Annali dell'Istituto Superiore di Sanità
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Hospital discharge diagnoses in patientswith positive blood cultures in an Italian academic hospital
Get PDFObjective. To assess the sensitivity of hospital discharge diagnoses for identifying sepsis in patients with blood culture confirmation.Methods. A cross-sectional study was conducted at the Italian 1000-bed University Hospital of Udine. The administrative databases of the Hospital were used as the source of information. Laboratory data were linked with hospital discharge data. We estimated the proportion of hospitalizations with at least 2 positive blood culture tests in which at least one discharge diagnosis indicated bloodstream infection.Results. From 2011 to 2017, 3571 hospitalizations (1.2%) had positive blood culture tests. Of them, only 49.5% had at least one ICD-9-CM discharge diagnosis code of sepsis, with lower proportions in surgical than in medical wards.Conclusions. The sensitivity of ICD-9-CM discharge codes for sepsis is low as compared with the blood culture gold standard. Using discharge codes for epidemiological estimates of sepsis, health planning and risk management may yield biased results. Audits and ICD coding training are needed
Night work and quality of life. A study on the health of nurses
Get PDFBackground. Job quality and evaluation of workers’ health have both medical and social important implications. We studied health-related quality of life (HRQL) in nurses who perform their activity in night shifts. Methods. A cross-sectional study was conducted between October and November 2014. Nurses who attended night shift in the Siena Teaching Hospital (Azienda Ospedaliera Universitaria Senese – AOUS) were sampled using EpiInfo software (confidence interval 95%) and investigated using the SF-36 Questionnaire. Our results were compared with the Italian general population (Apolone, 1997). A Descriptive analysis was conducted. Wilcoxon test, Pearson coefficient, t-test, Wilcoxon signed-rank test and logistic regression were used for the statistical investigation.Results. 197 questionnaires were analyzed. Females were 71.7%; mean age was 39.2 years (DS 8.6); smokers were 37.8%. Males scores were higher than those of females in all dimensions of physical and mental health (p <0.05). The time taken to reach the place of work appeared to influence the dimension of General Health (coeff. -0.17); we found a worsening of 0.17 points of this dimension for every minute spent in travel. Men and nurses with more working years had a better score in Physical Pain dimension. AOUS nurses scored significantly (p <0.05) less compared with the correspondent Italian general population in General Health, Energy-fatigue, Social unctioning, Physical functioning and Bodily pain.Conclusions. There is a significant relationship between night work and HRQL of nurses. The health profile of AOUS nurses’ ranks below the values of the Italian general population in various dimensions.
Design and hygiene issues in sports facilities. A pilot study which investigates fitness centres by using a multidisciplinary tool
Get PDFIntroduction. In recent years there has been a considerable increase in general public\u27s awareness of the benefits of physical activity on health, and the number of people becoming physically active has risen. Being gyms the main indoor environment for practicing physical activity, the growth of their attendance has increased the importance of these places.Methods. A multidisciplinary team has developed an assessment tool for hygiene and safety of these areas that evaluates different components (location, dimension, maintenance, etc.). Each section consists of a series of questions that evaluators and facility managers must answer.Discussion. The tool was tested on a sample of case studies analyzing several critical issues that might affect the quality of spaces and users’ health.Conclusions. The observed critical points will allow the future implementation of the instrument. Several design and management considerations also were highlighted, in order to improve the hygiene and health aspects of gyms.Keywords. Design and Management strategies; Fitness centers; Evaluation tool; Indoor Environment; Multidisciplinary approach
After the Italian Constitutional Court’s ruling on the absence of criminal liability for assisted suicide: the role of ethics committees and clinical ethics
Get PDFThe Constitutional Court handed down a judgment on 25 September 2019 following on from that Court’s Order No 207 of 24 October 2018. The issue of constitutionality of Article 580 of the Criminal Code, in the part about the punishment of the aid to suicide, was raised by the Court of Milan. According to the Court “under certain conditions, a person who facilitates the execution of the suicide intention, autonomously and freely formed, of a patient kept alive by life support treatments and affected by a irreversible pathology, source of physical or psychological suffering that he considers intolerable but fully capable of making free and conscious decisions”.According to the Court, a local ethics committee must provide an opinion in all cases involving a request for medically-assisted suicide
Measuring health literacy in Italy: the validation study of the HLS-EU-Q16 and of the HLS-EU-Q6 in Italian language
Get PDFHealth literacy (HL) is the capacity of individuals, families, and communities to make sound health decisions in the context of everyday life: at home, at the workplace, and in the community, marketplace, healthcare sector, and political arena. The aim of this study is to validate the Italian version of the short form (HLS-EU-Q16) and of the short-short form (HLS-EU-Q6) of the HLS-EU-Q47, as a part of a research conducted to assess the level of HL in a population-based sample in Florence. Two-hundred twenty-three subjects (57% females; age: 53.7±11.8 years) were interviewed. The results provided the first evidence for the reliability and validity of the HLS-EU-Q instruments (HLS-EU-Q16, HLS-EU-Q6, General-HL Index) in Italian general population. The differences in some of the results with respect to other published studies lay for specific cultural characteristics, that affect HL level and the relationships between HL, antecedents, and outcomes
Behavioral responses in people affected by alcohol use disorder and psychiatric comorbidity: correlations with addiction severity
Get PDFAim. In this study, we investigated in people suffering from alcohol use disorder (AUD) with or without dual diagnosis (concomitant psychiatric disability) how they feel their dependence condition. We predicted that AUD people with a dual diagnosis could feel potentiated their addiction.Methods. Alcohol habits and psychiatric conditions of 183 AUD men and 62 AUD women were measured by using the DSM-5, the severity of alcohol dependence questionnaire (SADQ), the alcohol anamnesis and psychiatric examination by the symptom check list 90-R (SCL-90-R).Results. We have shown that alcohol drinking does not correlate with both psychiatric examination and self-reported psychopathology. SADQ shows that severe alcohol dependence correlates with highest psychiatric symptoms and with the levels of alcohol consumption.Conclusions. This finding suggests that high SADQ scores may represent a tool to early disclose only patients with dual diagnosis. SADQ may provide information to address pharmacological interventions because revealing aspects of the dark side of addiction potentiated by AUD associated psychopathology.
Towards integration of epidemiological and social sciences approaches in the study of communities affected by asbestos exposure. Preface
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Integrated gastroenterology and rheumatology ambulatory: an innovative approach for enteropathic spondylarthritis early diagnosis
Get PDFPatients with inflammatory bowel disease (IBD) may develop rheumatic diseases, particularly enterophatic spondyloarthritis (ESpA). Similarly, an IBD may develop in patients with SpA. Management of these patients in a dedicated ambulatory could be advantageous. We pioneered an integrated “GastroReumatology” ambulatory where a gastroenterologist and a rheumatologist with a long-lasting expertise in IBD and pondyloarthritis, respectively, simultaneously visit those patients referred for a suspected SpA. A total of 101 different patients with suspected or known IBD and/or a rheumatic disease were visited. A new diagnosis of ESpA was eventually achieved in 13 (12.9%) patients, and further 12 patients with an already known ESpA were referred for an appropriate management. No cases of IBD in those patients with an established rheumatic disease were observed. Early diagnosis of ESpA is possible in a “GastroReumatology” ambulatory.