Annali dell'Istituto Superiore di Sanità
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The tattooed population in Italy: a national survey on demography, characteristics and perception of health risks
Get PDFBackground. In recent years, Italy has seen a constant upward trend in the practice of tattooing. The Italian National Health Institute has conducted a national survey to determine the prevalence of tattooed people in Italy and to study related features of the phenomenon. Aim. Establish the prevalence and characteristics of the tattooed population and evaluate awareness of the risks associated with tattoos, which can contribute to consumer health protection. Methods. Computer-assisted telephone interviews and computer-assisted web interviews were completed by a sample of the general population; 7608 people aged between 12 and 75+. Results. The prevalence of tattooed people was 12.8% of the general population in Italy (95% CI: 12.05%-13.55%), equivalent to an estimated 6 900 000 tattooed individuals. Tattoos were more prevalent among women, at 13.8%, while tattooed men accounted for 11.8%. The vast majority of tattooed subjects had decorative tattoos of small dimensions, with a higher prevalence of monochromatic tattoos. Only a minority of tattooed participants reported having cosmetic tattoos (3.0%) or medical tattoos (0.5%). According to the data, 3.3% of tattooed subjects claimed complications or reactions; of these, only 21.3% consulted a dermatologist/general practitioner; more than half (51.3%) did not consult anyone. In general, only 58.2% of the sample were aware of health risks. The Italian survey showed that 36.7% of all tattoos had been performed in the last five years prior to the interview. Conclusions. The estimated prevalence of tattoos in Italy is in agreement with the statistics of the European Union. The prevalence in the age group 35-44 years is almost double that of the Italian population and it is higher in women than in men. Tattooing is relevant to public health. The high number of tattooed Italians, the potential long-term effects on health and the reported complications call for the awareness of health authorities. Appropriate intervention should ensure safer tattooing by reinforcing the training of tattooists, by improving surveillance and by providing information to raise public awareness of the risks and contraindications of tattooing.
Costs and effectiveness of influenza vaccination: a systematic review
Get PDFBackground: Seasonal influenza can cause a significant public health burden. Vaccination is proposed as the most effective measure to prevent influenza and related undesired outcomes. Objective: To estimate the efficiency of influenza vaccination. Methods: A literature review of economic evaluations of influenza vaccinations, published over the last 5 years, was performed using MEDLINE (through PubMed), Web of Science and Scopus. Results: 935 papers were identified and 30 were selected, including studies performed in different population subgroups: general population, children, adults, elderly, pregnant women and high risk patients. Twenty-one studies were performed in Europe and in US. The majority of the studies were carried out on elderly patients and children. All except one were cost-effectiveness analyses and reported influenza vaccination as a cost-saving or cost-effective intervention. Conclusions: Vaccination strategies are economically favourable in a range of countries and sub-groups of patients.
The “New Charter for Health Care Workers” and the ethics of organ donation and transplantation
Get PDFComparison is made between the proposals put forward by the “New Charter for Health Care Workers” in the matter of organ transplants and other models of bioethics. The personalist approach adopted by the New Charter is illustrated and the proposals contained in it are finally placed alongside the reference ethical principles underlying the Italian transplant network: they are found to be fully in agreement.
Ulcer-risk classification and plantar pressure distribution in patients with diabetic polyneuropathy: an exploration of the factors that can lead to foot ulceration
No full textPlantar pressure is critical in the onset of neuropathic foot ulcers. However, no international risk classifications include it as a stratification parameter. Whether plantar pressure distribution affects ulcer-risk was investigated in a research context and in a clinics-oriented scenario.Totals of 134 and 83 patients from a research study and from a clinics-oriented study, respectively, were categorized by ulcer-risk using the guidelines of the International Working Group on the Diabetic Foot. Patients were divided into one non-neuropathic and three neuropathic groups. Pressure distribution was acquired during gait (Pedar-X System); contact time, peak pressure, maximum force, pressure-time integral, and contact area were assessed for the patients’ hindfoot, midfoot, forefoot and toes. Analyses of variance (P < 0.05) were conducted for all parameters and regions. Groups were also divided into two sub-groups: low or high BMI; the same statistical analysis was conducted on sub-groups as well.Pressure distribution changed with polyneuropathy even in the low-risk groups. Neuropathic patients’ risk classification corresponded poorly with pressure distribution (median p = 0.686 [0.374–0.828]). Pressure integral, contact time and contact area changed (median p = 0.048 [0.001–0.223]). BMI, age and walking speed influenced most parameters (p < 0.05) except for contact area and pressure integral and made the studies almost incomparable (2-way ANOVA factor A > 0.05). The only comparable parameter was PTI which, together with the above factors, may increase ulcer-risk stratification models’ predictive abilities, once stronger evidence is proved through standardized measurement investigations
Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: a systematic review and meta-analysis
Get PDFIntroduction. Although frailty is common among community-dwelling older adults, its prevalence in Europe and how this varies between countries is unclear. Methods. A systematic review and meta-analysis of literature on frailty prevalence in 22 European countries involved in the Joint Action ADVANTAGE was conducted. Results. Sixty-two papers, representing 68 unique datasets were included. Meta-analysis showed an overall estimated frailty prevalence of 18% (95% confidence interval, CI, 15- 21%). The prevalence in community (n = 53) vs non-community based studies (n = 15) was 12% (95% CI 10-15%) and 45% (95% CI 27-63%), respectively. Pooled prevalence in community studies adopting a physical phenotype was 12% (95% CI 10-14%, n = 45) vs 16% (95% CI 7-29%, n = 8) for all other definitions. Sub-analysis of a subgroup of studies assessed as high-quality (n = 47) gave a pooled estimate of 17% (95% CI 13-21%). Conclusions. The considerable and significant heterogeneity found warrants the development of common methodological approaches to provide accurate and comparable frailty prevalence estimates at population-level
Highly-integrated programs for the prevention of obesity and overweight in children and adolescent: results from a systematic review and meta-analysis.
Get PDFBackground: Since overweight and obesity has become epidemic in children and adolescent, the aim of this study was to determine the role of highly-integrated programs in preventing and reducing prevalence of children and adolescent obesity and overweight. Methods: A systematic review of literature and a meta-analysis was conducted. Results: According to PRISMA guidelines, we identified 23 studies describing 14 programs. For 11 out of 14 programs, obese/overweight prevalence changing from baseline were definable and meta-analysis of them showed a significant change of obese/overweight prevalence (-0.03; 95% CI = -0.04 to -0.01; P < 0.0001). Secondary outcomes as dietary (such as vegetable intake, carbonated beverages, fruit juice, drinks, healthful food consumption), physical activity and TV-time-spent was analyzed in many of the studies to define community readiness and behavioral changes. Macro-interventions, based on what was observed in our systematic review have a high potential to reach the entire population. Conclusion: Adoption of coordinated cross-sectoral, multi-component and multi-stakeholder initiatives to oppose obesity remains a challenge, but it is also desirable as one of the possible solutions to this major public health issue
