Pub Date : 2024-05-01Epub Date: 2024-02-22DOI: 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。
{"title":"Vaccination status among COVID-19 patients and duration of Polymerase Chain Reaction test positivity: evaluation of immunization schedule and type of vaccine.","authors":"Paola Guerriero, Claudia Cipollone, Roberta Martinelli, Federica Caputo, Maurizio Cervellini, Leondino Mammarella, Mario Muselli, Riccardo Mastrantonio, Giada Mastrangeli, Leila Fabiani","doi":"10.7416/ai.2024.2613","DOIUrl":"10.7416/ai.2024.2613","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study design: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>This study highlights, in a large cohort of patients, the association between vaccination schedule and the response to infection.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"327-334"},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139929690","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 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.
{"title":"Adverse human health effects of climate change: an update.","authors":"Tommaso Filippini, Stefania Paduano, Federica Veneri, Giulia Barbolini, Gianluca Fiore, Marco Vinceti","doi":"10.7416/ai.2024.2595","DOIUrl":"10.7416/ai.2024.2595","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study design: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results and conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"281-291"},"PeriodicalIF":2.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671139","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}
<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
{"title":"Fluoride and caries prevention: a scoping review of public health policies.","authors":"Federica Veneri, Silvio Roberto Vinceti, Tommaso Filippini","doi":"10.7416/ai.2024.2593","DOIUrl":"10.7416/ai.2024.2593","url":null,"abstract":"<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","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"270-280"},"PeriodicalIF":2.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139484820","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 : 2024-05-01Epub Date: 2023-11-23DOI: 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.
{"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}
Pub Date : 2024-03-01Epub Date: 2024-01-31DOI: 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。
{"title":"Variations in avoidable hospital admissions and emergency visits by primary care characteristics: an ecological study in Italy.","authors":"Zeno Dalla Valle, Giovanni Emanuele Ricciardi, Carlo Signorelli, Cristina Renzi","doi":"10.7416/ai.2024.2608","DOIUrl":"10.7416/ai.2024.2608","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study design: </strong>Ecological study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"227-233"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650161","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: 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.
{"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}
Pub Date : 2024-03-01Epub Date: 2024-01-31DOI: 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
{"title":"Vaccination strategies for high-risk and fragile populations in Lombardy (Italy): a region-wide assessment of hospital-based models and best practices.","authors":"Anna Odone, Riccardo Vecchio, Luisa Brogonzoli, Elisa Sala, Giacomo Pietro Vigezzi, Alba Muzzi, Catia Rosanna Borriello, Danilo Cereda, Giuliano Rizzardini, Alessandro Venturi, Rosaria Iardino","doi":"10.7416/ai.2024.2607","DOIUrl":"10.7416/ai.2024.2607","url":null,"abstract":"<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","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"215-226"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650160","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 : 2024-03-01Epub Date: 2024-01-23DOI: 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.
{"title":"Quality of hospital care and clinical outcomes: a comparison between the Lombardy Region and the Italian national data.","authors":"Carlo Signorelli, Flavia Pennisi, Carlo Lunetti, Lorenzo Blandi, Gabriele Pellissero, Working Group Fondazione Sanità Futura","doi":"10.7416/ai.2024.2597","DOIUrl":"10.7416/ai.2024.2597","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study design: </strong>Observational study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"234-249"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541468","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 : 2024-03-01Epub Date: 2024-02-01DOI: 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.
{"title":"\"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.","authors":"Anna Odone, Alice Clara Sgueglia, Paola Bertuccio, Riccardo Vecchio, Alessandro Meloni, Vincenza Gianfredi, Laura Traverso, Maddalena Gaeta, Giacomo Pietro Vigezzi","doi":"10.7416/ai.2024.2604","DOIUrl":"10.7416/ai.2024.2604","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Study design: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results (expected): </strong>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.</p><p><strong>Discussion and conclusions: </strong>\"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.</p>","PeriodicalId":7999,"journal":{"name":"Annali di igiene : medicina preventiva e di comunita","volume":" ","pages":"144-152"},"PeriodicalIF":2.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139671138","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 : 2024-03-01Epub Date: 2024-01-18DOI: 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.
{"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}