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Lauriola P, Martín-Olmedo P, Leonardi GS, Bouland C, Verheij R, Dückers MLA, van Tongeren M, Laghi F, van den Hazel P, Gokdemir O, Segredo E, Etzel RA, Abelsohn A, Bianchi F, Romizi R, Miserotti G, Romizi F, Bortolotti P, Vinci E, Giustetto G, Santamaria M, Serafini A, Pegoraro S, Agius R, Zeka A. On the importance of primary and community healthcare in relation to global health and environmental threats: lessons from the COVID-19 crisis. BMJ Glob Health 2021; 6:bmjgh-2020-004111. [PMID: 33692145 PMCID: PMC7948151 DOI: 10.1136/bmjgh-2020-004111] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/29/2020] [Accepted: 01/06/2021] [Indexed: 12/05/2022] Open
Abstract
In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (P&CHC) system’s weaknesses worldwide. In many instances, P&CHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of ‘planetary health’. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that P&CHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic.
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Affiliation(s)
- Paolo Lauriola
- International Society of Doctors for the Environment (ISDE-Italy), Modena, Italy
| | | | - Giovanni S Leonardi
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Robert Verheij
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Michel L A Dückers
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - Ferdinando Laghi
- International Society of Doctors for the Environment (ISDE-Int'l), Geneva, Switzerland
| | - Peter van den Hazel
- International Network on Children's Health, Environment and Safety (INCHES), Ellecom, The Netherlands
| | - Ozden Gokdemir
- Faculty of Medicine, Izmir University of Economics, Balçova/Izmir, Turkey
| | - Evelyn Segredo
- Uruguayan Society of Family and Community Medicine, Montevideo, Uruguay
| | - Ruth A Etzel
- Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Alan Abelsohn
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Fabrizio Bianchi
- Istituto Fisiologia Clinica, Consiglio Nazionale della Ricerca (CNR-IFC), Pisa, Italy
| | - Roberto Romizi
- International Society of Doctors for the Environment (ISDE-Italy), Arezzo, Italy
| | - Giuseppe Miserotti
- International Society of Doctors for the Environment (ISDE-Italy), Piacenza, Italy
| | - Francesco Romizi
- International Society of Doctors for the Environment (ISDE-Italy), Arezzo, Italy
| | | | - Emanuele Vinci
- Health and Environment Working Group, National Medical Orders Federation, Rome, Italy
| | | | | | | | | | - Raymond Agius
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - Ariana Zeka
- Institute of Environment, Health and Societies, Brunel University London, Uxbridge, UK
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Piscitelli P, Marino I, Falco A, Rivezzi M, Neglia C, Della Rosa G, Militerno G, Bonifacino A, Rivezzi G, Romizi R, Miserotti G, Montella M, Bianchi F, Marinelli A, De Donno A, De Filippis G, Serravezza G, Di Tanna G, Gennaro V, Ascolese M, Distante A, Burgio E, Colao A. Reply to the Letter of Terracini B. et al. "Comment on Piscitelli et al. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health". Int. J. Environ. Res. Public Health 2017, 14, 495. Int J Environ Res Public Health 2017; 14:ijerph14111291. [PMID: 29068388 PMCID: PMC5707930 DOI: 10.3390/ijerph14111291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/10/2017] [Accepted: 10/12/2017] [Indexed: 11/16/2022]
Abstract
A letter to the IJERPH Editor was submitted by Terracini B. et al. as a comment to our latest paper "Hospitalizations in Pediatric and Adult Patients for all Cancer Type in Italy:[...].
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Affiliation(s)
- Prisco Piscitelli
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, Via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy.
| | - Immacolata Marino
- Department of Economics and Statistics and CSEF, University Federico II, 80131 Naples, Italy.
| | - Andrea Falco
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, Via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy.
| | - Matteo Rivezzi
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, Via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy.
| | - Cosimo Neglia
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, Via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy.
| | - Giulia Della Rosa
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, Via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy.
| | | | | | - Gaetano Rivezzi
- Division of Neonatology, St. Anna & St. Sebastiano Hospital, 81100 Caserta, Italy.
| | | | | | - Maurizio Montella
- IRCCS G. Pascale Foundation, National Cancer Institute, 80131 Naples, Italy.
| | | | - Alessandra Marinelli
- Department of Experimental Medicine, Second University of Naples (SUN), 80138 Naples, Italy.
| | - Antonella De Donno
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, 73100 Lecce, Italy.
| | | | | | | | | | - Mario Ascolese
- Division of Pediatric Surgery, Salerno University Hospital "Ruggi D'Aragona", 84100 Salerno, Italy.
| | - Alessandro Distante
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, Via Reali di Bulgaria, Mesagne, 72023 Brindisi, Italy.
| | - Ernesto Burgio
- European Cancer and Environment Research Institute (ECERI), 21004 Bruxelles, Belgium.
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy.
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Piscitelli P, Marino I, Falco A, Rivezzi M, Romano R, Mazzella R, Neglia C, Della Rosa G, Pellerano G, Militerno G, Bonifacino A, Rivezzi G, Romizi R, Miserotti G, Montella M, Bianchi F, Marinelli A, De Donno A, De Filippis G, Serravezza G, Di Tanna G, Black D, Gennaro V, Ascolese M, Distante A, Burgio E, Crespi M, Colao A. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health. Int J Environ Res Public Health 2017; 14:ijerph14050495. [PMID: 28486413 PMCID: PMC5451946 DOI: 10.3390/ijerph14050495] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 04/06/2017] [Accepted: 04/15/2017] [Indexed: 01/16/2023]
Abstract
Background: Cancer Registries (CRs) remain the gold standard for providing official epidemiological estimations. However, due to CRs’ partial population coverage, hospitalization records might represent a valuable tool to provide additional information on cancer occurrence and expenditures at national/regional level for research purposes. The Epidemiology of Cancer in Italy (EPIKIT) study group has been built up, within the framework of the Civic Observers for Health and Environment: Initiative of Responsibility and Sustainability (COHEIRS) project under the auspices of the Europe for Citizens Program, to assess population health indicators. Objective: To assess the burden of all cancers in Italian children and adults. Methods: We analyzed National Hospitalization Records from 2001 to 2011. Based on social security numbers (anonymously treated), we have excluded from our analyses all re-hospitalizations of the same patients (n = 1,878,109) over the entire 11-year period in order to minimize the overlap between prevalent and incident cancer cases. To be more conservative, only data concerning the last five years (2007–2011) have been taken into account for final analyses. The absolute number of hospitalizations and standardized hospitalization rates (SHR) were computed for each Italian province by sex and age-groups (0–19 and 20–49). Results: The EPIKIT database included a total of 4,113,169 first hospital admissions due to main diagnoses of all tumors. The annual average number of hospital admissions due to cancer in Italy has been computed in 2362 and 43,141 hospitalizations in pediatric patients (0–19 years old) and adults (20–49 years old), respectively. Women accounted for the majority of cancer cases in adults aged 20–49. As expected, the big city of Rome presented the highest average annual number of pediatric cancers (n = 392, SHR = 9.9), followed by Naples (n = 378; SHR = 9.9) and Milan (n = 212; SHR = 7.3). However, when we look at SHR, minor cities (i.e., Imperia, Isernia and others) presented values >10 per 100,000, with only 10 or 20 cases per year. Similar figures are shown also for young adults aged 20–49. Conclusions: In addition to SHR, the absolute number of incident cancer cases represents a crucial piece of information for planning adequate healthcare services and assessing social alarm phenomena. Our findings call for specific risk assessment programs at local level (involving CRs) to search for causal relations with environmental exposures.
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Affiliation(s)
- Prisco Piscitelli
- Medicina Futura Research, Southern Italy Hospital Institute (IOS), Centro Direzionale, Isola E3, Palazzo Avalon, 80143 Naples, Italy.
| | - Immacolata Marino
- Department of Economics and Statistics and CSEF, University Federico II, 80131 Naples, Italy.
| | - Andrea Falco
- Medicina Futura Research, Southern Italy Hospital Institute (IOS), Centro Direzionale, Isola E3, Palazzo Avalon, 80143 Naples, Italy.
| | - Matteo Rivezzi
- Medicina Futura Research, Southern Italy Hospital Institute (IOS), Centro Direzionale, Isola E3, Palazzo Avalon, 80143 Naples, Italy.
| | - Roberto Romano
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, 72023 Mesagne (Brindisi), Italy.
| | - Restituta Mazzella
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, 72023 Mesagne (Brindisi), Italy.
| | - Cosimo Neglia
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, 72023 Mesagne (Brindisi), Italy.
| | - Giulia Della Rosa
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, 72023 Mesagne (Brindisi), Italy.
| | - Giuseppe Pellerano
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, 72023 Mesagne (Brindisi), Italy.
| | | | | | - Gaetano Rivezzi
- Division of Neonatology, St. Anna & St. Sebastiano Hospital, 81100 Caserta, Italy.
| | | | | | - Maurizio Montella
- IRCCS G. Pascale Foundation, National Cancer Institute, 80131 Naples, Italy.
| | | | - Alessandra Marinelli
- Department of Experimental Medicine, Second University of Naples (SUN), 80138 Naples, Italy.
| | - Antonella De Donno
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, 73100 Lecce, Italy.
| | | | | | - Gianluca Di Tanna
- Centre of Primary Care and Public Health, Queen Mary University of London, London E14NS, UK.
| | - Dennis Black
- Department of Epidemiology and Biostatistics, University of California San Francisco (UCSF), San Francisco, CA 94158, USA.
| | - Valerio Gennaro
- National Cancer Institute IRCCS San Martino, 16121 Genova, Italy.
| | - Mario Ascolese
- Division of Pediatric Surgery, Salerno University Hospital "Ruggi D'Aragona", 84100 Salerno, Italy.
| | - Alessandro Distante
- Euro Mediterranean Scientific Bio-Medical Institute, ISBEM, 72023 Mesagne (Brindisi), Italy.
| | - Ernesto Burgio
- European Cancer and Environment Research Institute (ECERI), 21004 Bruxelles, Belgium.
| | | | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy.
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Piepoli MF, Brambilla A, Brambilla L, Ceconi C, Coruzzi P, Corvi U, Diaco T, Di Pasquale G, Malagoli A, Miserotti G, Pozzati A, Semprini PL, Sverzellati E, Urbinati S, Villani GQ. Preventive Cardiology: comparisons of European and Italian projects with the Cardiac Units from Emilia Romagna region. A workshop of IACPR/GICR - Emilia Romagna. Monaldi Arch Chest Dis 2015; 76:81-7. [DOI: 10.4081/monaldi.2011.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A workshop endorsed by the Italian Association of Cardiovascular Prevention and Rehabilitation – Emilia Romagna Section – held in Piacenza in May 2011, gave the opportunity to discuss the emerging role of Preventive Cardiology in the modern era. From the new documents recently published by the European and Italian Scientific Associations, the barriers in their implementation, and the contribution of the health care providers, physicians, nurses, both in primary and secondary prevention were discussed. The local initiatives of cardiac prevention in different areas were presented and compared. A new project of secondary prevention in the follow-up and management of patients with dilated cardiomyopathy and heart failure promoted by the Emilia Romagna Region Health Authority was presented.
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