Annali dell'Istituto Superiore di Sanità
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Someone to rely on: the impact of social support on self-perceived health in Slovene elderly
Get PDFIntroduction: Aiming at highlighting the importance of social networking for health of elderly, the association between social support and self-perceived health (SPH) was assessed in Slovenia.Methods: Data from three consecutive cross-sectional surveys on health behaviour in Slovenia (2008, 2012 and 2016), for 4599 elderly, aged 65-75 years, were pooled. Association between poor SPH (PSPH) and social support (taking into account also existence of extended personal social network (EPSN)), adjusted for confounders, was analysed by multiple logistic regression.Results: The PSPH odds were statistically significantly higher in single/divorced without EPSN (OR=2.99; p=0.005) and single/divorced with EPSN (OR=1.49; p=0.053) in comparison to married with EPSN.Conclusion: Irrespective of gender, socio-economic status or health-related factors, elderly with low level of social support were more likely to perceive their health as poor/very poor. Public health measures to reduce isolation of elderly should be included in the action plan in the frame of the Longevity strategy
Communication and health education in communities experiencing asbestos
Get PDFIntroduction. Numerous municipalities in Italy currently experience asbestos health impact, in particular excesses of pleural mesothelioma incidence and mortality. This paper presents an integrated analysis of epidemiological studies and communication actions in affected municipalities to highlight how communication has been implemented depending on health impact evidence and involvement of local stakeholders. Methodology. Four case studies are identified concerning industrial and natural sources of asbestos exposure having different diseases burden. This integrated analysis benefited from multidisciplinary skills.Discussion. Evidence of different stakeholders engagement is presented to emphasize their role in the communication process. Similarities and differences among case studies allowed us to identify lessons-learned to be transferred in other asbestos contaminatedsites.Conclusions. The adoption of communication strategies and practices, since the very early evidence of asbestos health impact, represents a relevant contribution for epidemiological and health surveillance, particularly for those communities where asbestos health impact has only been recently reported
Measles and rubella in Italy, e-learning course for health care workers
Get PDFIntroduction. Since 2003, strategic plans for the elimination of measles and congenitalrubella have been adopted in the World Health Organization European Region. In Italy,a network of reference laboratories for measles and rubella (MoRoNet) has been recentlyimplemented to ensure high-quality laboratory investigation for the confirmation ofcases and outbreaks. Training among health care workers (HCWs) is one of the tasks ofMoRoNet and an e-learning course was produced to improve the knowledge on internationaland national elimination plans and laboratory surveillance for measles and rubella.Methods. The course, based on the problem based learning methodology, was offeredfree of charge. Data about all participants and those who completed the course havebeen collected and analysed.Results. 5822 participants enrolled and 3995 (69%) completed the course; comparisonbetween pre- and post-test shows a significant improvement in knowledge. The averagescore obtained from the satisfaction questionnaire is 4.5 out of 5.Discussion and conclusions. Course’s results are satisfactory, and data show a significantimprovement in knowledge among participants. Most of them were satisfied withcontent, learning methodology and platform. Moreover, this course represents one ofthe possible strategies to overcome resistance and mistrust about vaccinations amongHCWs
Tuberculosis outbreak in a grammar school, Serbia, 2016
Get PDFSerbia has a low incidence of tuberculosis (TB), with a decreasing trend in the last decade. The purpose of this manuscript is to describe an outbreak of TB infection that occurred in 2016 among students of a grammar school in Novi Pazar. February and November 2016. A 17-year-old girl, third-grade student of a grammar school (the index case), was diagnosed with smear-positive tuberculosis. Contact investigation was conducted, including chest X-ray examinations of over 1100 persons. After the index case was detected, a total of 16 (10 pulmonary and 6 extrapulmonary) tuberculosis patients were newly diagnosed during 2016. Among 11 culture positive cases, MIRU-VNTR method revealed that all Mycobacterium tuberculosis isolates were identical. Diagnostic delay contributed to the transmission of infection
Effects of short-term aerobic exercise in a mouse model of Niemann-Pick type C Disease on synaptic and muscle plasticity
Get PDFBackground. Physical exercise can reduce the risk of developing chronic diseases andslow the onset of neurodegenerative diseases. Since it has not been assessed which kindof training protocol might positively modulate both synaptic and muscular plasticity inneurodegenerative diseases, we studied in a mouse model of Niemann Pick type C disease,a model of minimal Alzheimer’s Disease, the effect of a short term protocol.Methods. We evaluated the effect of a short term, aerobic uniform exercise training onsynaptic and muscle plasticity in three different mice groups: WT controls, NPC1+/-and NPC1-/- animals. The results were compared with those obtained in the sedentaryrespective groups. We analyzed the effects on synaptic plasticity by in vitro extracellularrecordings in hippocampal mouse slices; moreover hippocampal and muscle tissuemorphological structure have been investigated by transmission electron microscopy, tohighlight any structural and functional changes due to training.Results. The results indicate a rescue of long-term potentiation in homozygous but notin heterozygous mice slices and an induction of neuronal plasticity, observed by morphologicalanalysis, both in homozygous and in heterozygous trained mice.Conclusions. Hence this protocol is adequate to improve long term potent
Health systems for rare diseases: financial sustainability
Get PDFIntroduction. Distribution of public spending on health depends on a variety of factors, from disease burden and system priorities to organisational aspects and costs. Nowadays, virtually all health care systems face serious sustainability challenges. This is particularly true for rare diseases, where priority setting involves complex and often controversial value-laden choices. Method. The theoretical framework underlying the approach of this work is based upon the State of Health in the EU, a two-year initiative undertaken by the European Commission and developed in cooperation with the Organisation for Economic Co-operation and Development and the European Observatory on Health Systems and Policies. Results. The 2017 report identified five cross-cutting sustainability issues: health promotion and disease prevention, primary care, integrated care, health workforce planning and forecasting, person-centred health data. Implications and recommendations. Rare diseases have been one of the priorities of the Community’s programmes for research and development. The EU has stimulated a series of actions in the field of rare diseases. These project activities could set up the practical cooperation and come up with the knowledge to translate and to work on the identified five key challenges of EU Member States health systems’ sustainability and resilience
Integrated care for healthcare sustainability for patients living with rare diseases
Get PDFThe increasingly complex and multidimensional care request, combined with the presence of increasingly aware and demanding patients, accentuates the need for new strategies to preserve health systems economic sustainability. Therefore, integration mechanisms reveal an essential condition for ensuring continuity of care. The paper reviews the main literature available on the integration of heal services and relates it to rare diseases. The literature identifies several system levers for the effective design and implementation of integrated care frameworks, namely: political support and commitment, governance, stakeholder engagement, organisational change, leadership, collaboration and trust, workforce education and training, patient empowerment, financing and incentives, ICT infrastructure and solutions, monitoring and evaluation system