Annali dell'Istituto Superiore di Sanità
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Information needs on precision medicine: a survey of Italian health care professionals.
Get PDFBACKGROUND: Despite advances in technology development for precision medicine, obstacles remain as barriers to progress and change. In this context simple questions arise: what is the level of understanding of precision medicine among healthcare professionals? We tried to address this question with a survey whose objective was to explore the perception and understanding of precision medicine. METHODS: A questionnaire was administered to a sample made of oncologists, clinical and hospital pharmacists, pharmacologists and infectiologists in the context of five different Italian national congresses. Participation in the survey was voluntary and anonymous. RESULTS: The questionnaire was filled-in by a total number of 1,113 professionals out of 3,670 registered participants in the congresses. About half of respondents stated they were not sufficiently informed about precision medicine, and infectiologists were the ones who felt less informed. Most respondents agreed with the basic principles and definitions of precision medicine and believed this new approach is going to require deep changes in healthcare. CONCLUSIONS: Our findings show that healthcare professionals have partial knowledge on this topic and that there is a significant association between respondents’ knowledge and their clinical specialty. However, despite some misconceptions about precision medicine, a genuine interest and familiarity with its basic principles seems to emerge.
Incidence of frailty: a systematic review of scientific literature from a public health perspective
Get PDFIntroduction. Because of the dynamic nature of frailty, prospective epidemiological data are essential to calibrate an adequate public health response. Methods. A systematic review of literature on frailty incidence was conducted within the European Joint Action ADVANTAGE. Results. Of the 6 studies included, only 3 were specifically aimed at estimating frailty incidence, and only 2 provided disaggregated results by at least gender. The mean followup length (1-22.2 years; median 5.1), sample size (74-6306 individuals), and age of participants (≥ 30-65) varied greatly across studies. The adoption of incidence proportions rather than rates further limited comparability of results. After removing one outlier, incidence ranged from 5% (follow-up 22.2 years; age ≥ 30) to 13% (follow-up 1 year, age ≥ 55). Conclusions. Well-designed prospective studies of frailty are necessary. To facilitate comparison across studies and over time, incidence should be estimated in person-time rate. Analyses of factors associated with the development of frailty are needed to identify high-risk groups
How do recruits and superintendents perceive the problem of suicide in the Italian State Police?
Get PDFBackground. Suicide in international police is 2-3-fold that of the general population. Risk factors include suicidal ideation, diagnosis of mood or post-traumatic stress disorders, family/psychological problems, suffered abuse, alcohol use, service suspension, and stigma. A false stigma-related myth is to believe that suicide does not cause concern within military settings. Methods. We administered post-training to 6,103 Italian Police workers a 30-item questionnaire to assess the perception of suicidal phenomena. We conducted descriptive statistics and principal component analysis (PCA). Results. PCA identified six main areas, i.e., interest and multifactoriality; need for new preventive interventions; emotional reaction to suicide; utility of current preventive interventions; indifference and minimization; intervention difficulties. Conclusions. The questionnaire showed content validity and consistency in investigating perceptions about suicide in the State Police. Data synthesis showed a mature approach and appropriate perception of the suicide problem on behalf of Italian State Police workers
Proof of nicotine transfer to rat pups through maternal breast feeding to evaluate the neurobehavioral consequences of nicotine exposure
Get PDFThis study investigates the passage of nicotine from lactating dams to their offspring through breast milk in the frame of a research focused to ascertain toxicological and neuro-behavioural effects on pups as consequence of either unavoidable (“passive”) or voluntary (“active”) maternal nicotine exposure. To this aim, plasmatic concentrations of nicotine and cotinine were determined by LC-MS/MS in Wistar rat pups whose mothers were orally administered with nicotine during lactation. Mothers were divided into voluntary consumption group, unavoidable consumption group, and controls. The limits of detection and quantification of the LC-MS/MS method were 0.20 and 0.65 ng/mL, respectively. Within-laboratory reproducibility (CV%) was <10.0%, with recovery of 86.2-118.8%. Results showed the presence of nicotine in 67% of samples from voluntary consumption group (1.30±0.31 ng/mL) and in 60% of samples from “passive” consumption group (1.19±0.62 ng/mL); cotinine was found in all the samples from voluntary (1.92±0.77 ng/mL) and “passive” consumption groups (1.43±0.30 ng/mL). Data provide an evidence-based support to maternal/offspring nicotine transfer as function of different ways of oral exposure
Epidemiology, surveillance and population screening of frailty. Results from the systematic reviews of the European Joint Action ADVANTAGE. Preface
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The PIPER WEEKEND study. Children’s and adults satisfaction regarding pediatric pain in Italian Emergency Department
Get PDFBACKGROUND: Despite pain being a crucial aspect of urgent-emergency care, the attention of healthcare workers towards this symptom in the Emergency Department (ED) is still inadequate. The aims of this study were to assess children’s and their adults accompanier’s satisfaction regarding pain management in Italian ED, considering healthcare workers’ attention to the symptom as well as the appropriateness and efficacy of treatments received. METHODS: Questionnaires were administered face-to-face by trained interviewers over the period of one weekend in 29 Italian ED. The questionnaires were addressed to children 3-16 years old, assigned a green code at triage, and their adult accompaniers. RESULTS: Overall, 1581 questionnaires were administered (923 to parents or caregivers, 658 to children). The reported level of attention to pain by the care team was high (57.20%) as was the adults’ satisfaction with the pain management (95.01%); a high level of satisfaction was related to the healthcare workers’ attention to pain. According to the adults, 73.56% of the healthcare professionals collected accurate information about pain; this was confirmed by the children. Pain was managed by a doctor-and-nurse team in less than half the cases (43.77%). Therapy efficacy was reportedly poor: only 14.01% of children were pain-free when leaving the ED. CONCLUSIONS: Despite increasing understanding of pain and the availability of guidelines and effective analgesics, efficient pain relief in paediatric patients in the ED remains an unfulfilled goal: half of children with pain did not receive any treatments. Therefore the quality of pain management in the ED needs to be improved
Research and malignant mesothelioma: lines of action for clinical psychology
Get PDFThe purpose of this paper is to present two studies. Study 1 is a literature review on psychological needs of malignant mesothelioma (MM) patients. Study 2 is aimed at assessing how patients and caregiver experience the diagnosis. In study 1 we performed a systematic literature review; while in study 2 we performed a thematic analysis of semistructured interviews. Study 1 detected 5 psychological constructs (i.e. 1. Psychological impact of MM diagnosis; 2. Emotional aspects connected to the occupational context; 3. Coping strategies; 4. Treatment experiences; 5. Quality of life). Study 2 identified 4 themes (i.e. 1. Physical symptoms, affects, and defenses; 2. Living in or near a National Priority Contaminated Site; 3. “Nothing is like it was”; 4. “What will become of us?”). The literature review suggests a specific profile of suffering for MM, a result strengthened by the qualitative study on semi-structured interviews. The present paper highlights the lack of specific measures and clinical interventions for this distinctive population
Psycho-educational group therapy in acute psychiatric units: Creating a psychosocial culture. An update of spread and effectiveness of a psychosocial intervention in Italian psychiatric wards
Get PDFThe implementation of a Cognitive-Behavioural Group Intervention (CBGI) in Italian general hospital psychiatric units started in the years 2000-2001 in two Italian regions. Over the years it has became more and more popular also in other psychiatric units located in the rest of the country. Based on the "stress-vulnerability-coping" theory, the CBGI is a replicable and innovative psychosocial intervention that promotes the active involvement of inpatients in decisions concerning their individual objectives and care. In the present article, the authors briefly describe this intervention and the main findings regarding its implementation in several psychiatric units in different Regions of Italy. The authors emphasize that such a psychosocial approach to inpatient care is needed because it can produce improved clinical outcomes, reduction in untoward events and increased staff and inpatient satisfaction. However, its introduction and use still represents a major cultural and managerial challenge in our country