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1.
Eur Rev Med Pharmacol Sci ; 28(1): 392-401, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38235891

RESUMO

OBJECTIVE: The purpose of this study is to validate the 13-item version of the Work-Related Stress Questionnaire (WRSQ) on a representative sample of Italian public health residents. MATERIALS AND METHODS: The WRSQ was administered as part of the Public Health Residents' Anonymous Survey in Italy (PHRASI) from 14 June to 26 July 2022. Collinearity between each questionnaire item was assessed with Kendall's τ statistic. The latent factors identified associating similar items based on the authors' observations were workplace, job demand, support and unpleasant workplace. Goodness-of-fit was assessed with confirmatory factor analysis calculating: Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), Root Mean Square Error of Approximation (RMSEA), Standardized Root-Mean-Residual (SRMR). Cronbach's alpha (α) and Omega McDonald (ω) were calculated to evaluate the reliability of the questionnaire. R 4.2.2 was used to perform the analyses. RESULTS: 379 Public Health residents (58% women) responded to the questionnaire. No significant collinearity was found between the items (τ range -0.31 to 0.49). Confirmatory Factor Analysis showed CFI = 0.975, TLI = 0.967, RMSEA = 0.041 and SRMR = 0.051. Internal consistency of the WRSQ Total Score was α = 0.80 and ω = 0.85. CONCLUSIONS: Although validated in a sectorial subpopulation of healthcare workers, the WRSQ proved to be an excellent tool for assessing work-related stress. Unpleasant workplace latent factors showed lower factor loading and internal consistency than others. This could be due to the fact that topics investigated with unpleasant workplace items (e.g., abuse and discrimination) are experienced on a less regular basis than the ones assessed through the other items.


Assuntos
Estresse Ocupacional , Saúde Pública , Humanos , Feminino , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Análise Fatorial , Itália , Psicometria
2.
Ann Ig ; 34(2): 190-201, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35088826

RESUMO

ABSTRACT: The Author, now a Research Assistant at the Department of Public Health of the University of Milan, Italy, in the period she was a Resident of the School of Public Health of the University of Perugia, had the occasion to interview Prof Maria Antonietta Modolo, one of the most significant pioneers of Health Education and Health Promotion both in Europe and in this Country, and her mentor at that time. Prof Modolo, who recently passed away, in that occasion explained in detail all the goals of these disciplines, and the impact they can show on the life of the population of developed and developing countries, if applied within a robust public health framework.


Assuntos
Saúde Pública , Europa (Continente) , Feminino , Humanos , Itália
3.
Ann Ig ; 33(5): 499-512, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34113956

RESUMO

Abstract: After SARS-CoV-2 vaccines development came at an unprecedented speed, ensuring safe and efficient mass immunization, vaccine delivery be-came the major public health mandate. Although mass-vaccination sites have been identified as essential to curb COVID-19, their organization and functioning is challenging. In this paper we present the planning, implementation and evalua-tion of a massive vaccination center in Lombardy - the largest Region in Italy and the most heavily hit by the pandemic. The massive hub of Novegro (Milan), managed by the Gruppo Ospedaliero San Donato, opened in April 2021. The Novegro mass-immunization model was developed building a la-yout based on the available scientific evidence, on comparative analysis with other existing models and on the experience of COVID-19 immunization delivery of Gruppo Ospedaliero San Donato. We propose a "vaccine islands" mass-immunization model, where 4 physicians and 2 nurses operate in each island, with up to 10 islands functioning at the same time, with the capacity of providing up to 6,000 vaccinations per day. During the first week of activity a total of 37,900 doses were administered (2,700/day), most of them with Pfizer vaccine (85.8%) and first doses (70.9%). The productivity was 10.5 vaccines/hour/vaccine station. Quality, efficiency and safety were boosted by ad-hoc personnel training, quality technical infrastructure and the presence of a shock room. Constant process monitoring allowed to identify and promptly tackle process pitfalls, including vaccine refusals (0.36%, below expectations) and post-vaccinations adverse reactions (0.4%). Our innovative "vaccine islands" mass-immunization model might be scaled-up or adapted to other settings. The Authors consider that sharing best practices in immunization delivery is fundamen-tal to achieve population health during health emergencies.


Assuntos
COVID-19/prevenção & controle , Centros Comunitários de Saúde/organização & administração , Vacinação em Massa/organização & administração , Modelos Teóricos , Pandemias , SARS-CoV-2 , COVID-19/epidemiologia , Vacinas contra COVID-19 , Centros Comunitários de Saúde/estatística & dados numéricos , Eficiência Organizacional , Utilização de Instalações e Serviços , Arquitetura de Instituições de Saúde , Humanos , Itália/epidemiologia , Vacinação em Massa/métodos , Vacinação em Massa/estatística & dados numéricos , Melhoria de Qualidade
4.
Ann Ig ; 33(4): 307-321, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33270078

RESUMO

Results: Road tunnel construction workers revealed higher frequencies of cells with genotoxic damage (i.e., MN and NBUD). MN and NBUD resulted to be Poisson distributed and counts of these genotoxicity biomarkers were then analysed by Poisson regression. The frequency ratio (FR) for MN was 1.31 (95% CI: 0.84-2.04), with an increase in the exposed subjects; this finding, though indicating a higher genotoxic risk in the exposed subjects, did not reach statistical significance. On the other hand, the FR for NBUD was 3.49 (95% CI: 1.86-6.56), with a statistically significant increased risk of chromosomal damage. Even the frequencies of binucleated cells (a marker of cell proliferation) and pyknotic cells (a cell death biomarker) were significantly higher in tunnel workers. Introduction: Tunnel construction workers are exposed to complex mixtures of toxic agents, some of which are known to be genotoxic. The aim of this study was to evaluate the genotoxic risk in this occupational setting by comparing tunnel workers with a control group for frequencies of nuclear aberrations in oral exfoliated cells. Methods: To evaluate the genotoxic effects of tunnel air pollutants, we conducted a cross-sectional, molecular epidemiological study (35 tunnel workers and 35 healthy controls) using the buccal micronucleus cytome assay. A questionnaire was administered to obtain information about demographic variables, lifestyle, dietary habits, anthropometric data, and occupational history. Buccal mucosa cells were collected by scraping the buccal mucosa with a small-headed toothbrush. Coded slides were examined blind by trained scorers for micronuclei (MN), nuclear buds (NBUD), and other nuclear abnormalities. Conclusions: Our observations provide further knowledge and understanding of the occupational hazards of tunnel workers and confirm the complexity of effects (cytotoxic and genotoxic) probably induced by fumes and dust produced in underground operations.


Assuntos
Monitoramento Biológico , Exposição Ocupacional , Estudos Transversais , Análise Citogenética , Dano ao DNA , Humanos , Testes para Micronúcleos , Exposição Ocupacional/efeitos adversos
5.
Epidemiol Psychiatr Sci ; 30: e77, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-35048820

RESUMO

AIMS: Retirement is a major life transition that may improve or worsen mental health, including depression. Existing studies provide contradictory results. We conducted a systematic review with meta-analysis to quantitatively pool available evidence on the association of retirement and depressive symptoms. METHODS: We applied PRISMA guidelines to conduct a systematic review and meta-analysis to retrieve, quantitatively pool and critically evaluate the association between retirement and both incident and prevalent depression and to understand better the potential role of individual and contextual-level determinants. Relevant original studies were identified by searching PubMed, Embase, PsycINFO and the Cochrane Library, through 4 March 2021. Subgroup and sensitivity meta-analyses were conducted by gender, study design (longitudinal v. cross-sectional studies), study quality score (QS) and considering studies using validated scales to diagnose depression. Heterogeneity between studies was evaluated with I2 statistics. RESULTS: Forty-one original studies met our a priori defined inclusion criteria. Meta-analysis on more than half a million subjects (n = 557 111) from 60 datasets suggested a protective effect of retirement on the risk of depression [effect size (ES) = 0.83, 95% confidence interval (CI) = 0.74-0.93], although with high statistical heterogeneity between risk estimates (χ2 = 895.19, df = 59, I2 = 93.41%, p-value < 0.0001). Funnel plot asymmetry and trim and fill method suggested a minor potential publication bias. Results were consistent, confirm their robustness and suggest stronger protective effects when progressively restricting the included studies based on quality criteria: (i) studies with the highest QS [55 datasets, 407 086 subjects, ES = 0.81, 95% CI = 0.71-0.91], (ii) studies with a high QS and using validated assessment tools to diagnose depression (44 datasets, 239 453 subjects, ES = 0.76, 95% CI = 0.65-0.88) and (iii) studies of high quality, using a validated tool and with a longitudinal design (24 datasets, 162 004 subjects, ES = 0.76, 95% CI = 0.64-0.90). We observed a progressive reduction in funnel plot asymmetry. About gender, no statistically significant difference was found (females ES = 0.79, 95% CI = 0.61-1.02 v. men ES = 0.87, 95% CI = 0.68-1.11). CONCLUSIONS: Pooled data suggested that retirement reduces by nearly 20% the risk of depression; such estimates got stronger when limiting the analysis to longitudinal and high-quality studies, even if results are affected by high heterogeneity.As retirement seems to have an independent and protective effect on mental health and depressive symptoms, greater flexibility in retirement timing should be granted to older workers to reduce their mental burden and avoid the development of severe depression. Retirement may also be identified as a target moment for preventive interventions, particularly primary and secondary prevention, to promote health and wellbeing in older ages, boosting the observed impact.


Assuntos
Depressão , Aposentadoria , Idoso , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Promoção da Saúde , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade
8.
Ann Ig ; 32(3): 223-233, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32266360

RESUMO

INTRODUCTION: The role of vaccinations is widely acknowledged. However, over the last decades, an alarming reduction in immunization coverage and a rising number of reported cases of vaccine-preventable diseases have been recorded. This multicentre cross-sectional study aimed at examining whether there is an association between self-reported vaccination knowledge and the immunization behaviour of Health Sciences students. METHODS: A cross-sectional study was performed, using a validated questionnaire. A multivariate logistic regression with stepwise backward selection process with a univariate p-value <0.25 as the main criterion was used. The level of significance chosen for statistical analysis was 0.05. RESULTS: The sample consisted of 3,131 students (68.1% females). 38.9% of them are medicine and surgery students and 33.1% are nursing students. The multivariate logistic regression analysis shows that, regarding the "suboptimal level of knowledge about vaccine-preventable diseases ", the main and statistically significant independent variables associated are: older age (OR 1.56), having developed a vaccine-preventable disease in the last 5 years (OR 1.38), having been vaccinated against seasonal influenza last year (OR 0.70), having recommended the vaccination to patients or family members during the last influenza season based on clinical evaluation (OR 0.53) and according to the ministerial indications (OR 0.48), planning of recommending the influenza vaccination during the next season based on clinical evaluation (OR 0.67) and according to the ministerial indications (OR 0.69). DISCUSSION: The study highlighted the importance of academic education on vaccinations in order to build a future generation of health care workers that are aware not only of the usefulness of immunization, but particularly of the major role played by health professionals in promoting a vaccination culture among the general population.


Assuntos
Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Autorrelato , Estudantes de Medicina/psicologia , Estudantes de Enfermagem/psicologia , Vacinação , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Adulto Jovem
9.
Clin Ter ; 171(2): e130-e136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32141484

RESUMO

AIMS: Evaluation of the knowledge and behavioral risks related to sexually transmitted infections (STIs) among the student population of the degree course in nursing at the University of Palermo. MATERIAL AND METHODS: An anonymous online a survey was provided to students that investigate to socio-demographic information, sexual habits and the level of knowledge of the STIs. Multivariable logistic regression was performed, considering it as a dependent variable "Do you permanently have unprotected sex (without a condom)? Yes", in order to evaluate the role of the variables of the questionnaire. Results are expressed as adjusted Odds Ratio (aOR). RESULTS: The sample size consists of 405. The average age of the sample is 21.65 years (standard deviation±3.24). The analysis shows that the risk of having permanently unprotected sex (without condom) is significantly associated with the following variables: "Are you engaged or single? Engaged" (aOR 3.24, 95% CI 1.66 - 6.33); "Sexual orientation. Homosexual or Bisexual (aOR 4.45, 95% CI 1.30 - 15.29); "Have you occasionally had unprotected sex (without a condom)? Yes" (aOR 5.09, 95% CI 2.69 - 9.62); "How would you define your knowledge of sexually transmitted diseases? Good" (aOR 2.07, 95% CI 1.05 - 4.08); "How would you define your knowledge about contraceptive methods? Good" (aOR 2.51, 95% CI 1.23 - 5.15); "Have you or have you ever had a sexually transmitted disease? Yes (aOR 4.43, 95% CI 1.71 - 11.53); "Do you know that men can also undergo HPV vaccination? Yes" (aOR 2.57, 95% CI 1.03 - 6.40); "Age. As the unit increase" (aOR 1.14, 95% CI 1.02 - 1.26). CONCLUSIONS: These results highlight the importance of involving university students in programs aimed at improving the knowledge in terms of STIs and increase of Sexual and reproductive health. Further, because STIs prevention is based mainly on human behavior, tailored intervention is needed especially because behavior change remains a complex challenge.


Assuntos
Preservativos , Estudantes de Enfermagem/psicologia , Sexo sem Proteção/estatística & dados numéricos , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Masculino , Comportamento Sexual , Infecções Sexualmente Transmissíveis/prevenção & controle , Inquéritos e Questionários , Sexo sem Proteção/psicologia , Adulto Jovem
10.
Clin Ter ; 170(1): e59-e65, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31850486

RESUMO

INTRODUCTION: Breast cancer is the most common cancer in women worldwide, for which the survival rate is increasing over time. Growing evidence are showing that the effect of lifestyle could have the same weight of the effect of the usual clinical-pathological risk factors on survival rate. The DianaWeb study responds to the pressing request of patients diagnosed with breast cancer to know the most advanced point of scientific research on the prevention of recurrences, to have a virtual space to meet, where to receive advice and practical information for the daily management the lifestyle change. DianaWeb is a community-based participatory research, dedicated to breast cancer patients, aimed to monitor lifestyle, provide them tips to encourage sustainable lifestyle changes, and to analyze clinical outcomes. In order to achieve these aims, DianaWeb uses a specific interactive website (http://www.dianaweb.org/). METHODS: The web architecture has been designed essential and light, with a rigorous implantation that brings the figure of the woman to the center. In order to humanized the project the acronym used to identify the study was Diana (Diet and Androgens), a classical female name, who was illustrated as a female avatar, aimed to symbolize all women. The graphical interface was developed using seven pastel tones colors, which become a fundamental elements of the layout, such as frame, navigation menu, and separation interspaces. RESULTS: The project started in 2015, and in 4 days the web site was visited by more than 1000 people. A total of 2823 persons enrolled in the study, but 2182 did not send the full documentations, 61 persons abandoned the study, 641 timely answered to the questionnaires. CONCLUSIONS: The high number of participants' interaction within the web page, confirmed the high usability of the web page and the great interest of patients. Prevention of breast cancer recurrences with low cost technologies, easily available to everybody, is a priority for both public health and public finances.


Assuntos
Neoplasias da Mama/prevenção & controle , Promoção da Saúde/métodos , Internet , Tutoria/métodos , Recidiva Local de Neoplasia/prevenção & controle , Educação de Pacientes como Assunto/métodos , Telemedicina/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
11.
Ann Ig ; 31(3): 191-201, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31069364

RESUMO

BACKGROUND: Also in Italy, a flourishing evidence confirms the recent spread of vaccine hesitancy movements resulting in approximately 4-7% of the paediatric population not immunised every year against polio and approximately 9-15% against measles in the last few years. The aim of this paper is to describe the reasons of polio and measles missed vaccination in Italy, in the period 2015-2017, and to analyse any potential effect of the 2017 mandatory vaccination law. METHODS: Number of missed vaccinations in children younger than 24 months, stratified by reason, were collected separately for measles and polio with a regional level of detail. Data were collected using an electronic form developed using Microsoft Excel®. RESULTS: The most frequent reason for missed polio vaccination was "definitive informed dissent" with a mean value 1.5%, followed by "found/contacted, but did not attend the appointment" with a mean value 1.3%. Inversely, "acquired immunity subsequent to previous disease or vaccination performed elsewhere" and "excused in a permanent way for health conditions" were the less frequent with a mean value 0.03% for both. For measles vaccination the reason "found/contacted, but did not attend the appointment" was the most frequent (mean value 3.2%), followed by "definitive informed dissent" (mean value 2.9%). CONCLUSIONS: Percentage of missed vaccination showed a remarkable reduction in 2017. This decrease is likely due to the introduction of mandatory vaccination law. In point of fact, "Dissent" decreased for both polio and measles during the study period. While, "Delay" increased during the 3-years. It seems that hesitant parents prefer to postpone vaccinations instead of refusing them. Counselling, parents' empowerment and vaccine education are central to contrast vaccination postponing. Thus, for parents who refuse vaccines ("Dissent"), monitoring the trend is important as well as trying to understand their reasons.


Assuntos
Vacina contra Sarampo , Sarampo/prevenção & controle , Pais/psicologia , Poliomielite/prevenção & controle , Vacina Antipólio Oral , Recusa de Vacinação/psicologia , Pré-Escolar , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Geografia Médica , Pessoas Mal Alojadas/estatística & dados numéricos , Humanos , Lactente , Itália , Masculino , Motivação , Vacinação/legislação & jurisprudência , Recusa de Vacinação/estatística & dados numéricos
12.
Ann Ig ; 31(1): 21-34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30554236

RESUMO

INTRODUCTION: In Italy, as in the rest of the world, the number of homeless people is increasing considerably. Many of them suffer from chronic conditions, mental health problems and addiction to alcohol, drugs or smoking, and need complex medical care. Their health status is often exacerbated by greater difficulty in accessing primary care. The aim of the present study was to assess health conditions of homeless people living in Palermo, Southern Italy, and to find ways to limit the spread of common infectious diseases that can be prevented by vaccination. MATERIAL AND METHODS: A self-administered questionnaire was distributed. The questionnaire was structured into two parts including an introduction with socio-demographic information, and a second part investigating health status, chronic diseases and vaccinations. A multivariable logistic regression model was used and adjusted Odds Ratios (aOR) are presented. RESULTS: The sample consisted of 52 homeless, 35 (67.3%) of whom were male and the most represented age class (55.8%) was < 50 years of age. The average age of the sample was 49.6 years (SD ± 15.2) and 88.5% were born in Italy. A multivariable logistic regression model based on 52 observations was used. The analysis showed that the female gender was significantly associated with: not performing regular physical activity (aOR 4.14, 95% C.I. 1.20 - 14.32, p = 0.025), suffering from chronic diseases (aOR 3.52, 95% C.I. 1.02 - 12.11, p = 0.046) and taking medicines (aOR 3.95, 95% C.I. 1.14 - 13.64, p = 0.030). CONCLUSIONS: This particularly fragile population is exposed to diseases that are largely preventable or curable through a wider and more early access to care by local health facilities with a subsequent reduction in the worsening of clinical outcomes and related social costs.


Assuntos
Nível de Saúde , Pessoas Mal Alojadas/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Adulto , Doença Crônica/epidemiologia , Cidades , Exercício Físico , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e Questionários
13.
Public Health ; 165: 9-15, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30342281

RESUMO

OBJECTIVES: Pertussis is a vaccine-preventable disease. Despite this, it remains a major health problem among children in developing countries and in recent years, has re-emerged and has led to considerable outbreaks. Pertussis surveillance is of paramount importance; however, classical monitoring approaches are plagued by some shortcomings, such as considerable time delay and potential underestimation/underreporting of cases. STUDY DESIGN: This study aims at investigating the possibility of using Google Trends (GT) as an instrument for tracking pertussis outbreaks to see if infodemiology and infoveillance approaches could overcome the previously mentioned issues because they are based on real-time monitoring and tracking of web-related activities. METHODS: In the present study, GT was mined from inception (01 January 2004) to 31 December 2015 in the different European countries. Pertussis was searched using the 'search topic' strategy. Pertussis-related GT figures were correlated with the number of pertussis cases and deaths retrieved from the European Centre for Disease prevention and Control database. RESULTS: At the European countries level, correlation between pertussis cases and GT-based search volumes was very large (ranging from 0.94 to 0.97) from 2004 to 2015. When examining each country, however, only a few reached the threshold of statistical significance. CONCLUSIONS: GT could be particularly useful in pertussis surveillance and control, provided that the algorithm is better adjusted and refined at the country level.


Assuntos
Surtos de Doenças , Internet/tendências , Vigilância em Saúde Pública/métodos , Ferramenta de Busca/tendências , Coqueluche/epidemiologia , Europa (Continente)/epidemiologia , União Europeia , Humanos
14.
J Prev Med Hyg ; 59(1): E14-E19, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29938235

RESUMO

Vaccines recommendations are available for both healthcare professionals and the general public, but although the vaccination is the most effective method to prevent infectious diseases, the coverage is still behind the recommended rate. In Italy, according to a recent study, the anti-flu vaccination rate among healthcare worker range between 9% to 30%. The aim of our study was to identify knowledge, attitude and behaviours regarding influenza vaccination among community pharmacists in order to increase the coverage rate among healthcare professional. "PErCEIVE (Pharmacist Perception on Influenza Vaccine) in Umbria" was a cross sectional survey among community pharmacists in Umbria conducted between 16th November 2015 to 29th February 2016. The questionnaire was anonymous, on-line self-administered survey. Statistical analysis were performed using STATA/SE 12 software. The response rate was 28.91% (n = 72/249). Among the studied population 76.39% (n = 55) had never performed influenza vaccine during the previous 5 years. Regarding source of information, only 15.28% of the subjects (n = 11) consulted the scientific publications, vs 52.78% (n = 38) who did not show any kind of interest upon the influenza vaccine. Our results show a low attitude to be vaccinated among pharmacists together with a low grade of awareness regarding the important role that pharmacists might play in order to reduce influenza burden, to promote health literacy among their patients and to decrease the risk of patients infection. Pharmacists might be crucial healthcare workers involved in health promotion, in vaccines' uptake and practices progression.


Assuntos
Atitude do Pessoal de Saúde , Vacinas contra Influenza , Influenza Humana/prevenção & controle , Farmacêuticos/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Vacinação
15.
Ann Ig ; 30(2): 77-85, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29465145

RESUMO

BACKGROUND: Immunization Information Systems, or Immunisation registries (IRs), are essential to monitor and evaluate the accessibility, quality and outcomes of immunisation programmes both at local and national level. STUDY DESIGN: We conducted a cross-sectional survey in order to investigate and map the level of IRs implementation obtained by the 21 Italian Regional Health Authorities. On this basis we defined a roadmap towards implementing an Italian National IR. METHODS: We designed an online questionnaire. Data were collected from July to September 2016 from all the 21 Regional Health Authorities in charge of infectious diseases control and immunization management. RESULTS: 18/21 Italian Regions have fully implemented an IR, out of them, 11 use the same software for all Local Health Units. Two Regions have partially implemented their IRs and one Region is not yet computerised. CONCLUSION: The decentralization of the Italian Health System is reflected also on the IRs characteristics and functionalities in terms of fragmented implementation of IRs and diversity in the software systems and data flows in place. Future efforts should not only aim not only to clarify the functionalities of Regional IRs, but should also aim to define how aggregation of data at national level can be optimised.


Assuntos
Imunização/estatística & dados numéricos , Sistema de Registros , Estudos Transversais , Previsões , Pesquisas sobre Atenção à Saúde , Humanos , Itália
16.
Ann Ig ; 30(6): 470-481, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30614496

RESUMO

BACKGROUND: The International Classification of Sleep disorders, the International Classification of Diseases and the Diagnostic and Statistical manual of Mental Disorders defines insomnia as an experience of insufficient or poor sleep quality, characterized by at least one of the following symptoms: difficulty in initiating or maintaining sleep, early awakenings and poor restorative sleep. In Italy, the Morfeo 1 study detects a prevalence of 20% of insomnia and a 40% of cases with day-time symptoms. The chronic sleep deprivation is responsible for cognitive disorders with effects on social life. Being common knowledge, lifestyle can also influence sleep. Some of the "sleep hygiene rules" involve a control on smoking, coffee consumption and diet. The Mediterranean Diet (MD), thanks to its high level of tryptophan, has a positive influence on sleep and can protect against stress and anxiety. STUDY DESIGN: The aim of InSOMNIA study was to determine the prevalence of sleep disorders among nursing students of the University of Perugia and, therefore, to evaluate how lifestyle, eating habits, health status and academics performance are linked to night-time and daytime symptoms of the interrupted sleep. METHODS: We adopted a cross sectional survey, collecting data from "Sleep and Daytime Habits Questionnaire" to evaluate the sleep disorders and from PREDIMED questionnaire to assess the adherence to MD. RESULTS: We found a statistical significant association between PREDIMED score and BMI (p-value=0.0127), smoking habit (p-value = 0.0125), quality of life (p-value = 0.0480) and academic progress (p-value = 0.0092). CONCLUSIONS: We found a high prevalence of sleep disturbances statistically associated with diet and poor academic progress.


Assuntos
Desempenho Acadêmico , Dieta Mediterrânea , Qualidade de Vida , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , Distribuição por Idade , Consumo de Bebidas Alcoólicas , Estatura , Peso Corporal , Café , Estudos Transversais , Emprego/estatística & dados numéricos , Exercício Físico , Feminino , Nível de Saúde , Humanos , Itália/epidemiologia , Aprendizagem , Estilo de Vida , Masculino , Prevalência , Análise de Regressão , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/prevenção & controle , Fumar/efeitos adversos , Inquéritos e Questionários , Triptofano/administração & dosagem , Adulto Jovem
17.
Clin Ter ; 168(5): e327-e332, 2017.
Artigo em Italiano | MEDLINE | ID: mdl-29044356

RESUMO

AIMS: The study is a part of the "Active surveillance of adverse events following HPV vaccination" project conducted in order to actively register all common adverse events in girls 9-26 years after anti-HPV vaccination. METHODS: It is a multicenter cohort study which included 12 Regions and 87 local health authorities, coordinated by the National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS) ISS. We included all adolescents, 12 years old, actively contacted for HPV vaccination, as well as all women aged 9-26 years who recived, in the period under review, the same vaccination at the local health authorities in Spoleto. RESULT: Out of 147 girls enrolled in the program, only 102 have reported the diary filled after the first vaccine dose, 62 and 88 respectively after the second and third dose. The filled diaries shown that adverse events, if any, have occurred almost exclusively during the first 5 days of vaccination, with a strong prevalence of local reactions (erythema, pain and swelling at the injection site) followed by headache and muscles pain. CONCLUSION: Even though the results show a high number of reported adverse events, mainly due to the detection method (active surveillance), they are mild or moderate in almost all the cases. This is in line with that seen in previous trials.


Assuntos
Vacinas contra Papillomavirus/efeitos adversos , Adolescente , Adulto , Criança , Estudos de Coortes , Feminino , Humanos , Vigilância Imunológica , Itália , Adulto Jovem
18.
Mutat Res Rev Mutat Res ; 770(Pt A): 35-45, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27894689

RESUMO

Many studies have reported the occurrence of work-environment contamination by antineoplastic drugs (ANPD), with significant incorporation of trace amounts of these hazardous drugs in hospital personnel. Given the ability of most ANPD to actively bind DNA, thus inducing genotoxic effects, it is of pivotal importance to assess the degree of genotoxic damage (i.e., residual genotoxic risk) in occupationally exposed subjects. The lymphocyte cytokinesis-block micronucleus (L-CBMN) assay is largely used for biological effect monitoring in subjects occupationally exposed to ANPD. In this study, we identified and analyzed the studies published reporting the use of the L-CBMN assay as biomarker of genotoxic risk in health care workers exposed to ANPD with the aim of performing meta-analysis and providing a meta-estimate of the genotoxic effect of exposure. We retrieved 24 studies, published from 1988 to 2015, measuring MN in peripheral blood lymphocytes in health care workers occupationally exposed to ANPD. In 15 out of the 24 studies (62.5%), increased MN frequencies were recognized in exposed subjects as compared to controls. The meta-analysis of MN frequency of the combined studies confirmed an association between occupational exposure to ANPD and cytogenetic effects with an overall meta-estimate of 1.67 [95% CI: 1.41-1.98]. In 16 out of the 24 studies (66.6%) at least one other genotoxicity biomarker, besides L-CBMN assay, was employed for biological effect monitoring. In several studies the effect of exposure to ANPD was evaluated also in terms of MN in exfoliated buccal cells. Other studies focused on genotoxicity endpoints, such as sister chromatid exchanges (3 studies), chromosome aberrations (6 studies), or primary DNA damage investigated by comet assay (7 studies). Overall, there was good agreement between other genotoxicity tests employed and L-CBMN assay outcomes.


Assuntos
Antineoplásicos/toxicidade , Citocinese/efeitos dos fármacos , Linfócitos/efeitos dos fármacos , Testes para Micronúcleos/métodos , Exposição Ocupacional , Humanos , Linfócitos/ultraestrutura
19.
Pediatr Med Chir ; 36(4): 92, 2014 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-25573708

RESUMO

Nephrogenic remnants (NRs) are nodular collections of undifferentiated renal blastema cells in the postnatal kidney that are recognized as putative precursor lesions of Wilms tumor (WT). NRs may remain stationary, undergo regression, or proliferate. In the last case, there is a high risk for the development of a WT. During infancy, they are most frequently of microscopic size, to be found only at autopsy in approximately 1% of infant kidneys. Approximately 1 out of 100 microscopic lesions persist and grow developing lesions large enough to be seen by ultrasound in the first months of life. We report on a case of NRs in a six year old child, as incidental finding during abdominal ultrasound performed for other purposes. In consideration of the potential evolution in WT, after a period of close surveillance of 14 months, the lesion was resected. Histological examination revealed the presence of NRs, no neoplastic lesions were found. Currently the patient is 16 years old, in good health, and there have been no signs of recurrence.


Assuntos
Neoplasias Renais/etiologia , Rim/diagnóstico por imagem , Tumor de Wilms/etiologia , Adolescente , Criança , Seguimentos , Humanos , Achados Incidentais , Rim/patologia , Rim/cirurgia , Neoplasias Renais/prevenção & controle , Masculino , Ultrassonografia/métodos , Tumor de Wilms/prevenção & controle
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