Acta Biomedica de l''Ateneo Parmense最新文献

Background and aim Hospital facilities are one of the most stressful environments and there is evidence that during Covid-19 having outdoor and green spaces helped medical staff and nurses to decrease the stress and anxiety level. Nevertheless, knowledge about the type of green space is limited. The aim of the study is to systematize the existing scientific literature on the topic in a specific time period.     Methods Scopus, Pubmed, and Cochrane library databases have been explored in a systematic way. Following the Prysma diagram 25 studies have been included. Descriptive statistics and content analysis have been performed to highlight green typologies, users and functional area involved, spatial focus, relationship between users and space and vegetation typology. The different topics have been clustered according to Kellert's biophilic framework.     Results Articles reviewed included studies from the 2000 to 2020. The selection led to the analysis of 25 documents; it was significant to understand the major areas of application (pediatrics, ma-ternity, oncology, hospitalization, etc) and forms of green (images, furniture, healing gardens, vegetable gardens, etc).   Conclusions The present review highlight the main characteristics of green space in hospital built environment with specific focus on pre-pandemic situation.

Background and aim Ultraviolet radiation (UV) is the portion of the electromagnetic spectrum of wavelengths between 200 and 400 nm divided into three bands called UVA, UVB and UVC. Due its well-described antimicrobial activity, UVC can represent a useful tool for disinfect surfaces, water, and air. The aim of this study was to illustrate the studies over time ultraviolet germicidal irradiation (UVGI) to disinfect air and surfaces. Methods Articles on Scopus published until April 14, 2023, were considered. Many issues involving UV were deepened crosschecking with e.g., "air", "surfaces", "disinfection", "bacteria", "fungi", "operating theatres". According to the case, the following variables were considered: years and related number of articles, sources of publications, subject areas, type of document published, type of journal, nationalities of the authors. Results Since 30's, 287 448 articles on UV have been published. Among UVGI, 22 159 articles covered bacteria issue, followed by fungi and viruses with about 12000 both. UVGI was addressed by 1941 and 931 articles for surfaces and air respectively. Of these, 122 were performed in operating theatres. Since 1987 works have been published on spacecraft and since 2000, on the use of UVGI robots for disinfect air and surfaces. Conclusions Our study shows the studies on UVGI and related issues. It also shows most recently perspectives about the applications e.g. during prolonged human-crewed missions on spacecrafts, to inactivate microorganisms in environments where the exchange of air is impossible.

Background and aim: Proper nutrition during childhood and puberty is essential to ensure healthy growth of children and good health in adulthood. Different types of interventions have been suggested to promote nutritional health in children. This systematic review aims to summarize the available evidence from experimental studies on the efficacy of digital media tools for the promotion of a healthy diet in school-aged children.

Methods: According to PRISMA guidelines, a literature search was conducted in the three main electronic databases (PubMed/Medline, Embase e Scopus) until April 2022. We included all experimental studies assessing the effectiveness of digital media tools for nutritional health promotion in children from 5 to 12 years of age.

Results: Four studies were included in our analysis, all carried out in school settings. Three of them investigated the use of a videogame, while one study involved watching a cartoon. Each intervention tested was effective in promoting a healthy diet in school-aged children in the short term, regardless of the type of intervention and age of the children involved. A statistically significant increase was observed post-intervention in all studies, both in knowledge of food groups and food frequencies, and in practices (i.e. the amount of fruit and vegetables servings consumed per meal), although the effect faded over time (when follow-up was available).

Conclusions: Digital media tools can be used to effectively implement health promotion interventions to improve knowledge and adherence to healthy diets in school-aged children. Further studies are needed to assess the long-term effectiveness of these interventions.

Background and aim: COVID-19 highlighted significant criticalities of the Italian National Healthcare System (NHS) and recently the Italian Government approved the National Recovery and Resilience Plan (NRRP) to relaunch its economy and at the same time to promote health, sustainability and digital innovation. Specifically, M6C1 (Mission 6 Component 1) wants to introduce Community Health Centers (CHCs), Community Hospitals (CHs) and Local Operative Centers (LOCs) to strength territorial healthcare services. Starting from the Italian Ministerial Decree n. 77 (2022), AGENAS (National Agency for Regional Healthcare System) and POLIMI (Politecnico di Milano) working group developed the meta-design guidelines for CHCs, CHs and LOCs facilities with the aim of supporting decision-makers to define spatial features and building performances in order to be responsive to functional issues.

Methods: The spatial strategies of these facilities have been elicited through three different steps: a) a survey about the current national and international scenario regarding the territorial healthcare; b) a review of all national and regional regulations; c) the development of the meta-design guidelines have been elaborated from the analysis of the a) and b) steps.

Results: The regulatory instructions and scientific indications collected through the literature have been translated into spatial and functional layouts. The services have been organized by homogeneous macro-areas and defined in a synoptic framework which shows the performance approach and their features. Each macro-area, sorted by type of functions, has been subdivided into a list of all its specific spatial units.

Conclusions: The study conducted aims at supporting the planning of these facilities in relation to the catchment area and their sizing. It will be necessary to define the location by evaluating the possibility of setting them up within existing hospitals, as well as to guarantee a sustainable approach in the realization of these infrastructures.

Background and aim: Universal Design (UD) is the design of environments equally accessible and usable to the wider range of people regardless their abilities or disabilities. Various studies highlight the lack of evaluation tools to support decision makers to enhance inclusive environments, especially complex constructions with various users as healthcare facilities. The research proposes a tool to evaluate the quality of building according to UD through a new set of objective indicators with a performance-based approach.

Methods: the tool has been developed through three main phases: 1. Analysis of the state of the art through a systematic literature review and workshops with stakeholders and experts; 2. Elaboration of the evaluation framework following the Multicriteria analysis methodology; 3. Application, to test and validate the tool in hospitals.

Results: the tool, named Design for All A.U.D.I.T., evaluates the level of UD analyzing Physical, Sensory-cognitive, and Social quality through a set of criteria specified by indicators and measurable requirements. The tool assesses the different healthcare environments through criteria and indicators to verify the level of appropriateness in terms of UD. The tool provides report with quantitative, qualitative and graphical information in plan of the facility status and design strategies.

Conclusions: The study proposes an innovative evaluation system to determine the inclusion of hospitals, both for projects and for existing buildings. The flexible structure allows the tool to beapplied in different building typologies, currently adopted to identify hospital's weaknesses and setting priorities of intervention on inclusion.

Background and aim: This study aims to assess the quality of the population-based breast cancer screening programme in Pavia, northern Italy computing its key performance indicators and estimating its sensitivity for the years 2016-2018.

Methods: Invitation and examination coverage, participation rate, recall rate, detection rate and positive predictive values were computed on the basis of data provided yearly to the Italian Ministry of Health. Sensitivity was estimated identifying interval cancers in the local Cancer Registry and computed with the proportional incidence method.

Results: In 2016-2018 the adjusted invitation coverage was 90%, and the adjusted participation rate was 62%. Recall rate was 8.4% for first screenings and 3.9% for subsequent ones. The number of screen-detected cases was 268, corresponding to a detection rate of 6.6‰ for first screenings and 4.6‰ for subsequent screenings. The number of interval cancers observed was 110 over the study period; the proportional incidence was 22% for the first interval year and 50% for the second interval. The overall sensitivity of the screening program was 64%.

Conclusions: The analysis of performance indicators and sensitivity estimates for the Pavia programme indicates that the programme performance is in line with the quality standards set by the European Union and the Italian reference scientific society (GISMa).

Objective: To evaluate the impact of the health educational program "Igiene Insieme 2021/2022" on Italian primary school children's knowledge, attitudes and practice of hygiene and sanitation and to compare incidence of SARS-CoV-2 in schools participating the project with regional data of Lombardy and Apulia.

Methods: Participating schools were provided with a hygiene kit containing educational material for teachers and sanitizing products for students. We conducted a pre-post evaluation administering a questionnaire before and after the intervention. In addition, we compared SARS-CoV-2 incidence of the participating primary schools (225 in Lombardy and 120 in Apulia) to regional-level data. We tested the differences between groups by using the Chi-squared test.

Results: Of 1,991 schools, 472 responded to both questionnaires for a total of 16,988 students. 17.3% of the students learned the importance of handwashing in preventing infections, 22.6% when to wash hands, 18.5% the existence of alternative solutions in absence of soap and water, 23.2% how to correctly wash hands. A lower incidence of SARS-CoV-2 infections was recorded in primary schools participating in the project as compared to the average regional incidence in Lombardy (9.6% vs.14.8%) and Apulia (10.7% vs.12.0%) for the same age group.

Conclusions: We report an overall positive effect of health education interventions in primary schools. Although the limitations in the study design, our findings are important to inform planning, implementation and monitoring of health promotion campaigns in young generations so as to contribute to limit the risk of infection spread at the community level.

Background and aim: Early cancer diagnosis is a public health priority, but large proportions of patients are diagnosed with advanced disease or as an emergency, even in countries with universal healthcare coverage. The study aimed at examining factors contributing to diagnostic delays and inequalities in cancer care, discussing challenges and opportunities for improving the diagnosis of cancer.

Methods: We performed a critical review of the literature examining factors contributing to delays and inequalities in cancer diagnosis, published between 2019-2023, in Europe with a specific focus on Italy.

Results: Disparities in screening, cancer diagnosis and treatment have been reported in many European countries, with poorer outcomes for some population sub-groups. For example, some Northern regions in Italy have six-times higher screening participation versus Southern regions. In 2019 36% of the Italian population aged 50-74 reported colorectal cancer screening, higher than the EU average (33%), but lower than in countries like Denmark (>60%). In Italy, the EU country with the largest percentage of people aged 65+, incident cancers are expected to rise by 19.6% over two decades. Older age is also associated with multimorbidity, with physical and mental health morbidities possibly affecting cancer diagnostic pathways. For example, colon cancer patients with pre-existing mental health conditions were 28% less likely to have a prompt colonoscopy when presenting with red-flag symptoms, according to recent UK research. Covid-19 has exacerbated pre-existing inequalities, with reductions in scheduled surgery and oncological treatments, especially affecting women, older and less educated individuals.

Conclusions: For ensuring appropriate care, it is crucial to better understand how different factors, including physical and mental health morbidities, impact cancer diagnosis. The "NextGenerationEU" program and the "National Recovery and Resilience Plan" (PNNR in Italy) following the Covid-19 pandemic offer opportunities for reducing inequalities, improving cancer care and chronic disease management for ageing populations.

Background and aim: In Italy, the number of physicians decreased in recent years due to retirements not being replaced by young specialists. To address this shortage of medical personnel, proper planning is needed, taking into consideration the number of accesses in medical schools and residency contracts. The main objective of this study is to deepen the data on the number of physicians, provide a prospective picture and make some suggestions for future planning.  Materials and Methods: Estimates of the number of physicians, contracts, assignments, and abandonments for specialist schools are based on data from the General Medical Council, the Ministry of University and Research, Eurostat and the "Associazione Liberi Specializzandi".    Results: Estimates of the number of physicians for the period 2023-2032 predict the minimum availability of active doctors between 2028 and 2029. While there has been an increase in the number of contracts for residents in recent years, there are concurrently high dropout rates and non-assignment of contracts, varying across Schools of Specialization. An examination of the available data for the 39 Schools of Specialization in Hygiene and Preventive Medicine shows lower than-average abundance rates.  Conclusions: In recent decades, poor planning and early retirement have led to a shortage of doctors, particularly specialists, that will not be resolved until after 2030. Proposed solutions to this 'health emergency' include importing doctors from abroad, delaying the retirement age, recruiting junior doctors to the National Health Service and changing the distribution of junior doctor contracts.

Background and aim: Rolling reviews have been widely used by the scientific community during the COVID-19 pandemic to provide guidelines and identify potential treatments in such a quickly evolving emergency. Throughout the two pandemic years, we provided independent and continuously updated (rolling) e-learning courses on COVID-19 targeted to Italian healthcare professionals with the aim of increasing dissemination based on the emerging evidence. The results of this project are presented in this brief report.

Methods: We launched five main courses on COVID-19 - with focus on treatments and vaccines - from February 2020 to December 2022. For each course, we collected and analised participation data and, via questionnaires, customer-satisfaction data on relevance, quality, efficacy and sponsor perception.

Results: From 22 February 2020 to 31 December 2022, a total of 224,459 enrollments were registered over the five courses with 192,966 passes (86%), for which Continuing Medical Education (CME) credits were awarded. Over 94% of participants considered the contents of high quality, relevant and effective for their educational needs. The absence of sponsorship perception, 83% overall, decreased relevantly for the two courses on COVID-19 vaccines (68.3%).

Conclusions: Italian healthcare professionals working during the pandemic overwhelmingly appreciated and valued the rolling e-learning offer aimed at widening the dissemination of the best practices on COVID-19. This educational model provides independent, evidence-based and tailored information with the undoubted advantages of time flexibility, remote participation and continuous update, all elements that make it a useful tool in a pandemic as well as in a post-pandemic era.