1,721,006 research outputs found
Public health as a discipline in the face of violence, injuries and inequalities
No full text[No abstract available
Appropriateness of frequent use of emergency departments: A retrospective analysis in Rome, Italy
Full text linkBackground: Frequent users (FUs) are patients who repeatedly and inappropriately visit the emergency department (ED) for low-grade symptoms that could be treated outside the hospital setting. This study aimed to investigate the phenomenon of the FU in Rome by profiling such users and analyzing ED attendance by FUs. Methods: The analysis was carried out for attendance in 2021 at 15 EDs in the Local Health Authority Roma 1 geographical area. A digital app collected data, including information on the following variables: number of attendance, demographic characteristics, emergency medical service (EMS) usage, triage code, and appropriateness of attendance. COVID-19 diagnosis was also studied to analyze any possible influence on ED attendance. Differences between FUs and non-FUs were investigated statistically by t-test and chi-square test. Univariate analysis and multivariable logistic regression were performed to analyze the associated factors. Results: A total of 122,762 ED attendance and 89,036 users were registered. The FU category represented 2.9% of all users, comprising 11.9% of total ED attendance. There was a three times higher frequency of non-urgent codes in attendance of FU patients (FU: 9.7%; non-FU: 3.2%). FUs were slightly more likely to have used the EMS (13.6% vs. 11.4%) and had a lower frequency of appropriate ED attendance (23.8% vs. 27.0%). Multivariate logistic analysis confirmed a significant effect of triage code, gender, age, EMS usage, and COVID-19 diagnosis for the appropriateness of attendance. The results were statistically significant (p < 0.001). Conclusion: The FU profile describes mostly non-urgent and inappropriate attendance at the ED, including during the COVID-19 pandemic. This study represents an important tool for strengthening preventive policies outside the hospital setting. The Italian National Recovery and Resilience Plan represents an excellent opportunity for the development of new strategies to mitigate the phenomenon of FUs
Gaetano pieraccini. Public health giant who created Italian social medicine
Full text linkAbstract
It’s well known all over the world that Italy is the birthplace of Bernardino Ramazzini (1633 -1714), the real founder of occupational medicine, and that Italian doctors had a great importance in scientific and cultural development in occupational medicine. One of the most celebrated of them was Luigi Devoto, Professor of Medical Pathology at Pavia in 1901, who undertook a free course of Occupational medicine, creating in the same year the fortnightly journal "Work" -that became "Occupational medicine" since 1925 -and opening a Labour Clinic in Milan in 1910. In 1907 the first two Italian schools of occupational medicine arose in Milan and in Naples. In 1901 Guido Yule Giglioli wrote the first systematic treatise about workers’ diseases. In this cultural background, Gaetano Pieraccini grew and developed his original cultural approach to the field of occupational medicine, which got from him a new dimension: the Social Medicine. © 2016, Prex S.p.A. All rights reserve
Lorenzo Tomatis: A Great Doctor in the Broadest Sense
No full textLorenzo Tomatis was a great doctor in the broadest sense: he gave a major
contribution to cancer research, voting himself to study cancer causes and prevention. His job was not only to serve Public Health but to denounce social and health nequalities without threats by political and economic constraints
Avedis Donabedian: The Giant
No full text“Giant” is the most frequent word in commemorating Avedis Donabedian. Rarely there was such agreement among scholars worldwide to define the role of a scientist in the field of Public Health. And it’s impossible to disagree. Avedis Donabedian had a really huge role in the progress in Public Health studies. It’s not exaggerated even to say that his insights influenced all scientific research.</p
Archie’s beautiful adventure
No full textArchibald “Archie” Cochrane is the brilliant creator of the evidence-based
medicine (EBM). His book “Effectiveness and Efficiency: random reflections
on health services” is one of the fundamental texts of Medicine today. For
his influence on the progress of medicine, Cochrane may be considered one
of the greater physicians of all time. He gave an exceptional boost to the
improvement of medical practice worldwide. Cochrane’s vision of medicine
and his great scientific achievements are still alive through the Cochrane
Collaboration, an organization which provides valuable impulses to improving
the quality of medical care. Also he was a great epidemiologist, very proud of his epidemiological work, and his life is interesting for adventurous events and extraordinary examples of righteousness and generosity
Burden of delayed discharge on acute hospital medical wards: A retrospective ecological study in Rome, Italy
Full text linkIntroduction: Delayed discharge represents the difficulty in proceeding with discharge of patients who do not have any further benefit from prolonged stay. A quota of this problem is related to organizational issues. In the Lazio region in Italy, a macro service re-organization in on the way, with a network of hospital and territorial centers engaged in structuring in- and out- of hospital patient pathways, with a special focus on intermediate care structures. Purpose of this study is to quantify the burden of delayed discharge on a single hospital structure, in order to estimate costs and occurrence of potential resource misplacement. Material and methods: Observational Retrospective study conducted at the Santo Spirito Hospital in Rome, Italy. Observation period ranged from 1/09/2022, when the local database was instituted, to 1/03/2023 (6 months). Data from admissions records was anonymously collected. Data linkage with administrative local hospital database was performed in order to identify the date a discharge request was fired for each admission. Surgical discharges and Intensive Care Unit (ICU) discharges were excluded from this study. A Poisson hierarchical regression model was employed to investigate for the role of ward, Severity of Disease (SoD) and Risk of Mortality (RoM) on elongation of discharge time. Results: 1222 medical ward admissions were recorded in the timeframe. 16% of them were considered as subject to potentially elongated stay, and a mean Delay in discharge of 6.3 days (SD 7.9) was observed. Discussion and conclusions: Delayed discharge may cause a "bottleneck" in admissions and result in overcrowded Emergency Department, overall poor performance, and increase in overall costs. A consisted proportion of available beds can get inappropriately occupied, and this inflates both direct and indirect costs. Clinical conditions on admission are not a good predictor of delay in discharge, and the root causes of this phenomenon likely lie in organizational issues (on structure\system level) and social issues (on patient's level)
Ernst L. Wynder: A pioneer of no tobacco world.
No full textErnst L Wynder was a great epidemiologist who devoted his career to
investigate harmful effects of tobacco smoke, in particular his studies represent
a landmark in the history of epidemiological research on lung cancer.
The commitment of Ernst Wynder was not limited to the risk factors related
to tobacco. In fact, he studied also the role of nutritional factors in the
incidence of tumors.
His talent, enthusiasm and tireless energy have allowed him to obtain a
complete victory despite the difficulties and the initial loneliness
Charles Everett Koop:the “Family Doctor of America”
No full textCharles Everett Koop was a great Surgeon General, probably the most
influential in the history of the United States of America. He never missed courage in his life and often he had used it to tackle professional and personal tough problems.
In his public activity, he faced controversial health problems of American people as smoking, abortion and the first occurrence of the epidemic Acquired Immune Deficiency Syndrome (AIDS). Koop was a rigorous man. The lodestar that guided Koop in his work, as a public servant was to do the best for health of Americans. In his prestigious and difficult role, he faced the pressing problems of health of millions of people trying to avoid political influence.
During his mandate of eight years, Koop increased the influence and authority
of his role. His appearance and behaviour were unmistakable: Lincolnesque beard and uniform, conduct hard and pure, exclusively oriented to the health of citizens, over the personal conveniences, political pressure and lobbying.
An exemplary man, who for his passion for medicine and his sincere interest
in promoting public health, was affectionately considered the "Family Doctor of America"
Gaetano pieraccini: Public health giant who created Italian social medicine
Full text linkIt’s well known all over the world that Italy is the birthplace of Bernardino Ramazzini (1633 -1714), the real founder of occupational medicine, and that Italian doctors had a great importance in scientific and cultural development in occupational medicine. One of the most celebrated of them was Luigi Devoto, Professor of Medical Pathology at Pavia in 1901, who undertook a free course of Occupational medicine, creating in the same year the fortnightly journal "Work" -that became "Occupational medicine" since 1925 -and opening a Labour Clinic in Milan in 1910. In 1907 the first two Italian schools of occupational medicine arose in Milan and in Naples. In 1901 Guido Yule Giglioli wrote the first systematic treatise about workers’ diseases. In this cultural background, Gaetano Pieraccini grew and developed his original cultural approach to the field of occupational medicine, which got from him a new dimension: the Social Medicine
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