Annali di igiene : medicina preventiva e di comunità
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The Italian National Immunization Prevention Plan (PNPV) identifies vaccines actively offered free of charge to target populations within the National Health Service. Despite this, childhood immunization coverage has been declining in Italy in recent years. As a response, the Italian Parliament in July 2017 approved law n. 119 extending mandatory childhood vaccines from four to ten, this stimulating a lively debate at both the scientific and policy level. ⋯ Preliminary data show that childhood immunization coverage increased since the approval of the new law on mandatory vaccination. Nonetheless, as additional data are accumulating and will make it possible to further assess the impact of the new law, strengthened efforts are needed in Italy to promote informed and proactive vaccine uptake.
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Diagnostic Therapeutic Pathways (DTPs) are multidisciplinary plans designed by each healthcare organization for a specific category of patients to reduce the variability of professional behaviors and to ensure greater safety and better overall healthcare outcomes. Hip fractures are a frequent traumatic injury, particularly in the elderly, and DTPs recommend early surgical intervention, often not done due to organizational challenges and bureaucracy. Medical conditions suggesting a delay are not frequent, however long waiting times not only increase the risk of complications and mortality, but also increase the number of diagnostic test and physician consultations. This study tried to understand the benefits of performing surgical intervention within 48 hours in terms of cost savings, reduction of complications and better overall outcomes. We performed statistical analyses on data gathered from 130 patients submitted to DTPs, and we evaluated the benefits obtained by operating within 48 hours in terms of resource saving (number of physician consultations, hospitalization days, etc.), reduction in complications reported in the literature. ⋯ The lack of available hospital beds and staff shortages are the main reasons for the delay in performing surgery, this situation does not allow an efficient treatment and timely release of patients from the healthcare system. Therefore, there is an important need to implement standardized orthopedic and geriatric pathways (DTPs), inspired by the collaboration between healthcare system management, orthopedic and geriatric specialists, and physical therapists, to drive shorter days of hospitalization and better overall patient health outcome by performing surgery as soon as possible.
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Ambrosia is an annual anemophilous weed producing allergenic pollen affecting public health in European countries. In Italy, the most infested region is Lombardy where, in some areas, it is the major cause of hay fever. In the Parma district, until 2007, Ambrosia seemed to be very rare, despite an observed increase of Seasonal Pollen Index (SPI), of pollen peak value and of asthma among ragweed sensitized patients. The aims of this study were to calculate ragweed pollen season and trends from 1996 to 2015, to assess the relationships between pollen season characteristics and selected meteorological data, to map plants in the territory and to evaluate the presence of beetle Ophraella communa (Ophraella), known as an eater of Ambrosia leaves. ⋯ The results showed the spread of ragweed plants over the territory and the risk of allergy increase that ragweed could cause. It remains to evaluate the role of the Ophraella in the reduction of Ambrosia pollen concentration. It is important to consider the potential risk Ophraella may represent for sunflower and other taxonomically related crop plants and other native and exotic species. The lack of initiatives by the Health Authorities to prevent and to contrast the spread of Ambrosia in the Parma area could cause public health consequences and an increase in health expenditures.
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In Europe, flu remains one of the major public health problems. Healthcare workers (HCWs) are a category at high-risk of contracting the infection and infecting their patients; consequently, for this category, vaccination is highly recommended. Unfortuntely, coverage levels remain insufficient with rates ranging between 4 and 40. ⋯ Despite the observed increase, the adherence remains very low. We found that the main causes of this result are the fear of adverse effects, the negligence and indolence of the same workers and a lack of risk perception of contracting the disease and transmitting it to patients. Our work stressed the importance of offering correct information and of meeting the needs of HCWs, often unable to leave their ward for the excess workload. This could be, in future years, one of the possible solutions to increase vaccination adherence.
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This study aims to verify whether there are, and to which degree, knowledge and adherence to guidelines on the prevention and control of healthcare associated infections by nursing staff. Study design. A descriptive study was conducted on a sample of nurses in the areas of medicine, surgery, and its own specialties of the Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico in Milan from 1st December 2015 to 29th February 2016. ⋯ Some knowledge gaps and differences with respect to adherence to best-practice principles for the prevention and control of healthcare associated infections was highlight by the present study.