42 research outputs found
Le vaccinazioni per il migrante: necessità ed opportunità per una sanità pubblica di valore
No full textIl fenomeno migratorio ha assunto una particolare rilevanza negli ultimi
anni riportando in auge le problematiche riguardanti i bisogni di salute della
popolazione immigrata, sia sul piano terapeutico che preventivo, e le scelte di
politica sanitaria più adatte ai reali problemi degli stranieri.
L’Italia, a causa della sua posizione geografica e la mancanza iniziale di una
legislazione in materia d’immigrazione, funge da porta verso l'Europa per
migliaia d’immigrati dalla metà degli anni ‘80. Una concezione moderna del
fenomeno migratorio ha evidenziato un aspetto che negli anni passati era
pressoché assente: quello dell’accoglienza. Un’accoglienza attenta e adeguata
dell’immigrato, legale o illegale che sia, è un’espressione di democrazia e di
convivenza civile [1].
In base ai dati dell’ISTAT, gli stranieri residenti in Italia al 1° gennaio 2011 sono
4.570.317, 335.000 in più rispetto al 2010 (+7,9%). La quota di cittadini stranieri
sul totale dei residenti (italiani e stranieri) continua ad aumentare; infatti, al
1° gennaio 2011 ha raggiunto il 7,5% rispetto al 7% registrato un anno prima.
L’incremento del numero degli stranieri residenti nel corso del 2010 ha come
componente principale l’immigrazione dall’estero (425 mila individui). L’altra
componente è rappresentata dai 78.082 nati in Italia da genitori stranieri, che
costituiscono il 13,9% del totale dei nati residenti e sono in leggero aumento
(+1,3%) rispetto al 2009 [2].
I report epidemiologici sullo stato di salute della popolazione immigrata in Italia
hanno dimostrato che le malattie che interessano gli immigrati sono strettamente
connesse ai sistemi di accoglienza e ai processi d’inclusione sociale messi in atto
nel Paese ospite. Infatti, la maggior parte delle patologie sono legate alle scadenti
condizioni abitative e lavorative, alle difficoltà di relazione e di socializzazione, al
grado di accesso ai servizi sanitari. Il grado di accessibilità e fruibilità dei servizi
sanitari rappresenta una questione cruciale per la salute del migrante, l’accessibilità
dipende prevalentemente dalla normativa, la fruibilità dalla capacità dei servizi di
adeguare le risposte alle necessità dei nuovi utenti [3].
Sulla base di queste premesse, si è formato un Gruppo di Lavoro costituito
da Esperti delle principali associazioni e società scientifiche interessate ai temi
dell’immigrazione con l’obiettivo di:
1) fare il punto della situazione per identificare i bisogni medico-vaccinali nella
popolazione immigrata (adulta e pediatrica) e le priorità d’intervento in base
alla tipologia di popolazione e al contesto territoriale;
2) proporre un calendario vaccinale che possa fungere da modello per le
diverse realtà territoriali;
3) produrre documentazione utile ai fini della divulgazione delle conoscenze
nel settore.
L’obiettivo centrale è quindi la necessità di adottare politiche in grado di
tutelare realmente la dignità, la salute e la qualità della vita dei migranti, in
conformità con la Risoluzione del Parlamento europeo sulla riduzione delle
disuguaglianze sanitarie nell'UE (2010/2089 (INI)) [4]
A pilot application of a questionnaire to evaluate visually induced motion sickness in spectators of tri-dimensional (3D) movies
No full textBackground: The increasing popularity of tri-dimensional (3D) movies has raised public concern and media interest about the safety of projected images for spectators. No specific instrument exists to assess the occurrence of visually induced motion sickness (VIMS) symptoms in 3D movie spectators in movie theaters. Methods: We developed a questionnaire containing 20 items divided into socio demographics, individual characteristics, movie vision characteristics and VIMS symptoms (during, right after, and at two hours from the viewing of the movie). The questionnaire was self administered to 38 subjects, asking them to report time taken for its completion, comments and eventual difficulties in interpreting items. Results: Poor understanding or problems in identifying the correct item choice were noted for 4 questions belonging to the socio demographics section that were simplified in the final version of the questionnaire. Two other questions were merged into one after homogeneity analysis. Most VIMS symptoms were observed during the movie and quickly thereafter. Tired eyes was the symptom most often reported (39.5% of responders) followed by headache (18.4%), dizziness (18.4%) and nausea (15.8%). Double vision and palpitation were reported with very low frequency (respectively 5.3% and 2.3%) and vomit was not reported by any respondent. Homogeneity of symptom items was good (Cronbach alpha= 0.69). Reliability analysis showed satisfactory item-total correlations (alpha coefficient ranging from 0.61 to 0.73). Conclusions: The refined survey questionnaire can be applied in future studies to assess the frequency of VIMS symptoms in spectators of 3D movies and to identify the risk factors connected to inter-individual differences in susceptibility and to the characteristics of the movie viewing
H1N1 pandemic influenza: habits and behaviour of the nurses. A public health issue.
No full textOne of the main concerns related to pandemic H1N1 influenza 2009 is the overwhelming burden on medical structures. The aim of this work is to study the behaviour and attitudes of Nurses in relation to the spreading pandemic in order to develop public health strategies. During the spread of Pandemic, in winter 2009, an anonymous questionnaire online of thirty-four questions was available for participants. Data obtained were analyzed using descriptive, univariate and multivariate statistics. A total of 2313 nurses were interviewed. In univariate analysis 72.6% of 573 males (versus 63.9% of 1740 females) have been talk to a doctor (p<0.001). The female group appear less likely to get vaccinated (60.3% vs 51.1%, p<0.001). Multivariate analysis revealed that to be worried (OR=2.82 95% CI: 2.31-3.46), female (OR=0.62 95% CI: 0.51-0.77), age group 30-49 (OR=0.72 95% CI: 0.58-0.90) were associated with the willingness of Get vaccinated. Prevention, as washing hands and vaccination, are crucial in pandemics events. Given the low rates of acceptance of pandemic vaccination among nurses, public health bodies should consider campaign education, in order to prevent nosocomial transmission, to protect patients and the continuity of the essential health-care infrastructure
Randomized controlled trial on the promotion of healthy lifestyles among adolescents in the orthodontic setting: Study protocol [Trial clinico randomizzato sulla promozione di corretti stili di vita tra gli adolescenti in ambito ortodontico: Protocollo dello studio]
No full textMany studies have shown that the bad lifestyles are the major factors thought to influence susceptibility to many diseases in our society and often these habits during the adolescence begin. The aim of the study was to evaluate the health promotion intervention effect in an orthodontic adolescent sample, in particular: deterring adolescents from smoking; discourage the use and abuse of alcoholic beverages; encourage the adherence to the Mediterranean style diet. A blinded randomized controlled trial will be performed. The participants will be adolescents aged 10 to 14 years that will receive a medical examination in the Complex Unit of Orthodontics. The sample will be followed for three years. The collected evidence would be a scientific support for decisions in public health, in order to increase the health of the young generations. © Società Editrice Universo (SEU)
A cross-sectional study on dermatological diseases among male prisoners in southern Lazio, Italy.
No full textPrisoners have heightened health needs, and only recently has the importance of skin diseases in this group been recognized. The aim of this study was to estimate the prevalences of dermatological diseases among prisoners in the jails of southern Lazio and to investigate the determinants of these. A cross-sectional study was carried out in three jails in southern Lazio. Retrospective data collection for sociodemographic characteristics, lifestyle habits, and health status was realized using patients' charts. The study sample consisted of 2653 male prisoners detained during 1995-2000. A total of 7.9% of the sample were found to have dermatological disease. The most common diseases were nonspecific dermatitis (3.1%), acne (1.5%), mycosis (1.4%), and scabies (0.7%). Multiple regression analyses were conducted to establish the associations of skin diseases with substance addiction status and age. In addition, a highly significant association emerged between length of detention and rate of dermatological disease. This study shows that habitual offenders, foreign inmates, prisoners serving long sentences, and prisoners who are illiterate are the most affected by dermatological disease. The conditions of detention may be the main reason; preventative strategies such as limiting overcrowding and the provision of electronic case sheets and a centralized database to collect and maintain patient clinical data might be effective in improving public health in jails. © 2013 The International Society of Dermatology
Pathways to labour market marginalisation : aspects of common mental disorders, migration status and age
No full textBackground: Labour market marginalisation (LMM), measured as sickness absence (SA)/disability pension (DP) or unemployment, differs between young immigrants and natives in several countries. The aim of this project was to investigate the risk of LMM among immigrants, second generation immigrants, and refugees and if the risk differed with region/country of birth, age, generation, refugee status and before and after a diagnosis of common mental disorder (CMD). A second aim was to assess psychiatric healthcare utilization before and after DP due to CMD among immigrants and natives, and if it differed before and after changes in social insurance regulations in Sweden in 2008.Methods: Four studies were conducted, all based on Swedish nationwide register data. Study I. a cohort study of all 3 507 055 individuals living in Sweden in 2004 (19-50 years), with a 6-year follow-up. Hazard ratios (HR) and 95% confidence intervals (CI) for DP were estimated by Cox regression for first and second generation immigrants compared to natives, across regions of birth and stratified by age. Study II. individuals with incident DP due to CMD (n=28 354), before or after the introduction of stricter social insurance rules, were included. Patterns of psychiatric in- and specialised outpatient healthcare utilization during a 7-year window before and after being granted DP were assessed by Generalized Estimating Equations. Study III. A total of 28,971 individuals (19-30 years) with an incident CMD in 2007 were included. Groupbased trajectory models were utilised to identify trajectories of annual months of LMM three years before and six years after the diagnosis. Study IV. A prospective cohort study including individuals (19-30 years) with CMDs during 2009 (N=69,515). Cox regression was used to calculate HR for future LMM (2010-2013).Results: In the first generation immigrants compared to natives, HRs for DP were higher (range: 1.17 to 1.74). Also in the second generation immigrants, HRs were higher (range: 1.10 to 1.30) (study I). Prevalence rates of psychiatric inpatient healthcare were comparable among immigrants and natives, lower though in non-Western immigrants. Three years after granted DP, non-Western immigrants in comparison to natives and Western immigrants had a stronger decrease in inpatient psychiatric healthcare. After 2008, a strong reduction in outpatient psychiatric healthcare after granted DP was observed, similarly in immigrants and natives (study II). Young natives and immigrants showed similar trajectories of SA/DP in individuals with CMDs. A higher proportion of non-Western immigrants (21%) followed trajectories of high levels of unemployment compared to Western immigrants (15%) and natives (17%). Educational level and duration of residence in Sweden discriminated trajectories of both SA/DP and unemployment (study III). Regarding subsequent unemployment, both refugees and nonrefugee immigrants with CMDs had a higher risk compared to natives. Regarding subsequent SA, refugees from Africa and Asia showed a lower risk compared to natives (study IV).Conclusions: Immigrants differed in comparison to natives in LMM in terms of a higher level of DP in both generations, in lower levels of inpatient psychiatric healthcare after DP granting, particularly among non-Western immigrants, in higher unemployment trajectories after a CMD and in higher unemployment risk and lower SA risk, particularly among refugees. Educational level, psychiatric comorbidity and duration of residence are relevant factors in discriminating differences in LMM trajectories among immigrants and natives.List of scientific papersI. Di Thiene D, Helgesson M, Alexanderson K, La Torre G, Tiihonen J, Mittendorfer-Rutz E. Risk of disability pension in first and second generation immigrants: the role of age and region of birth in a prospective population-based study from Sweden. BMC Public Health. 2017;17:931. https://doi.org/10.1186/s12889-017-4944-x II. Di Thiene D, Rahman S, Helgesson M, Wang M, Alexanderson K, Tiihonen J, La Torre G. Mittendorfer-Rutz E. Healthcare use among immigrants and natives in Sweden on disability pension, before and after changes of regulations. European Journal of Public Health. 2018;28:445-451. https://doi.org/10.1093/eurpub/ckx206 III. Di Thiene D, Mittendorfer-Rutz E, Rahman S, Wang M, Alexanderson K, Tiihonen J, La Torre G, Helgesson M. Trajectories of sickness absence, disability pension and unemployment in young immigrants with common mental disorders. European Journal of Public Health. 2019 Mar 30. pii: ckz046. https://doi.org/10.1093/eurpub/ckz046 IV. Di Thiene D, Helgesson M, Rahman S, Alexanderson K, Tiihonen J, La Torre G, Mittendorfer-Rutz E. Risk of labour market marginalisation in young immigrant with common mental disorders and the role of country of birth, refugee status, duration of residence and age at arrival in the country. [Submitted]</p
Seasonal and pandemic influenza: The role of communication and preventive strategies
No full textAppropriate, timely, and data-driven health information is a very important issue in preventive strategies against influenza. Intuitively, a link between willingness to be vaccinated against seasonal influenza and against pandemic influenza exists, given the similarities in decision-making for this vaccine. International and national literature reviews suggest that progress has been made in order to incorporate and disseminate crisis risk communication principles into public health practice, as such investments in public health could be important for building capacity and practice which aid in the realization of countermeasures in response to a future pandemic and epidemic situation. This study emphasizes the lack of perception by Health Care Workers (HCWs) of the importance of being immunized against seasonal and pandemic influenza and the doubts concerning safety. In the future, particular efforts are needed during vaccination campaigns, to provide more information to HCWs and the general population regarding role and safety of such vaccines.Abstract
Appropriate, timely, and data-driven health information is a very important issue in preventive strategies against influenza. Intuitively, a link between willingness to be vaccinated against seasonal influenza and against pandemic influenza exists, given the similarities in decision-making for this vaccine. International and national literature reviews suggest that progress has been made in order to incorporate and disseminate crisis risk communication principles into public health practice, as such investments in public health could be important for building capacity and practice which aid in the realization of countermeasures in response to a future pandemic and epidemic situation. This study emphasizes the lack of perception by Health Care Workers (HCWs) of the importance of being immunized against seasonal and pandemic influenza and the doubts concerning safety. In the future, particular efforts are needed during vaccination campaigns, to provide more information to HCWs
Do the quality of the trials and the year of publication affect the efficacy of intervention to improve seasonal influenza vaccination among healthcare workers? Results of a systematic review
No full textIntroduction: Despite longstanding recommendations by public-health authorities vaccination coverage in health care workers worldwide are poor. The aim of this study is to conduct a systematic review of the trials conducted to increase seasonal influenza vaccination rates among health care workers. Results: 10 articles met the pre-determined criteria. For all article the score calculation was performed. Discussion: The combination of an educational and a promotional element appared the most effective in augmenting the influenza vaccination coverage among health care workers. But some cases, the intervention did not contribute to increasing the vaccination rates among health care workers. In any case, the quality of controlled trials plays an important role in the results obtained by carrying out a specific intervention and contributed to obtaining this debatable results. Materials and Methods: Research was conducted using Scopus and PubMed database. We selected all clinical trials to perform the meta-analyses
Workplace safety in private companies of freights and on the road workers: comparison between small and medium enterprises
No full textWorkplace safety in private companies of freights and on the road workers: comparison between small and medium enterprises". Background: The road freight and passenger transport sector exposes the workers of this sector to a considerable health risk. Application of the relative legislation to safeguard worker's safety is an obligation for the employer. Objectives: The aim of the study was to assess the application of current legislation in the trucking sector and ascertain whether there are differences between large and small enterprises. Methods: The study was conducted through direct interview with managers of road freight and passenger transport companies in the Lazio Region in 2009. Information was collected using a questionnaire composed of 77 items concerning risk assessment and organization aspects in the enterprises. The enterprisers were stratified by number of workers and drivers. To detect possible associations the Chi-squared and Fisher's Exact tests were used. Results: A total of 42 enterprisers participated in the study. Significant differences were found between larger enterprisers (>= 10 workers) and smaller enterprises (<10 workers), concerning risk assessment from vibrations (p=0.006), night work (p=0.026), microclimatic conditions (p=0.047). Regarding risk prevention/management aspects, the enterprisers with a higher number of workers were more likely to have a workers' representative for safety compared to the smaller enterprises (respectively 88.9% versus 50.0%) and a road accidents Register (77.8% versus 16.7%), with p<0.001 significance levels. Conclusions: The risks most frequently assessed, in decreasing order, were: vibrations, manual handling of loads, stress, noise, awkward postures, night work, alcohol consumption, drug addiction and microclimatic conditions. Vibrations, night work and microclimatic conditions risks were assessed to a lower degree in the smaller enterprisers compared to the larger enterprises
A survey of visually induced symptoms and associated factors in spectators of three dimensional stereoscopic movies
No full textBackground: The increasing popularity of commercial movies showing three dimensional (3D) computer generated images has raised concern about image safety and possible side effects on population health. This study aims to (1) quantify the occurrence of visually induced symptoms suffered by the spectators during and after viewing a commercial 3D movie and (2) to assess individual and environmental factors associated to those symptoms. Methods: A cross-sectional survey was carried out using a paper based, self administered questionnaire. The questionnaire includes individual and movie characteristics and selected visually induced symptoms (tired eyes, double vision, headache, dizziness, nausea and palpitations). Symptoms were queried at 3 different times: during, right after and after 2 hours from the movie. Results: We collected 953 questionnaires. In our sample, 539 (60.4%) individuals reported 1 or more symptoms during the movie, 392 (43.2%) right after and 139 (15.3%) at 2 hours from the movie. The most frequently reported symptoms were tired eyes (during the movie by 34.8%, right after by 24.0%, after 2 hours by 5.7% of individuals) and headache (during the movie by 13.7%, right after by 16.8%, after 2 hours by 8.3% of individuals). Individual history for frequent headache was associated with tired eyes (OR = 1.34, 95% CI = 1.01-1.79), double vision (OR = 1.96; 95% CI = 1.13-3.41), headache (OR = 2.09; 95% CI = 1.41-3.10) during the movie and of headache after the movie (OR = 1.64; 95% CI = 1.16-2.32). Individual susceptibility to car sickness, dizziness, anxiety level, movie show time, animation 3D movie were also associated to several other symptoms. Conclusions: The high occurrence of visually induced symptoms resulting from this survey suggests the need of raising public awareness on possible discomfort that susceptible individuals may suffer during and after the vision of 3D movies
