal and proximal determinants of health;
- social inequalities in health;
- priority definition;
- natural course of a health problem and possible interventions;
- primary and secondary prevention; universal, selected and indicated prevention;
determinants of human behaviours and reference theories;
- on the complexity of interventions on human behaviour;
- evaluation of prevention interventions;
- effective prevention interventions;
secondary prevention;
- indicators of validity of a diagnostic and screening test;
- lenght bias, lead-time bias, overdiagnosis;
- characteristics and guide lines indications for main cancer screening;
- hygiene and prophylaxis of infectious diseases;
- epidemiology of infectious diseases;
- hospital infections;
- vaccination and vaccination plans.
- Evidence Based Medicine and Evidence Based Practice.
- Systematic Reviews, Guidelines, Point of Care summaries; other tools of synthesis of the evidence.
- Sources of scientific evidence.
Biomedical databases (Medline, Embase, Psychinfo, Cochrane).
- Checklist for evaluating the quality of primary and secondary studies (CASP), and of Guidelines (AGREE).
- Characteristics of randomized controlled trial (RCT)
- Between and within patients study designs
- Randomization methods
- Sample size
- Systematic errors
- Measurements of association and impact
- Basics of survival analysis
- Real word evidence vs RCT
- Bibliographic search
- Study quality assessment
- Meta-analyses
- Organizational Theory
- Basic challenges of organizational design
- Organizational Structures
- Organizational Culture
- Change Management
- Human Resource management
- Healthcare system and healthcare organizations.
- Human Resource Management in health care sector.

At the end of the course, students will know:

A) Knowledge:
- to discuss main characteristics of the Italian health system;
- to identify main health problems of the Italian population;
- to identify main risks of the Italian population;
- to elaborate simple measures of health status;
- to read a report on the health status of a population;
- to describe main risk factors of the Italian population;
- to identify effective prevention interventions in the appropriate data bases;
- to apply effective primary prevention interventions of medical competence;
- to discuss critical elements of primary and secondary prevention interventions;
- to address towards effective screenings;
- to address towards compulsory and recommended vaccinations;
- to apply main norms of prevention of infectious diseases.
- to know principles and methods of Evidence Based Practice;
- to know the bibliographic sources available on the web and the biomedical databases;
- to know the methods for the evaluation of the quality of a scientific report.
- the main features of controlled and randomized clinical trials
- the main statistical methods for the analysis of studies from controlled and randomized clinical trials
- the scales useful for assessing the quality of a study
- the methods of conducting a meta-analytic study

B) Skills: students will be able to:
include conducting a controlled and randomized clinical trial
carry out a search of the scientific literature regarding a specific clinical question and evaluate the quality of the articles found
The knowledge acquired during the course will allow the student to use the organizational skills and competences to be applied in the health care. In particular, the student must acquire the business language of the company disciplines and be able to formulate the organizational analysis of the company processes.