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The Herpes Zoster (HZ) vaccination has proven both safe and effective in alleviating conditions related to HZ, leading to significant cost savings in national healthcare and social systems. In Italy, it is recommended and provided free of charge to individuals aged 65 and older. To achieve broad vaccination coverage, alongside ordinary immunization campaigns, active and catch-up campaigns were implemented. This retrospective observational study aimed to observe the vaccination coverage achieved in the Romagna Local Health Authority (LHA) during the 2023 active campaign, with a secondary goal of assessing the impact of the 2022 catch-up campaign and the 2023 active campaign compared to ordinary campaigns. As of 3 July 2023, an overall vaccine uptake of 13.5% was achieved among individuals born in 1958, with variations among the four LHA centers ranging from 10.2% to 17.7%. Catch-up and active campaigns together contributed to nearly half of the achieved coverage in Center No. 1 and a quarter in Center No. 2. Notably, individuals born in 1957, not included in the Center No. 2 catch-up campaign, reached significantly lower vaccination coverage compared to other cohorts and centers. Analyzing the use of text messages for active campaigns, it was observed that cohort groups did not show substantial differences in text-message utilization for warnings. However, having relatives who had experienced HZ-related symptoms significantly reduced the reliance on text messages as warnings. These results highlighted how catch-up and active campaigns effectively increased vaccine coverage. Nevertheless, differences in uptake among different centers within the same LHA and the limited contribution of other information sources compared to text messages suggest the necessity of designing campaigns involving all available channels and stakeholders to maximize vaccine uptake.
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INTRODUCTION: Elderly people who are not capable of performing the basic activities of daily living (ADL) represent a fragile population at greater risk for morbidity and mortality. In order to better describe the size and characteristics of the non self-sufficient population in Italy, we evaluated data from the Argento Study, a survey conducted in 2002 in 11 Italian regions. MATERIALS AND METHODS: A sample of 210 non-institutionalised elderly individuals aged >65 years was selected in each region (310 in the Campania region) by the cluster sampling technique. Home interviews were performed using a standardised questionnaire which included 6 questions on ADL. Participants were considered to have a severe level of dependence if unable to perform any of the 6 activities of daily living independently, partially dependent if able to perform only 1-5 activities independently, and self-sufficient if able to perform all of the activities. A multivariate analysis was performed to evaluate risk factors associated with functional dependence. RESULTS: Complete information regarding ADLs was available for 2,355 (99%) of the interviewed subjects. Of these, 78% (95% CI 76-80%) were found to be self-sufficient, 19% (95% CI 18-22%) partially dependent and 3% (95% CI 1.9-3.2%) severely dependent. Twenty percent of self sufficient subjects and 18% of partially dependent subjects lived alone. Multivariate analysis showed a statistically significant association between being either partially or severely dependent and the following factors: age >75 years (OR 2.8), female sex (OR 1.5), having >2 chronic disorders, (OR 2.8), history of ictus (OR 2.8), having a cognitive disorder (OR 2.6), vision problems (OR 2.3) and hearing problems (OR 1.9). DISCUSSION: These results highlight the presence of a substantial number of partially dependent elderly people that live in the community and that have numerous medical problems and a high frequency of cognitive disorders. It is essential that these fragile elderly subjects be identified, through the active involvement of general practitioners, so that the necessary measures may be undertaken to improve quality of life and of emergency interventions (for example, during heat waves).
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Atividades Cotidianas , Qualidade de Vida , Idoso , Humanos , Prevalência , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
Tobacco smoke is the main cause of preventable death in Italy. It is important therefore to develop evidence-based measures aimed at preventing and treating tobacco addiction. This article describes the "Smoke-free" community project, implemented in the territory of the Cesena Local Health Authority. The success of the project shows that it is possible to carry out inter-sectorial and evidence-based prevention. It also leads to considerations about the role of Prevention Services in the fight against tobacco smoke.