[Cardiovascular screening]. / Lo screening cardiovascolare.

OBJECTIVE: To evaluate, through active call, lifestyles of an asymptomatic population in order to identify hyperglycaemic subjects and/or high-blood pressure sufferers to dispatch to their GP to perform suitable checking, and subjects to invite to a cardiovascular disease prevention programme because of their lifestyles. SETTING AND PARTICIPANTS: Between April 2011 and March 2013, all healthy residents in 6 Local Health Authorities of Regione Veneto aged 45-59 years were invited to join a cardiovascular disease prevention programme. DESIGN: All participants were evaluated through an administered lifestyle questionnaire. Parameters such as blood pressure (BP), glycemia, waist circumference and body mass index were collected and recorded. Participants also received counseling, informational materials on lifestyle and were invited to individual or group health promotion initiatives in relation to personal risk factors. RESULTS: Among the invited, 60.84%(10,346/17,004) adhered. Subjects without risks factors were 23.95%. Subjects with lifestyle risk factors but normal BP and glycemia were 56.59%, while those with altered values for BP and glycemia were 13.9%. The 5.55% of the respondents was not eligible for the study. CONCLUSIONS: The results confirmthat a preventive programme based on the citizens active call by the Department of prevention could be an effective tool to identify asymptomatic individuals with unknown hypertension and/or hyperglycaemia and to offer lifestyle interventions to lower the risk of cardiovascular diseases. Since the results were positive, the the Regional Veneto Centre for Disease Prevention and Control (CCMR - Veneto) presented a similar project to the Ministry of Health, involving 12 Italian Regions.

[Evidence-based prevention]. / La prevenzione basata sulle evidenze scientifiche.

The purpose of this contribution is to indicate the situation of the initiatives ongoing in the nation to abolish preventative action lacking evident and solid foundations of efficacy from our health legislation. The status of the proposal for the bill, "Measures for the simplification of administrative duties related to the protection of health and other health-related actions", is illustrated, as well as the ongoing work of the "EBP (Evidence Based Prevention) subcommittee" instituted within the permanent scientific committee of the CCM. The national situation regarding two of the first interventions of rationalization activated is presented: the abolition of health controls for food workers and health controls on minors with low-risk jobs. The first data are presented of the latest monitoring of the administrative and health effects in the Veneto Region following the abolition of LISA, which occurred in 2004. A troubling evaluation is expressed on the state of the attempt to renew prevention in the nation especially regarding the sectors of veterinary medicine and job-related medicine. Further effort on the part of scientific societies is hoped for and the necessity of a strong initiative by the coordinating inter-regional prevention round-table is demonstrated. The round-table should take the initiative to discuss with the CCM a work program that involves evaluation interventions in all areas of prevention, including those relative to work-places and veterinary services. In this way, an attempt to reconstruct, from the bottom-up, a unitary vision of intervention will be possible, one that is now strongly fragmented at the level of the central government.

[The role of the public health personnel in the Prevention Department (in the Hygiene Services and Public Health Care and Hygiene of Food and Nutrition): proposal for the future of public health care]. / Il ruolo del medico di sanità pubblica del Dipartimento di prevenzione (nei servizi di Igiene e Sanità Pubblica e Igiene degli Alimenti e Nutrizione): una proposta per il futuro della sanità pubblica.

A global and local discussion on Public Health relevance is taking place, including the future role and organization of its services. Noteworthy becomes the role played by Public Health Specialists. This work presents the results of a workshop, carried out following the Guilbert methodology, whose aim was to define Public Health Doctors functions and their related activities. The programme involved 30 professionals from Triveneto area (North Eastern Italy), working in Prevention Departments at National Health Service and Universities. The key-functions identified were: 1) Health status assessment and identification of community risk factors, 2) Health Promotion, 3) Prevention, 4) Protection, 5) Planning, 6) Communication, 7) Professional Training, 8) Alliances and resources for complex Public Health programs, 9) Crisis management in Public Health, 10) Research. For each function activities were identified, meaning concerning areas and contents that must be warranted by professionals. This experience allowed to share existing attitudes and experiences present in Triveneto area, and it can stand as a feasible instrument for different settings. Nevertheless, it appears mandatory explaining at each level in the society role and functions of Prevention Departments.

Supervised walking groups to increase physical activity in elderly women with and without hypertension: effect on pulse wave velocity.

To date, only a few studies have evaluated the effect of physical activity on PWVcf in the elderly. In the current study, 21 community-dwelling women, with a mean age of 68.19±5.72 years and a mean BMI of 28.63±4.69 kg m(-2), participated in moderate physical activity sessions for 1 h per day and 2 days each week under the supervision of a qualified physical education instructor for a total of 24 weeks. At the beginning of the study, at 3 months and at 6 months, the study participants' body weight, waist circumference, sagittal abdominal diameter (SAD) and body composition by dual energy X-ray absorptiometry (DEXA) were recorded along with the participants' Physical Activity Scale for the Elderly questionnaire. Total low-density-lipoprotein and high-density lipoprotein cholesterol; triglycerides (TGs) and HbA1c; blood pressure (BP); and arterial stiffness, as determined by carotid-femoral and carotid-radial pulse wave velocity (PWVcf, PWVcr), were also assessed. During the follow-up period, the waist and SAD significantly decreased, whereas fat-free mass, BMI and weight did not decrease. A significant decline in TGs was observed. A significant decline in PWVcf, even after adjusting for mean arterial pressure, heart rate triglycerides and waist diameter changes, was observed. In a sub-analysis that examined the effect of physical activity separately in the hypertensive and normotensive subjects, we observed a significant decline in PWVcf in the hypertensive subjects and a nonsignificant tendency in the normotensive subjects. The data showed an association between light aerobic physical activity in the elderly and decreased PWVcf, even after adjusting for changes in systolic BP (SBP), TGs and central adiposity. These results suggest a beneficial effect of moderate physical activity on subclinical vascular damage, particularly in hypertensive subjects.