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Infectious risk profile and strategies for prevention and control of outbreaks in refugee, asylum seekers and migrant populations in EU/EEA countries: a systematic narrative review of evidence. 欧盟/欧洲经济区国家的难民、寻求庇护者和移民群体的传染病风险概况和疫情防控策略:对证据的系统性叙述性回顾。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-03-28 DOI: 10.7416/ai.2024.2610
Francesco Paolo Bianchi, Daniel Fiacchini, Emanuela Maria Frisicale, Renata Gili, Stefano Greco, Stefano Guicciardi, Matteo Riccò, Salvatore Zichichi, Nunzio Zotti, Silvio Tafuri

Introduction: The recent surge in migration to and within the European Union and European Economic Area has brought the development of migration policy, including health policy, to the forefront of regional priorities. While migrants, in general, do not pose a health threat to the host population, specific subgroups of migrants, including refugees, asylum seekers, and irregular migrants, are particularly vulnerable to infectious diseases. To support public health policies in this area, the Emergency Preparedness and Management' working group of the Italian Society of Hygiene, Preventive Medicine and Public Health has conducted a systematic narrative review with the aim to comprehensively analyze the infectious disease risk within the refugee and asylum seeker populations in EU, EEA, and EU-applicant countries.

Methods: Forty-two studies were systematically selected from scientific articles in the MEDLINE/PubMed database from January 1, 2008, to June 1, 2023. The infectious risk associated with each infectious disease among refugees and asylum seekers, as well as the strategies to prevent and control outbreaks, was collected from all available studies.

Results: The congregate living conditions in refugee camps, transit centers, and temporary housing facilities make this population particularly vulnerable to infectious diseases. As such, implementing stringent hygiene and preventive measures is critical to safeguarding the health of refugees and reducing the risk of outbreaks that may affect both the refugee population and the host communities.

Conclusion: Effective vaccination and preventive strategies for migrants, refugees, and asylum seekers are vital for public health and the well-being of these populations. They should be delivered as part of universal health care. By addressing barriers and implementing tailored programs, we can ensure equitable access to vaccines and protect the health of these vulnerable individuals.

导言:最近,向欧洲联盟和欧洲经济区移民的人数激增,包括卫生政策在内的移民政策的制定已成为区域优先事项的重中之重。虽然移民一般不会对东道国人口的健康构成威胁,但包括难民、寻求庇护者和非正常移民在内的特定移民亚群特别容易感染传染病。为了支持这一领域的公共卫生政策,意大利卫生、预防医学和公共卫生学会的 "应急准备和管理 "工作组进行了一项系统的叙述性综述,目的是全面分析欧盟、欧洲经济区和欧盟申请国的难民和寻求庇护者群体的传染病风险:从 2008 年 1 月 1 日至 2023 年 6 月 1 日的 MEDLINE/PubMed 数据库中的科学文章中系统地选取了 42 项研究。从所有可用研究中收集了难民和寻求庇护者中每种传染病的相关传染风险,以及预防和控制传染病爆发的策略:难民营、转运中心和临时住房设施的集中居住条件使这些人群特别容易感染传染病。因此,实施严格的卫生和预防措施对于保障难民的健康、降低可能影响难民和收容社区的疾病爆发风险至关重要:结论:针对移民、难民和寻求庇护者的有效疫苗接种和预防战略对于这些人群的公共卫生和福祉至关重要。应将其作为全民医疗保健的一部分。通过消除障碍和实施量身定制的计划,我们可以确保公平地获得疫苗并保护这些弱势群体的健康。
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引用次数: 0
Vaccine hesitancy in South Tyrol: a narrative review of insights and strategies for public health improvement. 南蒂罗尔州的疫苗犹豫症:对公共卫生改进的见解和策略的叙述性回顾。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-09-01 Epub Date: 2024-03-28 DOI: 10.7416/ai.2024.2625
Christian J Wiedermann, Verena Barbieri, Barbara Plagg, Giuliano Piccoliori, Adolf Engl

Introduction: This review examines vaccine hesitancy in South Tyrol, Italy, a region characterized by cultural and linguistic diversity. The critical need for vaccination to control infectious diseases contrasts with the region's low vaccination rates, which pose a significant public health challenge.

Methods: Based on literature, reports, and studies, we used PubMed, Embase, and Google Scholar to explore vaccine hesitancy in South Tyrol. It emphasizes the analysis of historical, cultural, and socioeconomic factors, and focuses on quantitative surveys and qualitative interviews to understand the roots of vaccine hesitancy.

Results: In two studies with four reports, mistrust in health policies and institutions, misinformation, and cultural and linguistic barriers were identified as key factors contributing to vaccine hesitancy in South Tyrol. These factors are accentuated by the region's unique sociopolitical landscape, which influences public health policies and vaccination initiatives.

Conclusions: These findings highlight the need for public health strategies specifically tailored to South Tyrol. Recommended actions include developing culturally sensitive and multilingual communication campaigns, increasing community involvement, and rebuilding trust in healthcare systems. These approaches are essential for addressing the specific challenges in South Tyrol, thereby improving vaccine uptake and overall public health outcomes.

导言:这篇综述探讨了意大利南蒂罗尔地区的疫苗接种犹豫问题,该地区的文化和语言具有多样性。控制传染病对疫苗接种的迫切需求与该地区较低的疫苗接种率形成了鲜明对比,这对公共卫生构成了重大挑战:根据文献、报告和研究,我们使用 PubMed、Embase 和 Google Scholar 探索了南蒂罗尔的疫苗接种犹豫症。它强调对历史、文化和社会经济因素的分析,并侧重于定量调查和定性访谈,以了解疫苗犹豫不决的根源:在两项研究的四份报告中,对卫生政策和机构的不信任、错误信息以及文化和语言障碍被认为是导致南蒂罗尔人对疫苗犹豫不决的关键因素。该地区独特的社会政治环境影响了公共卫生政策和疫苗接种措施,从而加剧了这些因素:这些研究结果突出表明,有必要制定专门针对南蒂罗尔的公共卫生策略。建议采取的行动包括开展具有文化敏感性的多语言宣传活动、加强社区参与以及重建对医疗保健系统的信任。这些方法对于应对南蒂罗尔州的具体挑战,从而提高疫苗接种率和整体公共卫生成果至关重要。
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引用次数: 0
Predicting the risk of type 2 diabetes: Standardized diabetes risk score among the Khmer ethnic minority in Vietnam. 预测罹患 2 型糖尿病的风险:越南高棉少数民族的标准化糖尿病风险评分。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-08-29 DOI: 10.7416/ai.2024.2652
Tuyen Thi Hong Nguyen, Lam Phuc Duong

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.

背景:预测发展为2型糖尿病的风险,并确定增加这种风险的因素,有助于人们调整可改变的风险因素,提高生活质量,减轻疾病负担:对越南 918 名 40 岁及以上从未确诊为 2 型糖尿病的高棉少数民族进行了横断面研究:为了预测 2 型糖尿病的 10 年风险,采用了芬兰糖尿病风险评分表,并根据亚洲人群的情况对腰围和体重指数临界值进行了调整:结果:使用经亚洲人调整的芬兰糖尿病风险评分量表,越南南部 40 岁及以上高棉族人群 10 年内罹患 2 型糖尿病的预测风险为总人口的 10.54%,女性的风险较高,为 12.62%,而男性为 8.01%。在芬兰糖尿病风险评分量表的各项指标中,年龄、腰围、体重指数、糖尿病家族史、高血糖史和使用降压药是最准确的预测指标,其接收者工作特征曲线(ROC)下的面积分别为 0.83、0.81、0.77、0.75、0.74 和 0.73。识别进展为 2 型糖尿病的最佳临界值为 13.5 分(Se = 1.00,Sp = 1.00,p < 0.001)。多变量逻辑回归模型显示,与 10 年内 2 型糖尿病进展高风险相关的因素有年龄、性别、职业、经济状况、教育水平和经常饮酒(P < 0.05)。研究结果为提出潜在的解决方案以减少人群中可改变的 2 型糖尿病风险因素提供了依据。这些方案包括提供与文化相适应的健康教育和改变饮酒行为:讨论和结论:在越南高棉人口中,使用亚洲改良版芬兰糖尿病风险评分量表来预测发展为2型糖尿病的风险,并将其作为筛查未确诊2型糖尿病的工具是合适的。
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引用次数: 0
Pulmonary embolism: incidence and outcomes in a twelve-year historical series, in Tuscany - Italy (2010-2021). 肺栓塞:意大利托斯卡纳十二年历史序列中的发病率和结果(2010-2021 年)。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-24 DOI: 10.7416/ai.2024.2649
Gabriele Cerini, Carla Lunetta, Claudia Szasz, Leonardo Misuraca, Fabrizio Gemmi, Marisa Carluccio, Chiara Lorini, Guglielmo Bonaccorsi, Silvia Forni

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.

背景:肺栓塞是一个全球性的健康问题。行政数据库是对主要诊断或疾病的流行率和发病率进行广泛流行病学研究的宝贵资料来源。研究的主要范围是提供有关肺栓塞发病趋势的最新见解,研究管理和结果的变化:这项回顾性观察研究检查了托斯卡纳地区医院 12 年的数据集,涵盖了 Covid-19 大流行的头两年:分析采用的是 2010 年至 2021 年期间 18 岁及以上出院居民的管理数据:住院肺栓塞发病率从2010年到2019年略有下降(64.7到60.9 x 100,000;P=0.152)。75岁以下的男性发病率较高,而女性在较高年龄段的发病率较高。从 2010 年到 2019 年,住院死亡率和 30 天死亡率有所下降(p=0.001 和 0.020)。2020年,30天死亡率上升(12.4% vs 10.1%,p=0.029),而院内死亡率保持稳定。2010-2019年,一年死亡率保持稳定,但2020年有所上升(32.6% vs 29.4%,p=0.037)。考虑到多变量模型,一年死亡率与性别、年龄和合并症显著相关:我们的研究表明,肺栓塞仍然是托斯卡纳地区的一个相关负担,但在过去十年中,管理有所改善,药物治疗也发生了决定性的变化。与性别有关的差异显现出来,这突出表明需要采取针对不同性别的医疗保健方法。
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引用次数: 0
Firearm ownership and suicide: Has the time come to discuss uniformity of health and social assessments in aid of regulation? Reflection from a retrospective study on a forensic case series. 拥有枪支与自杀:是否到了讨论统一健康和社会评估以帮助监管的时候了?法医案例系列回顾性研究的反思。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-23 DOI: 10.7416/ai.2024.2648
Alberto Blandino, Nicola Galante, Fabio Cuppone, Maddalena Giriodi, Guido Vittorio Travaini

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.

背景:从健康和经济角度来看,与枪支有关的死亡一直是公众关心的问题。在世界范围内,枪支自杀的发生率差异很大,这取决于多个因素,包括每个国家的武器供应情况。尽管多项研究表明,国家有关枪支所有权的法律减少了合法获得枪支的机会,从而降低了持枪自杀的风险,但目前的情况却与差异巨大的立法相冲突:研究设计:法医案例系列的回顾性研究:方法:回顾性记录 2014 年 1 月至 2023 年 12 月期间米兰(意大利)法医部评估的尸检报告。仅考虑了枪支自杀。对每个案例的刑事犯罪报告都进行了仔细分析,以获得有关受害者性别、年龄、合法持有枪支、精神障碍、酗酒和非法药物滥用的信息:米兰法医部在 10 年间评估了 1,164 起自杀案件,其中 101 起(8.7%)与枪支有关。因此,男女比例约为 13:1。没有观察到季节性趋势。大多数人都拥有枪支执照。在整个数据集中,35.6%的人患有精神疾病,4%的人酗酒,2%的人吸毒。在拥有持枪执照的人中,42.3%患有精神疾病:对持枪自杀及其与合法持有枪支之间关系的了解有限,应重新考虑现行的预防性法律。本文讨论了意大利和一些欧洲国家目前为获得持枪执照所要求的行政和临床检查。评估与枪支有关的滥用风险是一项重要但复杂的程序,不仅需要临床--异常数据,还需要深入的精神病学信息。有必要开展并重启一场辩论,这场辩论目前提出了非常不同的解决方案,但可能会受益于对预防战略的共同愿景,这些战略可以为整个社会的利益而实施和颁布。
{"title":"Firearm ownership and suicide: Has the time come to discuss uniformity of health and social assessments in aid of regulation? Reflection from a retrospective study on a forensic case series.","authors":"Alberto Blandino, Nicola Galante, Fabio Cuppone, Maddalena Giriodi, Guido Vittorio Travaini","doi":"10.7416/ai.2024.2648","DOIUrl":"https://doi.org/10.7416/ai.2024.2648","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study design: </strong>Retrospective study on a forensic case series.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary care doctors retirements in the context of an ageing population in Italy. 意大利人口老龄化背景下初级保健医生的退休情况。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-01 Epub Date: 2024-01-31 DOI: 10.7416/ai.2024.2602
Zeno Dalla Valle, Carlo Signorelli, Cristina Renzi

Background: Ongoing shortages in primary care doctors/primary care paediatricians and increasing healthcare needs due to ageing of the population represent a great challenge for healthcare providers, managers, and policymakers. To support planning of primary healthcare resource allocation we analyzed the geographic distribution of primary care doctors/primary care paediatricians across Italian regions, accounting for area-specific number and age of the population. Additionally, we estimated the number of primary care doctors/primary care paediatricians expected to retire over the next 25 years, with a focus on the next five years.

Study design: Ecological study.

Methods: We gathered the list of Italian general practitioners and primary care paediatricians and combined them with the data from the National Federation of Medical Doctors, Surgeons and Dentists. Using data from the National Institutes of Statistics, we calculated the average number of patients per doctor for each region using the number of residents above and under 14 years of age for general practitioners and primary care paediatricians respectively. We also calculated the number of residents over-65 and over-75 years of age per general practitioner, as elderly patients typically have higher healthcare needs.

Results: On average the number of patients per general practitioner was 1,447 (SD: 190), while for paediatricians it was 1,139 (SD: 241), with six regions above the threshold of 1,500 patients per general practitioner and only one region under the threshold of 880 patients per paediatrician. We estimated that on average 2,228 general practitioners and 444 paediatricians are going to retire each year for the next five years, reaching more than 70% among the current workforce for some southern regions. The number of elderly patients per general practitioner varies substantially between regions, with two regions having >15% more patients aged over 65 years compared to the expected number.

Conclusions: over 65 years compared to the expected number. Conclusions. The study highlighted that some regions do not currently have the required primary care workforce, and the expec-ted retirements and the ageing of the population will exacerbate the pressure on the already over-stretched healthcare services. A response from healthcare administrations and policymakers is urgently required to allow equitable access to quality primary care across the country.

背景:初级保健医生/初级保健儿科医生持续短缺,而人口老龄化导致医疗保健需求不断增加,这对医疗保健提供者、管理者和政策制定者来说都是一个巨大的挑战。为了支持初级医疗保健资源分配规划,我们分析了意大利各地区初级保健医生/初级保健儿科医生的地理分布,并考虑了特定地区的人口数量和年龄。此外,我们还估算了未来 25 年内预计退休的初级保健医生/初级保健儿科医生的人数,重点是未来五年:研究设计:生态研究:我们收集了意大利全科医生和初级儿科医生的名单,并将其与全国医生、外科医生和牙医联合会的数据相结合。我们利用国家统计局的数据,分别根据全科医生和初级儿科医生的 14 岁以上和 14 岁以下居民人数,计算出每个地区每名医生的平均患者人数。我们还计算了每名全科医生所负责的 65 岁以上和 75 岁以上居民人数,因为老年患者通常有更高的医疗保健需求:平均每位全科医生负责的患者人数为 1,447 人(标清:190 人),而儿科医生负责的患者人数为 1,139 人(标清:241 人),其中有六个地区超过了每位全科医生负责 1,500 名患者的临界值,只有一个地区低于每位儿科医生负责 880 名患者的临界值。我们估计,在未来五年中,平均每年将有 2,228 名全科医生和 444 名儿科医生退休,在南部一些地区,退休人员占现有劳动力的 70% 以上。各地区每名全科医生负责的老年患者人数差别很大,有两个地区 65 岁以上的患者人数比预计人数多出 15%:该研究强调,一些地区目前没有所需的初级保健人员,而预期的退休和人口老龄化将加剧本已捉襟见肘的医疗保健服务的压力。迫切需要医疗管理部门和政策制定者采取应对措施,使全国各地都能公平地获得高质量的初级医疗服务。
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引用次数: 0
Influenza and Covid-19 Vaccination in 2023: a descriptive analysis in two Italian Research and Teaching Hospitals. Is the On-Site strategy effective? 2023 年流感和 Covid-19 疫苗接种:意大利两家研究和教学医院的描述性分析。现场战略是否有效?
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-01 Epub Date: 2024-03-21 DOI: 10.7416/ai.2024.2606
Pier Mario Perrone, Simone Villa, Giuseppina Maria Raciti, Laura Clementoni, Valentina Vegro, Francesco Scovenna, Augusto Altavilla, Adriana Monica Tomoiaga, Valentina Beltrami, Ilaria Bruno, Marcello Vaccargiu, Elisa Astorri, Navpreet Tiwana, Matteo Letzgus, Peter Johannes Schulz, Fabrizio Ernesto Pregliasco, Silvana Castaldi

Introduction: Vaccinations represent an extremely effective tool for the prevention of certain infectious diseases - such as influenza and COVID-19 -, particularly for those categories at risk due to both their frail condition or professional exposure, such as healthcare workers. The aim of this study is to describe the course of the anti-influenza and anti-COVID-19 vaccination campaign at two Research Hospitals in Milan, Italy.

Study design: Multicentre, cross-sectional study.

Methods: For the 2023-24 vaccination campaign, the two facilities opted for two different approaches. At the Hospital A, two dif-ferent strategies for vaccinating healthcare workers were implemented: a fixed-site vaccination clinic and two mobile vaccination groups run by Public Health residents of the University of Milan. At the Hospital B, on the other hand, a single fixed-site outpatient clinic run by Public Health residents of the University of Milan was used. On the occasion of the campaign, a survey was also carried out using anonymous online questionnaires to investigate healthcare workers attitudes towards vaccination.

Results: A total of 1,937 healthcare workers were vaccinated: 756 were immunized against influenza only, 99 against COVID-19 only, and 1,082 against both. The results show a substantial difference in vaccination adherence among medical and nursing staff compared to other professional categories. In particular, the category with the highest vaccination adhesion turned out to be that of medical doctors with 55.7% adhesion while, on the contrary, the category with the lowest adhesion turned out to be that of auxiliary personnel characterized by 7.4% adhesion. At the same time, the comparison between the two hospital facilities showed a double adherence rate by the staff of Hospital A as regards both the flu vaccine (40.6% and 20.1%) and the anti-COVID-19 vaccine (26.4% and 12.3%). Finally, the survey showed that the attitude towards influenza vaccination is lower among auxiliary staff in terms of both knowledge and vaccination attitude.

Conclusions: The results of the study show a vaccination adherence in line with that of previous years, although lower than the values recommended by the principal national and international Organizations. The analysis of the differences between the two facilities and the surveys carried out will allow for the implementation of targeted interventions to increase adherence in future campaigns.

导言:接种疫苗是预防某些传染病(如流感和 COVID-19)的极为有效的工具,尤其是对于那些因身体虚弱或职业暴露而面临风险的人群,如医护人员。本研究旨在描述意大利米兰两家研究医院开展的抗流感和抗 COVID-19 疫苗接种活动的过程:研究设计:多中心横断面研究:在 2023-24 年的疫苗接种活动中,两家医院选择了两种不同的方法。在 A 医院,对医护人员实施了两种不同的疫苗接种策略:一个固定地点疫苗接种诊所和两个由米兰大学公共卫生学院居民组成的流动疫苗接种小组。而在 B 医院,则采用了由米兰大学公共卫生学院住院医师开设的单一固定门诊。在活动期间,还通过匿名在线问卷调查了医护人员对疫苗接种的态度:共有 1,937 名医护人员接种了疫苗:结果:共有 1,937 名医护人员接种了疫苗:756 人只接种了流感疫苗,99 人只接种了 COVID-19 疫苗,1,082 人同时接种了两种疫苗。结果显示,与其他专业类别相比,医护人员在坚持接种疫苗方面存在很大差异。其中,接种率最高的职业类别是医生,接种率为 55.7%;相反,接种率最低的职业类别是辅助人员,接种率为 7.4%。同时,两家医院设施的对比显示,A 医院员工对流感疫苗(40.6% 和 20.1%)和抗 COVID-19 疫苗(26.4% 和 12.3%)的接种率均为双倍。最后,调查显示,辅助人员对流感疫苗接种的态度在知识和接种态度两方面都较低:研究结果表明,虽然接种率低于主要国家和国际组织的建议值,但与前几年的接种率一致。通过分析两个机构之间的差异和所开展的调查,可以在今后的活动中实施有针对性的干预措施,以提高接种率。
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引用次数: 0
Identification of bullet holes in mummified corpse. 鉴定木乃伊尸体上的弹孔。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-01 DOI: 10.7417/CT.2024.5101
K S Bisogni, F Magli, I A Galassi

Background: The evaluation of the cause of death in a forensic context is often challenging especially when the corpse is in a severely altered state (decomposed, skeletonized, charred, dismembered, etc.), thus making it difficult to obtain an overview of the features and/or lesions suggestive of the dynamics leading to death.

Case report: In this case, the corpse was partly in a state of saponification and partly in a state of mummification with signs of skeletonization. The head, trunk, arms and upper legs were mummified and almost completely dehydrated.

Conclusion: The use of special techniques such as the rehydration of bodies is an ancient practice. Parts of skin in different states of decomposition with the use of rehydration solution represents a useful procedure for the study of some damaging modalities, being able to identify damaged areas characterized by compression/dehydration effects, hidden by the advanced transformative state of the corpse, highlighting very damaged, in which skin normality can no longer be restored.

背景:在法医鉴定中,对死因的评估往往具有挑战性,特别是当尸体处于严重改变的状态(腐烂、骨骼化、烧焦、肢解等)时,因此很难获得导致死亡的动态特征和/或病变的总体情况:在这个案例中,尸体部分处于皂化状态,部分处于木乃伊化状态,有骸骨化迹象。头部、躯干、手臂和上肢呈木乃伊状,几乎完全脱水:结论:使用尸体补水等特殊技术是一种古老的做法。使用补水溶液对处于不同腐烂状态的部分皮肤进行研究,是研究某些破坏模式的有用程序,能够识别以压缩/脱水效应为特征的受损区域,这些区域被尸体的高级转化状态所掩盖,凸显出非常严重的损坏,其中的皮肤再也无法恢复正常。
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引用次数: 0
Effectiveness of hydrogen peroxide wipes for surface disinfection in healthcare facilities. 过氧化氢湿巾对医疗机构表面消毒的效果。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-01 Epub Date: 2024-03-21 DOI: 10.7416/ai.2024.2621
Marco Lopuzzo, Maria Teresa Montagna, Francesco Triggiano, Giuseppina Caggiano

Introduction: The correct method of surface disinfection in hospitals is an essential tool in the fight against the spread of healthcare-associated infections caused by multi-resistant microorganisms. Currently, there are many disinfectants on the market that can be used against different microorganisms. However, the effectiveness of different active molecules is controversial in the literature.

Study design: The aim of this study was to evaluate the effectiveness of wipes based on hydrogen peroxide (1.0 %) and highly specific plant-based surfactants, contained in H2O2TM (Hi-speed H2O2TM) products, against some hospital-associated microorganisms.

Methods: The effectiveness of the wipes was tested against nosocomial and control strains of methicillin-resistant Staphylococcus aureus, carbapenem-resistant Pseudomonas aeruginosa, Klebsiella pneumoniae carbapenemase, Aspergillus fumigatus and Candida parapsilosis. Specifically, in vitro activity was assessed using three different techniques: stainless steel surface testing, surface diffusion testing and well diffusion test.

Results: The three different methods tested confirm the wipes' good effectiveness against the most common multi-resistant bacteria and against fungi.

Conclusions: These data show that the tested wipes could be a valid adjunct to the disinfection process and could assist in the prevention of healthcare-associated infections.

导言:正确的医院表面消毒方法是防止多重耐药微生物引起的医疗相关感染传播的重要手段。目前,市场上有许多可用于对付不同微生物的消毒剂。然而,不同活性分子的有效性在文献中存在争议:研究目的:本研究旨在评估基于过氧化氢(1.0%)和高度特异性植物表面活性剂的湿巾(H2O2 TM(Hi-speed H2O2 TM)产品中包含)对一些医院相关微生物的有效性:方法:针对耐甲氧西林金黄色葡萄球菌、耐碳青霉烯类假单胞菌、肺炎克雷伯菌碳青霉烯酶、烟曲霉和副丝状念珠菌的鼻腔菌株和对照菌株,测试了湿巾的有效性。具体而言,体外活性评估采用了三种不同的技术:不锈钢表面测试、表面扩散测试和井扩散测试:结果:三种不同的测试方法证实了湿巾对最常见的多重耐药细菌和真菌的良好效果:这些数据表明,经测试的湿巾可作为消毒过程的有效辅助工具,有助于预防医疗相关感染。
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引用次数: 0
Impact of COVID-19 pandemic on emergency and elective surgery. A retrospective observational analysis in Apulia, southern Italy. COVID-19 大流行对急诊和择期手术的影响。意大利南部阿普利亚的回顾性观察分析。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-07-01 Epub Date: 2024-02-22 DOI: 10.7416/ai.2024.2612
Francesco Paolo Bianchi, Antonio Daleno, Donato Rizzi, Giovanni Migliore, Silvio Tafuri

Introduction: In Italy, at the beginning of the COVID19 pandemic, only emergency and life-saving elective surgical procedures were allowed with obvious limitations in terms of numbers of operable cases. The aim of our study is to evaluate the performance of surgical activities by Apulian healthcare facilities (Southern Italy) under the pandemic emergency pressure.

Methods: The surgical procedures in study were identified via the Apulian regional archive of hospital discharge forms. We used the ICD9 codes in order to define the elective and urgency surgeries in analysis, and we extended our search to all procedures performed from 2019 to 2021.

Results: The number of all procedures decreased from 2019 to 2020; the reduction was higher for elective surgery (-43.7%) than urgency surgery (-15.5%). In 2021, an increase compared to 2020 was recorded for all procedures; nevertheless, elective surgeries registered a further slightly decrease compared to 2019 (-12.4%), while a slightly increase was observed for urgency surgeries (+3.5%). No particular variation was observed considering sex and age at surgery of the patients, and days of hospitalization from 2019 to 2021.

Conclusions: The impact of COVID19 on Apulian regional health system has been extremely shocked and has required the implementation of strategies aimed at containing the infection and guaranteeing health services as far as possible. A new paradigm of hospital care for SARS-COV-2 patients in the post-emergency phase in Italy is needed, in order to optimize the resources available and to guarantee high standards of quality and efficiency for citizens.

导言:在意大利,COVID19 大流行之初,只允许进行急诊手术和挽救生命的择期手术,在可手术病例数量方面受到明显限制。我们的研究旨在评估阿普利亚医疗机构(意大利南部)在大流行病紧急压力下的外科手术情况:研究中的外科手术是通过阿普利亚地区的出院表档案确定的。我们使用 ICD9 编码来定义分析中的择期手术和紧急手术,并将搜索范围扩大到 2019 年至 2021 年期间实施的所有手术:结果:从2019年到2020年,所有手术的数量都有所下降;择期手术的下降幅度(-43.7%)高于急诊手术(-15.5%)。2021 年,与 2020 年相比,所有手术的数量都有所增加;然而,与 2019 年相比,择期手术的数量又略有减少(-12.4%),而急诊手术的数量则略有增加(+3.5%)。从患者的性别、手术时的年龄以及住院天数来看,2019 年至 2021 年没有特别的变化:COVID19对阿普利亚地区医疗系统的影响极为惊人,需要实施旨在遏制感染和尽可能保障医疗服务的战略。在意大利,急诊后阶段的SARS-COV-2患者住院治疗需要一种新的模式,以优化可用资源,保证为公民提供高质量和高效率的服务。
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引用次数: 0
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Annali di igiene : medicina preventiva e di comunita
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