The Buffering Effect of Humanity of Care in the Relationship between Patient Satisfaction and Waiting Time: A Cross-sectional Study in an Emergency Department.

This study aims to examine whether humanity of care and environmental comfort played a role in moderating the relationship between waiting time and patient satisfaction in an emergency department (ED). The study used a cross-sectional and non-randomized design. A total of 260 ED patients in two hospitals in Italy completed a self-report questionnaire. Moderated regression showed that after adjusting for control variables, waiting time was significantly and inversely associated with patient satisfaction. Humanity of care and environmental comfort showed a positive and significant association with patient satisfaction. Finally, the interaction term between waiting time and humanity of care was found to be significant, whereas the interaction effect between waiting time and environmental comfort was not significant. The conditional effect showed that when humanity of care was low, waiting time was negatively and significantly related to patient satisfaction. By contrast, when humanity of care was medium and high, the relationship between waiting time and patient satisfaction was not significant. These findings shed light on the key role of humanity of care in moderating the relationship between waiting time and patient satisfaction. The complex interrelations emerged should be carefully considered when interventions to foster patient satisfaction in an ED context are planned.

There comes a baby! What should I do? Smartphones' pregnancy-related applications: A web-based overview.

Our article aims to give an overview of the most mentioned smartphones' pregnancy-related applications (Apps). A keywords string with selected keywords was entered both in a general search engine (Google(®)) and PubMed. While PubMed returned no pertinent results, a total of 370 web pages were found on Google(®), and 146 of them were selected. All the pregnancy-related Apps cited at least eight times were included. Information about App's producer, price, contents, privacy policy, and presence of a scientific board was collected. Finally, nine apps were considered. The majority of them were free and available in the two main online markets (Apple(®) App Store and Android(®) Google Play). Five apps presented a privacy policy statement, while a scientific board was mentioned in only three. Further studies are needed in order to deepen the knowledge regarding the main risks of these devices, such as privacy loss, contents control concerns, the digital divide and a potential humanization reduction.

Use of self-medication among adolescents: a systematic review and meta-analysis.

BACKGROUND: We performed a systematic review and proportion meta-analysis in order to investigate the prevalence and the adverse effects of the self-medication among the teenagers. METHODS: We selected observational studies published from January 1990 until January 2014 that examined the use of self-medication in the adolescents (aged from 13 to 18 years). Keywords used on PubMed, ISI Web of Knowledge and Scopus were 'self medication', 'adolescent*', 'self prescription', 'over the counter preparations' and 'self administration'. RESULTS: Finally, 15 articles met the inclusion criteria, for a total of 143 213 subjects involved. Overall, 50% of adolescents use to take drugs without consulting a physician. Further analyses stratified by number of drugs used demonstrated that in the studies reporting that adolescents use more than one type of drug the prevalence rises up to 63%. Only one study reported the possible adverse effects related to the inappropriate use of drugs, which were experienced by 31.1% of the females and 19.6% of the males. CONCLUSIONS: Self-medication use among adolescents is a widespread phenomenon. It would be advisable to give more attention on this public health concern and to promote initiatives, such as mass media campaigns and governmental actions, in order to make the citizens more aware to the risks related to the consumption of drugs without medical consultation. Further studies on adverse effects are urgently needed.

Electronic cigarettes: assessing the efficacy and the adverse effects through a systematic review of published studies.

BACKGROUND: To investigate the efficacy and the adverse effects (AEs) of the electronic cigarette, we performed a systematic review of published studies. METHODS: We selected experimental and observational studies examining the efficacy (as reduction of desire to smoke and/or number of cigarettes smoked and/or quitting or as reduction of nicotine withdrawal symptoms) and the safety of EC (AEs self-reported or clinical/laboratory). The following search engines were used: PubMed, ISI Web of Knowledge and Cochrane Controlled Trials Register. RESULTS: Finally, six experimental studies and six cohort studies were included. In the prospective 12-month, randomized controlled trial, smoking reduction was documented in 22.3 and 10.3% at Weeks 12 and 52, respectively (P < 0.001 versus baseline). Moreover, two cohort studies reported a reduction in the number of cigarette/day (from 50 to 80%) after the introduction of the EC. 'Mouth and throat irritation', 'nausea', 'headache' and 'dry cough' were the most frequently AEs reported. CONCLUSIONS: The use of the EC can reduce the number of cigarettes smoked and withdrawal symptoms, but the AEs reported are mainly related to a short period of use. Long-term studies are needed to evaluate the effects of the EC usage after a chronic exposure.

Smoking ban policies in Italy and the potential impact of the so-called Sirchia Law: state of the art after eight years.

OBJECTIVE: The aim of the present work is to describe the state of the art of tobacco habits in Italy, eight years after the law was introduced. METHODS: Time series analyses, based on estimates of smoking prevalence/consumption derived from the openly available data of national surveys performed during the 2001-2013 period, were performed. Data have been expressed in percentage of smokers and daily cigarettes consumption. Time changes are expressed as expected annual percentage change (EAPC). RESULTS: Over time, the percentage of Italian smokers shows a constant and statistically significant decrease (from 28.9% in 2001 to 20.6% in 2013, EAPC = -2.6%, and P < 0.001). Regarding data stratified by gender, we found a stronger reduction among men (EAPC = -2.9%, P < 0.001) than in women (EAPC = -2.5%, P < 0.001). Similarly, the consumption of tobacco smoking, measured as the number of daily cigarettes smoked, registered a downward trend (P < 0.001). No join point (time point when a significant trend change is detected) resulted from the trend analysis. CONCLUSIONS: Data show a constant decrease of tobacco consumption in Italy, with no join point related to the introduction of the banning law. These findings require to reflect on the priorities of the smoking banning policies that may be focused on other intervention activities such as to increase the price of cigarettes.

Norovirus outbreaks on commercial cruise ships: a systematic review and new targets for the public health agenda.

Noroviruses are recognized as the leading cause of human acute viral gastroenteritis worldwide. The rate of outbreaks on cruise ships has grown significantly in recent years. Given the potentially harmful consequences of outbreaks for passengers and crewmembers and the subsequently high costs for cruise companies, disease outbreaks on cruise ships represent a serious public health issue. The aim of our study was to systematically review published studies related to Norovirus outbreaks on commercial cruise ships. We searched the PubMed and Scopus scientific databases. We included eligible studies published from January 1990 to July 2013 that were written in English and described infectious episodes involving at least two passengers and/or crewmembers on a commercial cruise ship. As a result, 15 studies and seven reviews met the inclusion criteria, describing a total of 127 outbreaks. The majority of the cases were reported in Europe and the USA, affecting <1 to 74% of the embarked passengers. In the majority of the studies, stool samples and/or serum specimens from ill passengers were collected and tested for laboratory confirmation. Twelve studies reported that an ad-hoc questionnaire was administered. Fifteen studies investigated the possible source of infection which was contaminated food in the majority of cases. Our findings suggest a strong need for the monitoring and implementation of preventive measures in semi-closed communities, such as cruise ships. It would be advisable to strengthen all relevant initiatives in order to improve the detection of, response to and control of Norovirus outbreaks on cruise ships.

Adverse events in hospitalized paediatric patients: a systematic review and a meta-regression analysis.

RATIONALE, AIMS AND OBJECTIVES: To gain insight into the incidence of paediatric adverse events (AEs); to assess if there are significant differences among study results and to what extent methodological issues can explain them. METHODS: From November 2012 to January 2013, systematic literature searches were conducted on PubMed, Scopus and the Cochrane Library. We selected studies from 1970 onwards that evaluated the incidence of AEs in hospitalized paediatric patients and included a minimum of 1000 patient records with the same definition of AE. Studies that reported only specific AEs or only a specific ward were not considered. Data were extracted on the method of data collection, study design, type of hospital, and the timing of the AE in relation to its discovery and the index admission (time frame). AE incidence and preventability were considered. RESULTS: The pooled incidence of AEs was 2.0% (95% CI: 1.3-3.0%). Five methodological differences among studies were taken into account. Only the time frame of detected events had a statistically significant effect on the incidence of AEs (P<0.0001). The pooled incidence of preventable AEs was 46.2% (95% CI: 35.3-57.5%) with a high variability among studies. CONCLUSIONS: Our meta-analysis confirms that AEs are a major public health issue. Although studies use the same definition of AE, the reported incidence of AEs and preventable AEs varied considerably. To direct prevention efforts properly, studies methodologically more homogeneous and more detailed about the standard of health care provided and the health system organization are needed.

[Point prevalence survey of health care associated infections and antimicrobial use in Piedmont Region long-term care facilities according to ECDC protocol]. / Prevalenza delle infezioni correlate all'assistenza e dell'uso di antibiotici nelle residenze sanitarie assistite della Regione Piemonte secondo il protocollo ECDC.

OBJECTIVE: Aim of this study is to examine the prevalence data from different types of long-term care facilities (LTCFs); we also analyzed similarities and differences between them and national data. DESIGN: «Healthcare-Associated Infections and Antimicrobial Use in European Long-Term Care Facilities Project¼ (HALT2) is a prevalence survey of health care associated infections and antimicrobial use in European long-term care facilities. The study protocol is developed, funded and promoted by the ECDC (European Centre for Disease Prevention and Control). SETTING AND PARTICIPANTS: Data were collected on a single day from long term care facilities (LTCFs) defined as facilities in which residents need constant supervision (24 hours). Two types of questionnaires had to be completed. MAIN OUTCOME MEASURES: Point prevalence of healthcare-associated infections (HAI) and antimicrobial use (AU). RESULTS: 63 LTCFs in Piedmont Region participated in the HALT-2 point prevalence survey; 3,984 residents met the eligibility criteria. The crude prevalence of residents with at least one HAI was 3% in LTCF and 10% in CA/DP facilities. The crude prevalence of residents receiving at least one antimicrobial agent was 4%; this percentage rose to 17.4 % in CA/DP facilities. CONCLUSIONS: Data from Piedmont Region are similar to national data; differences are highlighted in different types of LTCFs. The results show the need to improve antimicrobial stewardship and to define protocols in each type of facilities in order to standardize the appropriateness and patient management.