Annali dell'Istituto Superiore di Sanità
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Precision prevention network: new pathway for supporting women victims of violence
Full text linkIntroduction. Violence against women (VAW) is a persistent global public health problem that runs across all social classes and ethnicities with a considerable negative influence on women’s health and behaviour. Early detection, appropriate interventions and multidisciplinary cooperation are crucial factors in tackling gender violence.Objectives. This note describes “The Violence against women: long-term health effects for precision prevention” transdisciplinary and multicenter project that aims to implement the National Guidelines with two sets of questions: the European Injury Database (EU-IDB) violence module and the Post-Traumatic Stress Disorder (PTSD) questionnaire for improving innovative approaches to limit the long-term health effect of VAW.Furthermore, the analysis of epigenetic profile in women’s DNA may contribute to the knowledge of molecular mechanisms underlying PTSD and other non-communicable diseases. Epigenomic research in parallel with rigourous guidelines and social, educational, clinical and community interventions could accomplish innovative precision prevention protocols.Conclusions. Public health plays essential role in identifying risk factors and strengthening the support for women victims of violence
Responding to healthcare needs of different religious communities: implications for the Italian National Health Service: Religions and health service in Italy
No full textBackground. One of the challenges that our Italian National Health Service is facing is the structural change of society, regarding the migratory flows recorded in the last thirty years with the consequent increase in faithful who follow religions other than the Catholic one.Aim of the study. This study highlights the critical issues due to religious indications of different faiths which can have implications for our healthcare system. The study analyses the different concept of health, illness, well-being and pain, life and death, gender issues, rules regarding diet, fasting and drugs that can be taken by the patients. Religious norms regarding procreation, termination of pregnancy, and the use of contraceptive methods are also considered; as well as euthanasia, organ donation and the specific needs for end-of-life rites in different religious faiths, as they are presented in the literature and as they emerged in the dialogue with the national representatives of the religious faiths thatmake up the Interreligious Table of Rome.Conclusions and future perspective. The complexity of this relatively recent Italian reality necessarily leads to an in-depth analysis of religious and cultural diversity. The National Health Service must face a series of changes which concern both the adaptation of health structures and the adequate preparation of health workers, who are called upon to know how to communicate and offer care and assistance to all
Organizational Health Literacy as a supportive tool for the effective implementation of the 2013/59/ EURATOM Directive in Italy
Full text linkIntroduction. Since 2013, European countries have transposed the 2013/59/EURATOM Directive that lays down basic safety standards for protection against dangers arising from exposure to ionising radiation. In the years between the issuance of the European Directive and its formal transposition, Italian researchers investigated solutions to renew the technological, educational, and organizational culture in radiology departments.Scope. This article proposed a reflection on the contribution of Organizational Health Literacy (OHL) to implement Legislative Decree 101/2020 in the practice of Italian radiology departments.Results. By implementing OHL principles, examinations with exposure to ionizing radiation and related informative processes could be personalized based on patients’ knowledge, abilities, and competencies, as well as on the services’ provision. These principles can be in fact integrated with the organizational, training, and management requirements set by the Directive.Conclusions. According with the state-of-the-art, decision-makers and health managers could support the application of OHL principles in Italian radiology departments
Mortality in an Italian cohort of former asbestos cement workers
Full text linkBackground. A pooled study on Italian asbestos cement plant cohorts observed mortality risk for asbestos-related diseases. This study analysed the mortality of workers cohort of an asbestos cement plant in Syracuse, Italy.Methods. Workers’ vital status and causes of death, during 1970-2018, were identified in regional health databases. Standardized mortality ratios (SMRs) by sex and temporal variables were calculated.Results. Of the 900 cohort’s subjects (636 men, 259 women, 5 unknown sex), for 867 the vital ascertainment was possible: 505 died during study period. All-cause mortality is similarly to the expected among men and lower among women. Pleural and lung malignant neoplasms (MN) exceeded in men (SMR=27.1, SMR=1.95), retroperitoneal and peritoneal MN in both sexes, no cases of larynx MN were observed. Mortality excess for ovarian MN (SMR=1.5) and asbestosis in both sexes (men: SMR=431.9, women: SMR=116.6) were found.Conclusions. Exceeding mortality from asbestos-related diseases, particularly in men was highlighted
Registries or non-pharmacological observational studies? An operational attempt to draw the line and to provide some suggestions for the ethical evaluation of rare disease registries
Full text linkOriginally established to evaluate the ethical aspects of clinical trials, Ethics Committees (ECs) are now requested to review different types of projects, including, among others, observational studies and disease registries. In Italy, clinical trials on medicinal products for human use and on medical devices are regulated by EU Regulation 536/2014, EU Regulation 2017/745, and 2017/746 while pharmacological observational studies are regulated by the Italian Medicines Agency guidelines of 2008 and by Ministerial Decree of November 30th, 2021. The other types of studies are not strictly regulated, causing discrepancies in their definition and assessment by the ECs, and slowdowns in the start of projects. The present contribution aims to propose definitions and distinctions between non-pharmacological observational studies and disease registries, which constitute different entitiesbut are often assimilated by ECs, and to formulate suggestions for the evaluation of rare disease registries, which are an expanding research area of interest
The European legislation on the restriction on intentionally added microplastics
Full text linkThe potential impacts of microplastics pollution on the environment and possibly human health have raised concerns in various parts of the world. Once in the environment, microplastics do not biodegrade and cannot be removed. Several Member States have adopted or proposed specific measures. However, a patchwork of national restrictions can hinder the functioning of the internal market and therefore requires harmonization at Union level. The European Commission, on 9 November 2017, requested the European Chemicals Agency to prepare possible proposals for restrictions regarding oxo-plastics and intentionally added microplastic particles. On 25 September 2023, the restriction on microplastics intentionally added was published on the Official Journal of the European Union.By the end of 2024 it is envisaged the publication of a Guidance on the application of the microplastic restriction under Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH)
Exploitation of immunological approaches for the quality testing of human vaccines to phase out the use of animals
Full text linkPandemic impact on training and mental health of medical residents: an Italian multicentre prospective study
Full text linkObjective. To describe the mental health of Italian medical residents during COVID-19 pandemic and explore the impact of personal and work-related changes on their mental health.Methods. A multicentre prospective study was conducted on a sample of Italian residents across five timepoints (February-October 2021). Mental health outcomes (symptoms of post-traumatic stress disorder, PTSD, depression, anxiety, poor sleep quality)were assessed. Regressions analysed the association between pandemic-related personal and professional changes and the mental health outcomes.Results. Participants were 451. From February to October 2021, the prevalence of symptoms ranged from 21.6% to 12.7% (PTSD), 29.8% to 16.2% (depression), 36.2% to 28.8% (anxiety), 15.2% to 5.7% (sleep). Several work-related changes were significantly associated with symptoms, e.g. a perceived negative training change was associated with all outcomes; increased working hours with PTSD, depression, and anxiety; reallocation to tasks far from expertise area with PTSD.Conclusions. Residents reported a relevant frequency of mental issues. Many workrelated changes were associated with poor mental health