Journal of preventive medicine and hygiene最新文献

This paper presents a case study of the barriers to care faced by a 44-year-old patient from Ivory Coast who has been living in Italy for 15 years. The patient visited his general practitioner (GP) in his neighborhood in southern Italy, seeking treatment for a complex workplace-related hand injury for which parenteral antibiotic therapy was recommended. During the medical examination, the physician also diagnosed the patient with diabetes mellitus and prescribed specialist examinations (i.e., diabetology, physiatry, surgery). Even if the patient was a regular resident in Italy, he encountered difficulties in navigating the health system to obtain the recommended services (i.e., administration of parenteral antibiotic therapy, serial dressings for the wound, booking several medical appointments). The local office of the Italian non-governmental organization EMERGENCY (EMR) stepped in to support the patient in facilitating the health system navigation and collaborated with his GP on a diagnostic and therapeutic strategy. The course was regular and the patient did not develop any complications (i.e., gangrene, sepsis). The synergy between EMR, the patient, and his GP has resulted in (1) an effective clinical pathway, (2) reduced barriers to access, and (3) increased patient empowerment. However, this approach proved to be extremely resource-intensive. Organizing these resources with more planning and forethought would have granted many more patients access to care. If the SSN were to provide comprehensive healthcare to all patients without relying on the presence of NGOs, outcomes for marginalized individuals would improve significantly, and healthcare resources would be utilized more efficiently and sustainably.

Introduction: The growing importance of Preventive Medicine is creating a need for specialised professional figures, that are often missing in the actual national and international contexts. This study aimed to assess attitudes, knowledge, and compliance with preventive measures of the Italian physicians specializing in this field, addressing the unrecognized significance of the figure of a prevention expert in Italy and the inadequate training in this Public Health branch.

Methods: Between May 1 and May 31, 2023, an online survey was administered to approximately 200 Hygiene and Preventive Medicine Residents (HPMMDR), covering demographic data, health behaviours, training and interests in Preventive Medicine and in undergoing a visit of a "preventive doctor". The collected data were cross-referenced to understand which variables were most related to knowledge and interests in this field. Statistical analyses included parametric tests, hierarchical cluster analysis, and ordered logit regression.

Results: Demographically, 57.0% were female, median age 31, with central Italy having the highest representation (52.3%). Analyses revealed associations between demographics, health behaviors, and attitudes. Ordered logit regression showed a significant correlation (OR = 11.3, p = 0.03) between a healthier lifestyle and belief in specialists' usefulness.

Conclusion: Despite the lack of recognition and insufficient education, the study unveiled substantial interest and willingness to learn among HPMMDRs in Italy. Findings emphasize the need for recognizing shared priorities and implementing actions for effective Preventive Medicine interventions, guiding future research and policy decisions.

Background: Healthcare-associated infections (HAIs) are a significant healthcare complication, with major implications for public health. In the EU/EEA, up to 2.6 million new HAIs cases occur annually, causing significant burdens and economic costs. In Italy, the prevalence of HAIs is rising due to factors like invasive devices, antibiotic resistance, and poor infection control. The aim of this work is to evaluate the effectiveness of HAIs containment practices in long-term care facilities (LTCF).

Materials and methods: This cross-sectional study included eight LTCF inspected by Prevention Technicians of the Local Health Authority Tuscany South-East (LHA-TSE) in 2023. The study evaluated non-compliance in procedures for legionellosis prevention, cleaning and disinfection, laundry management, management of pans, HAIs prevention, healthcare tools disinfection, and hairdressing services. Data were analysed using descriptive statistics and the Mann Whitney test to compare infection rates with procedure compliance.

Results: In 2023, 606 infections were reported in the eight enrolled LTCF. The most frequent infections were COVID-19 (19.4%), urinary tract infections (16.9%), pharyngitis (15.6%), and influenza-like illness (ILI) (15%). For the "Laundry Procedure," 3 LTCF were compliant and 5 were not, showing a significant relationship with influenza syndromes (p = 0.02) and surgical site infections (p = 0.04). For the "Cleaning Check" procedure, non-compliance was linked to higher fungal infections (p = 0.01) and gastroenteritis (p = 0.04). The "Disinfection of Health Tools procedure showed non-compliance correlated with higher gastroenteritis (p = 0.04) and conjunctivitis (p = 0.01). Gastrointestinal infections from Clostridium difficile were linked to non-compliance with "HAIs Procedures Routes" (p = 0.04), "Pans" processes (p = 0.04), and cleanliness in the hairdressing service (p = 0.04). Herpes simplex or Herpes zoster infections were higher in LTCF with non-compliant hairdressing service rooms (p = 0.02). Two legionellosis cases were recorded in LTCF with reported non-compliance in analytical procedures for Legionellosis.

Conclusions: Our analysis showed significant correlations between cleanliness procedures and reductions in fungal infections, gastroenteritis, and ear infections. Compliance in laundry procedures was linked to ILI and surgical site infections. Non-compliance in healthcare tools correlated with higher rates of gastroenteritis and conjunctivitis, highlighting the need for stronger practices. The data suggest that effective prevention measures reduce HAIs, though discrepancies in implementation across facilities call for standardization and continuous monitoring.

Introduction: Tuberculosis (TB) represent a serious public health issue even in most developed countries, where TB cases are mostly concentrated in some risk groups, like immigrants from high-incidence TB countries. Aim of the study was to describe the occurrence of TB in Siracusa Local Health Authority (Italy) and to explore its determinants in three different populations: Italy-born, regular foreigner and irregular foreigner.

Methods: Cases were classified per patient origin and legal ground: Italy-born (IB); regular foreigners (REF); irregular foreigners (IRF). All the notifications were evaluated and uploaded to the Notification System of Infectious Diseases (PREMAL) by the Epidemiology Unit of the Prevention Department of Siracusa LHA.

Results: During the study period, 183 TB cases were detected: 72 (39.3%) were Italy-born, 26 (14.2%) were regular foreigners and 85 (46.5%) were irregular foreigners. Overall, foreign-born cases (regularly and irregularly residents) accounted for 60.7% of all cases. We demonstrated significative differences in epidemiological, demographic and clinical features among the three different groups.Furthermore, we registered a decrease in TB notifications of 59.5% among Italy-born patients, 46.0% among regular foreigners and 95.5% among irregular foreigners, who, however, remain the population group with the highest incidence of tuberculosis in Siracusa LHA.

Conclusions: TB control in migrants is considered key to achieving TB elimination in low TB incidence countries, in accordance with the World Health Organization (WHO)'s End TB Strategy, that set ambitious targets for 2020-2035, including 90% reduction in TB incidence and 95% reduction in TB deaths by 2035, compared with 2015.

Introduction: Breast cancer is a major worldwide health concern that affects women in both developed and developing nations. The purpose of the study is to assess Pakistani women with breast cancer's present understanding of breast self-examination (BSE) as well as their choices for traditional and non-conventional breast cancer treatment options.

Methods: A cross-sectional study was carried out in two hospitals' cancer departments as well as homeopathic and nutritional clinics in Lahore, Pakistan. The data for the present study was collected from January to June 2023.

Results: A total of 296 responses were obtained. The study findings showed that most participants had little knowledge about BSE and were using multiple treatment options without informing their healthcare provider.

Conclusions: Breast cancer awareness is crucial for early detection, education about risk factors, and proactive fitness management. Complementary and alternative medicine (CAM) might cause problems when used with allopathic medicines, especially if healthcare professionals are not adequately informed about its concomitant use.

Introduction: Implicit learning during clinical placements includes patient safety issues. Simulation scenarios offer ways to improve the learning process and students' awareness of patient safety. The aim of this study was to develop a prototype simulation scenario based on real student experiences.

Methods: This was a mixed-method study using a multi-phase design. Nursing students' experiences of workplace events they identified as possible threats to patient safety were collected between 2017 and 2019. These experiences were used to develop an interprofessional scenario about patient safety.

Results: A range of scenario materials were produced including a video. Participation in the scenario video had positive impacts including: "feeling safer" while performing nursing activities and more timely detection and reporting of errors. Nursing students reported that participation in the scenario taught important lessons about patient safety, communication, listening to patients and healthcare collaboration.

Conclusions: The role-playing methodology of the scenario provided opportunities for reflection on patient safety and improved interprofessional understanding and communication in an emotionally safe environment.

Objective: Rabies remains a significant public health threat, particularly in developing countries. This study aimed to analyze the epidemiological characteristics of animal bite injuries in Iranshahr, Iran, from 2019 to 2021.

Methods: A descriptive analysis was conducted on 6,085 animal bite incidents reported to Iranshahr University of Medical Sciences' rabies prevention centers between April 2019 and March 2021. Data collected included demographic information (age, gender, occupation, nationality), type of animal involved (dog, cat, etc.), timing of the incident, injury severity, and treatment received. Statistical analysis was performed using SPSS version 19, ArcGIS version 10.8.2, and Excel 2019.

Results: The average age of victims was 25.22 years, with males constituting 66.9% of cases. A significant majority (67.1%) of bites occurred in rural areas, and 38% of victims were under 19 years old. Dogs were responsible for 89.8% of bites, followed by cats at 5.2%. The highest incidence was noted in spring (30.8%). The cumulative incidence rate was 151 per 100,000 population, peaking at 253 per 100,000 in Rask City and dropping to 131 per 100,000 during the first year of the COVID-19 pandemic. Among the sampled animals suspected of rabies, eight were confirmed positive.

Conclusions: The findings indicate that school-aged children and adolescents are particularly vulnerable to dog bites, highlighting the need for targeted educational programs. The presence of confirmed rabies cases in animals underscores the necessity for comprehensive control measures, including stray dog management and vaccination initiatives for domestic pets.