Journal of preventive medicine and hygiene最新文献

Introduction: At San Martino IRCCS Hospital in Genoa, Italy, emergency and urgent surgery is classified according to the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) classification, whereby cases are divided into two categories and colour-coded accordingly: - EMERGENCY - (Colour-code: RED) "Surgery to be performed within minutes"; - URGENCY - (colour-code: YELLOW) "Surgery to be performed within hours". In this context, it is essential that the emergency surgical team gets clear and complete information from the proposing surgeon, in order to complete the surgical list.

Methods: Between 14^th April 2023 and 23^th July 2023, a new method of requesting urgent and emergency surgery by filling out an online form was tested.

Results: A total of 406 online requests were made, resulting in 367 E/U surgeries. The greatest number of emergency operations concerned thoracic-abdominal surgery (45%), followed by urology (19%). The requests analysed classified 18% of cases as red and 71% as yellow. The remaining 11% contained compilation errors. Moreover, 11% of the interventions were not performed within the time limits defined according to the severity code.

Conclusions: By means of this new tool, San Martino IRCCS Hospital's Healthcare Management Unit can monitor requests for surgery in real time, thereby achieving greater efficiency and implementing corrective measures in the use of Operating Room resources.

Introduction: Osteoarthritis (OA) is one of the most common degenerative joint diseases which involved all joints. It is very important to choose a treatment method with high efficiency to reduce the pain and disability of patients and also to improve their quality of life. The current study aimed to investigate the therapeutic effects of intra-articular injection of PRP and hyaluronic acid (HA) in the knee of people with knee osteoarthritis (KOA).

Methods: In this randomized clinical trial study, 90 patients with KOA were randomly divided into two groups of intra-articular HA and PRP. The patients of the two groups were followed up for five months and different outcomes were recorded. The McMaster index (WOMAC) evaluated all patients at rest and during movements. Measurements were taken at the beginning and after the third month of follow-up.

Results: Three month after the last injection (5th month) and after adjusting of baseline value using analysis of covariance, the mean of knee pain, stiffness, physical function and finally total score in the PRP group, was significantly lower than the HA group. Regarding the Osteoarthritis grade, the mean of knee pain, Stiffness, Physical function and finally total score in the PRP group was significantly lower than the HA group in all Osteoarthritis grades. Also, there were no complications in the studied groups.

Conclusions: The results of the current study showed that pain and stiffness reduction as well as physical function of the knee joint in the PRP group was better than in the HA group.

Background: Violence against healthcare workers is an escalating public health concern, affecting the quality of care, and causing significant psychological and physical effects on healthcare professionals. This study analysed the trend in aggressions in healthcare settings in the pre-pandemic, pandemic, and post-pandemic periods.

Methods: An observational descriptive study was conducted to analyse reports of violence against healthcare workers from January 2018 to June 2023 at a Local Health Authority "ASL3" in the Liguria region of Italy. The study considered variables such as the severity of aggression, professional category involved, and location of incident. Episodes of violence were classified according to severity by means of a colour-coded system. We used multinomial logistic regression to examine any associations between the pandemic phase and the various factors, while controlling for relevant variables.

Results: The number of reported aggressions rose from 48 in 2018 to 90 in 2022, with a partial count of 35 in the first half of 2023. The pandemic phase saw a rise in incidents classified as Green codes, which accounted for 58.3%, and a significant involvement of District Services. The post-pandemic phase showed a reversion to pre-pandemic levels but with an increase in Yellow codes (5.6%). Nurses were the most frequent victims, with figures ranging from 50.8% to 95.6% over the years. The Emergency Department and Psychiatric Services emerged as the most critical settings of aggressions, with incidents recorded in these areas constituting over half of the total number. However, an increase in violence was also recorded in district healthcare settings during the post-pandemic phase.

Conclusions: There is an urgent need for comprehensive strategies for the prevention of violence in healthcare settings. The increasing trend in violence, especially during the pandemic, necessitates integrated approaches that encompass training, psychological support, security policies, and a strong organizational culture to promote safety and respect. Protecting healthcare workers is crucial to their wellbeing and the quality of healthcare delivery.

After years of cost-containment policies, the Italian National Health Service (NHS) has now the chance to change and improve, especially thanks to the National Recovery and Resilience Plan (NRRP). The plan serves as a catalyst for reform, allocating substantial funds to reinforce proximity networks, facilities, and telemedicine for territorial healthcare. Mission 6, specifically dedicated to health, focuses on integrating primary healthcare, hospital, and specialty care networks, underscoring the importance of a robust primary healthcare system. In alignment with NRRP objectives, the Ligurian model introduces innovative structures, such as Community Houses (CdCs), Community Hospitals (OdCs), and Territorial Operation Centres (COTs). These interconnected components form a dynamic network designed to enhance healthcare accessibility, prevent inappropriate hospital admissions, and facilitate efficient patient transitions. The model prioritizes multidisciplinary collaboration, community engagement, and the integration of socio-healthcare services. Despite substantial NRRP funding for infrastructure, challenges related to staffing and human resources persist. The social and epidemiological context highlights concern about the economic feasibility of the reform, potential workforce shortages, and the imperative for updated regulatory frameworks. The strategic reallocation of personnel from acute hospitals to new facilities is crucial, requiring meticulous workforce planning, role definitions, and trainingIn conclusion, the Ligurian model emerges as a proactive response to the structural vulnerabilities exposed by the pandemic, aligning with international trends in emphasizing primary care, prevention, and community-based services.

Introduction: Cervical cancer is a global health concern primarily caused by human papillomavirus (HPV). It has a significant impact in Germany, with thousands of new diagnoses and deaths annually. Despite advancements in screening and treatment leading to improved survival rates of 65% for invasive cervical tumors, the financial burden remains substantial.

Aims: The study aims to assess the impact of gender and education of Wiesbaden students towards cervical cancer and its associated health policies. Data was collected through an online questionnaire distributed with 54 students in Wiesbaden, Germany participating in the study. Statistical analysis was performed using SPSS, including one-way ANOVA, t-tests, Kruskal-Wallis, and chi-square tests. The respondents' average age was 28.24 years, with a higher female participation.

Results: Education level did not significantly influence perceptions of ideal vaccination age (p < 0.581). Females and males perceived a lower number of vaccine doses (< 3) required compared to the standard. Education level showed a moderate association with knowledge of long-term complications, and gender had a moderate correlation with information sources (rho = 27, p = 0.090).

Conclusion: Gender disparities did not significantly impact knowledge of cervical cancer. Public health programs should consider education levels and tailor interventions to all age groups and genders.

Introduction: Acute bronchiolitis is one of leading causes of lower respiratory tract infection and hospitalisation in children less than one year old worldwide. The aim of our study is investigating the impact of bronchiolitis in children paediatric to the Emergency Department (ED) of Teaching Hospital (AOUS), Santa Maria alle Scotte of Siena, Tuscany (Italy).

Methods: A retrospective observational study was conducted on the accesses performed at the ED of the AOUS of Siena by children under 18 years of age suffering from bronchiolitis from September 2018 to April 2023.

Results: There were 36,031 patients between 0 and 18 years old in the Emergency Department, 383 of which presented bronchiolitis (age 4.8 months C.I.:3.5-6 months.; 54% male). Those who accessed the ED with a higher priority code were more likely to be subsequently admitted (O.R.:2.6; C.I.:1.3-5.1; p < 0.01). Those who accessed the ED with symptoms of bronchiolitis during the weekend were less likely to have been sent from community medicine services or professionals (O.R:0.1; C.I:0.0-0.5; p < 0.001). Children below 1 year old were more likely to access the ED with respiratory distress symptoms (O.R.:2.6; C.I.:1.5-4.3; p < 0.001). Finally, those who accessed the ED with bronchiolitis were more likely to be admitted than those who accessed for other conditions (O.R:24.5; C.I.:19.4-31; p < 0.001).

Conclusions: It is necessary to invest protocols integrating hospital services and community medicine in order to achieve a timely diagnosis and to reduce the accesses to the ED of children presenting mild, non-severe form of bronchiolitis in order to avoid the overload of hospital services.

A hundred years ago, Achille Sclavo (1861-1930) published his book entitled "Per la Propaganda igienica. Scuola e Igiene" (The Propagation of Hygiene. Schools and Hygiene) which he dedicated "To elementary teachers, from whom Italy expects the most effective propaganda in favor of hygiene". The words of the dedication were profoundly felt by Sclavo and reveal a precise choice by the great hygienist. Sclavo was then at an advanced age and had devoted his whole life to studying hygiene and disseminating its basic concepts, to promote a healthier life for all. Nowadays, Sclavo's book "The Propagation of Hygiene. Schools and Hygiene" still remains an important statement to the commitment of the great hygienist to spreading a culture of hygiene, and public health in Italy. This was a commitment that Sclavo clearly felt throughout his life, as a teacher, as a scholar, as the entrepreneur who founded the Serotherapy and Vaccinogenic Institute in 1904, and mainly as a policymaker who spoke to all citizens, especially young people.

Introduction: Respiratory Syncytial Virus (RSV) predominantly affects young children, with a peak incidence in temperate regions of the northern hemisphere from October to May. Children under 24 months of age are particularly vulnerable because of the immaturity of their lungs and immune systems, often leading to severe respiratory infections. The World Health Organization (WHO) recognizes RSV as a global health priority. Recently, Nirsevimab, a long-acting monoclonal antibody (mAb), was authorised to prevent RSV disease in infants.

Methods: Our narrative review brings together the effectiveness data of Nirsevimab available in the literature, highlighting the strengths and weaknesses of the published studies and the prevention opportunities represented by the new preparation.

Results: All reviewed studies provide evidence for the effectiveness of immunisation with Nirsevimab in real-world settings, beyond the controlled conditions of clinical trials, and highlight its safety and feasibility. Nirsevimab significantly reduces RSV hospitalisations and Intensive Care Unit (ICU) admissions. High coverage and high efficacy of immunisation have been reported, although supply issues and variability in studies present challenges.

Conclusions: Continued research and surveillance are critical to understanding the long-term effectiveness of Nirsevimab. Overall, available data provide valuable insights into the efficacy, safety, and impact of immunisation with Nirsevimab in preventing severe RSV infections in infants, highlighting its potential to reduce the burden of RSV-related hospitalisations and improve paediatric health outcomes.

Background: Eating a healthy diet is acknowledged as one of the main factors in preventing malnutrition and non-communicable diseases. As young students represent a group more prone to poor dietary habits, the aim of this study was to analyse the dietary habits of a group of undergraduate students attending university in a city of central Italy, Siena.

Methods: 4,700 students were invited to participate in a cross-sectional study completing an online self-administered questionnaire about their food habits. The obtained data were analysed by Microsoft Excel 2021 and Stata 17 software, through the Mann-Whitney and the Kruskal-Wallis test; a p-value < 0.05 was considered statistically significant.

Results: The students living at home consumed more fruit, vegetables, pasta, meat, fish, packaged foods, fruit juices, beer and wine; the only statistically significant differences were found for pizza and snacks. Even the gender influenced the consumption of many foods; women consumed more vegetables and coffee/tea, while males ate more pasta, meat, packaged foods, pizza, fries and beer.

Conclusions: With the transition from secondary school to university, students are continuously challenged to make healthful food choices and they must be self-disciplined to take care of themselves. It would be important for health campaigns to be promoted in young adults to help them make the right choices.

The complex challenges of the Anthropocene imply a careful reconsideration of the ethical boundaries of human morality and a heightened sensitivity to the interconnectedness among all living beings. This means that bioethics, traditionally anchored in interhuman relations within the healthcare domain, is called upon to broaden the scope of its operational horizon, encompassing issues related to interspecific relations, environmental health, sustainability, equitable distribution of natural resources, and responsibility for environmental damages. This article explores the intersection between the anthropocentric era and the ethical challenges arising from our increasing influence on the environment and other life forms with which we share the planet. The teaching of fundamental ethical concepts such as solidarity, social responsibility, and equity becomes crucial for nurturing informed and responsible citizens. In doing so, not only is greater awareness promoted regarding global challenges related to health and the environment, but critical skills are also developed to address them proactively.