UNIVERSITY OF KHARTOUM INSTITUTE OF ENDEMIC DISEASES Departmentof Epidemuology, Nutrtion & Refugees Health PROPOSAL: DIPLOMA / MASTER DEGREE IN CLINICAL NUTRITION BY COURSE AND RESEARCH 2013 University of Khartoum Institute of Endemic Diseases 1
Proposal : Diploma/Master / Degree in clinical Nutrition by Course and Research 1- Introduction Malnutrition is responsible for two-thirds of all deaths among under five children world - wide. Although the relationship between starvation and reduced resistance to infection is known from records of famines and pestilence, and also from recent epidemiological studies. yet, the concept of nutritional deficiency causing impairment of immuno-competence severity, susceptibility and management of the diseases is relatively recent. These are due to gaps in knowledge related to quantitative nutritional assessment and appropriate study design. Protection of people against the effects of illnesses, malnutrition and infection requires designing and monitoring programs employing multidisciplinary approaches involving both quantitative and qualitative methods. This requires accurate knowledge and apt skills on clinical nutrition to deal with metabolism, availability and absorption of food nutrients and diets, along with their effects on human health and the etiology and pathogenesis of diseases. Clinical nutrition, therefore, explains the interaction between nutrients needs and infections. For this, clinical nutrition research data is necessary to identify the requirements for growth and body building materials, prevention and management of specific infections and particularly important in policy formulation and planning of health and nutrition programs.the human nutrition research programs for ecological studies, standardization of methods, investigations, explanations, control studies and interventions. To contribute to identification and solving of problems related to public health, nutrition and susceptibility to endemic diseases in the Sudan, the Institute of Endemic Diseases proposes a program of Diploma / Master in Clinical Nutrition. 2- Preamble There is a great gap in the field of clinical nutrition in terms of implemented programs, content of these programs and tools of implementation. This gap has a negative impact on the implementation of the national and international programs. Improve knowledge and skills of professionals and researchers in health and nutrition from ministry of health, and academic institutions along with non-governmental organizations working in relief, in the field of clinical nutrition and its related health problems. 2
Courses structure and contents will fill the gaps in scientific knowledge of similar existing programs. The nature of the degree meet the requirements for donors supports. 3- Objectives: - General objectives: - Qualify participants with knowledge and modern research skills in the field of clinical nutrition with. Special objectives: - Develop candidates knowledge and skills in the field of clinical nutrition, to improve their future careers. Teach professionals to abide with clinical nutrition principles ( ethical principles scientific bases of endemics diseases and bio-safety ) in conducting the researches and studies and developing of the scientific skills. Contribute to resolving the national nutrition problems through conducting studies on evaluation of projects. Use modern technologies in nutritional diagnosis and assessment 4- Study Program Code Title Hours First Year : Semester: I - Basic knowledge Credit Contact Hours Hours Theory Practical CN6111 Cellular and Molecular Basis of Nutrition 2 2 - CN6113 Nuclear Basis of Nutrition and Medical Physics 3 2 1 CN6115 Food Hygiene and Safety 3 2 1 CN6117 Pathophysiology and Nutrition 2 2-3
CN6119 Nutrition Immunology and Infection 3 2 1 CN61111 Nutrition and pharmacology 2 2 - CN61113 Modern Issues in Clinical Nutrition 1 1 - Total 16 13 3 Contact Hours ( 285 ) First Year : Semester II : Skills, policies and application CN6122 Malnutrition and Obesity 1 1 - CN6124 Educational Theories in Nutrition Counseling 1 1 - CN6126 Communication Skills and Behavioral Change in 1 1 - Nutrition CN6128 Nutrition Policies, Guidance, and Regulations 1 1 - CN61210 Nutritional Assessment 4 2 2 CN61212 Food and Nutrition Services 1 1 - CN61214 Advanced Nutrition Therapy 4 2 2 CN61216 Nutrition and Epidemiology 2 1 1 Total 15 10 5 Contact Hours ( 300 ) Second Year : Semester I Planning and implementation of research CN6211 Research Design and Statistics 2 1 1 CN6213 Scientific Writing 1 1 - Seminar 2-2 Study Protocol Preparation 1-1 Study Implementation 4-4 Total 10 2 8 Contact Hours ( 410 ) Second year : Semester II 4
Reporting and documentation Data Analysis 2 2 Report Preparation 8-8 Total 10-10 Contact Hours ( 300 ) 5-Course Outlines CN6111 Cellular and molecular basis of nutrition 1) Learning Objectives : Introduce the major catabolic and anabolic pathways and investigates how organisms obtain and use energy. Explain how nutrients affects on molecular fundamental processes,( DNA repair, cell proliferation, and apoptosis). 2) Course content : Human metabolism. Biochemical and molecular nutrition. Genetic and metabolic disorders. Nutritional components. Regulation of dietary carbohydrates, Fat and protein metabolism and their impact on nutritional status and health. Fuel utilization in specific organs under various conditions. Regulation of energy metabolism. Phytochemicals. Methods in molecular nutrition research. 3) Learning outcomes learn the principles of human metabolism and integrates biochemical and molecular nutrition (genetic and metabolic disorders,): Gain knowledge in describing General nutritional components, 5
emphasizing regulation of dietary carbohydrates, fat, and protein metabolism and their impact on nutritional status and health. Learn the differences in fuel utilization in specific organs under various conditions and the regulation of energy metabolism. Gain knowledge in health impacts of dietary supplements and phytochemicals as new bioactive molecules of interest in human health. Learn the principles of the general roles for nutrients in Signal transduction, Gene Expression, and Proteolysis CN6113 Nuclear basis of Nutrition and Medical Physics 1) Learning Objectives : Acquire knowledge and understanding on application of physical principles in the assessment of nutritional situation and formulation of intervention polices and safety related environments. 2) Course content : Principles of medical physics. Principles of radiation therapy. Modern application of physics in nutritional assessment. Isotopes.Nuclear nutrition assessment. Human body composition. Total energy expenditure. Nutrient intake. Osteoporosis. Vitamin and mineral bioavailability studies. Food radiation. Radiation safety. 3) Learning outcomes Gain modern applications of physics in medicine and nutrition Acquire knowledge on physical principles underlying the operation of a wide range of nutritional techniques Learn the principles of nuclear and isotopic techniques ( assessment of human body composition, total energy expenditure, nutrient intake, 6
osteoporosis, vitamin and mineral bioavailability studies applied to support the nutritional studies. Acquire knowledge on detection of infection and analysis of foods (including food fortification). Understand how to use nuclear technologies to measure energy and protein needs of population groups, with different energy requirements( e.g. pregnant and lactating women, infants and children). Be able to apply the suitable nuclear techniques in clinical nutrition research an practices CN6115 Food Composition and Safety 1) Learning Objectives : Provide foundation knowledge and practical skills of the major food components and safety and how they contribute to the structure of the major food groups and its impacts on nutrition and health. 2) Course content Nature of foods. Food ingredients, Food safety measures.dietary carcinogens. Naturally toxic materials and their occurrence during food consumption chain, Application of food science to food preservation, processing, packaging and distribution. Quality attributes of food and how these attributes differ in different populations. The Impact of environmental factors (heat, light, irradiation, oxidation) and food preservation, processing, packaging and distribution on food quality. The Sensory properties of food. Principles of sensory evaluation. Applications in laboratory and consumer settings. Evaluating other s aspects of food quality. Nutritional and safety aspects. Food policy. legislation and consumer Protection. 7
3) Learning outcomes Acquire foundation knowledge of the major food components and safety and how they contribute to the structure of the major food groups; Gain Knowledge on the fundamental principles underpinning food safety and guidance on how hygiene practices should be implemented; Develop technical skills through laboratory investigations(e.g. analyzing food composition and exploring the microbiological aspects of food safety. CN6117 Pathophysiology and Nutrition : 1) Learning Objectives: Understand the mechanisms of Pathophysiology and the interrelated role of nutrition in prevention, etiology and treatment of disease. Examines the physiologic and metabolic alterations in chronic and acute illness and trauma requiring modifications in nutritional care. Course Content The concepts of disease and to the mechanisms by which cells undergo injury and adapt to such insult. Fluid and electrolyte balance. Acid-Base balance. Cellular and physiological response to injury.role of nutrition in prevention of disease and in medical treatment. Effects of nutritional status on disease outcome. Disease related malnutrition.determining energy and protein requirements. Body composition in health and disease. 2) Learning outcomes : 8
At the end of the course the student will be able to: Classify diseases based on pathogenetic or morphological characteristics. Describe the processes that lead to cell injury and describe responses for healing, including inflammation and fever. Outline the immune response and describe some diseases that affect immunity. Describe the pathology of various diseases, including: neoplastic disease, blood disorders, and hemodynamic and vascular disorders. Outline the pathophysiology of the cardiac, respiratory, gastrointestinal, hepatobiliary, pancreatic, renal, endocrine, reproductive, skeletal and muscular, and central nervous systems. CN6119 Nutrition Immunology and Infection 1) Learning Objectives : Provide knowledge on basic concepts of immunity and immunobiology. 2) Course Content: Organs, tissues and cells involved in the human immune system. Non-specific mechanisms of immunity. Granulocytes. Macrophages. Complement and related defenses. Role of cytokines. Chemokines and inflammatory mediators coordinating immune responses. Acquired immunity. Function, maturation. Activation of B and T lymphocytes. Mechanisms underlying specific lymphocyte activation. Antibody structure and function. The role of immunoglobulin and cell mediated immune mechanisms. 9
3) Learning outcomes At the end of this course the students will Become familiar with the different cells and organs of the immune system and their mechanisms to protect the body from infection. Acquire knowledge on the processes and signaling events that are important in communication between cells of the immune system.. Gain basic knowledge on immunological mechanisms of the human body and the role nutrients play in immune mechanisms, Gain knowledge in the role of therpapeutical nutrition strategies in the improvement of immune system functions Could be able to formulated suitable therapeutical diets to improve the immune system. CN61111 Nutrition and Pharmacology 1) Learning Objectives : Explore principles and applications of pharmacology in clinical nutrition. 2) Course Content General principles of pharmacology and pharmacokinetics. Drug-Nnutrient interactions. populations vulnerable to drug-nutrient interaction, Effects of nutritional status on drug metabolism and secretion. Functional foods. Nutraceuticals. (Nutritional deficiencies and their effect drug absorption and metabolism). Diet, exercise and pharmako therapeutic management of some diseases e,g. Type ll Diabetes, Cardiovascular Disease, and obesity. 3) Learning outcomes: 10
Understand the basic principles of pharmacology and to explain the general mechanisms of action of the most important classes of medicines; Understand and explain how the formulation of an active compound can influence its effects and side-effects; Be able to explain the differences and similarities between drugs (medicines), dietary supplements and functional foods in terms of their legal status and use; Be able to formulate and scheduling suitable therapeutics for patients using different types of drugs CN61113 Modern Issues in Clinical Nutrition 1) Learning Objectives: Provide knowledge on modern issues in clinical nutrition. 2) Course Content: Will be designed according to the selected topics, degree objectives and students background. 3) Learning outcomes: Acquire knowledge in issues pertaining clinical nutrition and related subjects. Modify and update knowledge and information in clinical nutrition aspects. Gain experiences to cope with international scientific finding. CN6122 Malnutrition and Obesity 11
1) Learning Objectives : Provide the student with over all principles and understanding of under and over nutrition. Evaluate and manage over and under nutrition.. 2) Course Content Malnutrition categorizations. Clinical manifestation. Causation.Prevention.Clinical and nutritional Management. 3) Learning outcomes : Be able to describe the current international epidemiology and clinical features of the major macro and micro-nutrient deficiency diseases across the globe and the impact of these deficiencies on public health outcomes; Discuss the major short and long term nutritional consequences facing the populations; Be able to evaluate the causes of the malnutrition and obesity in indigenous and transition populations; Gain experience on the current approaches being used to prevent and treat malnutrition. CN6124 Communication Skills 1) Learning Objectives : Provide the student with interpersonal skills essential for effective nutrition communication practice. 2) Course Content 12
Communication principles.components and barriers. Kinds of communication. Components and process. Important and benefits of effective communication.writing, reading, speaking and listening skills. Body language 3) Learning outcomes : Gain knowledge in Communication technology Addresses notable theoretical frameworks for health/nutrition programs. Program components including needs assessment, performance objectives, implementation strategies, and evaluation. CN6126 Behavioral Change and Educational Theories in Nutrition Counseling 1) Learning Objectives: Provide knowledge on different educational theories. Be able to use effective nutrition counseling programs. 2) Course Content : Introduction to behavior change. Communication. Concepts of human behavior and influence. Theoretical approaches to health behavior. Behavior change models. Planning and implementing a behavior change.communication program Definition, Principles of nutrition counseling 3) Learning outcomes: Acquire knowledge and experience in general education theories and behavioral change methods in nutrition counseling Be able to plan, implement and evaluate nutrition counseling sessions around specific dietary behavior and behavior change theory and strategies. 13
CN6128 Nutrition Policies, Ethics and Regulations 1) Learning Objectives : Provide information on national and international guidelines in nutrition policies, ethics, regulations and biosafety, and how it can be applied in research and general clinical nutrition practices. 2) Course content: International guidelines on preventive and curative nutrition. National guidelines. International guidelines in Bioethics. Biosafety guidelines. 3) Learning outcomes : Acquire knowledge on the Principles of bioethics ethics in medical and nutritional practices, national and related international policies and guidelines in all situation ( prevention and treatment ) and under different humanitarian settings. Be able to apply ethical principles and biosafety guidance along with national policies in the implementation of research protocols and general clinical nutrition practices ides. Be able to apply Biosafety theories and levels in different clinical or lab settings CN61210 Nutritional Assessments 1) Learning Objectives : 14
Understand general aspects of different methodology uses in nutritional assessment and the appropriate use of these tools in determining the nutritional status of a population and/or individual client. 2) Course Content: Techniques for determining body composition: Anthropometric techniques, bioimpedance analysis. Densitometric techniques. Isotope techniques. Techniques for measuring energy expenditure: Direct and indirect calorimetric, Non-calorimetric techniques. Biochemical analysis: short half life proteins. Acute phase proteins. Urinary markers. Micro and macro nutrients. Functional tests. Food consumption patterns.24hours recall. Dietary history. 3) Learning outcomes : Acquire knowledge and skills in various nutrition assessment techniques Acquire knowledge on the uses of suitable tools in determining the nutritional status of a population and/or individual client. Understand nutrition assessments and the interpretation of information from dietary, laboratory, anthropometrics, and clinical study. Be able to plan,implement and assess nutritional status and food consumption patterns CN61212 Food and Nutrition Services 1) Learning Objectives: Introduce advanced principles and practices related to management of food and 15
nutrition services in healthcare operations. 2) Course Content : Food and nutrition services in different settings : Food supply chain setting in different situation.food consumption chain.food and nutrition services in hospitals and health unites.biosafety and food waste.dietary carcinogens, Natural toxic materials. Health services setting.emergency and relief operations settings. 3) Learning outcomes : Gain knowledge on management of food and nutrition services in healthcare operations.. Gain knowledge on Food in emergency and relief program Understand how food business operators can ensure compliance with legislation Know how to implement food safety management procedures Know how to identify hazards Be able to contribute to practical improvements in food safety practice in different services strategies. Be able to plan, construct and assess nutritional services plant. CN61214 Advanced Nutrition Therapy 1) Learning Objectives: Application of information on Anatomical, physiological and biochemical changes associated with diseases on nutritional assessment and its uses in the modification and formulation of diets as adjuncts to other therapies for patients 16
with specific disease states. 2) Course Content; Methods for data collection. Interpretation and rationalization for nutritional prescribing. Nutritional therapy in malnourished patients in the hospital. Nutritional management in Diabetes.Management of malnutrition in Tuberculosis..Nutrition management in Chronic Kidney Disease. Nutrition management in Hypertension, Nutrition management in Lishmanisis. Nutrition management in Cancer. Management of Pediatric Under Nutrition.Understanding of the medical aspects of common disease states. 3) Learning outcomes : Acquire information on Anatomical, physiological and biochemical changes associated with diseases. Learn how to use modified diets as adjuncts to other therapies for patients with specific disease states. Gain basic fundamental knowledge on general understanding of the medical aspects of some common disease states Be able to formulate therapeutic diets for patients with different diseases patterns Be able to Evaluate the impacts of dietary management on health and disease management and to identify general causes for their therapeutic diets failure CN61216 Nutrition and Epidemiology 1) Learning Objectives: Acquire skills and knowledge on designing implementation and evaluation of studies and cases, using modern epidemiological principles and guidance 17
2) Course Content Introduction to the concept of nutritional epidemiology.epidemiological study designs ( Cross-sectional studies, longitudinal studies, Case-control studies, Cohort study, and Clinical trials. Study designs. Interpretation of findings. Assessment and summarization of findings from multiple studies. 3) Learning outcomes Acquire knowledge and experience on different epidemiological studies e.g. Cross-sectional studies, longitudinal studies, and clinical trials that can be applied in planning,implementation, follow up and evaluation of heath and nutrition programs. Learn the Methodology and applications of Nutritional Epidemiology. Compare results from different Nutritional Epidemiological Studies, regarding their biological significance, in the field of Public Health Nutrition and Community Medicine-Nutrition. Be able to discuss findings generated from major national surveys or trials. Conduct research and suggest future prevention strategies and policies on nutritional problems. CN6211 Research design and statistics 1) Learning Objectives: Acquire knowledge for defining research problems, and identifying designs and methodologies to address problem. Prepare the students to write and implement their research protocols. 2) Course Content: 18
Principles of research methods. Sources of information: Library searches. Databases and the internet. Journals. Referencing. Introduction to research methodologies. Quantitative and qualitative. Hypothesis setting and defining variable. Overview of research process. Descriptive statistics. Summarizing data. Measures of location and dispersion. The normal distribution. Basic parametric and non parametric. Statistics data analysis using parametric and nonparametric statistical procedures. Computerized statistical programs, such as SPSS, EPI. 3) Learning outcomes : Acquire knowledge in Relevant quantitative techniques used in International research. Manipulation of the data. Presentation of the results using verbal, graphical, mathematical, statistical and econometric means. Acquire skills to plan and design research proposal and work plans Apply theoretical and quantitative methods to the analyses of research problems Conduct individual assignments and perform effectively in a group environment by demonstrate leadership and team-building qualities Demonstrate a logical argument, analyze and interpret data and evaluate alternative perspectives based on objective reasoning. Communicate and present with clarity complex arguments orally and in writing. Present, interpret and analyze information in numerical form CN6213 Scientific writing 1) Learning Objectives To introduce students to the principles of good writing in general, with a focus on science writing. 19
2) Course Content Drafts, revisions, the structure of specific types of writing (scientific articles, essays, summaries). General points of style, sentence construction, voice and tense. 3) Learning Outcomes Gain knowledge on writing exercises, and mutual feedback Practicing different types of scientific writing and editing. Express scientific ideas clearly and concisely. 6- Educational and teaching methodologies Lectures and conventional practical sessions Methods for participatory active learning (e.g. electronic enrichment, field work assignments, tutorial classes,integrated Learning Activities (ILA) and Team Based Learning (TBL). 7- Human Resources and Facilities : A) Human resources: - Scientific staff: professors (5) Associate professor (2) Assistants professors (3) Teaching assistance (3) Technical staff : 20
Laboratory technologist (5) Medical assistants (3) B) Facilities : - Lecture rooms and Library : Hall with a capacity of 50 students equipped with all necessary teaching tools. Library and a reading hall of a capacity of 20 students. Ethics committee office and hall with a capacity of 20 members. Laboratories: Immunology Lab. Molecular biology Lab. Parasitological Lab. Genetics Lab. Clinical studies Lab. Nutrition, nuclear technologies. Lab. Regulatory Committees Ethics review committee Data safety and monitoring Board for clinical research. Research stations : o Professor El Hassan Center / Duka o Kassab hospital / Kassab o White Nile state research station ( under construction). 8- Collaborators from : Faculty of Medicines - University of Khartoum. Faculty of pharmacy - University of Khartoum Faculty of Dentistry - University of Khartoum 21
Faculty of Agriculture- University of Khartoum. Faculty of Animal Production- University of Khartoum. Faculty of Education- University of Khartoum. Food Research center - Agricultural Researches Corporation. Faculty of public and Environment Health- University of Khartoum. Faculty of Nursing sciences - University of Khartoum. Faculty of laboratory sciences - University of Khartoum Faculty of veterinary medicine- University of Khartoum Faculty of Mathematical Sciences Faculty of economics Ministry of health Soba Educational Hospital Ahmed Gasim Children Hospital Gafar Ibnaouf children Hospital General Regulations 9- Admission Regulations, terms of admission and registration procedures of graduate college of the University of Khartoum shall be applied. Applicants should be holders of Bachelor of Science in nutrition or health related subjects graduates from : 6 colleges of medical sciences ( Medicine,Pharmacology, Dentistry,nursing sciences, Medical Laboratory sciences and public Health.) Agriculture, Veterinary, Animal production and other related colleges. Their conditional admission will depend on the recommendations of the Institute of Endemic Diseases scientific committee and approval of the council of graduate college.educational level 22
and experiences determine if a students will be required to take extra non credit course to rectify any deficiencies The applicants academic qualifications and personal characteristics as revealed by interview will be considered in their admission for the program. Applicants should have had at least one year in a recognized institution after graduation or worked at an institution related to the objectives of the degree. Holders of general degrees or those who need upgrading should sit for and pass a qualification exam in the subjects of concern at the institute of endemic diseases. 10- Examination and Assessment o The general regulation of postgraduate College regarding the rules and conditions of examination for MSc. degree shall be applied. The degree is awarded by the senate of the University of Khartoum. Practical, field work portfolios and assignments must be completed and submitted before the final examinations of each semester. A student must pass the theory and practical parts of each examination independently. A student must satisfy, separately, an attendance of at least 75% of each of the approved courses and training periods. A student who absents himself/ her self from examination(s), without prior notification with acceptable reasons, will be considered a failure. o To be promoted to the second year a student must pass all the final examinations of both semesters, supplementary and substitutes inclusive. 23
A student who fail to a c quire the general requirement for the promotion to the second year will award a Diploma in clinical nutrition A student who fails in more than 25% and less than 50% of the subjects will be allowed to sit for supplementary examinations and be awarded The Diploma after passing the examinations. A student who fails in less than 25% of the subjects will be allowed to sit for supplementary examinations and be awarded grade pass in the particular subjects. Supplementary and substitute examinations of both semesters will be offered, together, at the end of each academic year A student who fails in more than 50% of the subjects or fails in any of supplementary examinations shall be dismissed and shall not be allowed to register again for the program.. 11- Assessment Examination and recording of grades will follow the University s examination regulation. Grade C in any single course is considered to be the minimum passing level. Grades Level GPA Scores Distinction ( A) 4.0 80% and more Very good ( B+) 3.5 70-79% Good ( B ) 3.0 65-69% Pass ( C ) 2.5 60-64% Fail ( F ) 0.0 Less than 60 12- Thesis 24
A student should be eligible for registration of the title of thesis and the appointment of the supervisor after successful completion of prescribed courses for master degree. The thesis could be supervised by supervisor with a minimum assistant professor rank and he/she should have a minimum 3 years experience in the related field. Institute members alone or with collaboration with other, cannot at one or at the same time supervise more than 5 master thesis. The master thesis must be characterized by originality and creativity. When the thesis is finalized the supervisor shall submit a detailed report to the scientific committee.examination committee will be formed in accordance with university regulations. 13- Award of the Degree The senate, on recommendation of the Graduate College Board, shall award successful candidates the Diploma or master degree in Clinical Nutrition. 14- Language of Instruction and Thesis Writing : English 15- Duration: Four Semesters 25