Annali dell'Istituto Superiore di Sanità
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Rubella immunity status and the active offer of MMR/MMRV vaccination during pregnancy
Get PDFIntroduction. The rubella test during pregnancy makes it possible to identify situations at risk of congenital rubella and those pregnant mothers who should be offered the MMR vaccine. Materials and methods. The Authors analysed test coverage and the immunity status of pregnant mothers between 2005 and 2017, using birth attendance certificates.
Results. Rubella test coverage on 61,437 pregnant mothers was 99.4%. The average proportion of susceptible subjects was 6.4%. Seroconversion was observed in 7 cases, with 1 confirmed case of congenital rubella. 32% of susceptible subjects were vaccinated, and adherence was seen to be influenced by the characteristics of the pregnant women and of the maternity unit.
Conclusions. A current information flow including a number of healthcare services, is useful both for monitoring the maternity care pathway and for public health purposes
Screening for celiac disease among the personnel in active service of an Italian Armed Force : Celiac disease in an Armed Force
No full textIntroduction and objective.Celiac disease (CD) affects the 1% of the general population worldwide. Because of its clinical variability, roughly the 70% of CD patients are not correctly diagnosed and not adequately treated. Active military personnel represent an interesting cohort for a CD screening. Upon the enrollment in the Armed Forces, a complete health check is carried out to exclude any diseases. Aim of the present work is to assess the CD prevalence among the personnel of Carabinieri Corps, an Italian armed force, through a serological screening.Results and discussion. Out of 291 militaries (281 M, 10 F age range: 18.2-61.5) enrolled, 2 resulted affected by CD (prevalence: 0.7%); 1 to have high serological anti-TG and EMA level without duodenal mucosal lesions and 1 to have high serological anti-TG, but not EMA. Conclusion. These results show that the CD prevalence among a cohort of Italian militaries is similar to that of the general population
Smoking prevalence among healthcare workers in Italy, PASSI surveillance system data, 2014-2018
Get PDFIntroduction. Data on smoking among Italian Health Personnel (HP) from PASSI surveillance system from 2014-2018 were analysed. Materials and methods. Among 169,678 working-age respondents, smoking prevalence was estimated among 1,253 Medical Doctors (MDs), 4,840 Non-Medical HP (NMHP), 87,749 Non-HP (NHP) and multivariate analysis was conducted. Results. Current smokers were 23.0% among HP. Smoking prevalence in MDs (16.0%) was significantly lower than those observed in NMHP (25.3%) and NHP (28.6%). A declining trend was detected in all three groups and was more evident among MDs: from 20.8% in 2014 to 11.5% in 2018. Amongst MDs, smoking was significantly associated with male gender (Adjusted Odds Ratio, AdjOR=1.61), younger age (AdjOR=2.00), residing in South (AdjOR=1.71). Among NMHP, smoking prevalence was associated with low economic condition (AdjOR=1.54) and non-university education. Discussion and conclusions. To further reduce smoking in HP, it is necessary to develop specific training courses in educational curricula
Clinical practice guideline for the integrated management of major trauma by the Italian Institute of Health: process and methods: Clinical practice guideline for the integrated management of major trauma
No full textBackground: Major trauma describes serious injuries requiring lifesaving interventions or resulting in long-term disability; it represents about 8% of all deaths worldwide. Specific guidelines can help reduce deaths and disabilities, provided they adhere to high quality and trustworthiness standards. This article aims at introducing the development process of the Istituto Superiore di Sanità (ISS) guideline for major trauma integrated management.
Methods: We applied the ISS methodological standards including the GRADE-ADOLOPMENT approach for adoption, adaptation, and de novo development of trustworthy guidelines.
Results: The scope was formulated by the multidisciplinary panel with stakeholders’ involvement; two guidelines were identified as appropriate sources for adolopment. Forty questions from the two source guidelines were prioritized and five new ones formulated. New systematic reviews or updates were conducted for each clinical question, Evidence to Decision frameworks developed or re-assessed, and the recommendations formulated after public consultations and external review. The policy on conflicts of interest was applied throughout the process.
Conclusions: Through a broad expertise representation, the early and wide stakeholders’ participation, a continual process for disclosure and management of conflict of interests, and the transparency of the process, ISS standards are proving to be an efficient model for developing trustworthy clinical guidance.
Levels of physical activity, nutrition and body composition in the workplace: reports from a distribution company
Get PDFAbstractIntroduction. Lifestyle factors, as eating habits and physical activity, are associated withhealth and productivity of workers. The aim of this study is an assessment of lifestyle ofthe employees of an international company of household items.Methods. 291 (170 female, 121 male) employees underwent body composition assessmentand completed two questionnaires (International Physical Activity Questionnaireand National Institute for Research of the Food and Nutrition).Results. The weight status of the sample is at the upper limits of normal weight. Productsbased on cereals are consumed about once a day, fresh meat 3.0 (0.0-12.0) perweek, fresh fruit (5.0, 0.0-25.0) and vegetables (6.0, 0.0-14.0) less than one serving aday. No vigorous physical activity is performed (0.0, 0.0-240.0 min/week), moderate isperformed 30.0 (0.0-450.0) min/week and only 106 subjects were aware of the numberof daily steps.Conclusions. Job duties can have an influence on the daily habits. Workplaces havegreat potential to change personal lifestyle choices and a preliminary assessment shouldbe performed in order to propose a tailored intervention
Evolution of Italian laws banning trafficking, use and abuse of psychotropic drugs
Get PDFThe penalty system implemented by Italian law still represents a barrier against psychoactive drugs and drug addiction, especially at a time when the age of first consumption has considerably dropped. Presidential Decree n. 309 of October 9, 1990 entitled “Consolidation of the laws governing drugs and psychotropic substances, the prevention, treatment and rehabilitation of drug addicts”, and referred to as Presidential Decree 309/90, is the reference text for the cultivation, production, trade and use of narcotics and other psychoactive substances in Italy. The Presidential Decree has its origins in the now-forgotten law of December 22, 1975, n. 685, amended by law 162/90, which provided a draft of the current Presidential Decree 309/90. The current text has been amended numerous times over the years
Coronavirus and birth in Italy: results of a national population-based cohort study
Get PDFIntroductionThe study was implemented to provide guidance to decision-makers and clinicians by describing hospital care offered to women who gave birth with confirmed COVID-19 infection. Materials and methodsNational population‐based prospective cohort study involving all women with confirmed COVID-19 who gave birth between February 25 and April 22, 2020 in any Italian hospital. ResultsThe incidence rate of confirmed SARS-CoV-2 infection in women who gave birth was 2.1 per 1000 maternities at a national level and 6.9/1000 in the Lombardy Region. Overall one third of the women developed a pneumonia and 49.7% assumed at least one drug. Caesarean rate was 32.9%, no mothers nor newborns died. Six percent of the infants tested positive for SARS – CoV-2 at birth. ConclusionsClinical features and outcomes of COVID-19 in women who gave birth are similar to those described for the general population, most women developing mild to moderate illness
Life-long individual planning in children with developmental disability: the active role of parents in the Italian experience
Get PDFAbstractMany young adults with neurodevelopmental disorders experience poor transition outcomesin key areas, including employment, health care, and independent living. Innovativewelfare models highlight the importance of involving the local community, and inparticular the parents, as important stakeholders capable to generate services and affectlocal economy. As indicated by the World Health Organization, the availability of person-centered responses, also providing a health budget, appears to be the basis for takinginto account person’s rights to self-determination. Health services and local stakeholderscould play an important role to facilitate the implementation of support networks thatare functional for an effective social inclusion. In order to improve current practices intransitioning to adulthood, it is of paramount importance to collect and learn from theliving experience of people with neurodevelopmental disabilities and their families
Reframing QoL assessment in persons with neurodevelopmental disorders
Get PDFAbstractThe paper reviews the international literature on quality of life (QoL) for persons withneurodevelopmental disorders (NDD) in order to define the theoretical frame for optimalassessment. The application of the QoL approach to assessment procedures shouldbe based on three main aspects: shared QoL, personal QoL and family QoL. The first aspectrefers to characteristics of individual life that are shared with other people. The secondaspect proceeds from the fact that each individual has a changing set of personal attributesthat determine the subjective experience of life. In the third aspect the previoustwo are applied to the family that includes a person with NDD. Disability impacts thewhole family and the determination of appropriate conceptualization of family outcomesrequires an understanding of the impact of members with a disability on family QoL. Atany level, it seems best to take a comprehensive approach to assessing QoL, integratingsubjective and objective aspects, self-reports and hetero-evaluations. The QoL approachis above all a way to explore the rich intricacies of personal quality of life. Such assessmentmay be used effectively with people with NDD, independently from the severityof their functioning impairment. Individuals with profound ID may express their innerstates through consistent behavioural repertoires, which can be discerned by personsclosest to them and validated by more independent others. Attention must be paid in usingnon-generic instruments, such as those that measure health-related QoL. Althoughthey do focus on the individual person, they still support a theoretical perspective ofQoL that has not departed significantly from the traditional medical approach. Currentlyavailable generic tools, although they have some common conceptual and evaluationcharacteristics, still show considerable differences in the areas to be included in “sharedQoL”, the dimensions used to evaluate “Individual QoL”, and the role attributed toindicators of QoL. QoL assessment should not represent a classification of individuals,services or systems, but it should help provide, within service systems and organizations,a value system that is consistent with those values held by people with NDD
An insight on drug resistance in Plasmodium vivax, a still neglected human malaria parasite
Get PDFPlasmodium vivax has been considered for years as responsible for a mild form of malaria, due to the absence in the majority of its infections of the severe form of the disease, typical instead of the deadly human parasite P. falciparum. In the last decade, studies on vivax malaria have had a partial step ahead especially after the completion of the whole genome project, but there is still a gap of knowledge in the biology of this parasite. Moreover, the emergence of P. vivax antimalarial resistance in ‘80s and its subsequent spread in the Southeast Asia have indicated new concerns about the possibility to control this parasite. P. vivax drug resistance poses a major threat to endemic countries and without important international efforts, we could assist in a near future to the paradox of seeing different malaria co-endemic countries, that have successfully controlled/eliminated P. falciparum, still fighting against P. vivax.