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

Introduction: Measles is a highly contagious disease, but it is preventable through vaccination. Despite the availability of measles vaccines, outbreaks continue to occur, due to factors such as vaccine hesitancy. In Italy, measles vaccination has been mandatory since 2017.

Methods: This study analyses vaccination coverage trends to assess the impact of this mandatory vaccination policy at regionjqal, national, and European Union levels.

Results: Results show a significant increase in measles vaccination coverage within Italy following implementation of the mandate, both at the national (+5,2%) and regional levels. However, the comparison of European countries with and without mandatory vaccination policies did not reveal statistically significant differences in coverage.

Conclusion: This suggests that while mandatory vaccination can improve coverage within a nation, additional strategies may be needed to address vaccine hesitancy and achieve herd immunity across broader geographical areas.

Introduction: Long-COVID represents a clinical condition characterized by the inability of the patient who survived COVID-19 to regain the same state of health prior to the acute infection. Mindfulness-based stress reduction focuses on increasing awareness and acceptance of moment-to-moment experiences including difficult emotions and physical discomfort.

Objective: To examine the effects of a Mindfulness-based stress reduction intervention on the functional and psychosocial outcomes of Long-COVID patients.

Design: A two-arm randomized controlled trial with repeated-measures design.

Setting: Department of Anesthesia and critical care.

Participants: COVID-19 survivors (105 patients).

Methods: The patients were randomly allocated to either psychoeducation (intervention group) or usual care (control group) (53 vs 52 patients per group). A Mindfulnes program was implemented in the intervention group included an 8-week Mindfulnes-program (2 hours per week) in a group format. Study outcomes included Chronic pain (pain intensity and pain interference) assessed with Brief Pain Inventory (primary outcomes), Anxiety and Depression assessed with Hospital anxiety and depression scale, Insomnia assessed with the Insomnia Severity Index. Data were collected at 6 month and 12 months after Mindfulness-program.

Results: A reduction in pain intensity and pain interference on some activities of daily living were observed 6 and 12 months after intervention. A statistically significant difference emerged in the mean score of symptoms of anxiety in favor of the intervention group (11.28 vs 13.15, t= -3.636, p< .001) at 6 month and at 12 months (10.88 vs 13.41, t= -5.167, p< .001) and in the mean score of the symptoms of depression in favor of the intervention group (9.95 vs 11.23, t= -2.823, p= .007) at 6 month and at 12 months (9.67 vs 10.69, t= -2.458, p= .018). Symptoms of insomnia were statistically reduced 6 months after the Mindfulness-program (score: 53.2 vs 30.4, x= 4.944, p= .026).

Conclusions: In light of what emerged from our study, we suggest a Mindfulness program in addition to drug therapy to be carried out once a year on patients with consequences of COVID-19. Studies with larger sample sizes that attempt to test a Mindfulness-program twice a year are needed.

Background: Vaccine hesitancy is considered one of the top ten threats to global health by the World Health Organization due to the potential public health consequences. Since April 1, 2021, the Italian Government has made COVID-19 vaccination mandatory for healthcare workers. Those who refused to undergo vaccination were suspended from activities involving patient care. This study aims to describe vaccine hesitancy among nurses in the Marche Region one year after the start of the COVID-19 vaccination campaign.

Study design: Observational study.

Methods: All nurses belongijg to the National Federation of Nursing Professions Orders of the Marche Region were included in the study. Data from December 27, 2021, to January 1, 2022, were provided by the FNOPI Presidents of provincial FNOPI for Pesaro-Urbino, Ancona, Macerata and Fermo.

Results: Among the 9,611 registered nurses, 1.34% were suspended because they refused to be vaccinated. The majority of suspended nurses were women (73.6%), 35.7% aged 50-59 years, and 29.4% aged 40-49 years, 21.7% aged 30-39 years, 10.1% aged ≥60 years and 3.8% aged <30 years. Vaccination hesitancy exhibited a north-south gradient: in particular, there was a prevalence of 1.73% suspended workers in Pesaro-Urbino, 1.46% in Ancona, 1.05% in Macerata and 0.71% in Fermo province.

Conclusions: Our study confirms the existence of vaccine hesitancy among nurses. The mandate imposed by the Government favored a higher adherence compared to the general population in the Marche Region, although it failed to reach full coverage by the entire nursing staff.

Background: Funding sources play a critical role in shaping the landscape of scientific research, including the one in public health, as they often determine not only the feasibility of specific projects but also its broader directions.

Study design: We aimed at assessing current funding sources for public health research in Italy and related implications.

Methods: We conducted a systematic PubMed search from January 2023 to June 2024, focusing on publications by 208 Italian tenured professors in hygiene and public health. We included only original articles they authored as first or last authors, excluding editorials, comments, and letters. We categorized funding sources into public internal, public external, private external, and unmentioned.

Results: We retrieved 760 non-duplicate eligible publications. Research topics focused almost equally on communicable (48.2%) and non-communicable (51.8%) diseases. Public external funding were the most common overall (33.7%), followed by private external (14.3%) and public internal (7.5%). Notably, 58.7% of studies did not report any funding sources. Private external, regional and EU sources predominantly funded communicable disease research, while non-communicable disease research received more support from public external sources, especially governmental.

Conclusions: In a European country such as Italy the funding landscape in public health research appears to be complex, due to the wide range of topics and intertwined roles of funding actors. Public funding are more frequent than private funding also independently of research topics, though most research activities did not require specific financial support, implying that public health research frequently has limited financial needs. This likely enables more flexibility and independence to investigators in public health, with major implications in terms of feasibility and absence of conflicts of interest.

Background: Predicting the risk of progression to type 2 diabetes, as well as identifying the factors that increase this risk, helps the population adjust the modifiable risk factors, improve quality of life, and reduce the disease burden.

Subjects and methods: A cross-sectional study was conducted on 918 ethnic Khmer minority people aged 40 and above in Vietnam who had never been diagnosed with type 2 diabetes.

Objective: To predict the 10-year risk of type 2 diabetes, the Finnish Diabetes Risk Scoring Scale, adjusted for the Asian population with modification of the waist circumpherence and Body Mass Index Cut-Offs, was used.

Results: The 10-year predicted risk of progression to type 2 diabetes in ethnic Khmer people aged 40 years and older in southern Vietnam, using the Asian-modified Finnish Diabetes Risk Scoring Scale, resulted 10.54% in the total population study, females have a higher risk at 12.62% compared to 8.01% of males. Among the items that make up the Finnish Diabetes Risk Scoring Scale, age, waist circumference, BMI, family history of diabetes, history of high blood glucose, and use of blood pressure medication were the most accurate predictors, with the area under the Receiver operating characteristic (ROC) curve at 0.83, 0.81, 0.77, 0.75, 0.74 and 0.73 respectively. The optimal cut-off score to identify progression to tipe 2 diabetes was 13.5 points (Se = 1.00, Sp = 1.00, p < 0.001). The multivariable logistic regression model shows that factors associated with high risk of type 2 diabetes progression in 10 years are age, gender, occupation, economic status, education level and regular alcohol consumption (p < 0.05). The study results provide a basis for proposing potential solutions to reduce modifiable risk factors for type 2 diabetes in the population. These include providing culturally appropriate health education and changing behavior to address alcohol consumption.

Discussion and conclusions: The use of the Asian-modified Finnish Diabetes Risk Scoring Scale to predict the risk of progression to type 2 diabetes and as a screening tool for undiagnosed type 2 diabetes is appropriate for the Vietnamese Khmer population.

Background: During the COVID-19 pandemic, telemedicine had the opportunity to demonstrate its potential. In Italy, after an initial period of mistrust, it became clear that remote medicine can provide significant benefits for both healthcare professionals and patients. In the Local Health Unit of Modena (Emilia Romagna region, Northern Italy), great importance was placed on developing, promoting, and managing all telemedicine activities. In particular, it was decided to prioritize the activation of tele-visit services in accordance with the guidelines of the Emilia-Romagna region.

Study design: This case study aims to illustrate the activities planned and developed at the Local Health Authority of Modena for the implementation of the first service of this kind, the tele-visit service for outpatients suffering from type 1 diabetes mellitus, and to analyze data from the first 12 months of activity (from May 2023 to April 2024) to share reflections on the strengths and critical points encountered.

Method: For the activation of tele-visits at the Local Health Authority of Modena, a dedicated working group was established with the mandate to manage all clinical, organizational, and IT aspects. Before starting the service, various preliminary activities were carried out, including selecting the clinical specialty to be activated, defining patient inclusion criteria, implementing IT systems, assessing clinical risks, preparing and distributing information materials, training healthcare personnel, and planning outpatient activities.

Results: During the first year of experimental activation of the service (May 2023-April 2024), a total of 72 patients were enrolled in the project, with 103 tele-visits provided. The patients were predominantly women (67%), and the most represented age groups were 30-39 (26%) and 40-49 (21%). Half of the specialists in the Diabetology Service (9/19) participated in the initiative by providing tele-visits, most of whom were young and all of whom were women. The main issues identified through regularly scheduled meetings with professionals, to which the working group is seeking the most appropriate solutions, include poor adherence by many patients who still have doubts about this modality, the habit of many patients rescheduling appointments multiple times, a habit not diminished by this visit method, the non-uniform adherence of professionals, and uneven territorial diffusion of the service. Lastly, professionals reported various IT difficulties. Although the number of tele-visits was not high, the initiative has sparked the interest of several specialists, some of whom have already proposed activating other telemedicine services, with some even suggesting innovative new projects. The next steps will involve extending diabetes monitoring to pregnant women with gestational diabetes and developing tele-visit services for endocrinology, neu

Background: Foodborne diseases are a major global public health concern, causing significant morbidity and mortality worldwide. The COVID-19 pandemic has had widespread effects on various aspects of life, including the food supply chain, potentially impacting the incidence of foodborne diseases. This study aims to analyze the differences between notified and diagnosed cases and investigate the potential impact of the COVID-19 pandemic on foodborne diseases in the metropolitan area of Bologna, Italy.

Study design: A retrospective time trend analysis from two databases was conducted.

Methods: The Local Health Authority of Bologna collected data re/Emilia-Romagna Region on the infectious disease reporting system over a six-year period (2017-2022), which included three years of the COVID-19 pandemic. This data was compared with information collected during the same period at the microbiology laboratory serving the entire metropolitan area of Bologna. Statistical methods included percent change calculations, binomial tests, annual averages, gender and age stratification, and trend analysis with regressio.

Results: An increase (+34.4%, P-value ≤ 0.01) in notified cases during the pandemic - compared to the pre-pandemic period - was found. However, no differences were observed in diagnosed cases when comparing the two periods. The year 2021 saw a significant increase in reported cases of foodborne diseases among schoolers (+300.0%) and workers (+133.3%) compared to 2020. On the other hand, diagnosed cases decreased significantly in 2020 (-19.1%, P<0.01) and increased in 2021 (+21.9%, P<0.01). In absolute terms, a stark difference was observed between notified and diagnosed cases across all the study years (2017-2022).

Conclusions: This study highlights the discrepancy between notified and diagnosed cases of foodborne diseases and how the COVID-19 pandemic has increased reporting without affecting transmission. These findings contribute to the ongoing discussion on improving foodborne disease reporting systems.

Background: The analysis of the complex interactions between outdoor or indoor greenness and the health of individuals and ecosystems is a topic of current and growing interest.

Study design: This review aims to examine and summarise the results of studies conducted to evaluate the effects of exposure to greenness on various aspects of human health and the natural environment.

Methods: For this purpose, in April 2024 we searched PubMed, Web of Science, and Scopus databases, Google Scholar and specialised books.

Results: Evidence gathered demonstrates a remarkable correlation between exposure to outdoor and indoor greenness and the improvement of mental health, including the reduction of stress, anxiety, and depression. Contact with greenness is also associated with improvements in physical health, such as reductions in blood pressure, heart rate, and inflammation, as well as in cognitive abilities, concentration, and overall recovery. These benefits are recognisable both in outdoor spaces, such as urban parks, oases, and public gardens, and in indoor spaces, through the introduction of plants and nature-evoking elements in living and working environments. The presence of vegetation in indoor environments, such as offices, schools, healthcare facilities, prisons, and others, can contribute to improving the quality of social spaces, fostering communication, and collaboration, and attenuating aggressiveness and inequalities, thereby increasing employee satisfaction and work efficiency. The combination of outdoor/indoor green spaces and the well-being of the living environment includes exposure to greater biodiversity, mitigation of extreme weather events, absorption of atmospheric pollutants, attenuation of urban background noise, and increased privacy. The presence of vegetation in urban areas has a positive impact on social cohesion, promoting interpersonal interaction and facilitating the development of more cohesive and inclusive communities, thus supporting a sense of belonging and collective identity.

Conclusions: In conclusion, these results underline the importance of considering contact with greenness as a fundamental element in promoting the psychophysical health and well-being of individuals and ecosystems, suggesting the adoption of nature-based therapies and interventions in public health policies and urban planning practices.