Annali di igiene : medicina preventiva e di comunità
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The aim of the article is to describe the new Italian National Health Service outlined by the third health care reform ("riforma-ter"), the fiscal federalism and the modifications to the title V of the second part of the Constitution. The authors examine the present "performance" of the Italian National Health Service in terms of health status of the population, perceived quality of care and health care expenditure, analyzing the international and national context in which the new reforms were developed. The most significant changes in health care programming, organization and functioning of the system, financing of the National Health Service and medical education are described. The authors conclude outlining research priorities to be addressed.
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The Italian juridical and legislative aspects of vaccination based on a compulsory system are presented considering the medico-legal questions. The prospective of a voluntary system, as anticipated by many normatives and other official documents, is examined. The experience of some local health authorities on cases of in observance of the vaccinal obligation are detailed Finally professional risks for vaccinal operators are examined and the need of specific guidelines for parents' consent to compulsory vaccination during infancy is prospected.
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In order to evaluate microbial and parasitological quality of water resources located in the area of Cassino, different typologies of water were monitored during the course of 2002. Analytical results showed that neither water sources nor chlorinated water were affected by microbial and parasitological contamination. Surface water can be used as drinking water after suitable treatment processes. The constant occurrence of parasitic protozoa in sewage shows their spreading in the environment; nevertheless their absence in groundwater and tap water suggests a good level of hygienic quality in water management.