Annali di igiene : medicina preventiva e di comunita最新文献

Objectives: To standardize a questionnaire about drug dispensers' attitudes and behaviors in dispensing antibiotics without prescription, and to evaluate drug dispensers' attitudes, behaviors, and relevant factors in dispensing antibiotics without prescription at community pharmacies in Can Tho City, Vietnam.

Methods: A descriptive cross-sectional study was conducted among community pharmacists in Can Tho City, Vietnam from June to December 2022. A self-administered questionnaire designed according to the Theory of Planned Behavior was used for data collection. The questionnaire was composed of 33 statements scored on the 5-point Likert scale, which was completed by interviews with 180 pharmacy dispensers to Can Tho. Exploratory Factor Analysis was also utilized to uncover major determinants of dispensing antibiotics without prescription.

Results: Of the 180 participants, 65% of drug dispensers were female (n=117), 59.4% were university graduates (n= 107), and 80.6% had experience of less than 10 years (n=145). A pharmacy is the first destination people think about when they have a health issue. Unfortunately, dispensing antibiotics without a valid prescription is not in compliance with governmental regulations. In the study, perceived behavioral control factors were found to be the most critical determinants of the behavior, followed by subjective norms. By contrast, attitudinal factors presented no impact on intention to dispensing antibiotics without prescription.

Conclusions: The provision of non-prescription is primarily influenced by the perception of the distributors and external factors. Developing interventions is necessary to increase public awareness of the misuse and misunderstanding of antibiotics.

Introduction: Work-related psychosocial risks have been identified as significant occupational health and safety risks; the occupational physicians must assess and monitor the health status of workers in order to verify that work is not a source of harm to exposed operators. The aim of the study was to investigate the outcomes related to anxiety and depression traits in workers exposed to stress-related work.

Methods: A questionnaire was administered to a large population of Italian public administration workers; the Centre for Epidemiologic Studies - Depression Scale questionnaire was used to measure depression, the Self rating Anxiety Scale was used to measure anxiety, the UK Management Standards Indicator tool questionnaire was used to assess work adjustment. A descriptive analysis, a multivariate analysis, as well as logistic regression models were used to assess the health outcomes related to stress.

Results: A total of 292 workers participated in the study; 100% of participants had a Centre for Epidemiologic Studies - Depression Scale score over the cut-off; 41.78% had a Self rating Anxiety Scale score over the cut-off; the results support a correlation between the Centre for Epidemiologic Studies - Depression Scale results and the UK Management Standards Indicator tool results; and a correlation between Self-rating Anxiety Scale results and the UK Management Standards Indicator tool results.

Conclusions: The Demand, Management, Support and Relationship results were associated with mental health outcomes, and it could be a useful tool in occupational medicine, to identify workers at risk for negative mental health outcomes, becoming an essential tool in workers' health assessment and for prevention of mental health disorders.

Background: A pilot study conducted in academic 2017/18 among undergraduates of the University of Sarajevo showed energy drinks to be most frequently consumed during academic activity, less frequently mixed with alcohol in leisure, and rarely in the sports activity. The aim of this study was to assess the impact of the COVID-19 pandemic on energy drinks consumption among undergraduates of the same University, with a focus on their consumption during exams.

Study design: A cross-sectional study was conducted by an online questionnaire.

Methods: The questionnaire, mainly based on the Consortium Nomisma-Areté questionnaire, was customized to compare energy drinks consumption before and during the COVID-19 pandemic, and distributed among students between July 26th, 2020 and April 3rd, 2021.

Results: Out of 1,045 students who chose to participate in the study (participation rate of 14.7%), 653 students, mostly women, attending the lower study years, reported energy drinks consumption. Both be-fore and during pandemic, overall energy drinks consumption was most frequently reported as rare [281 (43.9%) before, 326 (51.2%) during the pandemic], and exams-related energy drinks consumption as once or twice a week [156 (43.8%) before, 130 (42.1%) during pandemic]. The pandemic increased the number of frequent consumers (consumption of 4-5 energy drinks per week) in both overall [35 (5.5%) before, 46 (7.2%) during pandemic] and exams-related energy drinks consumption [42 (11.8%) before, 48 (15.5%) during pandemic]. Study year (OR=0.842; 95% CI 0.77-0.921; p<0.001), being single and living alone [OR=0.512; 95% CI 0.296-0.883; p=0.016), or living with a partner and children [OR=0.377; 95% CI 0.168-0.847; p=0.018) were identified as negative independent predictors for exams-related energy drinks consumption, while being a regular smoker (OR=0.429; 95% CI 0.223-0.875; p=0.011) appeared its new negative independent predictor during pandemic.

Conclusions: The pandemic seemed to decrease both the overall and exam-related energy drinks consumption among undergraduates of the University of Sarajevo with the exception of a portion of already frequent energy drinks consumers.

Background: Critically ill patients may develop health problems related to their illness, injury, mechanical ventilation or other treatments. Such problems cannot be totally prevented and can continue after the patient leaves the hospital.

Aim: To explore the level of anxiety, depression, post-traumatic stress Intensive Care Unit and quality of life in Intensive Care Unit survivors. A comparison analysis between Covid-19 patients and Non-Covid-19 patients was conducted.

Methods: A prospective observational study exploring psychological, emotional, and behavioral difficulties experienced in patients admitted to Intensive Care Unit was performed. The study was conducted in an Italian adult 8-bed Intensive Care Unit, from July 2020 to April 2021, and followed-up until 25th May 2022. Data were collected during Intensive Care Unit stay (data collection of demographic and clinical characteristics) and 6 and 12 months after Intensive Care Unit discharge (interviews).

Results: A total of 143 patients participated in the study, of which 54 were admitted for Covid-19 (37.76%). Depression symptoms were observed more among Non-Covid-19 patients compared to Covid-19 patients at six months (p= .037) and 12 months (p< .001) after Intensive Care Unit discharge. The quality of life perceived by the Intensive Care Unit patients surveyed improved between 6 and 12 months after discharge (Eq-VAS mean=62.03, + 11.2 vs Eq-VAS mean=66.6, + 9.8) (p=.034). Six months after Intensive Care Unit discharge, the mean of the perception of quality of life, for Covid-19 patients was 63.91 (sd ± 9.30), greater than Non-Covid-19 patients of the same period, which was 60.18 (sd ± 8.63) (p= .038).

Conclusions: Within 1 year from the acute infection, most hospital survivors of Covid-19 had good physical and functional recovery over time with better outcomes than other Intensive Care Unit patients and had returned to their original work and life.

Introduction: Lay training is essential to manage emergencies properly, although patients or bystanders need increased recognition of medical urgencies such as strokes. In Italy, as defined by Legislative Decree 81/08, all companies must train employees responsible for correctly recognizing and managing medical emergencies. Our study aims to evaluate the characteristics of medical emergencies concerning patients with a possible stroke in the Lombardy Region.

Methods: A retrospective observational study was conducted. All missions performed by Regional Agency for Emergencies and Urgencies (Agenzia Regionale Emergenza Urgenza - AREU) in which the patient presented a possible stroke, recorded in the SAS-Areu database, were analyzed. The study period was from January 1, 2019, to December 31, 2019.

Results: 10,201 patients with possible stroke were rescued, of whom only 540 (5.3%) occurred in workplaces. In workplaces, the percentage of males with a possible stroke was higher (62.2% vs 45.2%; p<0.01) and the mean age of rescued patients was lower (64.7 vs 77.5; p<0.01).

Conclusions: A stroke occurs less frequently in the workplace, while most events occur at home. Man-datory training on early stroke recognition should be extended to schools and conveyed through a media information campaign. Lay training is the first point in the chain of survival; redefining training is critical for the future.

Background: Microbial contamination of food and beverages is a topic of great interest. The most innovative technologies take advantage from UV light. This study aimed to evaluate a possible configuration of a nUV LED device at a wavelength of 405 nm installed on slush machines in order to reduce the microbial contamination.

Study design and methods: Study Design and Methods. The study was conducted in the Department of Molecular and Developmental Medicine, University of Siena, Italy. A nUV LED device with 408 nm wavelength was installed and used on the slush machines. The inner walls of the machine tanks were fouled with contaminated slush, to evaluate the effectiveness of nUV radiation in reducing microbial contamination over time.

Results: Experiment results on the slush machine showed a statistically significant logarithmic microbial reduction, in relation with the distance from the nUV LED light source. It has also been shown that the reduction of microbes is possible with a proper management of some parameters: the exposure time, the power and wavelength of the light source, the distance and the obstacles between the light source and the target to be irradiated.

Conclusion: To reduce the incidence of foodborne diseases it is necessary to take all necessary precautionary measures, and the use of nUV technology has proved to be a crucial element in achieving this goal.

Abstract: In October 2022, the European Commission released a draft of a new Directive aimed at securing more effective control and prevention of outdoor air pollution in Europe through the recasting and update of previous European legislation. The proposal is intended to reshape the current regulations in the field within the EU and its implementation at the Member State level and achieve lower air pollution in light of the recent advancements in environmental health and novel indications in the field from the World Health Organization. In addition, the proposed Directive provides a legal framework for air pollution control that falls within the wider legal context of the EU Green Deal and NextGenerationEU initiatives. The new rules are also remarkably consistent with corresponding and updated US regulations, though stricter in terms of air pollution control and more open to interactions with local authorities. In sum, the proposed EU Directive appears to take better stock of the emerging scientific evidence on the adverse effects of air pollution and may provide an effective legal instrument for adequate public health protection.

Background: Tuberculosis is a widespread communicable disease, which is one of the top 10 causes of demise globally. Several regression models have been built, and then utilized for the Tuberculosis incidence projections. However, when fitting a multiple linear regression model, an analysis must account for multicollinearity aspects. The present study aimed to develop a parsimonious model that produces unbiased results based on socioeconomic variables as predictors of Tuberculosis incidence.

Study design: Ecological study.

Methods: Data were collected from the Karaganda Regional Center of Phthisio-pulmonology and Bureau of National Statistics. By multiple linear regression model, we investigated associations between Tuberculosis incidence rate and socioeconomic determinants in Karaganda region, Kazakhstan, during 2001-2019. A Principal components analysis was performed on the socioeconomic variables with oblique rotation. Furthermore, associations of Tuberculosis incidence with the principal components derived from the Principal components analysis were assessed.

Results: The incidence of Tuberculosis in Karaganda region decreased over the period of 2001-2019. Economic development and healthcare capacity were negatively correlated with Tuberculosis incidence. A multiple linear regression equation on Tuberculosis incidence (y) was developed with economic development (x1) and healthcare capacity (x2) clustering two components (utilizing Principal components analysis) to eliminate collinearity: y = 1442 - 454.3x1 - 211.4x2. The incidence of Tuberculosis decreased with the increase of economic development and healthcare capacity.

Conclusions: In conclusion, the study indicated that economic development and healthcare capacity are closely associated with the incidence of Tuberculosis. The findings support the implementation of optimal preventive measures for Tuberculosis control, including improving the level of economic status, increasing social protection, health expenditure, and strengthening health sector capacity, which are key determinants of the incidence of Tuberculosis.

Background: Nowadays, two types of anti-pneumococcal vaccine are available: pneumococcal 13-valent conjugate vaccine (PCV13), first licensed in the United States (US) in 2013, and pneumococcal 23-valent polysaccaridic vaccine (PPSV23), first licensed in the US in 1999. These vaccines are recommended in Italy for the immunization of newborns and of the elderly, using a combined sequential schedule for the latter. This report aims to describe the PCV13- and PPSV23-related AEFIs notified in Puglia in 2013-2020, in order to design these products' safety profile in a real-life scenario, three years after the official recommendation about the sequential schedule for people over 60 years of age.

Methods: This is a retrospective observational study. Data were gathered from the list of AEFIs notified following PCV13 and PPSV23 administration in Puglia in 2013-2020. The number of administered vaccine doses was obtained from the regional immunization database. AEFIs were classified according to WHO's algorithm, and causality assessment was carried out in case of serious AEFIs.

Results: From January 2013 to December 2020, 764,183 doses of PCV13 and 40,382 doses of PPSV23 were administered in Puglia. In the same period, 71 PCV13 AEFIs (Reporting Rate: 9.29 x100,000 doses) and 5 PPSV23 AEFIs (Reporting Rate: 12.4 x100,000 doses) were reported. The overall male/female ratio in AEFIs was 0.85. The majority of AEFIs occurred in subjects aged less than 2 (64/76, 84.2%), while 10 out of 76 (13.2%) occurred in patients aged 60 or older. 22 AEFIs were classified as serious and for 12 (54.5%) causality assessment showed a consistent relationship with immunization. The most commonly reported symptoms were fever (Reporting Rate: 4.72 x100,000 doses) and neurological symptoms (Reporting Rate: 3.23 x100,000 doses). Only one death was notified, classified as non-vaccine-related.

Conclusions: The benefit of pneumococcal vaccination appears to be greater than the risk of AEFIs for both PCV13 and PPSV23. In fact, AEFIs occur in less than 0.1‰ of patients and the majority of AEFIs are mild and self-limiting.