55 research outputs found
Il centro storico di Riva del Garda: condizione abitativa e disgregazione della struttura fisica e sociale
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Universal Health Coverage in Italy: lights and shades of the Italian National Health Service which celebrated its 40th anniversary
No full textThe Italian National Health Service (I-NHS) was established in 1978 to guarantee universal access to healthcare. Prominent in international reports, the I-NHS has reached a satisfactory level of efficiency and excellent standards of care in many regions, in forty years. Along the years, I-NHS has developed a structural public-private partnership in health services delivery that in some regions contributes to the achievement of very high standards of healthcare quality. However, the I-NHS is currently facing some major challenges: (a) Italy is experiencing a remarkable aging of its population with increasing health needs; (b) the recent and constant cuts to public expenditures are reducing the budget for welfare. It is of utmost importance to ensure that on-going efforts to contain health system costs do not subsume health care quality. In addition, monitoring of the essential levels of care (Livelli Essenziali di Assistenza, LEA) highlights significant differences in healthcare delivery among Italian regions that, in turns, contribute to the burdensome migration of patients to best-performing regions. Therefore, a more consolidated and ambitious approach to quality monitoring and healthcare improvement at a system level is needed to guarantee its sustainability in the future
Universal Health Coverage in Italy: lights and shades of the Italian National Health Service which celebrated its 40th anniversary
No full texttThe Italian National Health Service (I-NHS) was established in 1978 to guarantee universal access tohealthcare. Prominent in international reports, the I-NHS has reached a satisfactory level of efficiencyand excellent standards of care in many regions, in forty years. Along the years, I-NHS has developed astructural public-private partnership in health services delivery that in some regions contributes to theachievement of very high standards of healthcare quality. However, the I-NHS is currently facing somemajor challenges: (a) Italy is experiencing a remarkable aging of its population with increasing healthneeds; (b) the recent and constant cuts to public expenditures are reducing the budget for welfare. It is ofutmost importance to ensure that on-going efforts to contain health system costs do not subsume healthcare quality. In addition, monitoring of the essential levels of care (Livelli Essenziali di Assistenza, LEA)highlights significant differences in healthcare delivery among Italian regions that, in turns, contributeto the burdensome migration of patients to best-performing regions. Therefore, a more consolidated andambitious approach to quality monitoring and healthcare improvement at a system level is needed toguarantee its sustainability in the future
Smart-working policies during COVID-19 pandemic: a way to reduce work-related traumas?
No full textEighth of March 2020, the Italian government introduced a national lockdown to counter the exponential increase in the number of COVID-19 cases; this decision avoided putting a strain on the health system. During the lockdown all non-essential services were stopped and a “stay at home” order was imposed. The purpose is to evaluate the impact of COVID-19 lockdown on Emergency Department (ED) visits due to work-related traumas in the Lombardy region. We performed a retrospective analysis on trauma admissions to the ED registered through the regional portal (EUOL), from 1st January 2019 to 31st December 2019 and from 1st January 2020 to 31st December 2020. The number of ED admissions for traumatic injury and work-related traumas dropped by 32% between 2019 and 2020. A remarkable reduction of work-related traumas was recorded during the two pandemic waves, from March to June and in October and November. The percentage of patient in critical condition in ED slightly raised. These results are probably a consequence of the unprecedented measures imposed by the Italian government to cope with the spread of COVID-19, with important implications for work contexts. This analysis should be considered to optimise the organisation of the emergency system in other critical scenarios. We speculate that the different epidemiology of occupational injuries during the lockdown period is a consequence of smart-working policies that can be held responsible for the drastic reduction of work-related traumas
Effectiveness of email-based reminders to increase vaccine uptake: a systematic review
No full textBackground: In times of vaccine hesitancy and decreasing immunization coverage, it is crucial to exploit the potential of digital solutions to support immunization programmes and ultimately increase vaccine uptake. Scant evidence exists on the impact of email-based immunization reminders. In particular, while email communication is exponentially increasing at the global level, its use for health communication is still sporadic and limited data exists on its application to immunization programmes. The objective of this study is to systematically retrieve and critically appraise the available literature on the effectiveness of email-based reminders to increase vaccine uptake, with the ultimate aim to inform and encourage its integration in the implementation of immunization programmes. Methods: We conducted a systematic review of literature following the PRISMA. We included studies providing quantitative comparative data on any measure of vaccine uptake. We extracted data on study design, study population, vaccine type and details of email-based interventions; data were pooled by type of comparison (no reminders, traditional reminders, other digital reminders). Results: Eleven studies were included, 90% with experimental study designs. While email communication succeeds in increasing vaccine uptake when compared with no intervention, weak and heterogeneous data exist supporting the superiority of email reminders, as compared to traditional methods or other digital reminders. Encouraging evidence report the effectiveness of reminder methods combining different strategies and tailored to target populations’ preferences. Conclusions: Theoretically, email communication offers many advantages: it is cheaper and faster, it can be automated and linked to electronic immunization registries, and reach people on the move. As we urge the need for further research to prove email communication impact on vaccine uptake in different settings, we underline the importance of identifying how to best integrate email communication in vaccine delivery equipping immunization programmes with technical infrastructures and normative frameworks suitable to embrace innovation
Frontline health workers: training needs assessment on immunisation programme. An EU/EEA-based survey
No full textBackground: As part of continuing medical education, frontline healthcare workers (FHWs) have to maintain high standards of competence and knowledge. It is particularly true in the field of vaccination and vaccine acceptance, where knowledge and technologies evolve rapidly. Methods: For this reason, we developed an anonymous 47-item web-based survey aimed to collect data about recent existing courses and FHWs’ knowledge, learning needs and preferences for future courses, both in vaccinology and vaccine acceptance at the European level. The survey was conducted from October to November 2021, and disseminated through the Association of Schools of Public Health in the European Region (ASPHER) and European Centre for Disease Control (ECDC) networks by email. Results: A total of 160 FHWs (63% females, 61% physicians) completed the questionnaire. Approximately half of the sample considered themselves skilled in almost all the explored areas considering vaccinology and vaccine acceptance. However, respondents were interested in attending courses regarding research and science and how to deal with misinformation and disinformation for the future. Moreover, an online version of the course, or at least a mixed format (in person and online), is considered the preferred format. Lastly, the most supportive materials in dealing with vaccinology and vaccine acceptance were short courses on specific topics. Conclusions: Our results are relevant to inform professional development staff in order to plan and implement more targeted courses in terms of educational training programmes and teaching formats that better match the interests and needs of FHWs
Audit methodology for the quality assessment of medical records in the emergency department
No full textMeasuring health outcomes of OECD countries’ urban greenspace, with a special focus on Milan (Italy)
No full textBackground
Urban world population has raised to 4.2 billion in 2018, with 2.5 billion more forecasted by 2050. Cities are places of opportunities but, at the same time, sites of environmental and social risk factors. Scientific evidence about urban green's environmental benefits is abundant, but Public Health outcomes are seldom carefully defined. The project aims at assessing the Public, Urban and Mental Health outcomes of urban green areas in Organisation for Economic Co-operation and Development (OECD) countries, and at exploring citizen urban greenspace perception in Milan, Italy.
Methods
A systematic review of literature was conducted according to the 2015 PRISMA statement. Two online databases (Medline and Embase), were consulted, and inclusion criteria were set, ruling in all OECD countries-based, English-written studies from 2000 to December 2019. Only objectively measurable health outcomes were deemed suitable for analysis. Based on the main review findings, a community-based survey was created, targeting residents of Milan and its suburban area to understand better how they benefit from the urban green areas in their city. The study is being carried out by an interdisciplinary team of medical doctors and architects.
Results
We grouped health outcomes into five separate domains, namely cardiovascular, obesity, respiratory, neoplasia and mental health. We found negative associations between disease prevalence and urban greenspace overall quantity. Size, perceived quality and accessibility were powerfully explanatory variables. Milan community-based survey drafting is underway. Results are still preliminary and will be presented by tables, graphs and plots.
Conclusions
Cities are increasingly becoming critical points for many emerging Public Health challenges. The results of our study may help urban planners, key stakeholders, policymakers and communities to preserve and increase existing green spaces, and to improve Urban Public Health
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