Annali dell'Istituto Superiore di Sanità
Not a member yet
755 research outputs found
Sort by
The impact of a school-based multicomponent intervention for promoting vaccine uptake in Italian adolescents: a retrospective cohort study
Get PDFBackground. In Italy, the National Immunization Prevention Plan recommends for adolescents between ages 11 and 18 several vaccines, however their adherence is below the expected coverage. School-based delivery strategies might represent an alternative to primary care settings. This study aims to evaluate the effectiveness of a school-based intervention aimed to increase the vaccination uptake amongItalian secondary class students.Methods. One of the four schools in which a school-based multicomponent intervention was previously carried out has been matched with a control school in the same geographical area. Students ‘coverage for mandatory and recommended vaccinations was assessed before and after an 8 months period using the Local Health Authority Immunization Register.Results. Seven hundred and fifty five students resident in the RMA Local Health Authority were included: 265 from the intervention school, 490 from the control school. At baseline, the two schools were comparable for grades and sex distribution; the intervention school had significant higher immunization rates for Meningococcal B, but lower ones for the 4thdose of dTap. After eight months, higher percentage of students received the HPV (30.5% vs 13.8% of females; p=0.003) Meningococcal C (6.0% vs 2.0%; p=0.005) and Meningococcal B (14.7% vs 0.3%; p<0.001) vaccines in the intervention school compared with control. The pre-post differences between the two schools in the immunization rates were significantly higher in the intervention school for the HPV, Meningococcal C and B vaccines. Conclusions.This study demonstrates that a school-based health promotion project was effective in improving the recommended vaccines uptake among adolescents with potential interesting implication for the national targets attainment. Considering the importance of informing and educating, innovative school-based health promotion programs could represent an excellent opportunity for the Local Health Authorities to get in touch with a hard-to-reach target. Performance in offering the vaccination in school facilities should be evaluated
“Candido’s List”: the workers of Collotta Cis & Figli at Molina di Ledro in Trento Province, Italy. A tale of magnesia, asbestos and work
Get PDFThe study entitled “Candido’s List” (La Lista di Candido) is not the work of the three authors alone. A good part of the community is entitled to feel itself coauthor, each for his/her own part, of a research project that has succeeded in blending a variety of different ingredients: history, entrepreneurship, the industrialization of the Trento Province with all its high and low points, personal life stories, medicine, genius, work, women’s emancipation, the past but also the present and future. The research comprises an eloquent collection of memories and a variety of iconographic materials; it has now become a book and a travelling exhibition containing the accounts of the people who worked at the Collotta-Cis factory in Molina di Ledro. It starts with the brilliance of Pier Antonio Cassoni, who in 1816 deposited the first patent in the world for the extraction of magnesium carbonate, and closes with the decontamination of the factory site in the late 1980s. A needful section has been set aside for the painful facts relating to the processing of asbestos fibre; a final space, midway between an artistic reading and an interpretation for the future, has seen the involvement of the Circolo Fotoamatori di Ledro, with a photographic itinerary enabling the reader to “virtually’ enter the remaining worksites and listen to these spaces “tell” their stories after years of silence. A story in black and white, where the two tones are also messages for reading a complex story, one that it is important to remember
Resilience actions to counteract the effects of climate change and health emergencies in cities: the role of artificial neural networks
Get PDFBoth the World Health Organization (WHO) with its 2015 "Climate and Health Country Profile Project" and the Istituto Superiore di Sanità (ISS) with its 2018 "Health and Climate Change", agree on the emergency generated by the climate change and concerning health problems. The mitigation strategy suggested by the Intergovernmental Panel On Climate Change (IPCC) against greenhouse gas emissions and their effects on climate change, has not yet yielded the desired results. It is therefore necessary to focus on adaptation strategies, to immediately counter the effects of Climate Change (CC) on most vulnerable people and environments, by increasing their resilience through local interventions and targeted resilience actions. Coordinated resilience actions are necessary to combat the effects of CC especially in urban areas. Useful tools to manage and optimize resilience actions are Artificial Neural Networks (ANN) in complex and dynamic domains as cities are. The case of ANN applied to a city is presented as an example to increase the climate resilience of health local systems. In the current state of knowledge, ANN prove to be the most advanced and global solution to coordinate and manage a set of resilience actions in urban areas
Value based healthcare for rare diseases: efficiency, efficacy, equity
Get PDFThe paper reviews the literature available on value based health care and relates it to rare diseases. Starting from the economic definition of value and healthcare evaluation, efficacy and efficiency, it includes the equity dimension to define value-based healthcare. It embraces also the cultural framework associated to the concepts of health and disease, normal and pathological, right or wrong for the patient. The paper highlights that a prevention and recovery view and global evaluation of costs/benefits ratio for rare diseases make difficult and limited the applicability of the value-based approach to rare diseases. Since epidemiology of rare diseases identified a series of difficulties in applying valuebased public health strategies to rare diseases, the paper underlines the necessity of new culture of health and well-being, radically re-examining how to organise the delivery of prevention, and healthcare services, and finding alternative ways of empowering and giving voice to vulnerable and marginalised group
Health systems sustainability in the framework of rare diseases actions. Actions on educational programmes and training for professionals and patients
Get PDFProtection of early development contributes to health of next generations. Congenital anomalies (and other adverse reproductive outcomes) are an important public health issue and early indicator of public health risks, as early development is influenced by many risk factors (e.g., nutrition, lifestyles, pollution, infections, medications, etc). Effective primary prevention requires an integrated “One Health” approach, linking knowledge and action. This requires surveillance of health events and potential health-damaging factors, science-based risk analysis, citizens’ empowerment and education of health professionals. From the policy standpoint, joint budgeting mechanisms are needed to sustain with equity intersectoral actions (involving policy domains of health, social affairs, education, agriculture and environment). States should devote resources to strengthen registries and systematic data collection for surveillance of congenital anomalies, to better inform national prevention strategies. Investing in primary prevention based on scientific evidence is essential to support sustainable and resilient health systems and sustainable development of the society
Resilience in rare disease networks
Get PDFA resilient system is one which continues to perform its function or goal during a period of change. The original concept was formed around return to the status quo after major external shocks. Recently the concept of “everyday resilience” has been proposed. Everyday resilience is the adaptive and learning response of systems to the daily disturbance of normal routines. For everyday resilience, human factors are as important as physical resources. Rare disease networks can use several strategies to build resilience
An international study of middle school students’ preferences about digital interactive education activities for promoting psychological well-being and mental health
Get PDFIntroduction. World Health Organization estimated that up to 20% of children and adolescents suffer from a problem of psychological or behavioural development worldwide and one in eight suffers from a mental disorder. Interventions promoting positive mental health may provide young people with necessary life skills to prevent mental health disorders.Methods. Computer and communication technologies are becoming more and more popular for life skills training programs. However, learning styles and communication technologies preferences of young people is understudied. Focus group interviews was used.Results. Participants were 283 students of five European countries (Bulgaria, Italy, Lithuania, Poland, and United Kingdom). The majority of preferences indicated smartphone to communicate or to get information, tablet for a better use in classroom and collaborative games for digital interactive educational activities.Conclusions. There is a need to encourage teachers to use this technology at school to improve students’ productivity and their emotional and social abilities
Unproven stem cell therapies: is it my right to try?
Get PDFBackground. Nowadays one of the most critical aspects of innovative cell-based therapies is the unregulated industry, as it is becoming a competitor of the regulated system. Many private clinics, worldwide, advertise and offer cell-based interventions treatments directly to the consumer and this poses a risk to both vulnerable patients and health systems. Several countries have implemented Compassionate Use Programmes (CUP) that provide patients with medicines that have not yet completed the approval pathway, in the event that no reasonable alternative exists. Recently, in the public discourse, compassionate use has been increasingly associated with a patient’s right to try. Thus, the aim of this study was to assess public knowledge of the clinical trials process with specific reference to innovative stem cell treatments, and trust in the institutions responsible for regulatory activities. We also asked people about their “right” to use unregulated therapies. Methods. We developed an ad hoc questionnaire on three main areas of concern and administered it to 300 people in the patient waiting room at an Italian university hospital.Results. Our findings suggest that people have a good knowledge of the clinical trials process and trust in healthcare institutions. Nonetheless, one person in two believes it is a right to use unregulated therapies.Conclusions. We stress the need, in the age of cellular therapies, for a commitment to support vulnerable patients and to strengthen awareness among the public about the substantial boundary that differentiates experimental therapies from unproven therapies. There should not be a “right to try” something that is unsafe but rather approved treatments and in line with good clinical practice. The trend, which emerged on this issue from our study, is quite different, confirming the urgent need to improve health information so that it is as complete as possible
Cancer incidence and congenital anomalies evaluation in the contaminated sites of Sesto San Giovanni – the SENTIERI Project
Get PDFThe Italian Institute for Environmental Protection and Research defines National Priority Contaminated Sites (NPCSs) as land where hazardous substances are likely to pose a risk to human health. SENTIERI was the first national project evaluating the health status of residents in NPCSs. We have extended, for the site of Sesto San Giovanni, the evaluation to cancer incidence and congenital anomalies (CAs). We have found an overall protective effect of living in the NPCS for overall cancer incidence in all ages and no association in paediatric, adolescent and young adults’ population. We have found an excess risk for bladder cancer, leukaemia, lymphoid leukaemia and chronic lymphocytic leukaemia in men and for lung and breast cancer in women. For the paediatric and adolescent population, we have found an excess in embryonic tumours. Total CAs were not different from expected, while we have found excesses regarding congenital ear, face and neck, digestive system and chromosomal defects