Syllabus
PUBLIC HEALTH Preventive medicine and public health Definitions and methodology, primary, secondary and tertiary prevention, health promotion models and strategies (community mobilization, school and community education, social marketing, peer leadership, passive and active countermeasures, health planning, health activism). Prevention and health promotion in the national health policy. Implementation of the WHO Health 21 Programme in Czech Republic, National Health Programme, health promotion projects and programmes. Comparative view on health care systems The seminar will focus on health care systems in the perspective of international comparison. The students will get known the structure and institutions of the health care system, basic subjects and principles of their establishment. The modern history, social and cultural context and typology will be presented, as well as the basic dilemma between costs and values (economy and humanity). Special attention will be paid to "moral hazard", subsidiarity and regulation mechanisms of demand and supply. Three basic examples will be introduced: U.S. professional health care system as an example of a market-based model, British National Health Service as an example of a state-run system and German health care system as an example of a mandatory health insurance. Description and comparison of the models according to the health care systems indicators will be provided (costs, quality, accessibility, equity and acceptability). Market incentives and new forms of regulation will be discussed in the end. Health Care System of the Czech Republic Brief history of the health care system transformation after 1989 will be presented followed by a detailed presentation of the current structure and organization of the Czech health care system, institutions of payers and providers. Special attention will be paid to medical profession and to the view of users. Problem of distribution of expensive medical care will be discussed - explicit and implicit forms of rationing, as well as macro- and micro-level rationing will be exposed. A special attention will be paied to the development of population health status during the social transformation of the 1990´s. Current problems of European health care systems Aging population, health care costs, equity and access, copayments, quality of care as an essential part of the reform. European Convention on Human Rights and Biomedicine - practical implementation. Patients rights and medical duties ? ethical and legal aspects (consent to treatment, informed consent, duties of treatment, obligatory treatment and hospitalisation without consent, medical duties in emergencies, professional confidentiality, medical negligence and malpractice). Main information sources on health databases. GENERAL HYGIENE General environment and health of the population Relationship between environment and health. Health measurement and evaluation. Environmental risks and strategies. Global problems of environmental pollution. Lifestyle and health of the population The lifestyle construct. The components of the lifestyle. Behavioral assessment. Social diagnosis, assessing a quality of life. Prevention and intervention strategies in tobacco smoking. Health effects of air pollution Sources of air pollution. Outdoor and indoor environment. Emissions, immisions. Basic forms of smog. Health effects of the most important air pollutants. Sick-building syndrome. Monitoring of the air pollution. Health indicators, biomarkers. Protection against air pollution. Preventive measures. Water - health importance, sources of contamination Drinking water supply. Drinking water quality. Health risks of drinking water from microbial and chemical contaminants. Chlorination by-products. Quantitative requirements and qualitative properties of drinking water. Health hazards of domestic equipments for treatment of drinking water. Packaged water. Health impact of wastes Solid and liquid municipal waste. Solid waste from industry and agriculture. Health risk of waste from health facilities. Liquidation of waste. Physical factors and their health effects Health effects of noise and vibrations. Physiological principles of the action of noise and vibrations on the organism. Thermal comfort and thermal balance. Lighting. Electromagnetic fields and their biological effects. Exposure of the population to electromagnetic waves. UV radiation - benefit and health risks. Principles of radiation protection against ionizing radiation Biologic effects of ionizing radiation. Sources of irradiation of the population. Dosimetric evaluation of the exposure and limits of irradiation for the population and workers. The principles of radiation protection. OCCUPATIONAL MEDICINE Harmful physical agents Noise, vibrations, ionizing radiation, non-ionizing radiation, overloading, its measurement and assessment, physical load and its calculation, stochastic effect of ionizing radiation and its assessment. Occupational lung disorders Pneumoconioses (asbestosis, silicosis), asthma, extrinsic allergic alveolitis, malignancy, other lung disorders. Occupational diseases caused by chemicals General principles of toxicology, exposure, assessment, biological exposure tests, concentration of chemicals in the air, liver, nervous, bone marrow and kidneys, diseases caused by chemicals, benzene or a homoloque intoxication, poisoning by lead, mercury and cadmium. Occupational diseases Diagnosis, prevention, notification and treatment of occupational diseases, work-related diseases, accidents and their prevention, special problems in occupational medicine, workplace hazard control, protection of the worker case-records, types of occupational diseases. SPORTS MEDICINE Response of body systems to short-term physical exercise Cardiovascular, respiratory, metabolic, hormonal systems responses. Energy substrates for physical work. Observation of cardiovascular, respiratory and metabolic variables during physical exercise. Exercise testing Indications, contraindications, types of load, laboratory testing, field testing. Dynamic exercise testing : sources of load, units of load, laboratory equipment, conditions for exercise testing. Protocols of ET. Physical fitness, physical capacity, maximal aerobic capacity, anaerobic threshold. Clinical significance of these variables. Pathological ET. Practical realization of maximum exercise test with complete spiroergometry Examinations of the patient in primary and secondary prevention Anthropometric measurements evaluations, body composition, risk scores, history of physical activity. Demonstrations of the use of submaximal exercise testing for the prescription of physical activity. Method of spectral analysis of heart rate variability Basic information, methodology, clinical use. Rehabilitation Muscle dysbalances in connection with spondylogenic back pain. Examination of muscle groups, therapy, stretching. Prescription of PA in primary prevention Choice of PA. Dynamics of PA - basic parameters of prescription intensity, duration, frequency. Motivation, adherence. Contemporary conception of ?Physical Activity for Health?. Field testing, monitoring in the field conditions. Strength training. Prescription of PA in secondary prevention Coronary heart disease, hypertension, ischemia of lower extremities, diabetes mellitus, obesity, lung diseases, osteoporosis, pregnancy. Obesity Current view on etiopathogenesis and therapy. Rehabilitation Rehabilitation of patients after stroke. Doping and other pharmacological and nutritional support in sports Adaptation of body systems to regular physical activity( training) Effects on cardiovascular system, skeletal muscle, metabolism of substrate, hormonal balance, body composition. Morbidity a mortality Effects of physical activity on morbidity and mortality. Metabolic syndrom General characteristics, physiology, clinical significance, role of physical activity. Nutrition in sports NUTRITION Risk from toxic contaminants in the food Many environmental toxic contaminants may enter the food chain and can negatively influence human health. The most important are (1) persistent chlorinated organic compounds such as polychlorinated biphenyls, dioxins, and organochlorine pesticides with the potential carcinogenic, immunotoxic, endocrine-disrupting effects, and reproductive toxicity, (2) polycyclic aromatic hydrocarbons formed during incomplete combustion or pyrolysis of organic material including cooking processes, (3) mycotoxins with multiple toxic effects including carcinogenicity (aflatoxins), nefrotoxicity (ochratoxins), or estrogenicity (zearalenon), (4) heavy metals such as lead as a known developmental toxicant, or cadmium with its carcinogenicity and nefrotoxicity. Chemical changes during food processing Some toxic and genotoxic compounds can be formed during cooking and/or processing of muscle food. Cooking and other heat processing of protein-rich foods induce the formation of heterocyclic amines with strong mutagenic and potential carcinogenic effects. Free radicals may be involved in the etiology of cancer and cardiovascular diseases through lipid peroxidation. Partial depletion of vitamins, minerals and trace elements can occur during improper cooking processes. Some toxic compounds can be caused by means of microbial contamination of food such as histamin from histidin in the fish meat, or nitrosamines by bacterial reduction of nitrates to nitrites and further reaction with amines. Current problem represents genetically modified food. Microbiological safety of the food Hygienic microbiology must ensure warning signals in the form of so-called indicator microorganisms in food and to the potential risk of possible diseases with a mass incidence. Attention is devoted
Annotation
Modul představuje hlavní poznatky a přístupy k ochraně a podpoře zdraví v rámci oborů veřejné zdravotnictví, obecná hygiena, pracovní lékařství, tělovýchovné lékařství, výživa, zdraví dětí a mládeže, epidemiologie a rodinné lékařství.
TVL:
Fyziologie odpovědi organismu na jednorázovou těesnou zátěž. Zátěžový test: provedeni a hodnocení. Preskripce pravidelné pohybové aktivity v primární a sekundární prevenci. Vliv pravidelné pohybové aktivity na organismus a jednotlivé systemy. Obezita: klinický obraz a zásady léčby. Metabolický syndrom: klinický obraz a zásady léčby. Výživa ve sportu. Doping. Svalové dysbalance: klinický obraz a stručně zásady léčby.