Annali dell'Istituto Superiore di Sanità
Not a member yet
755 research outputs found
Sort by
Development of a model of integration for complex chronic conditions across levels of healthcare and the community in Novo mesto, Slovenia
Get PDFBackground.
People with complex chronic conditions have multidimensional needs and often experience fragmentation in care. A model of integration was developed based on a case study of chronic wound management in Novo mesto, Slovenia.
Methods. JA CHRODIS Recommendations and Criteria were used as a framework for developing the practice. A baseline analysis, patient needs assessments and analysis of clinical pathways were performed using qualitative methodology.
Results. Baseline analysis identified facilitators and barriers to care. Patient needs assessment led to organizational solutions in health and social care. Analysis of clinical pathways proved high variability in treatment process. Using these results a model of integration was developed introducing protocol of care and care coordinator at the secondary (hospital) level.
Conclusions. The proposed model would significantly reduce fragmentation in care for people with complex chronic conditions. The model was discussed at the policy dialogue and action plan defined for potential sustainability and scalability of the practice
Network as a language for precision medicine
Get PDFThe article takes as a starting point the observation of a deep and long-standing gap between the views of biologists/physicians and that of physicists/data scientists when dealing with life sciences. This gap has been exacerbated by the advent of large-scale -omics technologies. Here, we focus on the impact of this gap in the field of precision medicine that impedes dialogue between omics data analysts and precision medicine physicians. To try to overcome this cultural divide, here we suggest a new possibility through the use of network science as a shared language composed of a vocabulary of words that have different meanings in each discipline but refer to the same biological entity. By doingso, one can move from biological concepts to network patterns and algorithms and backwards, thus generating a dialogue between “life scientists” and “number scientists”. The article presents several simple network concepts with a straightforward biological interpretation as a starting point for such interdisciplinary dialogue
Atmospheric depositions of persistent pollutants: methodological aspects and values from case studies
Get PDFDeposition monitoring, already in use by government control organizations of various countries, contributes to an important increase in experimental knowledge on pollutant deposition fluxes, on their environmental fate and on the possible effects on human health. At the European level, the necessity to consider with extreme attention the environmental contamination due to deposition, has brought to adopt a series of legislative measures and recommendations; this has contributed to set up environmental surveillance systems and monitoring campaigns for a series of pollutants which may accumulate in the environment as persistent organic pollutants (POPs) and for metals. More recently, with DL.vo 155/2010, the necessity to consider, in the development of monitoring stations, the possibility to detect also data on deposition rates which represent a non-direct exposure of the population through the food chain. For sampling the Decree considers only two types of depositions: for total deposition (bulk and Bergerhoff) and wet only deposition
Completed suicide during pregnancy and postpartum
Get PDFBoth pregnancy and the postpartum are typical periods for the onset or relapse of psychiatric symptoms and disorders, with depression and anxiety being the most common. The prevalence of suicide spectrum behaviour is significantly higher among women with a diagnosis of depressive or bipolar disorder. Suicide during pregnancy and postpartum is a multifactorial phenomenon and a history of psychiatric illness is only one of the possible risk factors involved in suicide spectrum behaviour. The present paper highlights the importance of a complete screening for both depression and suicide risk during peripartum
Medication prescriptions before, during and after pregnancy in Italy: a population-based study
Get PDFBackground. Monitoring medicine prescriptions in pregnancy is an aspect of extreme interest in term of public health.
Methods. A retrospective prevalence study using administrative healthcare databases was performed in order to evaluate medication prescriptions in Italy. A cohort of 274,938 pregnant women (15-49 years) residing in three Italian regions (Emilia-Romagna, Lazio, Puglia), who delivered in 2014-2017, were enrolled. The prevalence of medication use was estimated as the proportion of pregnant women with any medication prescription in each of the following five trimesters: 1 before pregnancy (pre-T), 3 during pregnancy (1st TP, 2nd TP, 3rd TP) and 1 after pregnancy (post-T).
Results. About 80% of enrolled pregnant women received at least one prescription during pregnancy, 36.5% before pregnancy and 50.7% in the post-partum. The most prescribed medicine was folic acid (42%), mostly used in 1st TP (35%). Progesterone use was concentrated in 1st TP (19%) and increased as the number of previous abortions. Pregnancy use of antidiabetics, antihypertensives, and thyroid preparations were 24.1‰, 21.5‰, 101.8‰, respectively.
Conclusions. At the national level, this study confirmed the prescriptive trend observed in other European studies, but a regional variability for all medication groups was found. Further studies are needed in order to identify determinants of medication prescriptions during pregnancy in Italy
First evidence of blaNDM-1 and blaOXA-23 carbapenemase genes in human body lice infesting a second-hand T-shirt in a street market in Italy
Get PDFBackground. The spread of carbapenems resistance is a public health concern. The main group of carbapenemases encoding the β-lactamases activity (bla genes) is the Metallo-β-lactamases (MBLs).
Methods. The presence of carbapenemase blaOXA-23-like, blaOXA-40-like, blaOXA-51-like, blaOXA-58-like, and blaNDM-1 genes was screened by real time PCR in 26 Pediculus humanus insects identified from second-hand clothes in a local market in Central Italy. Bacteria diversity was also characterized through shotgun metagenomic amplification for a deep sequencing of the host-associated bacterial microbiomes.
Results. The blaOXA-23 and blaNDM-1 carbapenemases genes were found and metagenomic analysis showed a great presence of Acinetobacter species.
Conclusions. These results suggest a new potential transmission path for carbapenemase gene spread through bacteria ingested by insects infesting humans
The complex and constantly evolving public health threat of new psychoactive substances in Italy: addressing the main functions of a national observatory of drugs
Get PDFAt the end of the 90s in Europe, the new psychoactive substances (NPS) phenomenon was limited to a small number of molecules traded as “legal” replacements for controlled drugs. NPS were mostly circulating in rave parties and electronic music festivals. The globalization, the evolution of e-commerce and the growing popularity of NPS, facilitated the development of a wide illegal market in constant expansion. The dynamic nature of this phenomenon has led to an evolution in the prevention and monitoring of NPS trafficking within the European Union. The European legislative system has been amended with the aim of creating a faster and more effective regulatory system to tackle NPS diffusion and ban their sale and circulation. At the end of 2008, in compliance with the European Council Decision 2005/387/JHA, the Anti-Drug Policies Department of the Presidency of the Council of Ministers activated the National Early Warning System to promote a rapid exchange of information on NPS between Italy and the EU
