Annali dell'Istituto Superiore di Sanità
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PASSI d’Argento (Silver Steps): the main features of the new nationwide surveillance system for the ageing Italian population, Italy 2013-2014
Get PDFBackground:Italyis particularly concerned by population ageing. The costs for society are substantial. In this context a national, representative surveillance system, Passi D\u27Argento (PDA), was implemented in 2009 to monitor "active aging" and health status in people aged over 64 and to develop preventive health programs to reduce frailty. Methods/Design: PDA recruited a representative sample of 24,129 individuals (March 2012-January 2013) aged over 64 who were interviewed by trained staff using a standardized questionnaire. The PDA collects information about participation in society and employment, independent living, health conditions, safety and living environment. Indicator values are used to obtain population health profiles and to compare different LHUs’ profiles within the same region or between different regions. Discussion: The PDA surveillance system proved to be feasible and to be a powerful and innovative local and national tool for monitoring health status, frailty inItaly’s elderly population and the essential levels of care currently provided to the elderly.
MMR vaccine in the postpartum does not expose seronegative women to untoward effects.
Get PDFContesto : Lo scopo di questo studio è stato quello di valutare se la vaccinazione rosolia immediatamente dopo il parto potrebbe esporre le donne sieronegative per effetti indesiderati specifici.Metodi : 163 donne rosolia-sieronegativi hanno ricevuto il vaccino MMR nel periodo post-partum; sono stati valutati a 1 mese a 3 mesi successivi attraverso interviste telefoniche. Come controlli, abbiamo confrontato 163 donne rosolia-sieropositivi, che potrebbe avere sintomi simili per qualsiasi motivo, nello stesso arco di tempo.Risultati : A un mese di follow-up, 161 donne nel gruppo dei casi e 162 controlli hanno risposto alla nostra intervista telefonica; alle tre mesi di follow-up, 154 casi e 159 controlli. Eruzione cutanea, faringite, artralgia, linfoadenopatia cervicale, mialgia e parestesia sono state le lamentele più frequentemente riportati in entrambi i gruppi. Una differenza statisticamente significativa nella frequenza di linfoadenopatia cervicale e rash cutaneo a un mese (p = 0.028 ep = 0.005, rispettivamente) è stata osservata tra i casi ei controlli; Tuttavia, nessuna differenza significativa è stata ancora osservata nella frequenza delle manifestazioni muscoloscheletriche acute e croniche a tre mesi.Conclusioni : Non sono sostanziali differenze sono stati segnalati tra casi e controlli per quanto riguarda la frequenza di artralgia e conseguente mialgia al MMR vaccinazione in post-partum . Postpartum rosolia la vaccinazione è sicura e consigliabile in caso di necessità per evitare la circolazione del virus e la sindrome da rosolia congenita
Do Italian pregnant women use periconceptional folate supplementation?
Get PDFDeficiency of Folic Acid (FA) has been identified as a risk factor for neural tube defects (NTDs) as well as other congenital abnormalities. Thus, periconceptional folate supplementation is recommended for all women planning to get pregnant.We conducted a KAP (knowledge, attitude, practice) survey to investigate the use of FA and its appropriateness. The survey included a sample of 562 women who delivered in Lazio region between 2013 and 2014. Two logistic regression analyses were performed to evaluate the association between the characteristics of participating women and both the information received on FA intake and its use. The prevalence of periconceptional FA assumption was 19.4% although 82.2% of the interviewed women had planned their pregnancies. It shows that more periconceptional counseling is needed to increase women\u27s awareness on the opportunity of FA supplementation
Vaccine hesitancy: parental, professional and public responsibility
Get PDFThe opposition to vaccinations is a well-known phenomenon that dates back to the Victorian age when it was self-limited by the awareness of the importance to be proctect against fearsome infectious diseases. In recent years a complex mixture of contextual factors have promoted its amplification, leading experts to study causes and consequences of the so called "vaccine hesitancy". Several studies have shown the impact for children and for the community of the refusal or hesitation towards vaccinations from different point of views, including epidemiological, clinical, social and economic evaluation. This article would provide an analysis of the vaccine hesitancy from an ethical perspective: parental, professional and public responsibility have been analysed and described according to the "responsibility of the fathers towards the children," as articulated by Hans Jonas in 1979
Pes planus and pes cavus in Southern
Get PDFIntroduction. Baropodometrical digital techniques map the pressures exerted on the foot plant during both static and dynamic loadings. The study of the distribution of such pressures makes it possible to evaluate the postural and locomotory biomechanics together with its pathological variations.Methods. From January 2011 to August 2016 we conducted a cross sectional study in order to diagnose flatfoot and hollowfoot through the baropodometric analysis, and collecting additional information such as gender and the age. 7816 static and dynamic baropodometric tests and radiological exams of the spine in different positions were performed in order to detect, evaluate and verify the presence of spine pathologies or postural disorders. 978 patients were screened for suspected foot deformities: 668 cases of hollow feet and 310 of flat feet were diagnosed.Results. Dividing patients in “younger” and “older” (> 60 years) according to WHO, there is a statistically significant difference in the prevalence of hollow feet and flat feet (p < 0.01): the young age is a risk factor for flat feet (OR = 1.61 CI 95% 1.22-2.11) but protective for hollow feet (OR = 0.62 CI 95% 0.47-0.81). There is a statistically significant difference (p < 0.01) due to sex in the prevalence of hollow feet (OR = 0.44 CI 95% 0.33-0.59) and flat feet (OR = 2.23 CI 95% 1.68-2.98): to be a man is a preventive factor for hollow feet, but a risk factor for flat feet.Conclusions. Flatfoot and hollowfoot represent a serious public health problem which is related to working life because these deformities negatively influence the productivity of employees and the quality of life of affected patients.
A comparison between the costs of dialysis treatments in Marche Region, Italy: Macerata and Tolentino hospitals
Get PDFBackgrounds: The main aim of this study was to estimate the costs of different dialysis modalities through the analysis of administrative databases in the Macerata and Tolentino hospitals, in Italy. Methods: We retrospectively analyzed two main categories: medical direct costs (all the monetary costs whose consumption is wholly referable to dialysis treatment) and non-medical direct costs (all the costs that make treatment possible but that are outside the medical care sector), related to 2013. Attention was focused on the analysis of the extracorporeal dialysis methods (HD, HDF/AFB, HDF/MID/HFR) and the peritoneal dialysis (APD, CAPD). Results: An analysis overall of economic costs (direct costs + indirect costs) for dialysis treatment, shows that the cost per week for Continuous Ambulatory Peritoneal Dialysis (CAPD) technique is less expensive for health-care budgets, followed by Automated Peritoneal Dialysis (APD). Regarding the extracorporeal dialysis methods, the treatment more affordable is HD. Conclusions: Results obtained confirm that peritoneal dialysis technique is more convenient for health-care budget than extracorporeal dialysis. Furthermore, this study allowed to develop a methodology that could be a reference for similar studies.
Publications from International Organizations on Public Health
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EURADOS intercomparison exercise on Monte Carlo modelling of a medical linear accelerator
Get PDFBackground. In radiotherapy, Monte Carlo (MC) methods are considered a gold standard to calculate accurate dose distributions, particularly in heterogeneous tissues. EURADOS organized an international comparison with six participants applying different MC models to a real medical linear accelerator and to one homogeneous and four heterogeneous dosimetric phantoms. Aims. The aim of this exercise was to identify, by comparison of different MC models with a complete experimental dataset, critical aspects useful for MC users to build and calibrate a simulation and perform a dosimetric analysis. Results. Results show on average a good agreement between simulated and experimental data. However, some significant differences have been observed especially in presence of heterogeneities. Moreover, the results are critically dependent on the different choices of the initial electron source parameters. Conclusions. This intercomparison allowed the participants to identify some critical issues in MC modelling of a medical linear accelerator. Therefore, the complete experimental dataset assembled for this intercomparison will be available to all the MC users, thus providing them an opportunity to build and calibrate a model for a real medical linear accelerator.
