Factors influencing the first thousand days of life. The importance of Nurturing Care.

Background: WHO, Unicef, the World Bank and the Maternal and Child Health Partnership wrote the document "Nurturing care for early child development: a global framework action". This paper highlights the benefits of early intervention and thus the need to invest more in health during this period. The aim of our study is to assess how much social support received by pregnant mothers can influence maternity outcomes. Materials and Methods: The retrospective observational study was conducted on a sample of mothers enrolled via social networks, who were administered a questionnaire from 1 July to 1 September 2021. The questionnaire consisted of 37 questions, 6 of which were used to calculate the "Maternity Social Support Scale". The ODDs Ratio was calculated. Results: Our sample consisted of 3447 women. 59.01% were between 26 and 35 years of age. The mean Maternity Social Support Scale (MSSS) score was calculated to be 23.9 points. A low MSSS score correlated with a higher probability of stopping breastfeeding before 6 months of age (OR: 1.2; CI:1.1-1.4) and of having a caesarean section (OR: 1.2; CI: 1.1-1.4) and to a lower probability of having a spontaneous labour (OR: 0.9; CI: 0.7-0.9) and a spontaneous delivery (OR: 0.8; CI: 0.7-0.9). In contrast, a high MSSS score had a lower likelihood of ceasing breastfeeding before 6 months (OR: 0.8; CI: 0.7-0.9) and caesarean section(OR: 0.8; CI: 0.7-0.9) and higher likelihood of spontaneous onset labour (OR: 1.2; CI: 1.1-1.3) and spontaneous delivery (OR: 1.2; CI: 1.1-1.4). Conclusions: Pregnancy, childbirth and maternity outcomes are strongly influenced and conditioned by the social context in which they occur and the support the woman may receive. The presence or lack of this support may affect the health of newborns.

Overview of case definitions and contact tracing indications in the 2022 monkeypox outbreak.

Background: In 2022, a new outbreak of the Mpox virus occurred outside of Africa, its usual endemic area. The virus was detected in European, American, Asian, and Oceanian countries where Mpox is uncommon or had not been reported previously and where the spread was rapid. The study aims to compare the case definition and the indications for contact tracing in case of Mpox infection among the World Health Organization (WHO), the European Centre for Disease Prevention and Control (ECDC), and four European Countries. Methods: From August 2022 to November 2022, we conducted research, first on the WHO and ECDC official websites and then on the official websites of the Ministry of Health or National Health Agencies of four European Countries (Italy, France, Spain, and Portugal). All reports found were compared to enlighten the differences in the definition of the case and indications for contact tracing. Results: The WHO divides the case definition into four categories: suspected, probable, confirmed, and discarded, while the ECDC divides cases into confirmed and probable. The ECDC defines contact as close and others, while the WHO divides it into high, medium, and minimal risk. The four countries analyzed show heterogeneity in both the case definitions and the indications for contact tracing. Conclusions: Our analysis revealed heterogeneity in the case definition between the WHO and ECDC. Different countries followed different indications or have given their indications for both the case definition and contact tracing indications. Harmonization strengthens public health preparedness and response and creates unified communication.

Inter-Regional Hospital Patients' Mobility in Italy.

BACKGROUND: The federalization of the Italian National Health Service (NHS) gave administrative, financial, and managerial independence to regions. They are in reciprocal competition according to the "quasi-market" model. A network of independent providers replaced the state monopoly. The NHS, based on the Beveridge model in which citizens are free to choose their place of treatment, was consolidated. The aim of our research was to analyze the fulfillment of need for hospital services on site and patients' migration to hospitals of other regions. MATERIAL AND METHODS: We analyzed data from 2013 to 2017 of Hospital Discharge Cards (HDCs) provided by the Ministry of Health. The subjects of the analysis (catchment areas) were the hospital networks of every Italian region. The study of flows was developed through Internal Demand Satisfaction, Attraction, Escape, Attraction, Absorption, and Escape Production indexes. Graphic representations were produced using Gandy's Nomogram and Qgis software. RESULTS: In the studied period, the mean number of mobility admission was 678.659 ± 3.388, with an increase of 0.90%; in particular, the trend for ordinary regime increased 1.17%. Regions of central/northern Italy have attracted more than 60% of the escapes of the southern ones. Gandy's Nomogram showed that only nine regions had optimal public hospital planning (Lombardy, Autonomous Province of Bolzano, Veneto, Friuli V.G., Emilia-Romagna, Tuscany, Umbria, Latium and Molise). CONCLUSION: The central/northern regions appear more able to meet the care needs of their citizens and to attract patients than the southern ones.