Midwifery

Activity type

Scienze medico - chirurgiche

SSD

MEDS-10/B

Year

1st year

Semester

2nd semester

CFU

2

Hours distribution

24 classroom hours

Lecturers

MARCO RIDOLFI

Activity type

Scienze propedeutiche

SSD

MEDS-24/B

Year

1st year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

ANNALISA ROSSO

Activity type

Prevenzione servizi sanitari e radioprotezione

SSD

MEDS-25/B

Year

1st year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

CORRADO COLAPRICO

Activity type

Prevenzione servizi sanitari e radioprotezione

SSD

MEDS-22/A

Year

1st year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

LUCIA MANGANARO

Activity type

Scienze ostetriche

SSD

MEDS-24/C

Year

1st year

Semester

2nd semester

CFU

1

Hours distribution

12 classroom hours

Lecturers

MARISA PATRIZIA MESSINA

The student must have acquired the knowledge and skills necessary to promote the health and safety of women, newborns, and families, as well as occupational health and safety.

Upon completion of the course, students will be able to:

Understand the fundamental principles of health promotion and disease prevention in healthcare and occupational settings.
Describe the main determinants of health and the risk factors affecting individual and population well-being.
Acquire knowledge of the core principles of occupational health and safety, with particular emphasis on the prevention of biological, chemical, physical, and ergonomic hazards.
Apply the fundamental regulations and best practices related to health and safety, adopting appropriate behaviors to protect patients, healthcare professionals, and the working environment.
Recognize the importance of clinical risk management, patient safety, and the prevention of adverse events, contributing to a culture of safety within healthcare organizations.

Students are expected to possess a basic understanding of human anatomy, physiology, and general principles of healthcare. Fundamental knowledge of medical terminology and an introductory background in healthcare organization and patient care are recommended.

No specific prior knowledge of occupational health and safety is required. However, familiarity with the principles of disease prevention, infection control, and evidence-based healthcare will facilitate the achievement of the learning outcomes.

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Radiation Protection Course Programme
1. Introduction to Radiation Protection
Definition and objectives of radiation protection.
Natural and artificial sources of radiation.
Medical applications of ionizing radiation.
Differences between ionizing and non-ionizing radiation.
Basic concepts of radiation risk.
2. Physical Principles of Ionizing Radiation
Atomic structure and radioactivity.
Types of ionizing radiation: X-rays, gamma rays, alpha particles, beta particles, and neutrons.
Production of X-rays.
Interaction of ionizing radiation with matter.
Attenuation, absorption, and scattering.
Dosimetric quantities and units of measurement:
Activity.
Absorbed dose.
Equivalent dose.
Effective dose.
Exposure.
3. Biological Effects of Ionizing Radiation
Interaction of radiation with cells and tissues.
Direct and indirect biological effects.
Cellular and tissue radiosensitivity.
Deterministic effects (tissue reactions).
Stochastic effects.
Somatic and genetic effects.
Early and late radiation effects.
Dose–response relationship.
Radiation-induced carcinogenesis.
Effects of radiation exposure during pregnancy and fetal development.
4. Fundamental Principles of Radiation Protection
Principle of justification.
Principle of optimization.
Principle of dose limitation.
The ALARA (As Low As Reasonably Achievable) principle.
Concepts of time, distance, and shielding.
Appropriate use of personal and collective protective equipment.
5. Radiation Protection Legislation
European and national regulatory framework.
Council Directive 2013/59/Euratom.
National legislation governing radiation protection.
Responsibilities of healthcare professionals involved in radiation protection.
Duties of employers, managers, and workers.
Role of the Radiation Protection Expert.
Role of the Occupational Physician.
Role of the Medical Physicist.
Role of the Head of the Radiology Department.
Education and training of occupationally exposed workers.
6. Occupational Radiation Protection
Classification of working areas:
Controlled areas.
Supervised areas.
Classification of occupationally exposed workers.
Occupational dose limits.
Radiation protection monitoring.
Health surveillance.
Personal and environmental dosimetry.
Proper use of personal dosimeters.
Personal protective equipment:
Lead aprons.
Thyroid shields.
Protective eyewear.
Radiation-protective gloves.
Radiation protection during interventional procedures.
Radiation protection for pregnant and breastfeeding workers.
Management of accidental occupational exposure.
7. Patient Radiation Protection
Justification of radiological examinations.
Appropriate imaging referrals.
Optimization of imaging protocols.
Dose reduction while maintaining diagnostic image quality.
Diagnostic Reference Levels (DRLs).
Recording and communication of radiation dose.
Prevention of unnecessary radiation exposure.
Patient identification and procedure verification.
Radiation protection in repeated examinations and follow-up imaging.
Quality assurance and quality control of radiological equipment.
8. Radiation Protection in Diagnostic and Therapeutic Procedures
Conventional radiography.
Mammography.
Computed Tomography (CT).
Fluoroscopy and interventional radiology.
Dental radiology.
Nuclear medicine.
Radiation oncology (Radiotherapy).
Hybrid imaging techniques.
Differences between diagnostic, interventional, and therapeutic radiation exposure.
9. Radiation Protection for Vulnerable Populations
Pediatric patients.
Women of childbearing age.
Pregnant patients.
Embryo and fetus.
Patients undergoing repeated imaging examinations.
Frail or non-cooperative patients.
Carers and individuals accompanying patients during medical exposure.
10. Pediatric Radiation Protection
Increased radiosensitivity in children.
Adaptation of imaging protocols according to age, body size, and weight.
Minimization of the irradiated field.
Prevention of repeat examinations.
Patient immobilization and preparation.
The "child-size" principle in selecting imaging parameters.
Communication with parents and caregivers.
11. Radiation Risk Management and Accidental Exposure
Identification and assessment of radiation risks.
Accidental and unintended radiation exposure.
Patient identification and procedural errors.
Equipment malfunction.
Reporting of significant radiation events.
Incident analysis and management of adverse events.
Emergency procedures.
Safety culture and error prevention.
Clinical audit and continuous quality improvement.
12. Protection of the Public and the Environment
Public exposure to ionizing radiation.
Management of radioactive sources.
Disposal of radioactive waste.
Internal and external contamination.
Environmental radiation monitoring.
Prevention of radioactive material release.
Management of radiological and nuclear emergencies.
13. Practical Sessions and Case-Based Learning
Identification of radiation hazards in a radiology department.
Correct use of personal protective equipment.
Proper positioning of healthcare professionals during radiological procedures.
Interpretation of dosimetry reports.
Analysis of accidental radiation exposure scenarios.
Assessment of the appropriateness of imaging referrals.
Practical application of the principles of time, distance, and shielding.
Discussion of clinical cases involving pediatric patients and pregnant women.


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slides and teaching materials


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classroom lectures

The course is delivered during the second semester through weekly lectures.

Student learning will be assessed through a written examination and an oral examination, designed to evaluate the achievement of the course learning outcomes. The written examination will assess theoretical knowledge and the ability to apply the principles of health promotion and safety, while the oral examination will evaluate students' understanding of the topics covered, critical reasoning skills, and the appropriate use of scientific terminology.

Examples of Written Examination Questions
Define ionizing radiation.
Explain the ALARA (As Low As Reasonably Achievable) principle.
Describe the principles of occupational radiation protection.
What are the main determinants of health, and how do they influence individual and population well-being?
Describe the main categories of occupational hazards in healthcare settings and the corresponding preventive measures.
Explain the concepts of patient safety and clinical risk management.
What are the main strategies for the prevention of healthcare-associated infections (HAIs)?
Examples of Oral Examination Questions
Discuss the biological and genetic effects of ionizing radiation.
Describe the main strategies for the prevention of infectious diseases.
Explain the role of screening programs for infectious diseases.
Discuss the principles of healthcare worker safety, including occupational risk prevention and infection control.

Module:

• Introduction to infections during pregnancy
  General principles of maternal-fetal and perinatal transmission. Difference between congenital, perinatal and puerperal infections. Concepts of screening, primary prevention, secondary prevention, prophylaxis and counselling.


• TORCH complex and congenital infections
  Toxoplasmosis, rubella, cytomegalovirus, herpes viruses and syphilis. Epidemiology, routes of transmission, fetal risk according to gestational age, maternal and fetal manifestations, diagnosis, prevention and general principles of management.
  
  
  Cytomegalovirus and emerging infections
  CMV infection during pregnancy, risk of vertical transmission, possible neonatal outcomes and counselling. Zika virus as an example of an emerging pathogen with fetal neurological tropism and risk of microcephaly.
  
  
  HIV and pregnancy
  Vertical transmission of HIV, role of antiretroviral therapy, management of pregnancy, delivery, breastfeeding, neonatal prophylaxis and counselling. Importance of screening and multidisciplinary care.
  
  
  Viral hepatitis during pregnancy
  HBV and HCV: screening, vertical transmission, interpretation of the main serological markers, role of viral load, neonatal prophylaxis for HBV with vaccine and immunoglobulins, counselling and follow-up.
  
  
  Sexually transmitted infections during pregnancy
  Syphilis, gonorrhoea, Chlamydia trachomatis, genital herpes, HPV and other relevant STIs. Impact on pregnancy and the newborn, screening, diagnosis, prevention, treatment and counselling.
  
  
  Group B Streptococcus
  Maternal colonization, vaginal-rectal swab screening, prevention of early-onset neonatal sepsis, indications for intrapartum antibiotic prophylaxis and the role of the midwife in the correct application of protocols.
  
  
  Urinary tract infections during pregnancy
  Asymptomatic bacteriuria, cystitis, pyelonephritis, main etiological agents, obstetric risk, urine culture screening, principles of treatment and follow-up.
  
  
  Chorioamnionitis, maternal sepsis and intrapartum infections
  Risk factors, clinical signs, early recognition, principles of multidisciplinary management, maternal-fetal surveillance and importance of timely medical referral.
  
  
  Puerperal infections
  Endometritis, surgical wound infections, mastitis, healthcare-associated infections and principles of prevention. Role of hygiene, clinical surveillance, patient education and postpartum counselling.
  
  
  Role of the midwife in infectious disease prevention
  Health education, vaccine counselling, promotion of adherence to screening programmes, recognition of risk factors, communication with the patient and collaboration with gynaecologists, infectious disease specialists, neonatologists and microbiologists.
  • Books: Required teaching material:
    
    Teaching material provided by the lecturer, including handouts, slides and summary schemes covering the topics discussed during the lessons.
    
    Recommended textbooks:
    
    Impey L., Child T. Obstetrics and Gynaecology. Wiley-Blackwell.
    
    Luzzi A.M., Brusaferro S. Igiene, epidemiologia e sanità pubblica. EdiSES.
    
    Updated guidelines and institutional documents on infectious disease screening during pregnancy, prevention of vertical transmission, vaccinations, sexually transmitted infections and healthcare-associated infections.