Annali dell'Istituto Superiore di Sanità
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Health risks related to illegal and on-line sale of drugs and food supplements: results of a survey on marketed products in Italy from 2011 to 2013
Get PDFObjectives. The increasing illegal and on-line market of medicines and food supplements is helping the widespread diffusion of harmful counterfeit and forbidden products among consumers of developed countries. The objectives of this survey were the description of the main frauds recognized by public officers and the detection of illegal or counterfeit drugs and food supplements.Methods. Medicines and food supplements found by Police forces on the illegal market or resulting from seizures made by Italian Customs authorities were visually inspected and analysed to evaluate their quality and the presence of other undeclared substances.Results. The visual inspection and the chemical analysis revealed unsuitable packaging (mostly lacking of adequate information for consumers), absence of the declared active substances and presence of undeclared active substances. Products containing doping agents, illegal substances and active ingredients requiring medical supervision were found.Conclusion. The present work confirmed the health risk associated with assumption of medicines purchased on the Internet and from the illegal supply chain and evidenced a new threat to consumer safety related to the presence of pharmaceutical active ingredients in food supplements claiming to contain only “natural ingredients”.
Validation of the Italian version of the Apathy Evaluation Scale (AES-I) in institutionalized geriatric patients
No full textObjectives: Apathy is a very common symptom in institutionalized elderly and represents a condition of both clinical and public health importance. The Apathy Evaluation Scale (AES) has been shown to be a valid and reliable tool for characterizing, quantifying and differentiating apathy in various health conditions. The aims of this study were to establish the validity and reliability of the Italian version of the AES, and to assess the severity of apathy in a sample of Italian institutionalized geriatric patients.Method: Data were collected from clinical interviews using the AES informant version (AES-I). Associations between measures of apathy and depression, cognitive functioning and perceived quality of life were evaluated, as well as the effect of the living environment on apathetic symptoms.Results: Multiple forms of reliability and validity (i.e. test-retest, internal consistency, discriminability of apathy rating from a standard measure of depression) were satisfied. Our results also show that the characteristics of the care setting may affect the severity of apathetic symptoms.Conclusions: The AES-I Italian version is a reliable and valid instrument for measuring apathy in Italian patients, also allowing a direct comparison with data gathered in other countries.
Health services and health literacy: from the rationale to the many facets of a fundamental concept. A literature review.
Get PDFBackground. The aim of this study is to make a critical analysis of the different definitions of health literacy to provide a framework of the concept. Methods. A literature search was conducted in PubMed, Embase, PsycINFO, ERIC, Health Evidence, Centre for Reviews and Dissemination and Cochrane Library. Google and OpenGrey were searched to find additional papers and unpublished works. Results. Among 7000 papers founded, we selected 26 works. During the 1990s, authors began to systematically study the relationship between health literacy and health status, according to a public health view. In the first decade of the new century, a new fundamental definition established three progressive degrees of health literacy: functional, interactive and critical health literacy. Sørensen (in 2012) provided a framework for the development of new assessment tools and interventions. Conclusion. The improvement of health literacy is a powerful tool for the development of a new type of relationship between individuals and the health system.
Open building and flexibility in healthcare: strategies for shaping spaces for social aspects
Get PDFIntroduction. The fast development of technology and medicine influences the functioning of healthcare facilities as health promoter for the society, making the flexibility a fundamental requirement. Among the many ways to ensure adaptability, one that allows change without increasing the building’s overall size is the Open Building approach. Methodology. Starting from the analysis of the State-of-the-Art and many case-studies, eight parameters of evaluation were defined, appraising their relative importance through a weighting system defined with several experts. The resulting evaluation tool establishes in what measure healthcare facilities follow the Open Building principles. Results and discussion. The tool is tested to ten case-studies, chosen for their flexible features, in order to determine his effectiveness and to identify projects’ weaknesses and strengths. Conclusions. The results suggest that many Open Building’s principles are already in use but, only through a good design thinking, it will be possible to guarantee architectures for health adaptable for future social challenges
Information needs of young Italians accessing the AIDS/STI Helpline at the Italian National Institute of Health
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Towards a greener labour market: occupational health and safety implications
Get PDFBackground. Climate change and environmental degradation are seriously jeopardizing the future environmental and economic sustainability at the global level prompting urgent calls for a shift towards more sustainable development and greener economies. The use of the so called green jobs is a key strategy to overcome economic and ecological crisis. Aim. The present study discusses the implications for employment and decent work of green jobs in order to identify information/training measures to enhance skills of employees protecting their working conditions. Results. Despite all the emphasis laid today on the green economy, occupational health and safety (OHS) issues have still been talked only limited, as already noted in previous studies and literature reviews. Conclusion. It is needed to assess traditional and new OHS risks within green jobs in order to facilitate the transfer of OHS knowledge to green technologies as well as identifying OHS training needs
Technology-based intervention for healthy lifestyle promotion in Italian adolescence.
Get PDFIntroduction. Healthy lifestyle promotion programs are essential to prevent metabolic diseases such as obesity and diabetes. Adolescents could represent the ideal target population especially using serious web games. Objective. To test the improvement of knowledge about healthy nutrition in adolescents and to analyze participants’ enjoyment in playing the web game “Gustavo in Gnam’s Planet” in comparison with a leisure web game. Subjects and Methods. Sixty-five adolescents were engaged in three supervised group sessions. Measures about healthy food knowledge and games’ enjoyment were collected during the three stages of assessment. Results. After playing Gustavo in Gnam’s Planet, participants significantly improved their knowledge on a healthy diet, compared to the recreational web games; whereas the level of fun experienced while playing the recreational and the educational games was not significantly different. Conclusions. Gustavo in Gnam’s Planet is an important promising tool, with entertainment property, to promote a healthy lifestyle in Italian adolescents.
Prevalence of breastfeeding in Italy: a population based follow-up study
Get PDFAbstract Introduction Breastfeeding is widely recommended. Updated data are needed to assess its prevalence and the effectiveness of interventions. Breastfeeding practices in Italy need to be promoted and monitored with updated and standard data The objective of this study is to provide estimates of the prevalence of breastfeeding and exclusively breastfeeding and to identify factors that may be modified to improve them. Materials and methods Two population-based follow-up surveys were conducted to evaluate the quality of maternal care in 25 Local Health Units in Italy during 2008-2011. Women were interviewed soon after giving birth and after 3, 6 and 12 months. Breastfeeding prevalences were estimated. A logistic regression model was used to investigate factors associated with exclusive breastfeeding at 3 months. Results Breastfeeding and exclusively breastfeeding prevalences were 91.6% and 57.2% at discharge, 71.6% and 48.6% at 3 months, 57.7% and 5.5% at 6 months. At 12 months, 32.5% were still breastfeeding. Women who are more likely to exclusively breastfeed at 3 months are multiparous, more educated, resident in the north/center, have attended antenatal classes and groups of breastfeeding support, have practiced the skin-to-skin contact in hospital and have initiated breastfeeding early. Conclusion In Italy many mothers do not comply with breastfeeding recommendations. The promotion and support of breastfeeding is still necessary in Italy and still needs to be monitored with representative data. Actions should aim at empowering women, reducing social inequalities and improving practices in hospitals and maternal care services which encourage breastfeeding
Addressing decisions about new hospitals’ siting: a multidimensional evaluation approach
Get PDFBackground. Site selection for urban facilities is a crucial topic in planning decision processes for the several side effects they produce and the multiple criteria involved, especially for healthcare facilities. Nevertheless, the location problem has been ignored by most of the existing evaluation systems. Methods. Starting from a deep literature review and the analysis of hospitals in 10 European cities, the paper proposes an evaluation system divided into four macro-areas (Functional quality, Location quality, Environmental quality, Economical aspects), each in turn composed by criteria and sub-criteria. Results. The evaluation system has been applied for the site selection of “La Citta della Salute” in Milan, Italy. Furthermore, the ShOS (Selection hospitals’ Site) Evaluation Tool has been defined, with the aim of assessing the land suitability for new healthcare structures. Conclusion. The ShOS evaluation tool improves the transparency and robustness of the decision-making process and it could be broadly applie