169,752 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
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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
Mitomycin C in highly myopic eyes - Author reply
No full textOphthalmology. 2005 Feb;112(2):208-18; discussion 219.
Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes.
Gambato C, Ghirlando A, Moretto E, Busato F, Midena E.
SourceRefractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy.
Abstract
PURPOSE: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.
DESIGN: Prospective, double-masked, randomized clinical trial.
PARTICIPANTS: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.
METHODS: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).
MAIN OUTCOME MEASURES: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.
RESULTS: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).
CONCLUSION: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK.
Comment in
Ophthalmology. 2006 Feb;113(2):357; author reply 357-8
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