Igiene e sanita pubblica最新文献

{"title":"Competitive colonization of Legionella and Pseudomonas aeruginosa in water systems of residential facilities hosting closed communities Legionella versus Pseudomonas aeruginosa in water systems of residential facilities.","authors":"Gian Loreto D'Alò,&nbsp;Alessandra Messina,&nbsp;Cinzia Mozzetti,&nbsp;Domenico Cicciarella Modica,&nbsp;Patrizia De Filippis","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Legionella and Pseudomonas aeruginosa are pathogens that live and multiply in water systems and resist disinfection through biofilm formation. As suggested by some studies, we wanted to verify whether the presence of P. aeruginosa can lead to a less frequent presence of Legionella in water systems of retirement homes and group homes. We collected 123 hot water and biofilm samples from showerheads. Samples were tested by selective culture methods, and Heterotrophic Plate Counts were determined. Legionella and P. aeruginosa were found in 35% and 39% of distal points, respectively. The presence of P. aeruginosa was significantly inversely correlated with the presence of Legionella when considering both matrices together (p&lt;0.01), water samples only (p=0.02), and biofilm samples only (p=0.04). The inverse relationship was strong for L. pneumophila sg1 (Odds Ratio 0.182, p=0.002), while it is no longer verified when only L. pneumophila serogroups 2-14 are considered. The implications for the development of environmental investigations and risk management are discussed.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"79 2","pages":"92-110"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474577","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":"Hospital networks in Italy: state of the art and future pespectives. Insights from a qualitative research study.","authors":"G Damiani,&nbsp;M Di Pumpo,&nbsp;G Giubbini,&nbsp;L Lombi,&nbsp;M L Specchia,&nbsp;L Sommella","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background Hospitals have undergone important that changes that have led, in recent decades at the international level, to the need for greater integration between hospitals and local healthcare services. The main institutional networks that have been developed in Italy are, as commended by the institutional levels, of 4 main types: the Emergency-Urgency Network, the Time-Dependent Networks, the Oncological Networks, and the Networks with primary care settings. It was important to assess the state of the art and analyze it in relation to possible future developments. Objective The aim of the study was to collect insights from both evidence-based knowledge and personal experience gained by experts in the field regarding the current condition and possible future developments of hospital networks. Material and methods A qualitative research methodology was chosen. Four mini-focus group meetings were organized among participants with proven expertise on the subject. Discussions were guided by four open-ended questions corresponding to the four areas of interest. Directed content analysis was chosen as the methodology for data analysis and final reporting of results. Results Four main categories were explored: \"hospital networks and complexity\", \"hospital networks complexity and the need for integration\", \"levers for hospital networks governance\" and \"the COVID-19 challenge and future developments for hospital networks\". In particular, the participants found that it is important to understand healthcare systems as complex systems and, therefore, to study the properties of complex systems. In this way it is possible to achieve value-based healthcare in complex contexts. It is also necessary to keep in mind that complexity represents a challenge for coordination/ integration in hospital networks. Mintzberg identified specific mechanisms to achieve it. Of them, mutual adaptation is the key to self-organization. Valentijn showed the organizational levels on which coordination/integration has to be obtained. Hospital network governance should include both hierarchy and self-determination logic to achieve integration in each of the four levels. The participants identified three key levers for governing complex organizations: \"education\", which consists of multi-professional and multi-level training in governance in complex systems; \"information\" consisting in considering the data registering as an integral part of the clinical care process to informative value; \"leadership\", which consists in convincing actors, directed towards personal gains, to achieve valuable goals. Finally, the challenge that COVID-19 served as an incentive for future developments of hospital networks. Discussion Various common points between the definitions of network and complex systems can be found. It is important to study the properties of complex systems in order to achieve value-based healthcare in the hospital networks context. The insights gained should be useful for all","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"79 2","pages":"70-91"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40474576","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":"[Topical interest of the origin of Hygiene and Public Health].","authors":"Armando Muzzi,&nbsp;Augusto Panà","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Potrebbe destare stupore richiamare l'attenzione dei cultori dell'Igiene e Sanità pubblica su una tra le opere più significative delle circa settanta che costituiscono il Corpus ippocratico - probabilmente assemblato nella biblioteca di Alessandria, all'inizio del III secolo a.C. - cioè sull' \"Aria, Acqua, Luoghi\", che identifica nell'ambiente, nelle condizioni metereologiche, nelle sostanze presenti nell'acqua da bere e in altri fattori molto concreti le possibili cause delle malattie, anziché attribuire loro un'origine soprannaturale. Questa intuizione millenaria attribuita ad Ippocrate, padre della Scienza medica, ha improntato tutta la storia dell'Igiene e Sanità pubblica dando luogo ad un immenso corpus dottrinale che, seguendo man mano le nuove conoscenze, ha dimostrato la natura dinamica e il continuo ampliamento della disciplina. Disciplina che sta ora sempre più interessando il mondo non solo scientifico ma anche politico e popolare impressionato dalla manifestazione di vistosi fenomeni naturali attribuibili ad una modificazione di equilibri tra i componenti dei tre regni della natura: animale, vegetale e minerale.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"79 2","pages":"58-61"},"PeriodicalIF":0.0,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40466286","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":"[Permanent environmental disinfection techniques in hospital settings with infectious risk].","authors":"P Manzi,&nbsp;G Messina,&nbsp;V Falcone,&nbsp;G Cevenini,&nbsp;I Bernardini,&nbsp;C De Lio,&nbsp;L Pieri,&nbsp;G De Filippis,&nbsp;S Violi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>While the world's economies avoid the COVID-19 pandemic blockade, there is an urgent need for technologies aimed at reducing the transmission of COVID-19 in confined spaces such as hospital environments. Although the cleaning and disinfection procedures now have rather complex and sophisticated weapons, they do not seem to be sufficient to continuously maintain low levels of environmental microbiological contamination. This result can now be achieved through the cross-use, in space and time, of improved, more efficient and effective technologies. This result can now be achieved through the cross-use, in space and time, of improved technologies. This work highlights the possibility of crossing and cooperation of different disinfection techniques, such as to keep the microbial and viral load low over time.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 6","pages":"676-692"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39765439","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":"[Radon exposure: also in this case it is better to open the window].","authors":"M Del Gaudio,&nbsp;A Lauro,&nbsp;P Marino","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Although many areas of the Italian territory are of volcanic origin, there is not much attention to the prevention of risks due to exposure to Radon gas. This gas is produced during the decay of uranium present in volcanic rocks and, if inhaled, its further decay produces radioactive radiation responsible for damage to lung tissues. It is estimated that these radiations are responsible for 10% of lung cancers. In conditions of poor air exchange, the concentration of Radon gas can easily reach high concentrations, particularly in underground rooms or on the ground floor that are in direct contact with the ground. In these territories, the designers of new buildings do not always consider this risk and the population is also poorly informed on the behavior to be adopted for prevention.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 6","pages":"693-702"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39765440","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":"L’ossimoro delle “Malattie rare” può diventare un problema di Sanità pubblica?","authors":"Armando Muzzi,&nbsp;Augusto Panà","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>La recente approvazione del testo unico sulle malattie rare da parte dei due rami del Parlamento (Disposizioni per la cura delle malattie rare e per il sostegno della ricerca e della produzione dei farmaci orfani) richiama l'attenzione degli operatori di Sanità pubblica su una materia vasta e disomogenea come la ricerca, la diagnosi e il trattamento delle malattie rare. La disponibilità di un testo di legge, anche se devono seguire i decreti attuativi per rispondere alle necessità concrete dei malati e delle loro famiglie, è comunque uno strumento essenziale nella \"cassetta degli attrezzi\" degli operatori in quanto «dai documenti storici più antichi a quelli contemporanei si hanno prove del ricorso ad atti normativi non solo nei momenti di emergenza (gestione delle epidemie) ma anche nell'organizzazione e il controllo della vita quotidiana sempre in nome e per conto della salute collettiva» (Editoriale. La normazione, lo strumento cardine di Sanità pubblica. Igiene e Sanità Pubblica 2020; 76: 284-286).</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"79 5","pages":"580-591"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39823172","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":"[Community Medicine revival. Community Medicine (revised and corrected)].","authors":"Armando Muzzi,&nbsp;Augusto Panà","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A &quot;la Scienza e l'Arte di prevenire le malattie, di prolungare la vita e di promuovere la salute attraverso gli sforzi organizzati della società&quot; sono stati attribuiti molti nomi, variamente associati tra loro: Sanità pubblica, termine onnicomprensivo della multidisciplinarietà della materia, ma anche Igiene, Medicina preventiva, Medicina sociale, Medicina di comunità a seconda del prevalente campo di attività messo in atto. L'inserimento della dimensione comunitaria nella teoria e nella pratica della Medicina richiede però la definizione di comunità, il coinvolgimento nell'azione di tutela della salute (promozione, conservazione e recupero), la localizzazione territoriale (dove la gente vive e lavora), la disponibilità di risorse finalizzate e così via. Una esigenza quanto mai necessaria specialmente ora che l'ormai &quot;mitico&quot; Recovery Plan - ovvero Piano Nazionale di Ripresa e Resilienza (PNRR) - cita ripetutamente la&quot;Comunità&quot; facendone un elemento di rilievo dell'azione progettuale. Uno degli interventi previsti è infatti la realizzazione entro il 2026 di 1.288 Case della Comunità. Queste sono ideate come strutture sanitarie, promotrici di un modello di intervento multidisciplinare, nonché luoghi privilegiati per la progettazione di interventi di carattere sociale e di integrazione sociosanitaria esprimendo una nuova modalità di presa in carico delle persone e delle comunità per prevenire le malattie, prolungare la vita e promuovere la salute. Ne consegue che la sede della Casa della Comunità deve essere visibile e facilmente accessibile per la comunità di riferimento (struttura di prossimità) perché è il luogo dove il cittadino può trovare una risposta adeguata alle più diverse esigenze sanitarie o sociosanitarie. La soluzione organizzativa raccomandata (in informatica &quot;hub & spoke&quot;) prevede un elemento centrale di una rete per le cure primarie e per i supporti sociali e assistenziali, proponendosi come luogo di offerta, ma contestualmente come luogo di relazione e di attenzione a tutte le dimensioni di vita della persona e della comunità.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 6","pages":"660-665"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39750944","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":"[Quadrivalent conjugate vaccines against ACWY meningococcal disease].","authors":"I Iovene,&nbsp;S Igidbashian,&nbsp;E Franco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Invasive meningococcal disease (IMD) is caused by 6 serogroups of the bacterium Neisseria meningitidis (A, B, C, W, X and Y). It is among the most serious vaccine preventable infectious diseases, characterized by a high case-fatality rate and risk of permanent sequelae. Worldwide, the incidence of IMD is generally low with differences among regions and age groups. The risk increases in overcrowded conditions or in case of travel to endemic areas. The first vaccines produced using polysaccharide capsular antigens have demonstrated a good protective efficacy, but of short lenght. The conjugation of antigens with proteins allowed to obtain a longlasting antibody response towards 4 serogroups: A, C, W, Y. Currently four ACWY quadrivalent conjugate vaccines are available, three of them approved in Europe, which have shown high immunogenicity and safety. In 2020 the MenACYW-TT vaccine conjugated to tetanus toxoid was approved in the USA and it is presently authorized in Europe for the immunization of individuals from 12 months of age. Clinical studies have demonstrated immunogenicity and safety on population samples belonging to different age groups and non-inferiority in comparing it with other vaccines already in use. The possibility of having an increasing number of safe, immunogenic and effective vaccines against IMD allows us to imagine a future without invasive meningococcal disease. It is therefore important to extend vaccination to an increasing number of subjects of different age groups and risk conditions.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"79 5","pages":"625-638"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39823174","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":"[What factors contributed to the higher incidence rate of in-hospital falls at the time of Covid 19? A paradigm shift?]","authors":"S Amato,&nbsp;A M Lombardi,&nbsp;C Fioravanti,&nbsp;V Gherlo,&nbsp;M Salvagni,&nbsp;M Cerimele","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The COVID-19 pandemic has put a strain on all health systems as there has been a growing rapidity in the demand for health care from COVID 19 positive patients in hospitals around the world. With the intensification of the pandemic, determining in real time the consequent needs for health resources (beds, personnel, equipment) has in fact become the fundamental priority for many countries to ensure health services consistent with the health needs expressed by the population. In Italy, the demand has often been satisfied with the conversion of existing beds and the remodeling of the healthcare offer or where the available resources allow it also with the opening of new beds dedicated to pandemic assistance. This work analyzes the falls detected at the time of COVID in patients and hospitalized in direct hospital beds (600 beds) of a Local Health Authority of Lazio (ASL ROMA 2). Although the data on the incidence of falls recorded in the three centers were equal to 2.21 every 1000 days of beds occupied and that the data recorded are lower than those reported in the literature, it is also true that the increase in average hospital stay and the reduction in the rotation rate of beds had an impact on the still low occupancy rates compared to the literature data.The COVID-19 pandemic has put a strain on all health systems as there has been a growing rapidity in the demand for health care from COVID 19 positive patients in hospitals around the world. With the intensification of the pandemic, determining in real time the consequent needs for health resources (beds, personnel, equipment) has in fact become the fundamental priority for many countries to ensure health services consistent with the health needs expressed by the population. In Italy, the demand has often been satisfied with the conversion of existing beds and the remodeling of the healthcare offer or where the available resources allow it also with the opening of new beds dedicated to pandemic assistance. This work analyzes the falls detected at the time of COVID in patients and hospitalized in direct hospital beds (600 beds) of a Local Health Authority of Lazio (ASL ROMA 2). Although the data on the incidence of falls recorded in the three centers were equal to 2.21 every 1000 days of beds occupied and that the data recorded are lower than those reported in the literature, it is also true that the increase in average hospital stay and the reduction in the rotation rate of beds had an impact on the still low occupancy rates compared to the literature data. In fact, the scientific literature shows that in England and Wales, whose national health service is very similar to the Italian one, the falls of patients in hospitals with optimal bed occupancy rates and optimal average hospitalization rates (equal to 4.5 days in general medicine, 3.5 days in general surgery, 3 days in orthopedics) represent the first sentinel event in terms of incidence and frequency, albeit with a very variable dam","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"80 6","pages":"666-675"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39750945","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":"Abitudini, stili di vita e socialità: una cluster analysis di studenti universitari italiani.","authors":"S Giampaoli,&nbsp;F R Lenzi,&nbsp;G Parente,&nbsp;V G Frajese,&nbsp;A Tessitore","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The analysis of health determinants in the student population can be useful in raising awareness on safe living conditions in new generations. The selection of specific biomedical markers, like advanced glycation end products (AGEs), and the analysis of social behaviors can support lifestyle choices evaluation. A questionnaire, containing an anamnestic section, a physical activity evaluation section, and a sociological section, was administered to a total of 110 students from two Italian universities, selected from the Faculty of Science of Movement and from the Faculty of Medicine. In addition, all subjects recruited in this study underwent to an AGEs accumulation assessment through skin autofluorescence. A non-hierarchical cluster analysis was performed on the collected data allowed the identification of two group of students: group 1 mainly consisted of male subjects from the Faculty of Science of Movement, characterized by an active lifestyle and a rather detached affective family condition; group 2 largely consisted of female subjects from the Faculty of Medicine, more sedentary and with stable relationships. The data analysis confirmed the correlation between low AGEs levels and healthy lifestyles, but at the same time underlined divergences between students from different Faculties.</p>","PeriodicalId":73329,"journal":{"name":"Igiene e sanita pubblica","volume":"79 5","pages":"591-604"},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39823175","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}