Journal of preventive medicine and hygiene最新文献

Background: Anemia is a condition in which the number of healthy red blood cells/ hemoglobin (Hgb) level (and consequently their oxygen-carrying capacity) is insufficient to meet the body's physiologic needs. Thus, the current study is aimed to assess the spatial distribution and determinant factors of anemia among women aged 15-49 in Burkina Faso.

Methods: A secondary data analysis was done based on 2021 Burkina Faso; Demographic and Health Surveys. Total weighted samples of 5655 women's were included. Data processing and analysis were performed using STATA 14; ArcGIS 10.1 and SaTScan 9.6 software.

Result: The spatial distribution of anemia in Burkina Faso among women aged 15-49.was found to be clustered (Global Moran's I = 0.25, p value < 0.0001). In the multivariable mixed-effect ordinal regression analysis; Age 25-29 years [AOR = 1.31 ; 95% CI: 1.06 1.61], rich wealth status [AOR = 1.32 ; 95% CI: 1.08 1.62], regions Cascades [AOR = 1.62 ; 95% CI: 1.16 2.25],Hauts-bassis [AOR = 1.40; 95% CI: 1.06 1.84], Plateau central [AOR = 0.72 ; 95% CI: -0.54 0.96 and Sahel[AOR = 0.42 ; 95% CI: 0.28 0.63], were significant predictors of anemia among women aged 15-49.

Conclusions: A significant clustering of anemia among women aged 15-49 were found in Burkina Faso. Age, wealth index, regions Cascades, Hauts-bassins, Plateau central, and Sahel were significant predictors of anemia.

Introduction: Surgical site infections (SSIs) are among the most frequently encountered complications in prosthetic surgery, and are associated with increased hospitalization, costs and in-hospital mortality. There is no national system for the comprehensive monitoring of the incidence of SSIs.

Methods: All patients undergoing orthopedic prosthetic surgery from April 1 to June 30, 2023 were enrolled. Clinical evaluation of the surgical site was conducted at 30 days, and a follow-up telephone interview was carried out by means of a specially designed questionnaire at 90 days.

Results: A total of 59 patients were included. Surgery was performed on the knee in 71.19% and on the hip in 28.81%. The patients' mean BMI was 28.25 ± 2.97, and their mean ASA score was 2.67 ± 0.58. Six patients had diabetes mellitus. The incidence of SSIs was 5.08%; two infections occurred in knee prosthesis surgery and one in hip surgery. Analysis of the data revealed that diabetes was the main risk factor for the development of infection.

Conclusions: Although based on a small number of patients, these results are encouraging, especially considering that the patients had an average ASA score of more than 2 and a high BMI. However, to further reduce the risk of infection, improved hygiene measures have now been implemented in the operating room and the antibiotic prophylaxis protocol has been updated to take into account the potential for MRSA colonization.

Introduction: The article aims to outline the features of the efforts for smallpox eradication within the pre-unitary context of the Kingdom of Sardinia, characterized by a long tradition in medical-health prevention. This tradition is partly inherited from the health magistracies of the Italian states during the ancient regime and partly adopted from policies initially outlined by Napoleon and later by other European states. In addition to prevention activities, authorities also engage in a vigorous information and awareness campaign aimed at eliminating common prejudices and doubts about vaccination among the population.

Methods: In analyzing the authorities' achievements in combating smallpox, this study examines the two epidemic waves (1829-30 and 1852-54), along with the legislative developments before, during, and after these periods. It also compares these regulatory changes with those in other European contexts.

Discussion: The epidemiological situation turned out to be more complex to manage than the authorities had anticipated, as evidenced by the increasing controls imposed. Scientific and political communities, both in the Kingdom of Sardinia and in other European nations, found themselves divided on the legitimacy of proposing restrictive measures by the state. Some advocated for restricted access to public places and imposed mandatory vaccination for vulnerable individuals.

Conclusions: The comparison with smallpox resulted in a gradual improvement in of health security levels, although vaccination coverage did not reach the desired targets. Several factors contributed to this failure, including the limited expertise and reluctance of medical personnel, who were burdened with much of the operation's costs. Additionally, particularly in rural areas, there was widespread mistrust among the population towards doctors. Despite these challenges, the fight against smallpox enabled authorities to develop population control tools in the name of public health protection. However, it was not until 1888 that mandatory vaccination was introduced.

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.