Journal of Preventive Medicine and Hygiene (JPMH)
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Validity and reliability of the Home Health Care Survey of the Consumer Assessment of Healthcare Providers and System (HHCAHPS) tool: a multicentre cross-sectional study
Full text linkIntroduction: This study aims to investigate the psychometric properties of the Home Health Care Survey of the Consumer Assessment of Healthcare Providers and System (HHCAHPS) in the Italian context.
Methods: This is a secondary analysis of data from the [blinded for peer review] study. A total of 9,780 patients cared for by home healthcare services completed the HHCAHPS along with a measure of satisfaction for the care received. Structural validity was assessed with a confirmatory analytical approach (CFA). Construct validity was ascertained via hypothesis testing (convergent validity) by correlating the HHCAHPS scores with the scores derived from the measure of patient satisfaction for care. Internal consistency was assessed with the Omega (ω) coefficient.
Results: Structural validity was confirmed, with satisfactory fit indices of the CFA model specified according to the conceptualized three-factor structure (“care of patients”, “communication with the providers”, and “specific care issues”). Construct validity was confirmed with moderate correlations between the level of satisfaction for care and the factors “communication with the providers” (r= 0.39, p <0.001), “care of patients” (r=0.34, p <0.001), and “specific care issues” (r=0.19, p<0.001). Internal consistency was satisfactory for the “specific care issues” factor (ω = 0.81), while it was at the threshold of acceptability for the other factors (ω = 0.60-0.62).
Conclusions: This study shows that the HHCAHPS is valid and sufficiently reliable when tested on the Italian population. Therefore, this tool can be supportive for promoting research and designing interventions to promote patient-centered care within home healthcare settings
Burden of human rabies disease: its potential prevention by means of Rabipur® vaccine
Full text linkRabies is a zoonotic viral disease transmitted mainly by bites of infected animals, especially dogs, which are responsible for 99% of human cases. Despite being preventable, it remains a neglected disease in low-income countries, with approximately 60,000 deaths per year, mostly concentrated in Africa and Asia. The real worldwide burden of rabies is probably underestimated, as death-reporting systems are inadequate and active surveillance is limited.
Rabies prevention implies two main, non-exclusive strategies: (i) dog vaccination, in order to interrupt virus transmission to humans, and (ii) human vaccination i.e. pre-exposure prophylaxis (PrEP) and PEP through the use of purified cell-culture and embryonated egg-based vaccines (CCEEVs).
Rabipur® is one of the available anti-rabies vaccines and is indicated for active immunization in individuals of all ages. Its efficacy and safety have been amply demonstrated.
In rabies-free countries, PrEP is indicated for individuals who face occupational and/or travel-related exposure to the rabies virus in specific settings or over an extended period.
Wider use of human rabies vaccination for PrEP and PEP in conjunction with programs to eradicate rabies from animal populations would be the right direction in reducing the burden of disease and achieving zero rabies, a challenging goal
Telemedicine: the technological revolution to address Healthcare System shortcomings
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Maternal MTHFR A1298C Polymorphism: A Crucial Consideration in Preventing Recurrent Pregnancy Loss: Maternal MTHFR A1298C Polymorphism
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Monitoring the utilization and effectiveness of Iron and Vitamin D supplementations program and its predictive factors in high schools’ girls in Qom, Iran
Full text linkBackground: Iron and vitamin D3 deficiency is one of the major global health problems in teenagers and adolescent population. It can have a negative impact during phases of rapid growth, increasing susceptibility to infection, autoimmune and other chronic disease. This study was aimed to determine the utilization of Iron and Vitamin D Supplementations Program (IVDSP) in high schools’ girls in Qom city.
Methods: In a cross sectional study, the pattern of iron and D3 consumption based on IVDSP on 400 high schools’ girl in Qom, Iran assesses. Data collection was used by a reliable and standard researcher based questionnaire and daily, weekly, monthly and seasonally consumption of complementary in schools including iron and vitamin D3 consumption based on CTP as well as home consumption of other complementary minerals including folic acid, Calcium, Zinc, Vitamin C, Multi Vitamin, Vitamin B, and Other complementary drugs were gathered. Data analysis conducted using SPSS version 20 (SPSS Inc., Chicago, IL, USA) by chi square and independent t-test.
Result: The mean age of subjects was 15.14±1.52 years and ranged from 12 to 18 years old. The total weekly prevalence of D3 and iron consumption in high schools’ girls was calculated 36.73% and the weekly prevalence of Iron and monthly prevalence of Vitamin D3 consumption was 33.75% and 40.5%, respectively. The most common causes of non-consumption were bad taste 49.31%, Iranian made drug 20.27%, drug sensitivity 19.82% and drug interaction 10.60%, respectively. Our results showed that contribution of students in explanatory sessions (P=0.003), contribution of students in school sessions (P=0.001) were predictor variables for better complementary consumption in high schools
Conclusion: The inadequate and incomplete rate of IVDSP in Qom was high and more than 60% of distributed supplementations have been wasted. Our results showed that students who were participated in educational orientation classes were more successful and eager in iron and vitamin D3 consumption. Therefore, it is recommended to increase interventions at individual, interpersonal, intra-organizational and inter-organizational levels in order to fully support the program and ultimately increase the efficiency of the program.
 
Monitoring emergency and urgent surgery: an improvement in a Healthcare Management Unit at a third-level hospital in Italy: Running title: Monitoring emergency and urgent surgery
No full textIntroduction At IRCCS San Martino Hospital of Genoa, Italy emergency and urgent surgery is classified according to the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) classification , assigning the relative colour-coded class, into two categories:
- EMERGENCY – (Colour-code class: RED) “Emergencies to be performed within minutes”.
- URGENCY – (colour-code class: YELLOW) "Urgencies to be performed within hours”. In this context, it is essential that the emergency surgical team gets clear and complete information from the proposal surgeon, in order to complete the surgical list. Method Between 14th April 2023 and 23th July 2023 a new method of communication, filling out an online form, was introduced for requests of urgent and emergency surgery. A three-months period of analysis and monitoring followed. Results: A total of 406 requests were filled, resulting in 367 E/U surgeries. The majority of all emergency operations were for thoracic-abdominal surgery (45%), followed by urology (19%). The requests analysed reported that 18% were classified as red, 71% as yellow. For the remaining 11% compilation errors were detected. Moreover, 11% of the interventions were not performed within the time limits defined according to the severity code. Conclusions: With the introduction of this new tool, the IRCCS San Martino Hospital’s Healthcare Management Unit may monitor the requests for intervention in real time, in order to achieve more efficiency and provide corrective actions in the use of the Operating Room resources
Balto and Togo during the cold winter of Alaska (1925): the two canine heroes in the fight against diphtheria.
Full text linkIn recent years, diphtheria has re-emerged in areas with inadequate vaccination coverage, and Europe has not been spared with several cases among migrants. Diphtheria is a potentially fatal infection caused mainly by toxigenic strains of Corynebacterium diphtheriae. Due to the high mortality rate, especially among young children, the fight against diphtheria is considered one of the first conquests of immunization. In the history of medicine, there is a unique case of an unconventional response to a diphtheria outbreak in which sled dogs were used to overcome the supply difficulties of diphtheria antitoxin. The mass media followed the medical response to the outbreak and raised audience awareness of public health issues. The facts of Nome, Alaska, in 1925 can serve as a catalyst to rethink conventional responses to diphtheria outbreaks in low-income countries today and promote mass media awareness of public health importance
Balance measures of mini and brief balance evaluation system tests for Iranian population
Full text linkIntroduction. Falling is a serious problem for all ages. There are several tests to assess balance. mini-BESTest and brief-BESTest are balance tests for which there are no normative values for Iranian people. We aimed to provide the normative values of mini-BESTest and brief-BESTest among healthy Iranian adults.
Methods. A cross-sectional study was designed. Three hundred healthy adults (150 males and 150 females) in six age groups (18-29, 30-39, 40-49, 50-59, 60-69, +79 years) completed the tests using Persian mini-BESTest and brief-BESTest. Normative values were calculated for age groups.
Results: Normative values of mini-BESTest and brief- BESTest decreased significantly with age (from 27 to 21.9 for mini-BESTest and from 22.9 to 15.4 for brief BESTest). There were no significant differences between genders except for females in 30-39 and 40-49 years age groups which scored better on brief-BESTest and mini-BESTest, respectively. Males had significantly scored better in brief- BESTest in 60-69 and ≥70 age groups.
Conclusions: The normative values of the mini-BESTest and brief- BESTest provided for healthy Iranian adults can help clinicians when assessing subjects with balance dysfunction. 
Trend of accesses to the ED of Teaching Hospital of Tuscany for bronchiolitis 2018-2023: new emergency
No full textIntroduction: Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalisation in children less than one year old worldwide. The aim of our study is to analyse paediatric accesses of children with bronchiolitis to the Emergency Department (ED) of Teaching Hospital (AOUS), Santa Maria alle Scotte of Siena, Tuscany
Methods: A retrospective observational study was conducted on the accesses performed at the ED of the AOUS of Siena by children under 18 years of age suffering from bronchiolitis from September 2018 to April 2023.
Results: There were 36031 patients between 0 and 18 years old in the Emergency Department, 383 of which presented bronchiolitis (age 4.8 months C.I.:3.5-6 months.; 54% male). Those who accessed the ED with a higher priority code were more likely to be subsequently admitted (O.R.:2.6; C.I.:1.3-5.1; p<0.01). Those who accessed the ED with symptoms of bronchiolitis during the weekend were less likely to have been sent from community medicine services or professionals (O.R:0.1; C.I:0.0-0.5; p<0.001). Children below 1 year old were more likely to access the ED with respiratory distress symptoms (O.R.:2.6; C.I.:1.5-4.3; p<0.001). Finally, those who accessed the ED with bronchiolitis were more likely to be admitted than those who accessed for other conditions (O.R:24.5; C.I.:19.4-31; p<0.001).
Conclusions: It is necessary to invest protocols integrating hospital services and community medicine in order to achieve a timely diagnosis and to reduce the accesses to the ED of children presenting mild, non-severe form of bronchiolitis in order to avoid the overload of hospital service
Adding COVID to Cancer: Does Cancer Status Influence COVID-19 Infection Preventive Behaviors?
Full text linkIntroductionA better understanding of how to promote disease mitigation and prevention behaviors among vulnerable populations, such as cancer survivors, is needed. This study aimed to determine patterns of and factors associated with COVID-19-related preventive behaviors among cancer survivors and assess whether the COVID-19 preventive behaviors of cancer survivors differ from the general population.MethodsIn June 2020, an online survey of adults (N=897) assessed predictors of COVID-19-related preventive behaviors, including socio-demographics, COVID-19 beliefs and perceptions (Health Belief Model [HBM] variables), and cancer statuses (cancer survivors currently in treatment, cancer survivors not currently in treatment, and individuals with no history of cancer). An average score of respondent engagement in eight preventive behaviors was calculated. Differences in HBM variables and preventive behaviors by cancer status were assessed using ANCOVAs. Hierarchical multiple regression analyzed associations among socio-demographics, HBM constructs, cancer statuses, and engagement in COVID-19 preventive behaviors.ResultsParticipants reported engaging in 3.5 (SD=0.6) preventive behaviors. Cancer survivors not in treatment engaged in preventive behaviors significantly less than the comparison group. In the final adjusted model, after adding COVID-19 beliefs and perceptions, cancer status was no longer significant. All HBM constructs except perceived susceptibility were significant predictors of preventive behaviors.ConclusionsCOVID-19 beliefs and perceptions were more robust predictors preventive behaviors than cancer status. Nonetheless, public health organizations and practitioners should communicate the risk and severity of infection among cancer survivors and emphasize the need to engage in protective behaviors for COVID-19 and other infectious diseases with this vulnerable population