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Vaccination status among COVID-19 patients and duration of Polymerase Chain Reaction test positivity: evaluation of immunization schedule and type of vaccine. COVID-19 患者的疫苗接种情况和聚合酶链反应检测阳性持续时间:对免疫接种计划和疫苗类型的评估。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-05-01 Epub Date: 2024-02-22 DOI: 10.7416/ai.2024.2613
Paola Guerriero, Claudia Cipollone, Roberta Martinelli, Federica Caputo, Maurizio Cervellini, Leondino Mammarella, Mario Muselli, Riccardo Mastrantonio, Giada Mastrangeli, Leila Fabiani

Background: The introduction of the vaccine against SARS-CoV-2 has represented a cornerstone in the containment of the pandemic. Our aim was to assess the vaccination schedules in relation to the infection free interval and to the duration of positivity in case of infection.

Study design: This study involves the SARS-CoV-2 infected people managed by the Local Health Authority ASL 1 Abruzzo. The data collected included: vaccine administration date, vaccine type, information on the Polymerase Chain Reaction test positivity, and demographic variables, such as age and sex.

Methods: The duration of Polymerase Chain Reaction test positivity was assessed in relation to the vaccination status, the vaccine type and the time interval between the last vaccination dose and the first nasopharyngeal positive swab over the considered period.

Results: The infection duration (DAYS) was significantly shorter in subjects vaccinated with a booster dose than unvaccinated subjects (12.8 vs 14.6; p<0.0001) and subjects vaccinated with the primary series only (12.8 vs 14.1; p<0.0001). Duration of PCR positivity was shorter with heterologous immunisation than with other vaccination schedules (p=0.0317).

Conclusions: This study highlights, in a large cohort of patients, the association between vaccination schedule and the response to infection.

背景:SARS-CoV-2疫苗的引入是遏制大流行的基石。我们的目的是评估疫苗接种时间与无感染间隔期和感染后阳性反应持续时间的关系:本研究涉及阿布鲁佐地方卫生局 ASL 1 管理的 SARS-CoV-2 感染者。收集的数据包括:疫苗接种日期、疫苗类型、聚合酶链反应检测阳性信息以及年龄和性别等人口统计学变量:评估聚合酶链反应检测阳性持续时间与疫苗接种情况、疫苗类型以及最后一剂疫苗接种与首次鼻咽拭子阳性之间的时间间隔的关系:结果:接种过加强剂疫苗的受试者的感染持续时间(天数)明显短于未接种者(12.8 天 vs 14.6 天;p):这项研究在一大批患者中强调了疫苗接种时间与感染反应之间的关系。
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引用次数: 0
Adverse human health effects of climate change: an update. 气候变化对人类健康的不利影响:最新情况。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-05-01 Epub Date: 2024-02-01 DOI: 10.7416/ai.2024.2595
Tommaso Filippini, Stefania Paduano, Federica Veneri, Giulia Barbolini, Gianluca Fiore, Marco Vinceti

Background: The world is currently facing a process of climate change, which may adversely impact human health in many different ways. The safety of food, water and urban environments is endangered by the consequences of climate change. Sea level and temperature rise, along with more frequent and longer heat waves, represent only a few of the effects of climate change. The increased risk of extreme climate events (e.g., cyclones, droughts and floods) is another serious public health issue. These adverse effects are enhanced in areas and countries not having the capacity to effectively deal with climate change.

Study design: We primarily aimed at summarizing the impacts of climate change on public health. A further aim was to identify the most concerning consequences of this phenomenon and the vulnerability factors that amplify the negative effects of climate change.

Methods: PubMed and other literature databases were used as literature sources for this narrative review based on the search terms 'climate change' and 'diseases categories' up to January 2024, in order to assess the most recent and relevant scientific evidence about the relation between climate change and public health, identify knowledge gaps and priorities for future research. We also screened the websites of major agencies devoted to human health protection and environmental health.

Results and conclusions: Climate change appears to induce a broad spectrum of generally adverse effects on public health. It may increase the risk of infectious diseases, psychiatric disorders, cancer and other diseases. Currently, we are not effectively counteracting this phenomenon, since pollutant and greenhouse gas emissions have been increasing alongside temperatures. A host of measures are required in order to prevent and fight climate change and related health effects. These include the adoption of a holistic approach and the collaboration of different kinds of expertise in order to design more effective strategies. Special attention should be paid to those who live in disadvantaged countries, and those who are more vulnerable to the adverse health consequences of climate change.

背景:世界目前正面临着气候变化的过程,这可能会在许多不同方面对人类健康产生不利影响。气候变化的后果危及食物、水和城市环境的安全。海平面和气温的上升,以及更频繁和更长时间的热浪,只是气候变化影响中的一小部分。极端气候事件(如气旋、干旱和洪水)风险的增加是另一个严重的公共健康问题。在没有能力有效应对气候变化的地区和国家,这些不利影响会加剧:我们的主要目的是总结气候变化对公众健康的影响。研究设计:我们的主要目的是总结气候变化对公众健康的影响,并进一步确定这一现象最令人担忧的后果,以及扩大气候变化负面影响的脆弱性因素:为了评估气候变化与公共健康之间关系的最新相关科学证据,确定知识差距和未来研究的优先事项,我们使用了 PubMed 和其他文献数据库作为本叙述性综述的文献来源,搜索关键词为 "气候变化 "和 "疾病类别",搜索时间截至 2024 年 1 月。我们还筛选了致力于人类健康保护和环境健康的主要机构的网站:气候变化似乎会对公众健康产生广泛的不利影响。它可能会增加患传染病、精神疾病、癌症和其他疾病的风险。目前,由于污染物和温室气体排放量与气温同步增长,我们无法有效地应对这一现象。为了预防和应对气候变化及相关的健康影响,需要采取一系列措施。这些措施包括采取综合方法,并与不同类型的专家合作,以制定更有效的战略。应特别关注那些生活在处境不利国家的人们,以及那些更容易受到气候变化不利健康影响的人们。
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引用次数: 0
Fluoride and caries prevention: a scoping review of public health policies. 氟化物与龋齿预防:公共卫生政策范围审查。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-05-01 Epub Date: 2024-01-17 DOI: 10.7416/ai.2024.2593
Federica Veneri, Silvio Roberto Vinceti, Tommaso Filippini
<p><strong>Background: </strong>Dental caries is the most common infectious disease, affecting approximately 60 to 90% of the world population, especially young children, and disadvantaged communities. Due to the extremely high prevalence and the significant negative impact on general health, well-being, and quality of life it is considered a global public health problem. Despite the improvement of policies to promote oral health care in the past decades, dental caries is still a healthcare challenge, characterized by increasing disparities among different social groups between and within countries. Fluoride-based prevention of dental caries is a cost-effective approach, that has been implemented since 1940's. It includes systemic and topical administrations, through community-based or individual programs. Preventive interventions should be tailored to individual and community caries risk assessment and estimate of cumulative fluoride intake, in order to maximize the preventive effect and avoid the risk of potential adverse effects associated with excessive fluoride exposure. Regulation of public health policies plays a major role in this context.</p><p><strong>Study design: </strong>Scoping review.</p><p><strong>Methods: </strong>The aim of this scoping review was to report an overview of current guidelines regarding fluoride-based preventive strategies for dental caries and relevant policies on the matter, as well as to address current issues related to public health aspects of dental caries prevention. We searched for the relevant literature on the matter, focusing on policy documents, such as recommendations, position papers and guidelines, issued from the major scientific and regulatory institutions involved in oral health promotion and on publications concerning relevant aspects of public health law.</p><p><strong>Results: </strong>Prevention of dental caries through fluoride can rely on topical fluorides for home-use (toothpastes and mouthrinses), professionally applied topical fluorides (gels, varnishes, silver diamine fluoride, fluoride-releasing restorative materials and sealants), fluoride supplements (tablets and drops), and community-based strategies (community water fluoridation, fluoridated salt and milk). Current relevant guidelines for all these preventive aids are outlined in the paper. A significantly greater preventive effect of topical fluorides has been widely established in the recent past, as compared to systemic effects. Furthermore, increasing concerns have emerged on potential adverse effects on general health associated with early and excessive systemic exposure to fluoride, especially for children, supported by recent meta-analyses. Also, community water fluoridation has raised significant aspects of relevance for health law and policies. In a public health perspective, healthcare policymakers should tackle social iniquities by promoting information and oral health literacy, through community and school-based programs
背景:龋齿是最常见的传染病,影响着全球约 60% 至 90% 的人口,尤其是幼儿和弱势群体。由于龋齿发病率极高,且对总体健康、幸福感和生活质量有重大负面影响,因此被视为全球公共卫生问题。尽管在过去的几十年里,促进口腔保健的政策有所改善,但龋齿仍然是一项保健挑战,其特点是国家之间和国家内部不同社会群体之间的差距越来越大。基于氟化物的龋齿预防是一种具有成本效益的方法,自 20 世纪 40 年代以来一直在实施。它包括通过社区或个人计划进行系统和局部用药。预防干预措施应根据个人和社区的龋齿风险评估以及累积氟摄入量的估算量身定制,以最大限度地发挥预防效果,避免因接触过量氟而产生潜在不良影响的风险。公共卫生政策的监管在这方面发挥着重要作用:研究设计:范围综述:本次范围界定综述的目的是报告有关氟化物龋齿预防策略的现行指南和相关政策的概述,以及解决当前与龋齿预防的公共卫生方面有关的问题。我们搜索了与此相关的文献,重点关注参与口腔健康促进的主要科学和监管机构发布的建议、立场文件和指南等政策文件,以及涉及公共卫生法相关方面的出版物:通过氟化物预防龋齿可以依靠家庭使用的局部氟化物(牙膏和漱口水)、专业使用的局部氟化物(凝胶、清漆、二胺氟化银、氟释放修复材料和密封剂)、氟化物补充剂(片剂和滴剂)以及基于社区的策略(社区水氟化、含氟盐和牛奶)。文中概述了所有这些预防辅助手段的现行相关指南。与全身性效果相比,局部用氟化物的预防效果要大得多,这一点已在近期得到广泛证实。此外,最近的荟萃分析证实,人们越来越担心过早和过量地全身接触氟化物会对一般健康造成不良影响,尤其是对儿童。此外,社区饮水加氟还提出了与卫生法律和政策相关的重要问题。从公共卫生的角度来看,医疗保健政策的制定者应通过社区和学校项目促进信息和口腔健康知识的普及,确保早期牙科就诊和基本牙科护理的可及性,改善氟化物外用产品的可用性和可负担性,从而解决社会不公问题:基于氟化物的预防可提供一种简单且具有成本效益的方法,以降低龋齿发病率和相关的社会负担。在以氟化物为基础的预防策略中,以社区为基础的系统性氟化物施用应慎重考虑,因为目前已确定的风险效益比并不理想。考虑到最佳的风险效益比,外用含氟产品通常是首选。必须进一步努力,从公共卫生的角度确定和解决预防龋齿和相关社会弊端的障碍。有关口腔健康的政策和法律应通过有针对性的综合战略来促进龋齿预防的普及。
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引用次数: 0
Study of the excess mortality associated with the SARS-CoV-2 pandemic in the Local Health Authorities and Districts of the Autonomous Region of Sardinia - quinquennium 2017-2021. 撒丁岛自治区地方卫生当局和地区与SARS-CoV-2大流行相关的超额死亡率研究——2017-2021五年期。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-05-01 Epub Date: 2023-11-23 DOI: 10.7416/ai.2023.2589
Sara Maria Pani, Federica Cadoni, Luigi Minerba

Background: Based on the indications of the Italian National Recovery and Resilience Plan and the Ministerial Decree n°77/2022, detecting specific populations' social-welfare needs is essential to reorganize the national and regional health service. The present analysis studies the impact of pandemic and pre-pandemic conditions in terms of mortality on Sardinian health service organizational subunits to indirectly investigate the need for specific social and health interventions.

Design: Retrospective observational mortality study on the Sardinian resident population, surveyed by the Italian National Institute of Statistics (Istat) from 2017 to 2021.

Methods: The database was built by crossing demographic data from the Istat divided into 21 five-year age groups (0-4 to 100+). Mortality and excess mortality were calculated with a focus on local health authorities and districts. The analysis were made considering three age groups (0-64, ≥ 65, 0-100+) and comparing the individual years 2020 and 2021 with the pre-pandemic triennium 2017-2019. To better understand the phenomenon of excess mortality, the old age index was calculated for the Local Health Authority and District for each year of the quinquennium considered.

Results: Standardized mortality ratios increased in the biennium of the SARS-CoV-2 pandemic compared to the baseline 2017-2019. A global increaseof the Standardized mortality ratios in all districts (2021) was measured, including those with Standardized mortality ratios already increasing in 2020. Notably, the Standardized mortality ratios (2020 and 2021) were often increased by the 0-64 age group. The regional excess mortality (0-100+) confirmed an increase in mortality compared to the baseline, with a slight decrease from 2020 to 2021.

Conclusions: Sardinia presents peculiar demographic and geographical characteristics. Monitoring mortality rates and excess mortality confirms to be crucial to constantly re-modulating health interventions and planning of the supply of services, including the equitable allocation of resources based on actual health needs. Sardinia should embrace the concept of "age-friendly community" and create communities designed to promote active aging and social participation.

背景:根据意大利国家恢复和复原力计划和第77/2022号部长级法令的指示,查明特定人群的社会福利需求对于重组国家和地区卫生服务至关重要。本分析研究了大流行和大流行前的死亡率状况对撒丁岛卫生服务组织亚单位的影响,以间接调查具体社会和卫生干预措施的必要性。设计:意大利国家统计局(Istat)于2017年至2021年对撒丁岛常住人口进行回顾性观察性死亡率研究。方法:对全国21个5岁年龄组(0-4岁至100岁以上)的人口统计数据进行交叉整理,建立数据库。死亡率和超额死亡率的计算重点是地方卫生当局和地区。该分析考虑了三个年龄组(0-64岁、≥65岁、0-100岁以上),并将2020年和2021年与2017-2019年大流行前三年进行了比较。为了更好地了解死亡率过高的现象,在所考虑的五年期间,每年都为地方卫生当局和地区计算了老年指数。结果:与2017-2019年基线相比,SARS-CoV-2大流行两年期的标准化死亡率有所增加。测量了全球所有地区(2021年)标准化死亡率的上升情况,包括那些标准化死亡率在2020年已经上升的地区。值得注意的是,标准化死亡率(2020年和2021年)往往在0-64岁年龄组有所增加。区域超额死亡率(0-100+)证实,与基线相比,死亡率有所上升,从2020年到2021年略有下降。结论:撒丁岛具有独特的人口和地理特征。监测死亡率和过高死亡率对于不断调整保健干预措施和规划服务供应,包括根据实际保健需要公平分配资源,是至关重要的。撒丁岛应接受“老年人友好社区”的概念,并创建旨在促进积极老龄化和社会参与的社区。
{"title":"Study of the excess mortality associated with the SARS-CoV-2 pandemic in the Local Health Authorities and Districts of the Autonomous Region of Sardinia - quinquennium 2017-2021.","authors":"Sara Maria Pani, Federica Cadoni, Luigi Minerba","doi":"10.7416/ai.2023.2589","DOIUrl":"10.7416/ai.2023.2589","url":null,"abstract":"<p><strong>Background: </strong>Based on the indications of the Italian National Recovery and Resilience Plan and the Ministerial Decree n°77/2022, detecting specific populations' social-welfare needs is essential to reorganize the national and regional health service. The present analysis studies the impact of pandemic and pre-pandemic conditions in terms of mortality on Sardinian health service organizational subunits to indirectly investigate the need for specific social and health interventions.</p><p><strong>Design: </strong>Retrospective observational mortality study on the Sardinian resident population, surveyed by the Italian National Institute of Statistics (Istat) from 2017 to 2021.</p><p><strong>Methods: </strong>The database was built by crossing demographic data from the Istat divided into 21 five-year age groups (0-4 to 100+). Mortality and excess mortality were calculated with a focus on local health authorities and districts. The analysis were made considering three age groups (0-64, ≥ 65, 0-100+) and comparing the individual years 2020 and 2021 with the pre-pandemic triennium 2017-2019. To better understand the phenomenon of excess mortality, the old age index was calculated for the Local Health Authority and District for each year of the quinquennium considered.</p><p><strong>Results: </strong>Standardized mortality ratios increased in the biennium of the SARS-CoV-2 pandemic compared to the baseline 2017-2019. A global increaseof the Standardized mortality ratios in all districts (2021) was measured, including those with Standardized mortality ratios already increasing in 2020. Notably, the Standardized mortality ratios (2020 and 2021) were often increased by the 0-64 age group. The regional excess mortality (0-100+) confirmed an increase in mortality compared to the baseline, with a slight decrease from 2020 to 2021.</p><p><strong>Conclusions: </strong>Sardinia presents peculiar demographic and geographical characteristics. Monitoring mortality rates and excess mortality confirms to be crucial to constantly re-modulating health interventions and planning of the supply of services, including the equitable allocation of resources based on actual health needs. Sardinia should embrace the concept of \"age-friendly community\" and create communities designed to promote active aging and social participation.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"313-326"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138290165","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
Variations in avoidable hospital admissions and emergency visits by primary care characteristics: an ecological study in Italy. 按初级保健特征划分的可避免入院和急诊就诊的差异:意大利的一项生态研究。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-01-31 DOI: 10.7416/ai.2024.2608
Zeno Dalla Valle, Giovanni Emanuele Ricciardi, Carlo Signorelli, Cristina Renzi

Background: Primary healthcare plays a central role in providing preventive care, managing chronic conditions and reducing inappropriate emergency presentations. The study aimed at providing population-level evidence on the correlation between the characteristics of primary healthcare across Italian regions and health outcomes included in the National Programs Outcomes of the National Agency for Regional Healthcare Services.

Study design: Ecological study.

Methods: We analysed healthcare data from the National Agency for Regional Healthcare Services, the public lists of primary care doctors and the National Federation of Surgeons and Dentists and the National Institutes of Statistics referring to the 20 Italian regions. Pearson's correlation and Spearman's correlation were used to assess the relationships between primary healthcare characteristics and health outcomes.

Results: Overall, across all Italian regions each general practitioner had on average 1447 patients and was 57.5 years old. The study found positive correlations between the number of patients per general practitioner and non-urgent Emergency Department visits among adult patients (Pearson's r = 0.58, p = 0.008), the number of residents aged 65+ per general practitioner and the rate of chronic obstructive pulmonary disease admissions (Pearson's r = 0.49, p = 0.029), and the age of general practitioners and lower-extremity amputations in diabetes patients (Pearson's r = 0.56, p = 0.011). A negative correlation was observed between the age of general practitioners and urinary tract infection admissions (Pearson's r = -0.76; p < 0.001). A non-linear negative correlation was found between the age of general practitioners and chronic obstructive pulmonary disease admissions (Spearman's ρ = -0.46, p = 0.041).

Conclusions: The findings emphasise the importance of guaranteeing sufficient numbers of primary healthcare physicians to meet patients' needs, and for limiting avoidable hospitalisations and emergency presentations. General practitioners' age might also influence the provision of care, but more research is needed on possible mechanisms.

背景:初级医疗保健在提供预防保健、管理慢性病和减少不适当的急诊就诊方面发挥着核心作用。这项研究旨在提供人口层面的证据,说明意大利各地区初级医疗保健的特点与国家地区医疗保健服务局国家计划成果中的健康成果之间的相关性:研究设计:生态研究:我们分析了国家地区医疗服务局、初级保健医生公共名单、全国外科医生和牙医联合会以及国家统计局提供的意大利 20 个地区的医疗保健数据。皮尔逊相关性和斯皮尔曼相关性用于评估初级医疗保健特征与健康结果之间的关系:总体而言,意大利所有地区的每名全科医生平均拥有 1447 名患者,年龄为 57.5 岁。研究发现,每名全科医生的患者人数与成年患者非急诊科就诊人数呈正相关(Pearson's r = 0.58,p = 0.008),每名全科医生的 65 岁以上居民人数与慢性阻塞性肺病入院率呈正相关(Pearson's r = 0.49,p = 0.029),全科医生的年龄与糖尿病患者下肢截肢率呈正相关(Pearson's r = 0.56,p = 0.011)。全科医生的年龄与尿路感染入院率之间呈负相关(Pearson's r = -0.76;p < 0.001)。全科医生的年龄与慢性阻塞性肺病入院人数之间存在非线性负相关(Spearman's ρ = -0.46,p = 0.041):研究结果强调了保证有足够数量的初级保健医生以满足患者需求的重要性,以及限制可避免的住院和急诊的重要性。全科医生的年龄也可能影响医疗服务的提供,但还需要对可能的机制进行更多的研究。
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引用次数: 0
Yoga or Mindfulness on Diabetes: Scoping Review for Theoretical Experimental Framework. 瑜伽或正念对糖尿病的影响:理论实验框架范围综述》。
IF 1.5 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-01-24 DOI: 10.7416/ai.2024.2600
Giovanni Cangelosi, Mattia Acito, Iolanda Grappasonni, Cuc Thi Thu Nguyen, Marina Tesauro, Paola Pantanetti, Luciana Morichetti, Enrico Ceroni, Andrea Benni, Fabio Petrelli

Background: About one in 11 adults worldwide suffers from diabetic disease with constantly increasing prevalence; from the 529 million patients registered in 2021, the number of people with diabetes was predicted to rise to approximately 1.31 billion in 2050. In Italy, 5.9% of the population is diabetic, with a higher prevalence with increasing age and in the South of the country. Yoga and Mindfulness could represent a valid support for the care of diabetic subjects especially in a stressful caring context such as the Covid-19 pandemic.

Study design: A scoping review was conducted to achieve the goals of the study. Yoga or Mindfulness interventions on diabetic subjects were specifically analyzed and qualitative-quantitative data collected in the selected randomized controlled trials were extensive for possible meta-analysis.

Methods: The review was conducted by two independent practitioners and a third one was consulted in case of conflict. The PRISMA method was used for both the selection and reporting of the studies to be included. Specific PICOS and search strategies have been developed on PubMed, Embase and PsycINFO databases. Included in the review were: randomised controlled trials, full dissertation articles and papers in English with a time limit on May 31, 2022.

Results: The Review included 22 studies; 12 on Mindfulness, 9 on Yoga and one about both disciplines; among these, one studied patients with Type 1 Diabetes, 14 with Type 2 Diabetes, 6 with both and one with Gestational Diabetes. Only one paper studied adolescent subjects while the other 21 focused on a range of adult subjects. The studies showed that Yoga and Mindfulness have strong potential not only on stress management, but also on clinical-metabolic parameters.

Conclusions: The recent Covid-19 pandemic has certainly redesigned a new way of treating and managing chronic diseases, such as diabetes. An increasingly fragile population, and with the growing need to reduce overall stress levels, could find alternative practices in Yoga and Mindfulness to support conventional therapies.

背景:全球约每 11 个成年人中就有一人患有糖尿病,且发病率不断上升;2021 年登记在册的糖尿病患者为 5.29 亿人,预计到 2050 年,糖尿病患者人数将增至约 13.1 亿人。在意大利,糖尿病患者占总人口的 5.9%,随着年龄的增长和意大利南部地区的发病率越来越高。瑜伽和正念可以为糖尿病患者的护理提供有效支持,尤其是在护理压力较大的情况下,如 Covid-19 大流行病:研究设计:为实现研究目标,我们进行了一次范围综述。研究设计:为实现研究目标,进行了一次范围综述,具体分析了针对糖尿病患者的瑜伽或正念干预措施,并广泛收集了所选随机对照试验中的定性-定量数据,以便进行可能的荟萃分析:方法:审查由两名独立从业人员进行,如有冲突,则咨询第三名从业人员。在选择和报告要纳入的研究时,均采用了 PRISMA 方法。在 PubMed、Embase 和 PsycINFO 数据库中制定了具体的 PICOS 和搜索策略。综述包括:随机对照试验、学位论文全文以及时间限制为 2022 年 5 月 31 日的英文论文:综述包括 22 项研究;12 项关于正念的研究,9 项关于瑜伽的研究,1 项关于两种学科的研究;其中 1 项研究的对象是 1 型糖尿病患者,14 项研究的对象是 2 型糖尿病患者,6 项研究的对象是两种糖尿病患者,1 项研究的对象是妊娠糖尿病患者。只有一篇论文的研究对象是青少年,其他 21 篇论文的研究对象都是成年人。这些研究表明,瑜伽和正念不仅在压力管理方面,而且在临床代谢参数方面都具有强大的潜力:最近的 Covid-19 大流行无疑重新设计了一种治疗和管理糖尿病等慢性疾病的新方法。越来越脆弱的人口,以及日益增长的降低整体压力水平的需求,可以在瑜伽和正念中找到替代做法,以支持传统疗法。
{"title":"Yoga or Mindfulness on Diabetes: Scoping Review for Theoretical Experimental Framework.","authors":"Giovanni Cangelosi, Mattia Acito, Iolanda Grappasonni, Cuc Thi Thu Nguyen, Marina Tesauro, Paola Pantanetti, Luciana Morichetti, Enrico Ceroni, Andrea Benni, Fabio Petrelli","doi":"10.7416/ai.2024.2600","DOIUrl":"10.7416/ai.2024.2600","url":null,"abstract":"<p><strong>Background: </strong>About one in 11 adults worldwide suffers from diabetic disease with constantly increasing prevalence; from the 529 million patients registered in 2021, the number of people with diabetes was predicted to rise to approximately 1.31 billion in 2050. In Italy, 5.9% of the population is diabetic, with a higher prevalence with increasing age and in the South of the country. Yoga and Mindfulness could represent a valid support for the care of diabetic subjects especially in a stressful caring context such as the Covid-19 pandemic.</p><p><strong>Study design: </strong>A scoping review was conducted to achieve the goals of the study. Yoga or Mindfulness interventions on diabetic subjects were specifically analyzed and qualitative-quantitative data collected in the selected randomized controlled trials were extensive for possible meta-analysis.</p><p><strong>Methods: </strong>The review was conducted by two independent practitioners and a third one was consulted in case of conflict. The PRISMA method was used for both the selection and reporting of the studies to be included. Specific PICOS and search strategies have been developed on PubMed, Embase and PsycINFO databases. Included in the review were: randomised controlled trials, full dissertation articles and papers in English with a time limit on May 31, 2022.</p><p><strong>Results: </strong>The Review included 22 studies; 12 on Mindfulness, 9 on Yoga and one about both disciplines; among these, one studied patients with Type 1 Diabetes, 14 with Type 2 Diabetes, 6 with both and one with Gestational Diabetes. Only one paper studied adolescent subjects while the other 21 focused on a range of adult subjects. The studies showed that Yoga and Mindfulness have strong potential not only on stress management, but also on clinical-metabolic parameters.</p><p><strong>Conclusions: </strong>The recent Covid-19 pandemic has certainly redesigned a new way of treating and managing chronic diseases, such as diabetes. An increasingly fragile population, and with the growing need to reduce overall stress levels, could find alternative practices in Yoga and Mindfulness to support conventional therapies.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"153-168"},"PeriodicalIF":1.5,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541474","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
Vaccination strategies for high-risk and fragile populations in Lombardy (Italy): a region-wide assessment of hospital-based models and best practices. 针对伦巴第大区(意大利)高危和脆弱人群的疫苗接种策略:对以医院为基础的模式和最佳做法进行全区评估。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-01-31 DOI: 10.7416/ai.2024.2607
Anna Odone, Riccardo Vecchio, Luisa Brogonzoli, Elisa Sala, Giacomo Pietro Vigezzi, Alba Muzzi, Catia Rosanna Borriello, Danilo Cereda, Giuliano Rizzardini, Alessandro Venturi, Rosaria Iardino
<p><strong>Background: </strong>Subjects with selected underlying medical conditions are at higher risk of infection and severe outcomes from vaccines preventable diseases. While most countries adopt life-course approaches to vaccination, high-risk group immunization programmes could maximize individual protection, while contributing to population health. The COVID-19 pandemic stimulated the planning and implementation of successful hospital-based high-risk groups' immunization models. However, in Italy, high-risk subjects' vaccine coverage is not actively monitored at the national or regional level, nor shared guidelines exist yet on hospital-based immunization programmes.</p><p><strong>Study design: </strong>The study reports findings from a region-wide assessment of the availability, characteristics, and setting-specific features of hospital-based immunization programmes for high-risk subjects in the Lombardy region.</p><p><strong>Methods: </strong>Fondazione The Bridge a not-for-profit organization based in Milan, in collaboration with the Prevention Unit of the Lombardy Region Directorate for Welfare, and the University of Pavia coordinated a project aimed at bringing together regional health institutions, key stakeholders, academic experts, scientific societies and patients' associations to assess high-risk subjects' barriers to vaccine uptake and inform preventive programmes and policies. In this context, we designed and implemented a survey to systematically map the existence and characteristics of hospital-based immunization programmes targeting high-risk subjects. The survey was proposed to all 115 hospital medical directions of the Lombardy region.</p><p><strong>Results: </strong>We collected data from 97 hospital medical directions, with a response rate of 85%. Among respondents, 24% were publi-cly managed hospitals, 17% were Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) and 59% accredited private hospitals. Overall, 51.5% facilities in the Lombardy Region reported to actively administer vaccines to high-risk subjects in hospital settings, the prevalence being 89.6% in public hospitals. Among hospitals where vaccines are actively administered, 46% reported to have centralized vaccines ambulatory clinics, while 54% reported to administer vaccines in the context of inpa-tient care, within clinical wards. In 14% of hospitals vaccination counselling is carried out at the hospital level, while patients are referred to community services for the vaccine administration, 58% have established clinical pathways and formalized internal procedures to integrate vaccine prevention within the clinical care.</p><p><strong>Conclusions: </strong>Half of hospital facilities in the Lombardy Region administer vaccines to high-risk patients. Hospital-based im-munization models vary widely by vaccines programmes, organizational aspects, vaccines procurement and workforce involved. Identifying best practices and effective models c
背景:患有特定基础疾病的受试者感染疫苗可预防疾病并导致严重后果的风险较高。虽然大多数国家都采用终生接种的方法,但高危人群免疫计划可以最大限度地保护个人,同时促进人口健康。COVID-19 大流行促进了以医院为基础的高危人群免疫模式的成功规划和实施。然而,在意大利,国家或地区层面并没有对高危人群的疫苗覆盖率进行积极监控,也没有关于医院免疫计划的共享指南:该研究报告了伦巴第大区针对高危人群的医院免疫计划的可用性、特点和特定环境的评估结果:位于米兰的非营利组织 "桥 "基金会与伦巴第大区福利局预防部门和帕维亚大学合作,协调开展了一个项目,旨在将地区卫生机构、主要利益相关者、学术专家、科学协会和患者协会聚集在一起,评估高危人群接种疫苗的障碍,并为预防计划和政策提供信息。在此背景下,我们设计并实施了一项调查,以系统地了解针对高危人群的医院免疫计划的存在情况和特点。调查对象为伦巴第大区的所有 115 家医院医务处:我们从 97 家医院的医务处收集了数据,回复率为 85%。受访者中,24%为公共管理医院,17%为科研、住院和医疗保健研究所(IRCCS),59%为经认证的私立医院。总体而言,伦巴第大区有 51.5% 的机构报告在医院环境中积极为高危人群接种疫苗,其中公立医院的接种率为 89.6%。在积极接种疫苗的医院中,有 46% 的医院报告有集中疫苗流动诊所,54% 的医院报告在住院治疗的临床病房内接种疫苗。14%的医院在医院层面开展疫苗接种咨询,同时将患者转介到社区服务机构进行疫苗接种,58%的医院建立了临床路径和正式的内部程序,将疫苗预防纳入临床护理:结论:伦巴第大区有一半的医院为高危患者接种疫苗。医院免疫模式因疫苗计划、组织方面、疫苗采购和所涉及的劳动力而有很大不同。确定最佳实践和有效模式有助于应对当前的挑战,提高高危人群的免疫覆盖率。
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引用次数: 0
Quality of hospital care and clinical outcomes: a comparison between the Lombardy Region and the Italian national data. 医院护理质量和临床结果:伦巴第大区与意大利全国数据的比较。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-01-23 DOI: 10.7416/ai.2024.2597
Carlo Signorelli, Flavia Pennisi, Carlo Lunetti, Lorenzo Blandi, Gabriele Pellissero, Working Group Fondazione Sanità Futura

Background: Improving the quality and effectiveness of healthcare is a key priority in health policy. The emergence of the COVID-19 pandemic has exerted considerable pressure on hospital networks, requiring unprecedented reorganization and restructuring actions. This study analyzed data from the Italian National Outcomes Program to compare some volumes and outcomes of public and private accredited hospitals in the Lombardy Region with national data.

Study design: Observational study.

Methods: A thorough examination of hospital outcomes between 2019 and 2021 was conducted, considering 45 volume indicators and 48 process and outcome indicators, comparing Lombardy with other Italian regions and public versus private accredited hospitals.

Results: In 2020, Italy and Lombardy experienced a considerable reduction in overall hospital admissions, with Lombardy showing a deeper decline (21.3% compared with 16.0% in Italy). In 2021, both experienced a partial recovery, especially marked in the Lombardy region (+7.3%, compared with national data). Focusing specifically on the private sector in Lombardy, a recovery of +9.3% in hospitalization was observed. In the analysis of clinical outcomes, Lombardy outperformed the national average for 63% of the indicators in 2020 and 83.3% in 2021.

Conclusions: The study shows the continuing decline in volumes compared to 2019 (pre-COVID), the excellent performance of hospitals in Lombardy and a relevant contribution for the volumes and the quality of outcomes of private accredited hospitals.

背景:提高医疗质量和效率是卫生政策的重中之重。COVID- 19大流行病的出现给医院网络带来了巨大压力,需要采取前所未有的重组和结构调整行动。本研究分析了意大利国家成果计划的数据,将伦巴第大区公立和私立认证医院的部分医疗量和成果与全国数据进行了比较:研究设计:观察性研究:对伦巴第大区与意大利其他大区、公立与私立认证医院进行比较,对2019年至2021年的医院成果进行了全面检查,考虑了45个数量指标和48个过程与成果指标:结果:2020 年,意大利和伦巴第大区的住院总人数大幅下降,伦巴第大区的降幅更大(21.3%,意大利为 16.0%)。2021 年,这两个地区都出现了部分复苏,尤其是伦巴第大区(与全国数据相比增长了 7.3%)。特别是在伦巴第大区的私营企业中,住院率恢复了 9.3%。在临床结果分析中,伦巴第大区在2020年有63%的指标优于全国平均水平,在2021年有83.3%的指标优于全国平均水平:该研究表明,与 2019 年(COVID 前)相比,住院量持续下降,伦巴第大区的医院表现出色,并对私立认证医院的住院量和疗效质量做出了相关贡献。
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引用次数: 0
"Leo&Giulia standing for public health": an animated series to promote the values of public health among school-aged children. Best practices and field-trial protocol. "Leo&Giulia 站在公共卫生一边":在学龄儿童中宣传公共卫生价值观的动画系列片。最佳做法和实地试验方案。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-02-01 DOI: 10.7416/ai.2024.2604
Anna Odone, Alice Clara Sgueglia, Paola Bertuccio, Riccardo Vecchio, Alessandro Meloni, Vincenza Gianfredi, Laura Traverso, Maddalena Gaeta, Giacomo Pietro Vigezzi

Background: The "Leo&Giulia standing for public health" project is an innovative digital health education model targeting primary school children. The project, developed during the COVID-19 pandemic, aims to educate primary school-aged children about public health issues through an animated cartoon series. It highlights the importance of early-life health promotion and the potential role of educational settings in shaping health behaviours.

Study design: A 2-year school-based cluster-randomized controlled community trial will be conducted among 8-10-year-old pupils in the province of Pavia, Northern Italy.

Methods: The intervention group will receive an educational programme via a new episode of "Leo&Giulia" animated series, focusing on smoking prevention. The study will assess changes in knowledge, attitudes towards smoking, and communication about smoking risks among peers and parents. The trial involves baseline and follow-up assessments through questionnaires targeting both children and parents.

Results (expected): We assume that children in the intervention group will demonstrate increased knowledge and awareness of smoking-related health risks and develop negative attitudes towards tobacco use compared to the control group. Enhanced communication about tobacco harms among peers and between children and parents, as well as increased parental involvement in anti-smoking socialization practices, are expected secondary outcomes.

Discussion and conclusions: "Leo&Giulia" integrates health education into the school curriculum, leveraging the appeal of animated content to engage children in public health topics. The project is expected to contribute to the field of health education by demonstrating the effectiveness of digital health interventions in childhood, foreseeing potential long-term impacts on health behaviors and in shaping future public health strategies.

项目背景Leo&Giulia 站在公共卫生的立场上 "项目是一个针对小学生的创新数字健康教育模式。该项目是在 COVID-19 大流行期间开发的,旨在通过动画片系列对小学生进行公共卫生问题教育。该项目强调了生命早期健康促进的重要性以及教育环境在塑造健康行为方面的潜在作用:研究设计:将在意大利北部帕维亚省的 8-10 岁小学生中开展为期 2 年的校本分组随机对照社区试验:干预组将通过新一集的 "Leo&Giulia "动画片接受以预防吸烟为重点的教育计划。研究将评估学生对吸烟的认识、态度以及与同伴和家长就吸烟风险进行交流方面的变化。试验包括通过针对儿童和家长的问卷进行基线和后续评估:我们假设,与对照组相比,干预组儿童对吸烟相关健康风险的了解和认识将有所提高,并对吸烟持消极态度。加强同龄人之间以及儿童与父母之间关于烟草危害的交流,以及提高父母在反吸烟社会化实践中的参与度,是预期的次要结果:"Leo&Giulia" 将健康教育纳入学校课程,利用动画内容的吸引力吸引儿童参与公共卫生话题。通过展示数字健康干预措施在儿童时期的有效性,预见其对健康行为的潜在长期影响,以及在制定未来公共卫生战略方面的作用,该项目有望为健康教育领域做出贡献。
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引用次数: 0
Social network characteristics and well-being in Italy: insights from the PHRASI Study. 意大利的社会网络特征与幸福感:PHRASI 研究的启示。
IF 2 Q3 HEALTH CARE SCIENCES & SERVICES Pub Date : 2024-03-01 Epub Date: 2024-01-18 DOI: 10.7416/ai.2024.2598
Nausicaa Berselli, Marta Caminiti, Angela Ancona, Lorenzo Stacchini, Veronica Gallinoro, Alessandro Catalini, Claudia Cosma, Valentina De Nicolò, Clara Mazza, Giuseppa Minutolo, Fabrizio Cedrone, Vincenza Gianfredi

Background: Mental well-being should be prioritized in public health as it represents a valuable resource for individuals and communities, influencing behavior, social cohesion and social inclusion. The support individuals receive from their social networks can have a significant impact on mental well-being. This study used data from the Public Health Residents' Anonymous Survey in Italy, a nationwide cross-sectional survey. The objective was to assess the level of well-being among the Public Health Residents and investigate the association between the social network characteristics and the well-being in this population.

Study design: The current cross-sectional study targeted 1,600 public health residents enrolled in various Italian public health specialization schools between June 14 and July 26, 2022.

Methods: Participants self-reported both functional and structural characteristics of social network. Well-being was assessed using the WHO-5 well-being index. Linear regression models, adjusted for age and sex, were applied to examine the association between WHO-5 score and social network characteristics.

Results: Out of 379 participants, 51.5% reported bad well-being. Those with bad well-being are more likely women, experience lower peer-to-peer and supervisor support, face higher work-to-private life interference, and less frequently have a partner. Greater peer-to-peer support (β=1.13, 95% CI=0.68; 1.57), and increased supervisor support (β=1.26, 95% CI=0.86; 1.67), were associated with higher levels of well-being. Conversely, higher work-to-private life interference was associated with lower perceived well-being. Having a partner resulted in a better perceived well-being (β=1.96, 95% CI=0.94; 2.98). In logistic regression analysis, higher peer-to-peer support (OR=0.68, 95% CI = 0.55;0.85) greater supervisor support (OR=0.60, 95% CI=0.49;0.74) and having a partner (OR=0.51, 95% CI = 0.32;0.82) were associated with reduced odds of bad well-being. Conversely, increased WLI was associated with higher odds of bad well-being (OR=1.47, 95% CI = 1.19;1.82).

Conclusions: The characteristics of an individual's social network play a crucial role in her/his well-being and should be considered both in personal and professional contexts when aimed to enhance mental well-being in communities.

背景:心理健康是个人和社区的宝贵资源,会影响行为、社会凝聚力和社会包容,因此应将其列为公共卫生的优先事项。个人从社交网络中获得的支持会对心理健康产生重大影响。本研究使用了意大利公共卫生居民匿名调查的数据,这是一项全国性的横断面调查。研究目的是评估公共卫生居民的幸福感水平,并调查社会网络特征与该人群幸福感之间的关联:本次横断面研究的对象是 2022 年 6 月 14 日至 7 月 26 日期间在意大利各公共卫生专业学校注册的 1600 名公共卫生居民:方法:参与者自我报告社会网络的功能和结构特征。幸福感采用 WHO-5 幸福感指数进行评估。采用线性回归模型(根据年龄和性别进行调整)研究 WHO-5 分数与社会网络特征之间的关联:结果:在 379 名参与者中,51.5% 的人表示幸福感不佳。幸福感差的人更可能是女性,得到的同伴支持和上司支持较少,面临的工作与私人生活干扰较多,有伴侣的人较少。更多的同伴支持(β=1.13,95% CI=0.68;1.57)和更多的上司支持(β=1.26,95% CI=0.86;1.67)与更高的幸福感水平相关。相反,工作对私人生活的干扰越大,感知幸福感就越低。有伴侣的人幸福感更高(β=1.96,95% CI=0.94;2.98)。在逻辑回归分析中,更多的同伴支持(OR=0.68,95% CI = 0.55;0.85)、更多的上司支持(OR=0.60,95% CI=0.49;0.74)和有伴侣(OR=0.51,95% CI = 0.32;0.82)与幸福感较差的几率降低有关。相反,WLI 的增加与幸福感变差的几率增加有关(OR=1.47,95% CI = 1.19;1.82):个人社会网络的特征对其幸福感起着至关重要的作用,在社区中提高心理幸福感时,应同时考虑个人和职业背景。
{"title":"Social network characteristics and well-being in Italy: insights from the PHRASI Study.","authors":"Nausicaa Berselli, Marta Caminiti, Angela Ancona, Lorenzo Stacchini, Veronica Gallinoro, Alessandro Catalini, Claudia Cosma, Valentina De Nicolò, Clara Mazza, Giuseppa Minutolo, Fabrizio Cedrone, Vincenza Gianfredi","doi":"10.7416/ai.2024.2598","DOIUrl":"10.7416/ai.2024.2598","url":null,"abstract":"<p><strong>Background: </strong>Mental well-being should be prioritized in public health as it represents a valuable resource for individuals and communities, influencing behavior, social cohesion and social inclusion. The support individuals receive from their social networks can have a significant impact on mental well-being. This study used data from the Public Health Residents' Anonymous Survey in Italy, a nationwide cross-sectional survey. The objective was to assess the level of well-being among the Public Health Residents and investigate the association between the social network characteristics and the well-being in this population.</p><p><strong>Study design: </strong>The current cross-sectional study targeted 1,600 public health residents enrolled in various Italian public health specialization schools between June 14 and July 26, 2022.</p><p><strong>Methods: </strong>Participants self-reported both functional and structural characteristics of social network. Well-being was assessed using the WHO-5 well-being index. Linear regression models, adjusted for age and sex, were applied to examine the association between WHO-5 score and social network characteristics.</p><p><strong>Results: </strong>Out of 379 participants, 51.5% reported bad well-being. Those with bad well-being are more likely women, experience lower peer-to-peer and supervisor support, face higher work-to-private life interference, and less frequently have a partner. Greater peer-to-peer support (β=1.13, 95% CI=0.68; 1.57), and increased supervisor support (β=1.26, 95% CI=0.86; 1.67), were associated with higher levels of well-being. Conversely, higher work-to-private life interference was associated with lower perceived well-being. Having a partner resulted in a better perceived well-being (β=1.96, 95% CI=0.94; 2.98). In logistic regression analysis, higher peer-to-peer support (OR=0.68, 95% CI = 0.55;0.85) greater supervisor support (OR=0.60, 95% CI=0.49;0.74) and having a partner (OR=0.51, 95% CI = 0.32;0.82) were associated with reduced odds of bad well-being. Conversely, increased WLI was associated with higher odds of bad well-being (OR=1.47, 95% CI = 1.19;1.82).</p><p><strong>Conclusions: </strong>The characteristics of an individual's social network play a crucial role in her/his well-being and should be considered both in personal and professional contexts when aimed to enhance mental well-being in communities.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"169-181"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490553","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}
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Annali di igiene : medicina preventiva e di comunita
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