aVLOZ1044 Ochrana a podpora zdraví IV

Lékařská fakulta
jaro 2023
Rozsah
2/0/0. 30. 2 kr. Ukončení: z.
Vyučující
prof. MUDr. Bc. Zuzana Derflerová Brázdová, DrSc. (přednášející)
Mgr. Jaroslav Divoký (přednášející)
doc. MUDr. Jindřich Fiala, CSc. (přednášející)
Mgr. Martin Forejt, Ph.D. (přednášející)
Mgr. Bc. Michal Koščík, Ph.D. (přednášející)
Mgr. Aleš Peřina, Ph.D. (přednášející)
MUDr. Bohdana Rezková, Ph.D. (přednášející)
Mgr. Aleksandra Maksimović (cvičící)
Ing. Veronika Išová (pomocník)
Garance
Mgr. Bc. Michal Koščík, Ph.D.
Ústav veřejného zdraví - Teoretická pracoviště - Lékařská fakulta
Kontaktní osoba: Ing. Veronika Išová
Dodavatelské pracoviště: Ústav veřejného zdraví - Teoretická pracoviště - Lékařská fakulta
Předpoklady
aVLOZ0943c Ochrana a podpora zdraví III-c
Prerequisites according to Faculty of Medicine study catalogue.
Omezení zápisu do předmětu
Předmět je určen pouze studentům mateřských oborů.
Mateřské obory/plány
Cíle předmětu
Deep understanding of topics related to public health, prevention counselling and medical law.
Výstupy z učení
By the end of this course student should be able to:
- understand of importance of lifestyle - oriented prevention counselling.
- provide individualized counselling that will reduce the risk of disease and health disorders, improve health and increase resistance and fitness, or reduce the need for medications and improve the disease.
- use nutritional counseling-methods to prevent the obesity.
- describe the term Public Health, describe theoretical framework and practice of Public Health;
- identify managerial and policy issues and techniques for decision-making in health care;
- demonstrate knowledge and understanding of a diverse range of global and national health policies, including current and emerging trends and also of disciplines relevant to the study of health policy, planning and financing (epidemiology, health economic and other social sciences);
- apply his knowledge and skills using a multidisciplinary approach to formulate and evaluate health policies and plans.
- use his knowledge from medical law in his professional life.
Osnova
  • 1. PREVENTIVE MEDICINE
  • A. LIFESTYLE- ORIENTED PREVENTION COUNSELLING
  • (assessment methods and recommendations)
  • 1) The content of the preventive check-up given by law in the Czech Republic.
  • 2) Objectives and implementers of lifestyle oriented counselling.
  • 3) Basic counselling steps (individual risk profile, information, recommendations, goal setting and motivation).
  • 4) Main determinants of health, comparison with the structure of allocated health expenditure.
  • 5) Behavioural determinants of health.
  • 6) Medical history: Content, importance and use in lifestyle-oriented counselling. Social genetics, social epigenetics.
  • 7) Smoking: Health impacts, smoking status assessment (and its definition - criteria), The “Fives As” method, Fagerström test (FTND) , short Intervention, pharmacological assistance in smoking cessation.
  • 8) Nutritional habits, overview of dietary assessment methods, nutritional history, a brief dietary assessment with Nutritional score (by WHO), methods of evaluation of 24h recall.
  • 9) Dietary Guidelines: Dietary reference values (DRV), General nutritional recommendations, FBDG, food labelling, nutrition declaration, nutrition claim, health claim, GDA (guideline daily amounts). Alternative diets, benefits and risks.
  • 10) Physical activity: Overview of assessment methods, IPAQ questionnaire, its scoring, levels of PA, Physical activity guidelines. (WHO 2011, US 2018).
  • 11) Alcohol: Impacts of alcohol consumption on health, health problems associated with alcohol use (categorization - alcohol dependence, health harm), definition of hazardous drinking, harmful drinking, binge drinking. Riskiness threshold for one dose. Assessment methods: CAGE, AUDIT, SASQ questionnaires. Alcohol quantification, content in beverages, concept of alcohol unit and its use. Frequency methods, weekly recall. Biochemical markers of high consumption.
  • 12) Nutritional status assessment (anthropometry): BMI - its classification, strengths and weaknesses. Percentage of body fat - assessment, diagnostic criteria. NWO syndrome (normal weight obesity). Abdominal circumference, method of measurement, diagnostic criteria, importance in comparison with other parameters. Metabolic syndrome.
  • 13) Blood pressure: BP evaluation, non-pharmacological means to reduce high BP (detailed in the associated topic "Primary prevention of cardiovascular diseases".
  • 14) Possibilities of other non-invasive examinations for risk identification - evaluation of glycation products using Age reader.
  • 15) Blood Cholesterol: Importance as a risk marker, possibilities of non-pharmacological reduction od blood cholesterol (detailed in the associated topic "Primary prevention of cardiovascular diseases".
  • 16) Validated nutritional assessment tests for malnutrition, MNA questionnaire.
  • B. SELECTED IMPORTANT DISEASES FROM THE VIEW OF PUBLIC HEALTH
  • Modification of the risk of cardiovascular diseases and cancer by lifestyle
  • a) CARDIOVASCULAR DISEASES - primary prevention of atherosclerotic cardiovascular diseases, specific recommendations and counselling of healthy lifestyle in relation to KVN
  • 1) Basic documents - European recommendations for prevention of KVN 2016. Classes of recommendations according to the level of evidence.
  • 2) SCORE system and its use and importance in primary prevention.
  • 3) Overview of lifestyle factors affecting cardiovascular risk.
  • 4) Family history and its practical importance in primary prevention of CHD.
  • 5) Recommendation on physical activity for the CHD prevention.
  • 6) Recommendations on smoking for the CHD prevention.
  • 7) Recommendation on nutrition for the CHD prevention - an overview, the most important nutritional factors.
  • 8) The importance of fatty acids, their classification, effect on health, dietary sources, recommendations. Effect of replacement SFA with different alternatives. The importance of nuts.
  • 9) Effect of minerals in the prevention of cardiovascular diseases.
  • 10) Effect of fibre in the prevention of cardiovascular diseases.
  • 11) Effect of fruits and vegetables in the prevention of cardiovascular diseases.
  • 12) Effect of fish in the prevention of cardiovascular diseases.
  • 13) Effect of alcohol on cardiovascular risk.
  • 14) Effect of soft drinks and sugar on cardiovascular risk.
  • 15) Mediterranean diet, functional foods.
  • 16) Effect body weight on cardiovascular risk.
  • 17) Lipid control, non-pharmacological reduction of blood cholesterol.
  • 18) BP management in the prevention of CHD, non-pharmacological possibilities of BP reduction.
  • 19) Target values for important cardiovascular risk factors.
  • 20) Principles - strategic steps of behavioral change intervention.

  • b) CANCER – influencing of cancer risk by lifestyle
  • 1) The main causes of cancer globally.
  • 2) List of human carcinogens (class A) - real view of importance in comparison to modifying factors.
  • 3) Level of evidence - criteria, interpretation and impact on the formulation of population recommendations.
  • 4) Importance of smoking as a principal modifiable cancer risk.
  • 5) Effect of fruits, vegetables and whole grain products on cancer risk.
  • 6) Effect of meat, fish and dairy products on cancer risk.
  • 7) Effect of food processing on cancer risk.
  • 8) Effect of alcohol on cancer risk.
  • 9) Effect of soft drinks and sugar on cancer risk.
  • 10) Effect of body weight and weight gain.
  • 11) Effect of physical activity.
  • 12) Summary of recommendations on nutrition and physical activity for cancer prevention.
  • C. OBESITY:
  • 1. Prevention of obesity-nutrition.
  • 2. Nutricional counseling-methods.
  • 3. Editing of dining records-practices
  • 2. PUBLIC HEALTH AND HEALTHCARE MANAGEMENT:
  • 1. Information on the course Public Health. Introduction to public health as a subject for teaching, research and healthcare practice area. Methods and research capabilities in the field of public health.
  • 2. Expanding the concept of public health.
  • 3. Organization of public health systems. Measuring and evaluating the health of a population.
  • 4. Ethical issues in public health and their possible solutions.
  • 5. Demographic transition, epidemiological transformation and health-care needs of a population.
  • 6. Social determinants of health. Inequalities in health.
  • 7. Transformation of health systems.
  • 8. Medical informatics and its application. Information base for the description and evaluation of public health.
  • 9. Health economics. The concept, theoretical background, main areas of interest (subjects), health economics.
  • 10. The market and health care.
  • 11. Causes of increasing health care spending.
  • 12. National health systems. Types of health systems in the world, their strengths and weaknesses. International comparisons, strengths and weaknesses.
  • 13. Healthcare financing (sources of finance, structure of cash expenditure on health care reimbursement forms).
  • 14. Health insurance (public health insurance, private health insurance).
  • 15. Healthcare management, its development, benefits and pitfalls. Economic tools for managing healthcare systems.
  • 16. Management theory and management of medical facilities.
  • 17. Benefits and risks of economic analysis, waste in health care.
  • 18. Evaluation of health care services (importance and evaluation methods, used indicators - productivity, effectiveness and efficiency, utility. Term explanation, their measurement, evaluation and their interpretation).
  • 19. Accessibility of health care services.
  • 20. The quality of health care, definitions, characteristics, possibilities for evaluation.
  • 21. Health needs (the needs, requirements and consumption of health services).
  • 22. Prevention and its obstacles (motivation to prevent, categorization prevention, prevention of barriers).
  • 23. Primary care and self-care.
  • 24. Health education; role, importance and types of health literacy.
  • 25. The role of the state in health care.
  • 26. The government protecting the public health. Public health office.
  • 27. Planning and managing health systems. Healthcare policy (term, focus, tools and healthcare policy goals). Regionalization and decentralization.
  • 28. Globalization of health. WHO. The European healthcare policy (source and basis of European healthcare policy, program WHO Health 2020).
  • 29. Human resources for health care.
  • 30. Current issues in healthcare development.
  • 3. MEDICAL LAW:
  • a) Statutory health insurance and out-of-pocket
  • - Citizen rights under the public health insurance system
  • - Health care provider and insurance entity
  • - Patient's out-of-pocket participation
  • - Ethical and regulatory dimension of cash
  • b) Employment law in health care
  • - Fundamental rights and obligations arising from the employment
  • - Organization of work (shifts, overtime, rest)
  • - Qualification growth and qualification agreements
  • - Labor liability of health professionals
Literatura
    povinná literatura
  • REQUIRED LITERATURE FOR PUBLIC HEALTH AND HEALTHCARE ADMINISTRATION
  • 1-) Tulchinsky T, Varavikova E: The new public health. 2nd edition. San Diego - USA. Elsevier Academic Press; 2009. pp 1-118, 375-636. - STATE EXAM C AND D.
  • 2-) Study material for public health and healthcare administration (Chapters 1,2,4-18) CAN BE BORROWED at the Department of Public Health A21, office 321. Students MUST return it back the day of examination in good condition. - STATE EXAM - C
  • 3-) Bonita R, Beaglehole R, Kjellström: Basic epidemiology. 2nd edition. Geneva - Switzerland: World Health Organization; 2006. pp 1-60, 83-115, 133-187. - STATE EXAM - C.
  • 4-) Seminar papers (Forty-two) in the subject’s vault - PUBLIC HEALTH STATE EXAM - QUESTION GROUP D.
  • REQUIRED LITERATURE FOR PREVENTIVE MEDICINE
  • 1-) Physical activity and obesity. Edited by Claude Bouchard - Peter T. Katzmarzyk. 2nd ed. Champaign, Ill.: Human Kinetics, 2010. xxi, 409. ISBN 9780736076357.
  • 2-) Present knowledge in nutrition. Edited by John W. Erdman - Ian MacDonald - Steven H. Zeisel. 10th ed. Ames, Iowa: International Life Sciences Institute, 2012. xxii,1305. ISBN 9780470959176.
  • Presentation in IS (study materials for the subject)
  • 2016 European guidelines on CD prevention in clinical practice. European Heart Journal (2016) 37, 2315–2381. www.athero.cz/media/1542/2016-esc-eas-eacpr.pdf
  • World Cancer Research Fund International: Diet, Nutrition, Physical Activity and Cancer: a Global Perspective - The Third Expert Report. London, UK, World Cancer Research Fund International; 2018 Available from: https://www.wcrf.org/dietandcancer
  • Global recommendations on Physical Activity for Health (2011). https://www.who.int/dietphysicalactivity/factsheet_recommendations/en/
  • Physical Activity Guidelines for Americans - 2nd edition. U.S. Department of Health and Human Services, 2018, 118 pp. https://health.gov/paguidelines/second-edition/pdf/Physical_Activity_Guidelines_2nd_edition.pdf
  • REQUIRED LITERATURE FOR MEDICAL LAW
  • Presentation in IS
Výukové metody

Seminars / practices.

Reading and studying ALL REQUIRED LITERATURE.
Metody hodnocení

REQUIREMENTS TO OBTAIN THE CREDIT:

A. Students are requirred to fullfil all of the requirements of the subject.
B. Attendance is compulsory. Only one excused absence is acceptable without any substitution.
Other situations:
1. In case of more than one excused absence, substutution is possible. This can be done by attending seminar(s) on the same topic in a different block during the semester. This must be agreed with the teacher.
2. If that one absence is not excused, substitutional paper of 1500 - 2000 words or presentation is required. The topic of the seminar work is entered based on the student's request, by the teacher from the lesson in which the student was absent. The student contacts the teacher by email. Seminar work has to be placed in the IS at the latest 7 days after the last day of teaching, otherwise the student will be refused → the student will not get a credit. If the seminar work is rejected due to deficiencies and will not be repaired and reassigned to the student, the student will not meet the requirements of the subject and receive credit (see also REQUIREMENTS TO OBTAIN THE CREDIT).
3. In case of more than one unexcused absence, substutution is not possible and this student has to repeat the subject in the following academic year.

CREDIT TEST INFORMATION:

1.   Get at least 70 % (14 out of 20 questions) in the credit test, which is a requisite to sit for examination.

2.   Each student must register in the Information System (IS) in one of the offered credit test terms. The credit test has fixed examination terms / dates - (Only during the examination period, except the examination pre-term). No extra-terms will be given.
3.   Students registered to a credit test term will fail the term if:
  a-) arrive late to the test. No late arrival will be allowed after the start of the credit test.
  b-) they are not present and previously do not cancel the term in the stipulated periods (see IS).

4.   In case of failure, EACH STUDENT CAN RETAKE THE CREDIT TEST TWO MORE TIMES, only in given terms (according to Masaryk University study and examination regulations).

5.   In case of failure during the third term (second resit), the student must repeat the course in the following school year.

6.   All credit test questions are based on ALL REQUIRED LITERATURE, seminars and lectures.


The credit test is a written examination → 20 multiple choice question test, with only one correct answer - (to pass the test, it is required a minimum of 14 correct answers / points).

SCORE:

  Passed → 14 and more correct answers / points.
  Failed → 13 or less correct answers / points.



  Correct answer = 1 point.
  No answer = 0 point.

ACADEMIC MISCONDUCT, PLAGIARISM DETECTION AND UNETHICAL ISSUES:

1.   Any attempts of ACADEMIC MISCONDUCT, such as cheating or assisting someone else to cheat during the credit test, will result in disciplinary actions, such as:
  a-) You will be required to hand over your examination paper and asked to leave the examination room. This means, you failed the examination (examination term), with the respective score F / 4, on your academic records in the information system.
  b-) Opening disciplinary proceedings.
  c-) Failing the subject / course.
  d-) Expulsion from university.

2.   During the examination, it is forbidden to:
  a-) Use smart phones / Tablets.
  b-) Use laptops.
  c-) To wear earphones or headphones (if not medical prescribed).
  d-) To talk.

*In such cases, disciplinary actions will be taken (See above numeral 1).

3.   Every seminar paper will be checked / scanned on university and external systems for online plagiarism detection.

4.   Cases of suspected plagiarism will be investigated and given to the Disciplinary Committee as a motion to open disciplinary proceedings, according to the Disciplinary Code for Faculty Students.

5.   Unethical issues will lead to seminar paper rejection → not getting the credit → repeating the course next school year or expulsion from university.

6.   The plagiarism scan system is able to detect cut and paste from other languages with its respective translation into English. Avoid complications. Simply read the source and use your own words and the citate (quote) the source of information.

7.   Students MUST be aware that before acceptance, all citations are controlled (compared with the original source). It will not be tolerated any attempts to create or manipulate citations (ACADEMIC MISCONDUCT). → Seminar paper rejection → not getting the credit → repeating the course next school year or expulsion from university.
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