Pub Date : 2024-09-01Epub Date: 2024-03-28DOI: 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.
{"title":"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.","authors":"Francesco Paolo Bianchi, Daniel Fiacchini, Emanuela Maria Frisicale, Renata Gili, Stefano Greco, Stefano Guicciardi, Matteo Riccò, Salvatore Zichichi, Nunzio Zotti, Silvio Tafuri","doi":"10.7416/ai.2024.2610","DOIUrl":"10.7416/ai.2024.2610","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"549-568"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140020791","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}
Pub Date : 2024-09-01Epub Date: 2024-03-28DOI: 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。
{"title":"Vaccine hesitancy in South Tyrol: a narrative review of insights and strategies for public health improvement.","authors":"Christian J Wiedermann, Verena Barbieri, Barbara Plagg, Giuliano Piccoliori, Adolf Engl","doi":"10.7416/ai.2024.2625","DOIUrl":"10.7416/ai.2024.2625","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"569-579"},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140304486","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}
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.
{"title":"Predicting the risk of type 2 diabetes: Standardized diabetes risk score among the Khmer ethnic minority in Vietnam.","authors":"Tuyen Thi Hong Nguyen, Lam Phuc Duong","doi":"10.7416/ai.2024.2652","DOIUrl":"https://doi.org/10.7416/ai.2024.2652","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Subjects and methods: </strong>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.</p><p><strong>Objective: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Discussion and conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103631","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}
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。
{"title":"Pulmonary embolism: incidence and outcomes in a twelve-year historical series, in Tuscany - Italy (2010-2021).","authors":"Gabriele Cerini, Carla Lunetta, Claudia Szasz, Leonardo Misuraca, Fabrizio Gemmi, Marisa Carluccio, Chiara Lorini, Guglielmo Bonaccorsi, Silvia Forni","doi":"10.7416/ai.2024.2649","DOIUrl":"https://doi.org/10.7416/ai.2024.2649","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Design: </strong>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.</p><p><strong>Methods: </strong>Administrative data from residents aged 18 and older discharged from hospital between 2010 and 2021 were used for the analysis.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756711","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}
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.
{"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}
Pub Date : 2024-07-01Epub Date: 2024-01-31DOI: 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.
{"title":"Primary care doctors retirements in the context of an ageing population in Italy.","authors":"Zeno Dalla Valle, Carlo Signorelli, Cristina Renzi","doi":"10.7416/ai.2024.2602","DOIUrl":"10.7416/ai.2024.2602","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study design: </strong>Ecological study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"392-404"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650159","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}
Pub Date : 2024-07-01Epub Date: 2024-03-21DOI: 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.
{"title":"Influenza and Covid-19 Vaccination in 2023: a descriptive analysis in two Italian Research and Teaching Hospitals. Is the On-Site strategy effective?","authors":"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","doi":"10.7416/ai.2024.2606","DOIUrl":"10.7416/ai.2024.2606","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Study design: </strong>Multicentre, cross-sectional study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"421-431"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140206257","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}
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.
{"title":"Identification of bullet holes in mummified corpse.","authors":"K S Bisogni, F Magli, I A Galassi","doi":"10.7417/CT.2024.5101","DOIUrl":"https://doi.org/10.7417/CT.2024.5101","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Case report: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":"175 Suppl 2(4)","pages":"134-137"},"PeriodicalIF":1.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888234","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}
Pub Date : 2024-07-01Epub Date: 2024-03-21DOI: 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.
{"title":"Effectiveness of hydrogen peroxide wipes for surface disinfection in healthcare facilities.","authors":"Marco Lopuzzo, Maria Teresa Montagna, Francesco Triggiano, Giuseppina Caggiano","doi":"10.7416/ai.2024.2621","DOIUrl":"10.7416/ai.2024.2621","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Study design: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>The three different methods tested confirm the wipes' good effectiveness against the most common multi-resistant bacteria and against fungi.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"487-497"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140304485","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}
Pub Date : 2024-07-01Epub Date: 2024-02-22DOI: 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.
{"title":"Impact of COVID-19 pandemic on emergency and elective surgery. A retrospective observational analysis in Apulia, southern Italy.","authors":"Francesco Paolo Bianchi, Antonio Daleno, Donato Rizzi, Giovanni Migliore, Silvio Tafuri","doi":"10.7416/ai.2024.2612","DOIUrl":"10.7416/ai.2024.2612","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"414-420"},"PeriodicalIF":2.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139929687","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}