Igiene e sanita pubblica最新文献

{"title":"Networks as a way to hospital and primary/community care integration: findings from a narrative review of the main international models.","authors":"Marcello Di Pumpo, Lorenzo Sommella, Gianfranco Damiani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Healthcare systems are complex systems. Achieving financial, social, and environmental sustainability of these systems requires a high degree of integration and coordination at all levels, especially between acute-care settings and primary/community care services. Some authors have, therefore, suggest redirecting integrated healthcare research towards the network theory and network concepts as a useful lens. Objective The current paper proposes to investigate the existence, the institutional level of formalization and the degree of development of hospital/primary-community care Networks currently present in the main types of healthcare systems worldwide by studying an appropriate selection of representative countries for each system typology. Materials and Methods A narrative review of the scientific and gray literature following the methodology by Green et al. was, therefore, conducted to describe hospital and primary/community care networks and their integration/coordination in the main international models. To select these models, one country with the current highest life expectancy at birth for each of the B öhm's five healthcare system categories was chosen. The grade of integration of the Networks retrieved for each State was therefore qualitatively appraised (high, medium or low degree), following Valentijn's framework. Results The networks retrieved show: in Norway, Australia and Japan both at the government/ national and at the regional/lower level/other a high degree of systemic, organizational, normative and functional integration; in Switzerland both at the government/national and at the regional/lower level/other a medium degree of systemic, organizational, normative and functional integration; in the USA at the governmental/institution level a low degree of systemic, organizational and normative integration, with a medium degree of functional integration and at the regional/lower level/other integration a low degree of systemic and normative integration with medium degree of organization integration and high degree of functional integration. Discussion The high levels and degree of hospital/primary - community care integration of Norway, Australia and Japan are in line with what could be expected from the universalistic healthcare system in place. The medium levels of integration of Switzerland are also in line with what the Social health insurance system and, especially, the cantonal system. The low levels of integration of the USA are in line with the privatistic healthcare systems. However, a medium degree was found for functional integration probably due to its unparalleled technological advancement. Conclusions The study shows how the levels of hospital/primary-community care integration are connected to the specific healthcare system in place in each country. COVID-19 showed how complex systems like healthcare systems had to reconfigure themselves to reach high levels of integration in small time to be able to","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 2","pages":"27-48"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9443646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monkeypox resurgence and its implications for Dentistry - A scoping review.","authors":"Syed Sarosh Mahdi, Rabeea Yaqoob, Raheel Allana, Gopi Batteneni, Syeda Sakina, Daniyal Agha, Niekla Survia Andiesta, Muneer Gohar Babar, Zohaib Ahmed, Umer Daood","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Monkeypox caused by the Monkeypox virus, a member of the Orthopoxvirus genus, is currently considered a major concern among healthcare authorities due to its high transmissibility rate. Currently, no specific treatment is available for this disease, due to which healthcare professionals, specifically Dentists, are required to look out for symptoms at early stages to prevent its spread.</p><p><strong>Objective: </strong>To analyze the role of dentists in identifying Monkeypox cases and limiting its spread.</p><p><strong>Methods: </strong>We conducted a scoping review on monkeypox and its oral manifestation. PRISMA protocols were observed in data collection. The relevant literature search was conducted in relevant databases like PubMed, Scopus, Web of Science, Embase, CINAHL, and Google Scholar. Relevant articles related to Monkeypox, and Dentistry were included in the final review. Articles published from March 2022- September 2022 were included in the review. Keywords and Mesh words related to monkeypox, and dentistry were used as part of the search strategy.</p><p><strong>Results: </strong>A total of 1881 articles were reviewed, among which 7 articles were included. Dentists were strongly advised to be on high alert for Monkeypox symptoms due to their close contact with patients. Around 70% of Monkeypox cases reported oral lesions at early stages, which requires a differential diagnosis from other oral lesions. Considering this, dentists should be well-versed in this new and emerging threat.</p><p><strong>Conclusion: </strong>Although dentists have been shown to play an important role in the treatment of monkeypox, there is insufficient data available. More research on dentistry and monkeypox will be needed in the near future.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 2","pages":"49-59"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9454171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of environmental sanitization in health clinics: evaluation of potassium peroxymonosulfate (KMPS) efficacy at two different concentrations.","authors":"Michele Totaro,&nbsp;Francesco Castellani,&nbsp;Francesca Di Serafino,&nbsp;Nunzio Zotti,&nbsp;Federica Badalucco,&nbsp;David Rocchi,&nbsp;Sara Civitelli,&nbsp;Giulia Geminale,&nbsp;Davide Masetti,&nbsp;Angelo Baggiani","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-associated infections (HAI) are closely related to several factors, such as prolonged hospital stay in high-risk areas and intensive care units, potentially predisposing underlying conditions. It has also been demonstrated that HAI incidence may be related to non-respected standards of assistance, such as not adequately cleaned structures or medical devices contaminated by environmental bacteria and multidrug resistant enterobacteria.</p><p><strong>Objective: </strong>In this case it has been carried on an efficacy evaluation of a microionization system using potassium peroxymonosulfate (KMPS) for outpatient clinics indoor air disinfection.</p><p><strong>Material and methods: </strong>Two outpatient clinics (AMB-1 and AMB-2) were treated with KMPS (1% and 2% concentration), at the end of routinary clinic activities. Microbial sampling of air (settle plates) and surfaces (contact plates) were submitted before and after sanitizing, checking total microbial load at 37°C, possible opportunistic pathogens and moulds.</p><p><strong>Results: </strong>Sanitizing system at 1% concentration was efficient in mesophilic bacteria reduction (max 83%). Moreover, total abatement of Klebsiella pneumoniae in AMB1 and Acinetobacter lwoffi in AMB2 has been seen, both on surfaces. Regarding air samplings, 89% moulds reduction has been seen, as observed on surfaces. Scaling up concentration to 2%, mesophilic bacteria reduction was ≥ 94%, both in air and on surfaces of the outpatient clinics. Same results have also been seen on moulds, whose maximum reduction was 97%.</p><p><strong>Discussion: </strong>Comparing results at different concentrations it has been observed that 2% KMPS induces an higher average reduction of mesophilic bacteria and moulds than 1%.</p><p><strong>Background: </strong>In this regard, microbial reduction percentage, either on surfaces or in the air, can be considered positive for outpatient clinics and healthcare settings indoor decontamination.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 1","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of antibody response anti SARS-Cov-2: A retrospective observational study (Marche-Italy).","authors":"Isabella Baglioni,&nbsp;Alessia Galli,&nbsp;Chiara Gatti,&nbsp;Simona Tufoni,&nbsp;Renato Rocchi,&nbsp;Federico Lattanzi,&nbsp;Fabio Toia,&nbsp;Adoriano Santarelli,&nbsp;Stefano Marcelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 has hit every country in the world. Almost a quarter of a billion cases and nearly 5 million deaths reported globally as of late September 2021. Compared to over 6 billion doses of COVID-19 vaccine administered, the pandemic does not seem to disappear. The duration of protective immunity is currently not defined. Primary immune responses are inevitably declining and the continuous transmission of increasingly worrying viral variants.</p><p><strong>Objective: </strong>The primary objective of the study is to evaluate the antibody response at 120 and 180 days in employees of an hospital of Marche (Italy) who have completed the vaccination cycle with Pzifer-Biontech vaccine and to highlight the correlation with quantitative and qualitative variables. The secondary objective is to study the nature and frequency of adverse events in relation to variables such as comorbidity, age, gender, working areas and developed antibody titer.</p><p><strong>Materials and methods: </strong>An observational retrospective study was carried out to evaluate the antibody response at 120 and 180 days. Subjects receiving a double dose of vaccine at least 21 days apart and those receiving the second dose of the same vaccine between 18 January 2021 and 31 March 2021 shall be considered. The study included non-probability sampling of convenience. All parties have provided informed written consent to access personal and clinical data.</p><p><strong>Results: </strong>The sample is composed by 1.115 subjects. The results of the study reveal an important immune response detected by IgG dosage, both at 120 and 180 days after the second dose of Sars-Cov-2 vaccine mRNA BNT162b2 vaccine (Pzifer-Biontech), other than very rare exceptions. Antibody values are higher among hospital workers compared to those working in other areas, both 120 and 180 days. These values are even higher in the health professionals who provide assistance in wards with positive Covid patients, both at 120 days (p=0.06) and at 180 days; the mean values of IgG are statistically higher in direct assistance of Covid patients at 180 days(p=0.029). The most frequent adverse drug events after the second dose of vaccine were pain at the site of inoculation of the vaccine (70.7%), fatigue (35%) and arthralgia (19%). It was finally shown that people with diabetes or smokers had an average antibody response statistically lower than 120 days and 180 days from the second dose.</p><p><strong>Discussion and conclusion: </strong>This study leads to the conclusion that the second dose of vaccine Sars-Cov-2 vaccine mRNA BNT162b2 vaccine allows a consistent antibody response. Further multicentric studies are needed to investigate the antibody response to vaccination Sars-Cov-2 mRNA BNT162b2.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 1","pages":"13-26"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10680762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Quality Management and Integrated Care Pathways (ICPs).","authors":"Giuseppe Gambale,&nbsp;Andrea De Giorgi,&nbsp;Marta Castellani,&nbsp;Elisa Mazzeo,&nbsp;Rosario Andrea Cocchiara,&nbsp;Giovanni Profico,&nbsp;Simona Amato","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Chronic Obstructive Pulmonary Disease (COPD) is one of the largest causes of morbidity and chronic mortality and a public health problem of high importance. In Italy, COPD afflicts 5.6% of adult (3.5 million people) and is responsible for 55% of all deaths related to respiratory diseases. Smokers have a higher risk, in fact up to 40% develop the disease. From the Covid-19 pandemic, the most affected population is the elderly (mean age 80 years old), with previous chronic diseases, in 18% with chronic respiratory. The aim of the present work was to validate and measure the outcomes produced by the recruitment and care of COPD patients enrolled by an Healthcare Local Authority in the corresponding Integrated Care Pathways (ICPs) in order to measure how a multidisciplinary, systemic and e-health monitored care impacts upon mortality and morbidity.</p><p><strong>Materials and methods: </strong>Enrolled patients were stratified through the GOLD guidelines classification, a unified method to discriminate the various degrees of severity of COPD, using specific spirometric cut-points and providing homogeneous classes of patients. Monitoring examinations include simple spirometry, global spirometry, diffusing capacity measurement, pulse oximetry, EGA, 6-minute walk test. Chest Rx, chest CT, ECG may also be required. The severity of COPD identifies the timing of monitoring, which involves a fixed annual re-assessment for mild offset clinical forms, biannually in case of exacerbation, a quarterly cadence in moderate forms that becomes bimonthly in severe forms.</p><p><strong>Results: </strong>In 2344 enrolled patients (46% women and 54% men, mean age 78 yo) 18% had GOLD severity 1, 35% GOLD 2, 27% GOLD 3 and 20% GOLD 4. In addition, 73% of patients had at least one other chronic comorbidity, mainly diabetes or hypertension, and in 48% both. The data analysis showed that the population followed in e-health presented a 49% reduction in improper hospital admissions and a 68% reduction in clinical exacerbations compared to the population enrolled in the ICPs but not followed also in e-health. Smoking habits present at the time of patient enrollment in the ICPs remained in 49% of the total population enrolled and in 37% of the population enrolled in e-health. The patients enrolled in GOLD 1 and 2 obtained the same benefits both if treated in e- health and if treated in the clinic. However, GOLD 3 and 4 patients instead presented better compliance if treated in e-health and continuous monitoring allowed punctual and early interventions such as to reduce complications and hospitalization.</p><p><strong>Conclusion: </strong>The e-health approach made possible to ensure proximity medicine and personalization of care. Indeed, the implemented diagnostic treatment protocols, if properly followed and monitored, are able to control complications and impact the mortality and disability of chronic disease. The advent of e-health and ICT tool","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 4","pages":"135-140"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9385892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare Management, avoidable mortality, telemedicine to improve health of the diabetic population.","authors":"Giuseppe Gambale,&nbsp;Marta Castellani,&nbsp;Elisa Mazzeo,&nbsp;Andrea De Giorgi,&nbsp;Rosario Andrea Cocchiara,&nbsp;Giovanni Profico,&nbsp;Simona Amato","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Worldwide the International Diabetes Federation (IDF) estimated that in 2021 9.2% of adults (536.6 million, between 20 and 79 years of age) are diabetic and 32.6% under 60 years (6.7 million) die because of diabetes. This disease is set to become the leading cause of disability and mortality by 2030. In Italy, the prevalence of Diabetes is about 5%; in the pre-pandemic period, from 2010 to 2019, diabetes was responsible for 3% of deaths recorded, while during the pandemic in 2020, these deaths increased to about 4%. The present work aimed to measure the outcomes obtained from the ICPs (integrated care pathways) implemented by a Health Local Authority according to the model of the Lazio region and its impact on avoidable mortality, i.e., those deaths potentially avoidable with primary prevention interventions, early diagnosis and targeted therapies, adequate hygienic conditions and proper health care.</p><p><strong>Materials and methods: </strong>Data from 1675 patients enrolled in the diagnostic treatment pathway were analyzed, 471 with type 1 diabetes and the remainder with type 2 (mean age 17.5 and 69, respectively). 987 patients with type 2 diabetes also had comorbidities: in 43% obesity, 56% dyslipidemia, 61% hypertension, 29% COPD. In 54% they had at least 2 comorbidities. All patients enrolled in the ICPs were equipped with a glucometer and an app capable of recording results on capillary blood, 269 with type 1 diabetes were equipped with continuous and 198 insulin pump measurement devices. All enrolled patients recorded at least one daily blood glucose reading, one weekly weight reading, and recorded steps taken daily. They also underwent glycated hemoglobin monitoring, periodic visits and scheduled instrumental checks. A total of 5500 parameters were measured for patients with type 2 diabetes and 2345 for patients with type 1 diabetes.</p><p><strong>Results: </strong>Analysis of medical records revealed that 93% of patients with type 1 diabetes were found to be adherent to the treatment pathway, adherence of patients with type 2 diabetes was recorded in 87% of enrolled cases. The analysis of accesses to the Emergency Department for decompensated diabetes saw only 21% of patients enrolled in the ICPs, but recording poor compliance. The mortality in enrolled patients was 1.9% compared with 4.3 percent in patients not enrolled in ICPs, and patients amputated for diabetic foot resulted in 82% of patients not enrolled in ICPs. Finally, it is noted that patients also enrolled in the telerehabilitation pathway or home care rehabilitation (28%), with the same conditions of severity of neuropathic and vasculopathic picture presented a reduction of 18% in leg or lower limb amputation compared to patients not enrolled or not adhering to ICPs, a reduction of 27% in metatarsal amputation and 34% in toes amputation.</p><p><strong>Conclusions: </strong>Telemonitoring of diabetic patients allows for greater patient empower","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 4","pages":"130-134"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9385893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of an Integrated Care Pathways (ICPs): an Italian Study.","authors":"Giuseppe Gambale,&nbsp;Elisa Mazzeo,&nbsp;Andrea De Giorgi,&nbsp;Marta Castellani,&nbsp;Rosario Andrea Cocchiara,&nbsp;Giovanni Profico,&nbsp;Simona Amato","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization defines chronic disease as long duration and generally slow progression disease, with a continuous treatment over decades. The management of such diseases is complex, as the aim of treatment is not cure, but maintenance of a good quality of life and prevention of possible complications. Cardiovascular diseases are the leading cause of death worldwide (18 million deaths per year) and hypertension remains the largest preventable cause of cardiovascular disease globally. In Italy, the prevalence of hypertension was of 31.1%. The goal of antihypertensive therapy should be to reduce blood pressure back to physiological levels or to a range of values identified as targets. The National Chronicity Plan identifies an Integrated Care Pathways (ICPs) for several acute or chronic conditions, at different stages of disease and care levels, in order to optimize the healthcare processes. The aim of the present work was to perform a cost-utility analysis of management models of Hypertension ICPs to assist frail patients with hypertension following the National Health Service (NHS) guidelines in order to reduce morbidity and mortality rates. In addition, the paper emphasizes the importance of e-Health technologies for the implementation of chronic care management models based on the Chronic Care Model (CCM).</p><p><strong>Materials and methods: </strong>The management of the health needs of frail patients in a Healthcare Local Authority finds an effective tool in the Chronic Care Model, involving the analysis of the epidemiological context. Hypertension Integrated Care Pathways (ICPs) includes a series of first-level laboratory and instrumental tests necessary at the beginning of the intake, for accurate pathology assessment, and annually for adequate surveillance of the hypertensive patient. For the cost-utility analysis were investigated the flows of pharmaceutical expenditure for cardiovascular drugs and the measurement of the outcomes of the patients assisted by the Hypertension ICPs.</p><p><strong>Results: </strong>The average cost of a patient included in the ICPs for hypertension is 1636.21 euros/year, reduced to 1345 euros/year using telemedicine follow-up. The data collected by Rome Healthcare Local Authority on 2143 enrolled patients allow us to measure both the effectiveness of prevention and the monitoring of adherence to therapy and thus the maintenance of hematochemical and instrumental tests in a range of compensation such that it is possible to impact on the outcomes, resulting in the 21% reduction in the expected mortality and the 45 % reduction in avoidable mortality due to cerebrovascular accidents, with related impact on potential disability. It was also estimated that patients included in ICPs and followed by telemedicine compared to outpatient care, obtained a 25% reduction in morbidity, with greater adherence to therapy and better empowerment results. The patients enrolled in th","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 4","pages":"125-129"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10824839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Covid-19 pandemic on palliative care provision by a hospital-based unit: results from an observational study.","authors":"Anita Maria Tummolo,&nbsp;Mara Adelaide Ricciotti,&nbsp;Eleonora Meloni,&nbsp;Sabrina Dispenza,&nbsp;Marcello Di Pumpo,&nbsp;Gianfranco Damiani,&nbsp;Christian Barillaro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Palliative care is a key approach in improving the quality of life of patients and their families facing the end-of-life care process. It is widely regarded as a public-health concern, especially considering the rapidly increasing end-of-life care needs worldwide. Its provision has been highly challenged by the COVID-19 pandemic emergency. Objective This study aims to analyse whether and to what extent the provision of Palliative Care to non-COVID patients provided by a hospital-based unit has changed during the COVID-19 pandemic. Material and methods A retrospective observational study was performed. All non-COVID patients admitted from October 1, 2019 to September 30, 2020 and evaluated by the hospital-based Palliative Care team were considered. Three time periods were considered: pre-lockdown, lockdown and post-lockdown. A trend analysis and multiple linear and logistic regressions to study and quantify the statistical significance of the associations were performed. Results A statistically significant positive linear trend of the number of hospitalized patients in need of Palliative Care was found over the study period. Compared to pre-lockdown, the rest of the study period presented more female and elderly patients, the length of stay and the number of patients discharged to a Hospice setting were significantly reduced. The waiting time did not change in lockdown but decreased in post-lockdown and the mortality rate was not significantly different. Also, the average number of Palliative Care consultations per patient significantly increased in the lockdown and post-lockdown. Discussion First, the significant admissions drop between the start of the pandemic and the following study period is in line with recent literature. The consequent rebound registered may be attributed to the high pressure from outside requiring admission and care. Second, the significantly older age of patients found during the lockdown than before the lockdown could be attributed to a \"selection effect\" of young patients, more able to delay hospitalization than the elderly, also in line with recent literature. Third, the shorter waiting time for Palliative Care activation the post-lockdown compared to the pre-lockdown period could be due to both increased hospital efficiency and to the greater pressure to discharge patients during the post-lockdown period. Also, the significant reduction in the lockdown and post-lockdown of the length of stay after Palliative Care activation could be explained considering both the greater receptivity of healthcare services outside the hospital, such as Hospices, and the greater pressure on hospital wards to discharge. Fourth, the unchanged in-hospital mortality rate remained over the entire period could be an indication of the high quality of care provided by this hospital setting to fragile patients, which is to be noted especially considering the average mortality rate registered during pandemic context in healthcare","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":" ","pages":"124-135"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40723298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of an injuries database in Italian ski resorts.","authors":"Saverio Giampaoli,&nbsp;Lorenzo Lupi,&nbsp;Luigi Faccia,&nbsp;Antonio Tessitore,&nbsp;Sabrina Demarie","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Italy is one of the main destinations for winter tourism. Specifically, the country can currently count on more than 5.700 km of ski runs, served by more than 1.700 lift facilities Objective. The purpose of this study has been the analysis of injuries in ski resorts in a continuous period spanning over several seasons (17 years). In addition, the possible effect of safety law enforcements, introduced in the selected period, were considered.</p><p><strong>Material and methods: </strong>A ski injuries database, prepared as a duty of policemen involved in rescue activity and consisting of 246616 records of injuries for the period from 7th December 2002 to 31st December 2019, has been analysed for qualitative and quantitative variables.</p><p><strong>Results: </strong>The majority of injuries (58%) occurred on slopes with medium difficulties. After the introduction of national ski safety law (Law 363/2003), a strong diffusion of protective helmet has been noticed. The adoption of the helmet has significantly reduced cranio-facial injuries both in children and in adults. Moreover, no death events were recorded in the database after the introduction of Law 363/2003. The diffusion of ski accident insurance programs is slowly increasing, even if in the year 2019 approximately 38% of skiers still didn't have an insurance program.</p><p><strong>Discussion and conclusions: </strong>It is possible to speculate that the introduction of a national ski safety law had a positive effect on injuries reduction. At the same time, collected data underlined several critical points that seem, at least in part, addressed by the law revision performed in 2021.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":" ","pages":"111-123"},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40723297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When there is no communication between urban planners and public health operators: urban Dermanyssus gallinae infestations in humans.","authors":"Annunziata Giangaspero,&nbsp;Vito D'Onghia,&nbsp;Antonella Puccini,&nbsp;Maria Filomena Caiaffa,&nbsp;Luigi Macchia,&nbsp;Alessandra Barlaam","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>At the international level, it is necessary to apply urban health strategies that can integrate concrete actions to protect and promote health in urban and architectural planning. In cities, the &quot;urban fauna&quot; mostly consists of synanthropic birds (sparrows, starlings, swallows, martins, jackdaws, crows, hawks, gulls, pigeons) that have adapted to a continuous relationship with humans. These animals enrich the ecological network of biodiversity but also pose health problems. The most successful avian colonizers are pigeons (Columba livia), which proliferate due to the abundance of food available to them and the absence of predators. Pigeons may harbor several organisms that are pathogenic for humans, and among these the role of Dermanyssus gallinae should not be underestimated. In the absence of their preferred pigeon host, these mites will move from the nest to windowsills and window frames from which they attack humans. The Authors show that modern architectural design features in towns can favor the establishment and proliferation of pigeons, contributing to the public health risk for dermanyssosis or other diseases related to these birds. They describe an outbreak of dermanyssosis due to incorrect or unsuitable structural interventions, and highlight the need of re-thinking urban architectural choices in order to safeguard public health.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"79 2","pages":"62-69"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}