Journal of preventive medicine and hygiene最新文献

Introduction: Nosocomial structures pose a high risk of Legionella spp. contamination due to complex water systems with challenging disinfection; moreover, the risk of severe legionellosis as a consequence of nosocomial exposure is very high in settings characterized by vulnerable patient conditions.

Methods: In the present work, we described the results of 7 years of environmental surveillance in a reference hospital in Liguria, in which a specific water safety plan (WSP) has been implemented in 2017, including data collected during the COVID-19 pandemic.

Results: During the study period, 1190 water samples were collected, of which 277 (23.3%) tested positive for Legionella spp. Positive samples with concentration values above 1,000 CFU/l were 184 (66.4%). Based on the new structure categorization contained in the WSP, hospital buildings classified as at "very high" risk resulted the most affected structures over the entire study period; however, the absolute number of positive samples greatly decreased over time, from 61 contaminated water samples in 2017 to only 9 in 2023.

Conclusions: Our findings prompted the reinforcement of control and prevention measures, affirming the appropriateness of risk-category classification. Indeed, the majority of contamination cases were associated with the water networks of buildings classified as "very high" risk.

Objective: To evaluate trends in physical activity levels and their associations with demographic characteristics, health status, and lifetime cardiovascular disease (CVD) risk.

Methods: A longitudinal analysis was conducted using data from 987 males and 1,001 females (45 ± 12 years old) participating in the ATTICA cohort study. Physical activity levels were assessed at baseline (2001-2002) and subsequent follow-ups (2006, 2012, and 2022). Four physical activity trajectories according to participants' physical activity tracking were defined, i.e., consistently active/inactive and changed from active/inactive. Twenty-year incidence of hypertension, hypercholesterolemia, and diabetes were evaluated in relation to physical activity trajectories; the life-table method was utilized to forecast the lifetime CVD risk (death without CVD was regarded as a competing event).

Results: in total, 47% of the participants were categorized as being consistently inactive, whereas only 9% of males and 15% of females sustained physical activity levels throughout the 20-year follow-up period (p < 0.001). Participants being consistently inactive were from lower socioeconomic backgrounds (p = 0.002). Transitioning to being physically active was associated with higher education level and being married (p < 0.001). Consistently active individuals had up to 35% reduced lifetime CVD risk, and lower 20-year incidence of hypertension, and hypercholesterolemia (p < 0.01); no association was observed regarding diabetes incidence.

Conclusions: Promoting and maintaining regular physical activity throughout lifespan is crucial for reducing lifetime CVD risk and related risk factors. Tailored interventions addressing demographic and socioeconomic factors may help enhance cardiovascular health outcomes.

The first annual meeting of the Italian Society for Artificial Intelligence in Medicine (Società Italiana Intelligenza Artificiale in Medicina, SIIAM) on December 7, 2023, marked a significant milestone in integrating artificial intelligence (AI) into Italy's healthcare framework. This paper reports on the collaborative workshop conducted during this event, highlighting the collective efforts of 51 professionals from diverse fields including medicine, engineering, data science, and law. The interdisciplinary background of the participants played a crucial role in generating ideas for innovative AI solutions tailored to healthcare challenges. Central to the discussions were several AI applications aimed at improving patient care and streamlining healthcare processes. Notably, the use of Large Language Models (LLMs) in remote monitoring of chronic patients emerged as an area of focus. These models promise enhanced patient monitoring through detailed symptom checking and anomaly detection, thereby facilitating timely medical interventions. Another significant proposal involved employing LLMs to improve empathy in medical communication, addressing the challenges posed by cultural diversity and high-stress levels among healthcare professionals. Additionally, the development of Machine Learning algorithms for standardizing treatment in pediatric emergency departments was discussed, along with the need for educational initiatives to enhance AI adoption in rural healthcare settings. The workshop also explored using LLMs for efficient data extraction and analysis in scientific literature, interpreting healthcare norms, and streamlining hospital discharge records. This paper provides a comprehensive overview of the ideas and solutions proposed at the workshop, reflecting the participants' forward-thinking vision and the potential of AI to revolutionize healthcare.

Introduction: The management of chronic diseases poses a challenge to the National Health Service (NHS), but it can also offer an opportunity for a radical renovation of healthcare provision. To improve the appropriateness of healthcare settings, it is essential to adopt integrated approach in all healthcare settings.

Methods: This study was conducted at San Giovanni Bosco Hospital, in the area of the "Città di Torino" Local Health Authority, between June 2021 and December 2022. Its main goal was to manage hospital patient flows in an integrated manner in order to improve the efficiency of the entire healthcare system. The data were examined in terms of effectiveness in optimizing hospital flows.

Results: The data indicated that hospital outpatient activities can become more specialized by leveraging the greater technological potential that a hospital possesses. At San Giovanni Bosco Hospital, the hub of the "Città di Torino" Local Health Authority (ASL), differential patient pathways were established in order to enhance the efficiency of the entire system by deploying hospital staff in a community setting. Implementation of the Otorhinolaryngology pathway avoided the hospitalization of 249 patients, who would otherwise have added strain to the overall organization of the hub hospital, which is currently short of space.

Conclusions: A significant effort is needed in order to build an integrated network that provides patients with reliable and stable references. The approach adopted at San Giovanni Bosco Hospital resulted in an improvement in the use of both hospital and territorial facilities.

Introduction: COVID-19 pandemic had impacted the reporting of notifiable communicable diseases. Since the beginning of the pandemic and the introduction of relate public health measures, notifications for most notifiable diseases have declined compared to previous years. In this study, we aim to quantify the changes in the incidences of notifiable infectious diseases during and after the pandemic in Siracusa Local Health Authority, Italy.

Methods: We collected and analysed the infectious disease notifications made in two different three-years periods, 2017-2019 and 2020-2022 in Siracusa Local Health Authority, Italy. Descriptive statistics were used to find the percentages and the 95% confidence interval (CI). Exact "F-tests" was performed to compare the mean values between the studied periods to evaluate the hypothesis that the number of reported cases would not differ significantly between the two periods. Significance was assessed at the p < 0.05 level.

Results: The total number of notifications significantly decreased by 69.3% in the pandemic period compared to the pre-pandemic one, with the highest reduction of air-borne transmission diseases (-86.5%), followed by food-borne diseases (-68.2%) and sexually transmitted diseases (-39.3%). Conversely, an increase in number of notifications was found only for legionellosis.

Conclusions: The COVID-19 pandemic had the potential to influence communicable disease reporting at multiple points. While the effects could vary considerably, the results would be expected to reduce the number and the detection of notifiable cases. Included would be changes in exposures, diagnostic testing, reporting to public health agencies, and public health investigations.

Introduction: Negative trends of trust in governments have been described around the world. This study aimed to describe the distrust level in the National Health Service (NHS) and in governmental management of the pandemic, one year after the start of the COVID-19 vaccination campaign.

Methods: A survey was distributed in February 2022 among a convenience sample. Outcomes were measured through validated tools: Revised Health Care System Distrust Scale, and the COVID-SCORE-10 questionnaire. Associations were assessed using multiple linear regression models.

Results: A total of 2111 questionnaires were collected (54.8% female, median age 43 years [IQR = 34-50]). Distrust in the NHS had a median level of 12 [IQR = 10-14], while trust in the government had a level of 47 [IQR = 35-60]. COVID-19 vaccine hesitancy, high educational attainment, worse economic status, low conventional and digital health literacy, as well as the presence of conspiracy thoughts and distrust in the NHS were significantly associated with lower trust in government during the COVID-19 pandemic. Lack of trust in governmental actions, along with low education and health literacy, as well as the presence of conspiracy thoughts and worse perceptions of one's own health, were associated with greater distrust in the NHS.

Conclusions: Overall, low levels of trust in both the government and the NHS have emerged. Since the determinants of reduced trust in institutions can be very diverse and that such levels of distrust after a pandemic can last for an entire generation, tailored interventions are needed to rebuild adequate levels of trust in institutions among the population.

Introduction: Adverse pregnancy outcomes pose serious health risks to both periconceptional women and newborns. This study aimed to investigate the levels of knowledge, attitudes, and practice (KAP) toward adverse pregnancy outcomes among women of reproductive age in Al-Suwaira, Wasit governorate, Iraq.

Methods: During November 2021 to February 2022, cross-sectional research of randomly selected women was performed. The KAP was evaluated with a standard, self-administered questionnaire. The outcomes were described using a descriptive analysis.

Results: The questionnaire was completed by 118 women. Participants had good knowledge and positive attitudes and practices toward adverse pregnancy outcomes. The findings revealed that the majority of participants were between the ages of 20 and 25 (n = 57, 48.3%) and had a Bachelor's degree (n = 106, 89.8%).Knowledge gaps were discovered in the areas of the danger of pregnancy at a young age of less than 17 years (30.5%), the link between lack of maternal education and poor births (24.6%), and the influence of drug misuse on the fetus (17.8%). The participants learn more around pregnancy-related risk factors via internet (n = 38, 32.2%) and university (n = 34, 28.8%).

Conclusions: The participants in this study had good knowledge, positive attitude, and positive practice regarding adverse pregnancy outcomes. However, there were some knowledge gaps. Therefore, to raise awareness among local women, it seems advisable to strengthen and strictly apply awareness-raising plans.

Background: Overweight has been associated with several social and phycological problems and is perceived as one of the major health care challenges to focus on in the future. The purpose of the study is to investigate the correlations among nutritional status, assessed by the Body Mass Index, the perception of one's own health status and Life Satisfaction, detected in Italian adolescents living in Tuscany Region, and to investigate the influence of gender on them.

Methods: A statistically representative sample of 2760 Tuscan adolescents aged 11, 13 and 15 was involved in the 2018 Health Behaviours at School-aged Children survey. The participants were divided into three nutritional status class: underweight, normal weight and overweight (overweight + obese).

Results: The results show that there is a statistically significant difference in all categories between boys and girls aged 13 and 15 years; in girls aged 11 and 13 years, the Life Satisfaction of the overweight group is statistically lower than that of normal and underweight groups; Self-Rated Health is statistically lower in all age groups for overweight individuals compared to normal weight children, except for 11-year-old females.

Conclusions: Viewing the psychosocial problems related to overweight, more attention and care must be placed on adolescents to ensure their healthier development.

Background: Occupation significantly influences oral health, with factors like the work environment, stress levels, access to dental care, and job-related habits playing crucial roles. The oral health of construction workers, especially migrant workers, is a noteworthy concern. Understanding the oral health of this population is crucial for enhancing their quality of life through various means. This study aimed to investigate the prevalence of dental caries, oral hygiene status, and deleterious habits in this occupational group of Belagavi district, Karnataka.

Materials and methods: Study design was cross-sectional in nature. Before commencement of the study a pilot study was conducted. Multi-stage random sampling technique was employed, and 610 participants were recruited for the study. Trained and calibrated examiners recorded WHO dentition status and treatment needs (2013) and Oral Hygiene Index Simplified (OHI-S). Collected data was analyzed using descriptive analysis, chi-square, one-way ANOVA, and multiple linear regression analysis.

Results: The prevalence of dental caries among construction workers was significantly high (81%), and poor oral hygiene was observed among 36.9% of them. The prevalence of smoking, the tobacco chewing habit, and alcohol consumption among the construction workers was found to be 21.6%, 59.9%, and 37.3%, respectively. The dependence of OHI-S and DMFT on predictors (age, gender and deleterious habits) was found to be 21.5% and 39.6%, respectively.

Conclusions: Migrant construction workers in Belagavi had a high caries prevalence, poor oral hygiene status, and a high prevalence of deleterious habits such as tobacco use. These results emphasize the necessity of awareness and dental health education programs to improve the oral health of construction workers.