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

Abstract: Schools continue to represent one of the main settings that guarantee health promotion interventions, as it has been widely demonstrated in numerous fields that diet and eating habits are shaped in the early stages of life and maintained into adulthood. Through the food education promotion project, "Healthy Snack", implemented by the Prevention Department of the Local Health Authority ULSS 1 Dolomiti, the interventions carried out by healthcare workers have been evaluated over time to measure their effectiveness in terms of changes in eating habits considered incorrect, with a particular focus on snacks eaten at school.

Background: Firearm-related deaths are an issue of ongoing public interest, from a health and economic perspective. Worldwide, firearm prevalence in suicides varies widely, depending on multiple factors including the availability of weapons in each country. Although several studies have shown that national laws about gun ownership, reducing legal access to guns, decrease the risk of suicide by firearm, the current situation clashes with widely differing legislations.

Study design: Retrospective study on a forensic case series.

Methods: Autopsy reports assessed at the Section of Legal Medicine of Milan (Italy) from January 2014 to December 2023 were retrospectively documented. Only firearm suicides were considered. For each case, a close analysis of the criminal offence reports has been performed to obtain information about the gender and age of the victim, as well as the legal possession of firearms, psychiatric disorders, alcohol, and illicit drug abuse.

Results: Among all the 1,164 suicides assessed at the Section of Legal Medicine of Milan over a 10-year-period, 101 cases (8.7%) were firearm-related. The male to female ratio was therefore about 13:1. No seasonal trends were observed. Most of the individuals owned the firearm license. Of the entire dataset, 35.6% suffered from psychiatric disorders, 4% of alcohol abuse and 2% of drug addiction. Among the owners of a firearm license, 42.3% had psychiatric disorders.

Conclusions: Knowledge about firearm suicide and its relation to firearm legal possession is limited and current preventive laws should be reconsidered. Present administrative and clinical examinations required to obtain a firearm license in Italy and in some European territories are dealt with. The evaluation of the firearm-related risk of abuse is an essential but complex procedure, which requires not only clinic-anamnestic data but also in-deep psychiatric information. There is a need to develop and reinvigorate a debate that currently presents very heterogeneous solutions, but which would probably benefit from a common vision of the prevention strategies that can be implemented and enacted for the benefit of the entire community.

Abstract: Vaccination coverage are generally geographically variable, even within large cities; furthermore, across target population are embedded difficult-to-reach clusters. To address this issue and improve coverage of mandatory vaccinations, a study group explored bringing vaccination at home as an interventional strategy. In a pilot experience, parents of unvaccinated and under vaccinated children of the 2020 birth cohort living in Naples, Italy were contacted by telephone to offer home administration of vaccinations. A specifically trained team arranged vaccinations visits at home. Coverage rates were evaluated at baseline and one month after the intervention strategy. A significant positive increase in hexavalent vaccine (+1.43%) and measles-mumps-rubella (+1.85%) coverage was registered despite the short duration of the pilot program. Home vaccination turned out to be a medical resource consuming but feasible and successful strategy to increase mandatory vaccinations coverage among the most difficult-to-reach and fragile segments of the pediatric population.

Background: In the past years, migration has increasingly affected the European continent. The concerns of the local population about infection spread by migrants may increase as an unjustified stigma. Our study aimed to assess the knowledge and risk perception of infectious disease associated with migration among university students.

Methods: Between January and February 2020, we conducted an online survey in Italian and Spanish University students. We collected data on demographics, perception, and knowledge of infectious diseases associated with migration. We performed descriptive and risk factors analysis to assess the association among selected variables.

Results: We collected 1,397 answers, 73.16% from Italian students and 26.84% from Spanish students, 34.54% and 38.67% enrolled in healthcare degrees, respectively. We found a statistically significant correlation between the knowledge of infectious diseases and the perception of the infectious risk associated with migration, not confirmed for the area of study. Healthcare students had the best levels of knowledge and perception of the migratory phenomenon, but the higher perception of infectious risk. Exposure to the media coverage about migration was associated with the worst perception of the migratory phenomenon and infectious risk.

Conclusion: Our study showed that, despite healthcare students had the best levels of knowledge, they had the highest risk perception of infectious diseases associated with migration. The inclusion of courses on migration medicine in current healthcare curricula and the increase of practical training could help to avoid the development of biased approaches towards migrants among healthcare professionals.

Abstract: Disinfection practices in dental settings are fundamental to clinical safety, playing a pivotal role in preventing cross-infections and protecting the health of patients and healthcare professionals. This article examines the key components of effective disinfection, based on evidence-based protocols developed by international organizations such as the WHO and the U.S. CDC, alongside European and Italian regulatory standards. Dental instruments require stringent sterilization by autoclave or chemical methods, while high-level disinfection is essential for non-sterilizable items. Clinical surfaces require routine biocidal treatment tailored to microbial hazards and material compatibility. The European Biocidal Products Regulation and the Medical Devices Regulation provide critical oversight, ensuring product safety and effectiveness while preventing resistance. Antiseptics also play a vital role in oral care, with applications ranging from infection prevention to the treatment of periodontal disease, and are governed by strict regulatory frameworks. Disinfection effectiveness is significantly affected by factors such as microbial load, presence of biofilm, pH, temperature and biocide exposure time. Preventing bacterial resistance requires appropriate germicide selection, adherence to manufacturer protocols, robust sterilization and cleaning procedures. In addition, the increased use of disinfection during public health emergencies highlights the need for adaptability to mitigate evolving risks. Regular audits, biological tests, and training for healthcare personnel ensure the consistent application of these rigorous protocols. By integrating international and national standards, dental facilities achieve a uniform approach to hygiene and safety, advancing public trust and compliance. This article highlights the imperative for ongoing research and dissemination of best practices to enhance infection control in dental care environments.

Background: Ramadan fasting is a religious observance practiced regularly by Muslims and may have an effect on sleep quality, especially for athletes. Our systematic review with meta-analysis aims to identify the effect of Ramadan observance on the sleep patterns of athletes and non-athletes during Ramadan fasting over the teen years (2014-2024).

Study design: A systematic search of Scopus, Web of Science, and Pubmed, was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses.

Methods: After a deep search in the three databases, we downloaded all the references that respected our request. all the references were imported into the COVIDENCE platform. Two independent researchers were designated to look for the criteria inclusion and to appraise each study. A third reviewer resolved conflicts if there is a divergence of judgment. Then, we obtained an Excel file that compiles all the data collected. The meta-analysis and meta-regression were compilated.

Results: 345 documents were found. Of these, 14 respected all the criteria. Our findings revealed that while sleep latency and di-sturbance remained unaffected by Ramadan, sleep duration and efficiency were negatively impacted, particularly among amateur athletes. Interestingly, the overall sleep quality, daytime dysfunction, and subjective sleep quality showed a positive impact from Ramadan, which was more evident among amateur athletes.

Conclusions: In the context of Ramadan fasting, these results suggest that Ramadan has a negative impact on the sleep patterns of athletes and non-athletes.

Introduction: Respiratory syncytial virus is a leading cause of respiratory hospitalisations in infants. This systematic review (registration number: CRD42021248309) aims to synthesise the available evidence on Respiratory Syncytial Virus-related hospitalisations among children aged 0 to 6 years in Italy.

Methods: The literature search was conducted on PubMed, Embase, Scopus, and International HTA, covering the period from January 2000 to July 2022, with a focus on studies that reported information on Respiratory Syncytial Virus-associated hospitalisation in children aged 0-6 years in Italy.

Results: Eight articles were included after screening 20,845 records. These retrospective studies reported that most hospitalisations were among those <1 year (71.5%-88.8%), infants aged <1 year were also at higher risk of hospitalisation in intensive care unit. Respiratory Syncytial Virus infections typically peaked December-February, with an atypical early start in August 2021. Subtype analysis showed alternating prevalence of Respiratory Syncytial Virus-A and Respiratory Syncytial Virus-B across different seasons. Coinfections were not uncommon (1.1%-37.4%), with rhinovirus and bocavirus being the most frequent.

Conclusions: All infants at their first Respiratory Syncytial Virus season showed an increased risk of severe infection and hospitalisation, regardless of the gestational age at birth, compared to older participants. This systematic review will enrich the understanding about Respiratory Syncytial Virus disease and help support decisions regarding prevention efforts in Italy.

Background: Pulmonary embolism poses a global health concern. Administrative databases serve as valuable sources for broad epidemiological studies on the prevalence and incidence of major diagnoses or diseases. The primary scope is to provide up-to-date insights into Pulmonary Embolism incidence trends, examining shifts in management and outcomes.

Design: This retrospective observational study examines a 12-year dataset from hospitals in the Tuscany Region, covering the first two years of the Covid-19 pandemic.

Methods: Administrative data from residents aged 18 and older discharged from hospital between 2010 and 2021 were used for the analysis.

Results: Hospitalized pulmonary embolism incidence slightly declined from 2010 to 2019 (64.7 to 60.9 x 100,000; p=0.152). Males under 75 showed a higher incidence rate, while females had higher incidence rates in older age groups. In-hospital and 30-day mortality decreased from 2010 to 2019 (p=0.001 and 0.020 respectively). In 2020, 30-day mortality increased (12.4% vs 10.1%, p=0.029), while in-hospital mortality remained stable. One-year mortality was stable from 2010-2019 but increased in 2020 (32.6% vs 29.4%, p=0.037). Considering the multivariable model, one-year mortality is significantly associated with sex, age, and comorbidities.

Conclusions: Our study shows that Pulmonary Embolism persists as a relevant burden in Tuscany region, but with improvements in management over the past decade and a decisive change in pharmacological treatment. Gender-related differences emerge, highlighting the need for a gender-specific healthcare approach.

Background: The surgical pathway represents a fundamental process in hospital productivity, and its digitalization is a major focus for hospital management. ASL Roma 1 health authority has taken up this digitalization challenge by introducing an Operation Room Management (ORM) system within the operating block of one of its hospital facilities in 2022.

Study design: Interrupted Time Series analysis.

Methods: To evaluate the impact of Operation Room Management system adoption, data on surgery were collected from all inter-ventions performed during two periods: January-June 2019 and January-June 2023. Analysis of the Operation Room Management system utilization rate since its introduction was performed, to estimate staff adaptation to the new software.

Results: As of June 2023, paper-registered interventions were 9%, nearing 100% for elective procedures only. The difference between the average intervention times was significantly in favor of the Operation Room Management cohort when restricting the analysis to Orthopedics (-9.02 minutes, p=0.006) and Surgery (8.47 min, p = 0.03). There was a modest but significant impact of Operation Room Management on the 'entering Operation Room to Incision' time (5 min, p < 0.01).

Conclusion: Overall, the adoption of the Operation Room Management did not worsen process outcomes. Operation Room Mana-gement offers advantages in real-time data quality, integrated with territorial and hospital platforms, contributing to a favorable cost-benefit assessment of digitalization.