Population and International Health (PIH)

Outline 2012

Module coordinator: Assoc Prof Dr Hemantha Wickramatillake

Overview

Population and International Health (PIH) is one half of the whole module PIH-EBH.

Marks and Standards for this module are in the Appendix below.

PIH is organised around five themes which start with the basic principles of epidemiology and public health medicine, then applying these principles to diseases, and finally to the planning and provision of services. Throughout the course, an international perspective will be taken, with applications drawn from both developed and developing countries, and a discussion of key issues at global as well as national level.

Theme 1: Measuring health and disease

This theme starts with introducing the principles of epidemiology and public health medicine and explains why epidemiology is fundamental to the practice of public health medicine. The theme describes changes in disease profiles and population dynamics. It covers measures of health and disease in populations, using available information that is routinely collected to guide decision making. It illustrates the challenges of measuring the burden of disease in populations.

Theme 2: Epidemiology and prevention: chronic non-communicable disease

This theme describes the public health challenge of chronic non-communicable diseases. The burden of these diseases can be limited by strategies to reduce their occurrence, delay their onset or minimise their effects. Hence this theme addresses health promotion, disease prevention and screening. The epidemiology and prevention of major chronic diseases are described, including time trends, risk factors and approaches to prevention. Diseases described include cardiovascular disease, diabetes and cancer.

Theme 3: Environmental and occupational epidemiology

This theme focuses on how the environment in which we live and work strongly influences the causation of disease and injuries. Environmental epidemiology provides a basis for studying and interpreting relationships between the environment and population health. Approaches to public health emergencies and health issues related to climate change are addressed. Occupational epidemiology deals specifically with environmental factors and infectious diseases in the workplace.

Theme 4: Infectious diseases: epidemiology surveillance and response

Infectious disease has re-emerged as a major contemporary health challenge. This theme covers principles and applications of infectious disease control: surveillance, immunisation and outbreak investigation. The outbreak investigation is an individual online exercise on Moodle and is based on an evolving scenario of a disease outbreak. With its limited number of exposures and outcomes mediated through specific pathogens, outbreaks present an excellent basis upon which to teach the

fundamentals of epidemiology and to explain measures of association. Emphasis is placed upon the core issue of emerging infectious diseases.

Theme 5: Health systems and services

This theme introduces and explains the concept of the health system, and demonstrates how the values, structure and mechanisms of financing a country’s health system determine who and how quickly people get access to the health services they need. The advantages and disadvantages of different countries’ health systems are compared, both in their design and in the population health outcomes they contribute to. Basic concepts in clinical management, health economics and health policy are introduced, and in some instances explained using case studies. Economic analysis, as a tool for evaluating health services and interventions, is introduced and explained.

PIH Learning objectives

After completing this module, students should be able to:

• describe the nature and use of epidemiology

• describe the distribution of common diseases at a national and global level, the factors that determine health and disease

• evaluate risk and apply epidemiological principles and public health approaches to reduce and prevent disease and improve the health of populations

• identify the characteristics of a range of health systems and the merits and problems associated with each.

Course format

The course will have two components: lectures, and a team-based project.

Lectures

The taught course will be based on 40 - 60-minute presentations.

Course topics

Theme 1: Measuring health and disease Lecturer

PIH 1 Introduction to Public and International Health

PIH 2 The health of the people, health of populations

PIH 3 Measuring disease frequency

PIH 4 Measuring death rates

PIH 5 Measuring the burden of disease (DALY)

PIH 6 Patterns of disease: the demographic transition

PIH 7 Patterns of disease: the epidemiological transition

PIH 8 Sources of data on population health

Theme 2: Epidemiology and prevention: chronic non-communicable disease

PIH 9 Health promotion, theory and practice (alcohol)

PIH 10 Disease prevention: levels and strategies

PIH 11 Screening principles

PIH 12 Epidemiology and prevention of cancer

PIH 13 Epidemiology and prevention of cardiovascular diseases

PIH 14 Epidemiology and prevention of lung cancer

PIH 15 Epidemiology and prevention of diabetes

Theme 3: Infectious diseases: epidemiology surveillance and response

PIH 16 Epidemiology of infectious diseases

PIH 17 Controlling infectious diseases

PIH 18 Infectious disease surveillance

PIH 19 Immunisations

PIH 20 Disease outbreaks

Theme 4: Environmental and occupational epidemiology

PIH 21 Occupational Health

PIH 22 Occupational Health (2)

PIH 23 Public health emergencies

PIH 24 Environmental health and disease

PIH 25 Environmental health and disease

Theme 5: Planning and providing services

PIH 26 Context of International & Multi lateral Organisations in Health Care

PIH 27 Doctors and the managerial process

PIH 28 Economic Evaluations of Health Interventions

PIH 29 Health Economics

PIH 30 Public Health: Health policy

PIH 31 Health systems: international

PIH 32 Health systems: international

PIH 33 Health systems: Ireland

Team-based project (coordinator Hemantha Wickramatillake)

The PIH team-based project has two components: an analysis of the epidemiology and prevention of a health problem and the analysis of the team process and performance (including peer marking). Students will work in a team with 4-6 students on an allocated topic. Group work processes are monitored through student up-loads of reports. Workshops on search and information retrieval skills, team working and conflict management skills (for team leaders) will be given to support teams in doing the team-based project. The duration will be six weeks.

Recommended reading:

1. Bonita, R, Beaglehole, R. And Kjellstrom, T.Basic epidemiology. Geneva: World Health Organization.

APPENDIX: PIH-EBH Marks and Standard, JC3 October 2012

Population and International Health (PIH) and Evidence Based Health (EBH) together form a 10 credit module. PIH-EBH is assessed as follows:

1. Continuous assessment: (40%)

Comprising A, B and C:

A. Projects 35%

PIH team project: 17.5%

EBH team project: 17.55

B. Mid Semester Formative Assessment) 5.0%

(2 SNQs and 6 MCQs)

2. End of Semester Written Exam: (60%), comprised of:

Multiple Choice Questions (50 MCQs): 40%

Short Note Questions (6 SNQs): 20%

The 50 MCQs and the 6 SNQs will be divided equally between EBH and PIH (25+25, 3+3)

SNQs may be based on graphs and figures, journal articles and case scenarios.

Marks and standards

Candidates in both RCSI-Dublin and RCSI-Bahrain will be required to score a minimum of 45% in the combined written components of the examination (MCQ + short-notes and written formative assessment) to pass. For candidates whose written mark is below 45%, their written mark will be treated as their overall mark; i.e., their continuous assessment marks will not count.

Candidates who fail to contribute adequately to the team projects will have marks deducted. If failure to contribute is sufficiently serious, they will be deemed to have failed the module irrespective of their total mark

Repeat exam (200 marks = 100%), comprised of:

50 MCQs for which up to 67% (134 marks) will be awarded

6 SNQs for which up to 33% (66 marks) will be awarded

In the repeat examination, continuous assessment (team project) marks cannot be carried

forward and will not count as part of the candidate’s repeat assessment resu