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Mercogliano M, Valdecantos RL, Fevola G, Sorrentino M, Buonocore G, Triassi M, Palladino R. An ecological analysis of socio-economic determinants associated with paediatric vaccination coverage in the Campania Region: A population-based study, years 2003-2017. Vaccine X 2024; 18:100482. [PMID: 38585381 PMCID: PMC10997839 DOI: 10.1016/j.jvacx.2024.100482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Vaccines are the most cost-effective and straightforward intervention against severe infectious diseases. However, in Europe and in Italy, paediatric vaccination coverage for certain vaccines remains suboptimal, with considerable regional differences in Italy. Vaccine coverage varies significantly due to socio-economic and organisational factors. Aim of this study was to assess the influence of the Deprivation Index, the density of General Practitioners and General Paediatricians per inhabitants on the coverage of both mandatory and non-mandatory paediatric vaccinations across local health authorities and health districts in the Campania Region for birth cohorts from 2001 to 2015. Materials and methods Population-based, ecological time series analysis focusing on the Campania Region, most populous region in the south of Italy. Vaccination coverage data were extracted from the regional immunization database, whilst information on the Deprivation Index and number of primary care doctors and primary care paediatricians per local health district were extracted from public health records. Univariate descriptive statistics were employed to describe study characteristics, as appropriate, whilst and mixed-effect linear regression models were employed to assess the associations between variables of interest and vaccination coverage. Results Overall vaccination coverage has generally increased, except for the MMR vaccine, which showed coverage fluctuations. An increase in the Deprivation Index, indicative of less favourable socio-economic conditions, was associated with decreased vaccination coverage in the 24-month age group for some mandatory vaccines (DTaP: Coef -0.97, 95% CI -1.77 | -0.17; Poliomyelitis: Coef -0.98, 95% CI -1.78 | -0.17; Hepatitis B: Coef -0.90, 95% CI -1.71 | -0.10). Moreover, areas with a greater density of General Paediatricians per inhabitants saw increased coverage for Haemophilus influenzae type b in the 6-year age group (Coef 9.78, 95% CI 1.00 | 18.56). Conclusions It is necessary to target public health policies to address vaccination inequalities. These efforts should include expanding vaccination campaigns, enhancing catch-up programs, and increase resource allocation in primary care settings to facilitate the role of General Practitioners and Paediatricians in fostering awareness and adherence.
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Affiliation(s)
| | | | - Gianluca Fevola
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Gaetano Buonocore
- Clinical Directorate, University Hospital “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131 Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), 80131 Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, UK
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Affinito G, Salerno V, Di Gennaro M, Scafa L, Russo A, Fumo MG, Giordana R, Falco F, Della Pia F, Di Cecca A, Migliaccio M, Ilardi CR, Criscuolo C, Spisto M, Triassi M, Brescia Morra V, Palladino R, Salvatore E, Moccia M. Incidence and prevalence of dementia: A 2015-2020 population-based study in the Campania Region of Italy. Neuroepidemiology 2024:000539031. [PMID: 38657587 DOI: 10.1159/000539031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE To provide population-based estimates of prevalence and incidence of any dementia and Alzheimer's dementia in the Campania Region (South Italy), and to validate towards a clinical registry. METHODS Population-based study, using routinely collected healthcare data of individuals living in the Campania Region (South Italy) from 2015 to 2020. We included individuals aged ≥65 years alive at the prevalence day (1 January 2021) who had at least one administrative record for dementia and/or Alzheimer's dementia from 2015 to 2020. Age-and sex-standardised prevalence rates were calculated using direct standardisation method (European population in 2020 as reference population). To estimate incidence, we tested three possible algorithms, which differed for the duration of the time interval between study baseline (Jan 1, 2015) and index date (first record for dementia and/or Alzheimer's dementia in administrative databases). We employed a clinical database for the validation of our algorithms towards neuropsychological test results. RESULTS Among individuals aged over 65, 80,392 had dementia, of which 35,748 had Alzheimer's dementia. The age- and sex-standardized prevalence rates per 1,000 individuals for any dementia and Alzheimer's dementia were 77.64 (95%CI = 77.57; 77.68) and 34.05 (95%CI = 34.01; 34.09), respectively. There were 82.10 incident of any dementia cases per 100,000 per year (0.79 sensitivity and 0.62 specificity), and 59.89 incident cases of any dementia per 100,000 per year (0.80 sensitivity and 0.59 specificity). The capture-recapture method showed very low number of undetected cases (1.7% for any dementia and 3.0% for Alzheimer's dementia). Our algorithms showed acceptable performance with AUC ranging from 0.59 to 0.72, and double likelihood ratio of correctly identifying individuals above and below MMSE standard cut-offs (24 and 26). CONCLUSIONS Prevalence and incidence of any dementia and Alzheimer's dementia in the Campania Region (South Italy) from 2015 to 2020 are in line with previous estimates from other countries. Our algorithm, integrating administrative and clinical data, holds potential for assessing dementia's epidemiological burden, identifying risk factors, planning healthcare access, and developing prevention strategies.
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Moccia M, Affinito G, Marrazzo G, Ciarambino T, Di Procolo P, Confalonieri L, Carotenuto A, Petracca M, Lanzillo R, Triassi M, Brescia Morra V, Palladino R. Utilization of Ocrelizumab within Different Treatment Strategies for Multiple Sclerosis: A 5-Year Population-Based Study. Neurol Int 2024; 16:394-405. [PMID: 38668126 DOI: 10.3390/neurolint16020029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/19/2024] [Accepted: 03/26/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND We aim to provide up-to-date real-world evidence on the persistence, adherence, healthcare resource utilization, and costs of multiple sclerosis (MS) by comparing ocrelizumab to other disease-modifying treatments (DMTs) and within different DMT sequences. METHODS We included 3371 people with MS who first received or switched DMT prescriptions from January 2018 to December 2022; they were identified through hospital discharge records, drug prescriptions, and exemption codes from the Campania Region (South Italy). We calculated persistence (time from the first prescription to discontinuation or switching to another DMT), adherence (proportion of days covered (PDC)), DMT costs, and MS hospital admissions and related costs. RESULTS The most frequently prescribed DMT was dimethyl fumarate (n = 815; age 38.90 ± 11.91 years; 69.5% females), followed by ocrelizumab (n = 682; age 46.46 ± 11.29 years; 56.3%); 28.8% of the patients treated with ocrelizumab were naïve to DMTs. Using ocrelizumab as a statistical reference, the risk of discontinuation was higher for other highly active (HR = 6.32; 95%CI = 3.16, 12.63; p < 0.01) and low-/medium-efficacy DMTs (HR = 10.10; 95%CI = 5.10, 19.77; p < 0.01); adherence was lower for other highly active DMTs (Coeff = -0.07; 95%CI = -0.10, -0.04; p < 0.01) and low-/medium-efficacy DMTs (Coeff = -0.16; 95%CI = -0.19, -0.14; p < 0.01). monthly DMT costs were higher for other highly active DMTs (Coeff = 77.45; 95%CI = 29.36, 125.53; p < 0.01) but lower for low-/medium-efficacy DMTs (Coeff = -772.31; 95%CI = -816.95, -727.66; p < 0.01). The hospital admissions and related costs of MS were similar between ocrelizumab, other highly active DMTs, and other low-/medium-efficacy DMTs, and with ocrelizumab as the first-line DMT after other highly active DMTs and after low-/medium-efficacy DMTs, which was possibly due to the low number of observations. CONCLUSIONS From 2018 to 2022, ocrelizumab was among the most frequently prescribed DMTs, with 28.8% prescriptions to incident MS patients, confirming its relevance in clinical practice. Ocrelizumab was associated with the highest persistence and adherence, pointing towards its favorable benefit-risk profile. The costs of ocrelizumab were lower than those of other highly active DMTs.
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Affiliation(s)
- Marcello Moccia
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Giuseppina Affinito
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | | | - Tiziana Ciarambino
- General Directorate for Healthcare Protection and Management of the Regional Healthcare Service, Strategic Management Office, Caserta Healthcare Authority, 81100 Caserta, Italy
| | | | | | - Antonio Carotenuto
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Maria Petracca
- Department of Human Neurosciences, Sapienza University, 00185 Rome, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Via Sergio Pansini 5, 80131 Naples, Italy
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
- Department of Primary Care and Public Health, Imperial College, London W6 8RP, UK
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Maida E, Bresciamorra V, Triassi M, Lanzillo R, Bonavita S, Lavorgna L. Cost-Analysis of Telemedicine Interventions Compared with Traditional Care in the Management of Chronic Neurological Diseases: A Systematic Review. Telemed J E Health 2024; 30:404-414. [PMID: 37466471 DOI: 10.1089/tmj.2023.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Background: Telemedicine has proven successful in relieving the burden of chronic neurological disorders from the national health care systems by ensuring a highly customized and effective management plan. Although many studies focus on assessing telemedicine effectiveness, little is known about the economic implications of telemedicine applications in chronic neurological diseases (CNDs). This issue could account for a lack of widespread implementation. Objective: Our study attempted to fill this gap by systematically reviewing scientific literature on the economic evaluation of telemedicine compared with traditional care in the management of CNDs. Methods: We performed a literature search on PubMed, Google Scholar, Scopus, Embase, and Medline. The inclusion criteria were as follows: (1) studies with a full cost-analysis; (2) randomized controlled trials; (3) studies comparing telemedicine interventions with traditional care; (4) articles focusing only on CNDs. Conversely, the exclusion criteria were as follows: (1) studies focusing on acute neurological conditions or other diseases and (2) study protocols, case report, duplicate articles, abstract only, books, letters to editors, and review articles. Results: Ten articles met the inclusion criteria. Three different approaches of telemedicine intervention could be identified: digital cognitive-behavioral therapy (CBT), motor telerehabilitation, and home monitoring and assessment devices. Conclusion: Cost-analysis showed an overall benefit in terms of both cost and effectiveness from the application of telemedicine instead of in-presence management in CNDs. Among the identified interventions, digital CBT proved to be the most cost-saving. However, promising results were also found in monitoring and assessment devices and in telerehabilitation. Definitely, however, more thorough, comprehensive, and high-quality economic evaluation studies are needed.
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Affiliation(s)
- Elisabetta Maida
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Vincenzo Bresciamorra
- Department of Neurosciences and Reproductive and Odontostomatological Sciences and University "Federico II" of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University "Federico II" of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), University "Federico II" of Naples, Naples, Italy
| | - Roberta Lanzillo
- Department of Neurosciences and Reproductive and Odontostomatological Sciences and University "Federico II" of Naples, Naples, Italy
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
| | - Luigi Lavorgna
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Napoli, Italy
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Moccia M, Santoni L, Vaccari I, Affinito G, Caliendo D, Rubba F, Lanzillo R, Triassi M, Brescia Morra V, Palladino R. Author Correction: Utilization of peginterferon-β-1a in the real-world practice for relapsing-remitting multiple sclerosis. Eur Rev Med Pharmacol Sci 2024; 28:1241. [PMID: 38436157 DOI: 10.26355/eurrev_202402_35445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Correction to: European Review for Medical and Pharmacological Sciences 2024; 28 (1): 411-418. DOI: 10.26355/eurrev_202401_34930-published online on January 16, 2024. After publication, the authors have applied some corrections to the galley proof: • In the Patients and Methods section of the abstract, "National Health System" is corrected to "National Health Service". • In the Conclusions section of the abstract, "SC PEG-IFN-β-1a and IFN- β-1a" is corrected to "PEG-IFN-β-1a and SC IFN-β-1a". • In the Population section, the study period "January 1st 2015 to December 31st 2019" was not reported; therefore, this specification has been added to the text. • The legend of Figure 1 was wrongly reported as the same as Table I. The correct title of Figure 1 is "Study flow diagram". • Under Tables I, II, and III, "interferon beta 1a IFN-β-1a" is corrected to "interferon beta 1a (IFN-β-1a)". • In Table III, "CS Glatiramer acetate" is corrected to "SC Glatiramer acetate". • In the Conclusions section, "SC IFN-β-1a SC" is corrected to "SC IFN-β-1a". • The funding section has been amended as follows: "This study was sponsored by Biogen Italia (Milan, Italy)." There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/34930.
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Affiliation(s)
- M Moccia
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital of Naples, Naples, Italy
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Di Duca F, Montuori P, De Rosa E, De Simone B, Russo I, Nubi R, Triassi M. Assessing Heavy Metals in the Sele River Estuary: An Overview of Pollution Indices in Southern Italy. Toxics 2024; 12:38. [PMID: 38250994 PMCID: PMC10819315 DOI: 10.3390/toxics12010038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/28/2023] [Accepted: 01/01/2024] [Indexed: 01/23/2024]
Abstract
Rapid industrialization, coupled with a historical lack of understanding in toxicology, has led in an increase in estuary pollution, frequently resulting in unexpected environmental situations. Therefore, the occurrence of heavy metals (HMs) constitutes a major environmental issue, posing a serious risk both to aquatic ecosystems and public health. This study aimed to evaluate the levels of eight HMs (As, Hg, Cd, Cr, Cu, Ni, Pb, and Zn) in water, suspended particles, and sediment near the Sele River estuary (Italy) in order to assess their environmental impacts on the sea and health risks for humans. The results revealed an increasing order of HM concentration according to the scheme suspended particulate matter (SPM) > sediment (SED) > dissolved phase (DP) and a moderate contamination status in sediment. The health risk assessment indicated that the non-carcinogenic risk was negligible. Carcinogenic risk, expressed as the incremental lifetime cancer risk (ILCR), was negligible for Cd and Ni and within tolerable limits for As, Pb, and Cr. The findings suggested that, even if there are currently no specific limits for chemical parameters in the transitional waters of Italy, monitoring systems should be implemented to determine pollution levels and implement effective steps to improve river water quality and reduce human health risks.
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Affiliation(s)
| | - Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini 5, 80131 Naples, Italy (R.N.)
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Moccia M, Santoni L, Vaccari I, Affinito G, Caliendo D, Rubba F, Lanzillo R, Triassi M, Brescia Morra V, Palladino R. Utilization of peginterferon-β-1a in the real-world practice for relapsing-remitting multiple sclerosis. Eur Rev Med Pharmacol Sci 2024; 28:411-418. [PMID: 38235893 DOI: 10.26355/eurrev_202401_34930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
OBJECTIVE Peginterferon β-1a (PEG-IFN-β-1a) is the most recent interferon beta formulation approved for treating relapsing-remitting multiple sclerosis (RRMS). We aim to describe the real-world utilization of PEG-IFN-β-1a in RRMS and compare it with other injectable disease-modifying therapies (DMTs). PATIENTS AND METHODS In this population-based study, we used 2015-2019 routinely collected healthcare data of the Campania region of Italy from National Healthcare System DMT prescriptions, inpatient and outpatient clinical records of hospitals in Campania, and the Federico II University MS clinical registry for a subset of patients. We included individuals with RRMS receiving new prescriptions of PEG-IFN-β-1a [n=281; age = 38.8±12.3 years; females=70.5%; disease duration = 8.4±8.3 years; Expanded Disability Status Scale (EDSS) at baseline=2.0 (1.0-6.5)], glatiramer acetate [n=751; age = 46.0±11.4 years; females=67.1%; disease duration = 9.8±8.2 years; EDSS=4.0 (1.5-8.5)], and subcutaneous (SC) IFN-β-1a [n=1,226; age = 39.7±11.7 years; females=66.5%; disease duration = 8.2±6.5 years; EDSS 2.5 (1.5-6.5)]. Adherence [medication possession ratio (MPR)], escalation to more effective DMTs, hospitalization rates and costs were measured. We used mixed-effect linear regression models (for adherence, hospitalization rates and costs) and Cox regression models (for escalation) to assess differences between PEG-IFN-β-1a (statistical reference), glatiramer acetate, and SC IFN-β-1a. All models included age, sex, previous treatment/untreated, year of treatment initiation, treatment duration, and adherence as covariates. RESULTS Adherence was lower in glatiramer acetate (MPR = 0.91±0.1; Coeff=-0.11; p<0.01), and IFN-β-1a (MPR = 0.92±0.1; Coeff=-0.08; p<0.01), compared with PEG-IFN-β-1a (MPR = 1.01±0.1). The probability of escalating to more effective DMTs was higher for glatiramer acetate (14.9%; HR=4.09; p<0.01) and IFN-β-1a (9.1%; HR=3.35; p=0.01), compared with PEG-IFN-β-1a (4.9%). No differences in annualized hospitalization rates were identified between glatiramer acetate [annualized hospitalization rates (AHR) = 0.05±0.30; Coeff=0.02; p=0.31), IFN-β-1a (AHR = 0.02±0.21; Coeff=0.01; p=0.97], and PEG-IFN-β-1a (AHR = 0.02±0.24); however, monthly costs for MS admissions were higher for glatiramer acetate (€49.45±€195.27; Coeff=-29.89; p=0.03), compared with IFN-β-1a (€29.42±€47.83; Coeff=6.79; p=0.61), and PEG-IFN-β-1a (€23.91±€43.90). CONCLUSIONS SC PEG-IFN-β-1a and IFN-β-1a were used in relatively similar populations, while glatiramer acetate was preferred in older and more disabled patients. PEG-IFN-β-1a was associated with higher adherence and lower escalation rates toward more effective (and costly) DMTs.
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Affiliation(s)
- M Moccia
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital of Naples, Naples, Italy.
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Palladino R, Balsamo F, Mercogliano M, Sorrentino M, Monzani M, Egidio R, Piscitelli A, Borrelli A, Bifulco G, Triassi M. Impact of SARS-CoV-2 Positivity on Delivery Outcomes for Pregnant Women between 2020 and 2021: A Single-Center Population-Based Analysis. J Clin Med 2023; 12:7709. [PMID: 38137777 PMCID: PMC10744135 DOI: 10.3390/jcm12247709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 12/24/2023] Open
Abstract
Despite the existing body of evidence, there is still limited knowledge about the impact of SARS-CoV-2 positivity on delivery outcomes. We aimed to assess the impact of SARS-CoV-2 infection in women who gave birth at the University Hospital "Federico II" of Naples, Italy, between 2020 and 2021. We conducted a retrospective single-center population-based observational study to assess the differences in the caesarean section and preterm labor rates and the length of stay between women who tested positive for SARS-CoV-2 and those who tested negative at the time of labor. We further stratified the analyses considering the time period, dividing them into three-month intervals, and changes in SARS-CoV-2 as the most prevalent variant. The study included 5236 women with 353 positive cases. After vaccination availability, only 4% had undergone a complete vaccination cycle. The Obstetric Comorbidity Index was higher than 0 in 41% of the sample. When compared with negative women, positive ones had 80% increased odds of caesarean section, and it was confirmed by adjusting for the SARS-CoV-2 variant. No significant differences were found in preterm birth risks. The length of stay was 11% higher in positive cases but was not significant after adjusting for the SARS-CoV-2 variant. When considering only positive women in the seventh study period (July-September 2021), they had a 61% decrease in the odds of receiving a caesarean section compared to the fourth (October-December 2020). Guidelines should be implemented to improve the safety and efficiency of the delivery process, considering the transition of SARS-CoV-2 from pandemic to endemic. Furthermore, these guidelines should aim to improve the management of airborne infections in pregnant women.
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Affiliation(s)
- Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
- Department of Primary Care and Public Health, Imperial College School of Public Health, London SW7 2BX, UK
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80131 Naples, Italy
| | - Federica Balsamo
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Michelangelo Mercogliano
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Marco Monzani
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Rosanna Egidio
- Clinical Directorate, Academic Hospital “Federico II” of Naples, 80131 Naples, Italy
| | - Antonella Piscitelli
- Azienda Ospedaliera di Rilievo Nazionale (AORN) Dei Colli, Vincenzo Monaldi Hospital, 80122 Naples, Italy
| | - Anna Borrelli
- Clinical Directorate, Academic Hospital “Federico II” of Naples, 80131 Naples, Italy
| | - Giuseppe Bifulco
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, 80131 Naples, Italy (M.M.); (M.S.); (M.M.); (G.B.)
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80131 Naples, Italy
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Sorrentino M, Mercogliano M, Esposito F, Lamberti AM, Buonocore G, Riganti C, Triassi M, Palladino R. Identification of organizational barriers to HPV vaccination uptake in medical students in southern Italy: a cross-sectional study. Front Public Health 2023; 11:1272630. [PMID: 38045958 PMCID: PMC10691465 DOI: 10.3389/fpubh.2023.1272630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/30/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Despite proven efficacy, HPV vaccination coverage is still suboptimal. Factors influencing vaccination uptake are education attainment, socio-economic position, and knowledge about HPV. This study aimed to assess HPV vaccination uptake and its correlates among medical students and identify logistic-organizational barriers, knowledge, and attitudes with regard towards HPV vaccination to improve current public health vaccination strategies. Medical students, with their acquired biological knowledge, were selected as a low-risk groups for HPV vaccination uptake. This cross-sectional study was conducted using a validated questionnaire. Methods Students in their the first 3 years of study students were preferentially invited. Eventually, the invitation was extended to every medical student. Logistic multivariable regression was used to assess determinants of HPV vaccination uptake. Additional analysis explored determinants of knowledge of and attitude toward HPV vaccination. Finally, a sensitive analysis was conducted to further assess the effect of knowledge and attitude on the HPV vaccination rate. Results A total of 882 medical students participated, with 74.5% enrolled in the first 3 years of their training. HPV vaccination uptake was 55.5%, ranging from 78.5% for females to 16.5% for males. Male sex and increasing age were consistently associated with a lower vaccination uptake (males sex: OR 0.03, CI 0.02-0.05; age: OR 0.77, CI 0.68-0.88), whereasilst progress in their academic career was associated with a to higher likelihood of being vaccinated (6th year: OR 3.45, CI 1.24-9.57). These associations were confirmed when considering the knowledge of and attitude towards HPV. Additionally also, an active outreach from healthcare institutions was associated with a higher likelihood of receiving HPV vaccination (OR 1.70, CI 1.09-2.65. Conclusion HPV vaccination in medical students was higher than in the general population; however, it was still suboptimal. An active and up-to-date call strategy and extending the free-of-charge offer are essential measures for to improvinge vaccination uptake. The findings support the need to improve public health strategies and increase awareness and knowledge ofregarding HPV vaccination.
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Affiliation(s)
- Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | | | - Federica Esposito
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | | | - Gaetano Buonocore
- Clinical Directorate, niversity Hospital “Federico II” of Naples, Naples, Italy
| | - Carla Riganti
- Clinical Directorate, niversity Hospital “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
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10
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Affinito G, Trama U, Palumbo L, Fumo MG, Giordana R, Di Gennaro M, Triassi M, Lanzillo R, Morra VB, Palladino R, Moccia M. Impact of COVID-19 and system recovery in delivering healthcare to people with multiple sclerosis: a population-based Study. Neurol Sci 2023; 44:3771-3779. [PMID: 37672178 PMCID: PMC10570189 DOI: 10.1007/s10072-023-07052-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND COVID-19 pandemic has affected the management of multiple sclerosis (MS). OBJECTIVE To explore the impact of COVID-19 on healthcare delivery to people with MS and the subsequent recovery of the system. METHODS In this population-based study in the Campania Region (Italy), we included people with MS across pre-COVID-19, lockdown, pre-vaccination, and vaccination periods. Differences in continuous outcomes between periods were explored using linear mixed models (annualized hospitalization rate (AHR) and adherence measured as medication possession ratio (MPR)). Differences in disease-modifying treatment (DMT) prescription rates (first DMT prescription, any DMT switch, switch from platform to highly effective DMT, and combination of first DMT prescription and any DMT switch) were assessed using an interrupted time series design. RESULTS Compared with pre-COVID-19, AHR decreased during the lockdown (Coeff = 0.64;95%CI = -0.69, -0.59; p < 0.01), and remained lower during pre-vaccination and vaccination periods. Adherence decreased during pre-vaccination (Coeff = -0.04;95%CI = -0.05, -0.03; p < 0.01) and vaccination periods (Coeff = -0.07;95%CI = -0.08, -0.07; p < 0.01). After the lockdown, there was an increase in any DMT switch (IRR 2.05 95%CI 1.38,3.05; p < 0.01), in switch from platform to highly effective DMTs (IRR 4.45;95%CI 2.48,8.26; p < 0.01) and in first DMT prescriptions (IRR 2.48;95%CI 1.64,3.74; p < 0.01). CONCLUSIONS DMT prescriptions quickly returned to pre-pandemic levels, reflecting good health system recovery. However, adherence has remained lower than the past, as from suboptimal care. Assessing long-term COVID-19 impact on MS healthcare is warranted.
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Affiliation(s)
- Giuseppina Affinito
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Ugo Trama
- Drug Policy and Devices Unit, Regione Campania Health Department, Naples, Italy
| | - Laura Palumbo
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | | | | | | | - Maria Triassi
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Roberta Lanzillo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Vincenzo Brescia Morra
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, Federico II University of Naples, Naples, Italy
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- Department of Primary Care and Public Health, Imperial College, London, UK.
| | - Marcello Moccia
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
- Department of Primary Care and Public Health, Imperial College, London, UK
- Department of Molecular Medicine and Medical Biotechnology, Federico II University, Naples, Italy
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11
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Pennino F, Fiorilla C, Sorrentino M, Armonia U, Parisi A, Mirizzi PD, Di Lillo M, De Silva O, Montuori P, Triassi M, Nardone A. Investigating Awareness Regarding Travel-Related Infectious Disease Prevention in a Metropolitan Area. Trop Med Infect Dis 2023; 8:476. [PMID: 37888604 PMCID: PMC10611143 DOI: 10.3390/tropicalmed8100476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
The rise in international travel has led to an increase in travel-related infectious diseases. It is predicted that by 2030, the number of international travelers will reach 1.8 billion, with over 250 million people affected globally. This issue also has an economic impact, as the eradication of travel-related infectious diseases leads to a loss of USD 12 billion in tourism. To understand the association between demographic variables and knowledge, attitude, and behaviors related to travel-related infectious diseases, a cross-sectional survey-based study was conducted among 1191 individuals in the metropolitan city of Naples, Italy. Multiple linear regression was performed over three models. The results revealed that knowledge about travel-related infectious diseases was positively associated with age, female gender, non-smoking habits, being single, and higher education attainment. The attitude towards travel-related infectious diseases was positively associated with being female, non-smoking habits, being single, higher education attainment, and a higher level of knowledge. A statistically significant association was observed between behaviors and non-smoking habits and between higher levels of knowledge and attitudes. To address this issue, public health programs could be implemented to improve behaviors in the general population. Overall, this study provides valuable information about the determinants of knowledge, attitude, and behaviors related to travel-related infectious diseases in the general population.
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Affiliation(s)
- Francesca Pennino
- Department of Public Health, “Federico II” University, Via Sergio Pansini No. 5, 80131 Naples, Italy
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12
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Montuori P, Gentile I, Fiorilla C, Sorrentino M, Schiavone B, Fattore V, Coscetta F, Riccardi A, Villani A, Trama U, Pennino F, Triassi M, Nardone A. Understanding Factors Contributing to Vaccine Hesitancy in a Large Metropolitan Area. Vaccines (Basel) 2023; 11:1558. [PMID: 37896961 PMCID: PMC10610669 DOI: 10.3390/vaccines11101558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/13/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
Vaccine hesitancy has become a major global concern, leading to a significant decrease in the vaccination rate, with the World Health Organization recognizing it as one of the top ten threats to public health. Moreover, the health cost generated is evaluated to be 27 billion dollars per year in the US alone. To investigate the association between demographic variables and knowledge, attitudes, and behaviours related to vaccination, a survey-based cross-sectional study was conducted with 1163 individuals. Three models were used to perform a multiple linear regression analysis. In Model I, knowledge about vaccinations was found to be associated with smoking habits, education, and marital status. In Model II, attitudes towards vaccinations were significantly associated with sex, smoking habits, education, marital status, and knowledge. In Model III, behaviours related to vaccination were associated with sex, smoking habits, having children, knowledge, and attitudes. One potential solution to improve behaviours related to vaccinations in the general population is to implement specific public health programs, which can be a cost-effective intervention. This study provides valuable insights into the determinants of knowledge, attitudes, and behaviours related to vaccinations in the general population.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Immanuela Gentile
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Claudio Fiorilla
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Benedetto Schiavone
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Valerio Fattore
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Fabio Coscetta
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Alessandra Riccardi
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Villani
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale C3, 80143 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Maria Triassi
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, "Federico II" University, Via Sergio Pansini nº 5, 80131 Naples, Italy
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13
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Pennino F, Maccauro ML, Sorrentino M, Gioia M, Riello S, Messineo G, Di Rosa C, Montuori P, Triassi M, Nardone A. Insights from a Cross-Sectional Study on Knowledge, Attitudes and Behaviors Concerning Antibiotic Use in a Large Metropolitan Area: Implications for Public Health and Policy Interventions. Antibiotics (Basel) 2023; 12:1476. [PMID: 37887177 PMCID: PMC10603846 DOI: 10.3390/antibiotics12101476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
The overuse and inappropriate use of antibiotics pose a grave threat to public health, contributing significantly to the accelerated development of antimicrobial resistance (AMR) and increased rates of morbidity and mortality, making it a leading cause of death globally. To examine the relationship between demographic variables and knowledge, attitudes, and behaviors concerning antibiotic use, a survey-based cross-sectional study was conducted involving 1158 individuals. The questionnaire included two sections: in the first section, participants' socio-demographic characteristics were analyzed; the second investigated knowledge, attitudes, and behaviors concerning antibiotics utilization using a total of 36 questions. Descriptive statistics were used, and then a multiple linear regression analysis (MLRA) using three models was carried out. In Model I, knowledge about antibiotics exhibited correlations with smoking habits and educational attainment. In Model II, attitudes were significantly associated with gender, smoking habits, age, education, relationship status, and knowledge. In Model III, behaviors related to antibiotics were correlated with educational attainment, having children, knowledge, and attitudes. Implementing tailored public health programs could be a cost-effective intervention to enhance behaviors associated with antibiotic use in the general population. This study offers valuable insights into the determinants of knowledge, attitudes, and behaviors regarding antibiotics in the general population.
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Affiliation(s)
- Francesca Pennino
- Department of Public Health, “Federico II” University, Via Sergio Pansini nº 5, 80131 Naples, Italy
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14
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Moccia M, Affinito G, Fumo MG, Giordana R, Di Gennaro M, Mercogliano M, Carotenuto A, Petracca M, Lanzillo R, Triassi M, Brescia Morra V, Palladino R. Fertility, pregnancy and childbirth in women with multiple sclerosis: a population-based study from 2018 to 2020. J Neurol Neurosurg Psychiatry 2023; 94:689-697. [PMID: 37068930 DOI: 10.1136/jnnp-2022-330883] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/28/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND We aim to evaluate whether fertility, pregnancy, delivery and breastfeeding have been actually improving in women with multiple sclerosis (MS), compared with general population, and in relation to treatment features. METHODS We included 2018-2020 population-level healthcare data on women with MS living in the Campania region (Italy). Fertility, pregnancy and delivery outcomes were obtained from Certificate of Delivery Assistance; breastfeeding was collected up to 6 months after delivery by trained personnel. RESULTS Out of 2748 women with MS in childbearing age, 151 women delivered 156 babies. Fertility rate was 0.58 live births per woman with MS, compared with 1.29 in Campania region and 1.25 in Italy. Disease-modifying treatment (DMT) continuation during pregnancy was associated with lower birth weight (coeff -107.09; 95% CI -207.91 to -6.26; p=0.03). Exposure to DMTs with unknown/negative effects on pregnancy was associated with birth defects (OR 8.88; 95% CI 1.35 to 58.41; p=0.02). Birth defects occurred in pregnancies exposed to dimethyl fumarate (2/21 exposed pregnancies), fingolimod (1/11 exposed pregnancies) and natalizumab (2/30 exposed pregnancies). After delivery, 18.8% of women with MS were escalated of DMT efficacy, while 50.7% started on same/similar-efficacy DMTs, and 30.5% did not receive DMT. The probability of breastfeeding was higher in women who were treated with breastfeeding-safe DMTs (OR 5.57; 95% CI 1.09 to 28.55; p=0.03). CONCLUSIONS Fertility rate in women with MS remains below the general population. Family planning and subsequent DMT decisions should aim to achieve successful pregnancy, delivery and breastfeeding outcomes, while controlling disease activity.
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Affiliation(s)
- Marcello Moccia
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Napoli, Italy
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
| | - Giuseppina Affinito
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | | | - Roberta Giordana
- Campania Region Healthcare System Commissioner Office, Naples, Italy
| | - Massimo Di Gennaro
- Innovation and Data Analytics, Regional Healthcare Society (So.Re.Sa), Naples, Italy
| | | | - Antonio Carotenuto
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Maria Petracca
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
- Department of Human Neurosciences, Sapienza University, Rome, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Unit, Policlinico Federico II University Hospital, Naples, Italy
- Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples Federico II, Naples, Italy
- Department of Primary Care and Public Health, Imperial College, London, UK
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15
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Albertini P, Mainardi P, Bagattini M, Lombardi A, Riccio P, Ragosta M, Pennino F, Bruzzese D, Triassi M. Risk Influence of Some Environmental and Behavioral Factors on Air Contamination in the Operating Room: An Experimental Study. Int J Environ Res Public Health 2023; 20:6592. [PMID: 37623177 PMCID: PMC10454192 DOI: 10.3390/ijerph20166592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/31/2023] [Accepted: 08/14/2023] [Indexed: 08/26/2023]
Abstract
Air contamination in operating rooms (ORs) depends on the conditions of the room and on activities therein performed. Methodologies of air quality assessment in ORs are often inadequately described in the scientific literature, and the time required for a change in status in air quality is never taken into account. The purpose of this study was to determine the influence of the state and the presence of human operators on air quality by implementing a precise measurement protocol that also took into account the time required for changes in the room to affect air pollution. As the main indicators of air pollution, bacterial load and concentration of airborne dust were measured. The results showed that: the use of surgical masks by operators in the OR did not significantly affect bacterial load within a distance of 2 m; keeping OR doors open did not induce a significant increase in bacterial load and of 5 μm particles while 10 μm particles concentration was positively affected; and air pollution measured with open doors was not significantly different from that due to the presence of two staff members, whether or not they were wearing masks. The results clarified the role of some factors on air pollution in ORs.
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Affiliation(s)
- Prospero Albertini
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy; (P.A.); (P.M.); (M.B.); (A.L.); (D.B.); (M.T.)
| | - Pierangela Mainardi
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy; (P.A.); (P.M.); (M.B.); (A.L.); (D.B.); (M.T.)
| | - Maria Bagattini
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy; (P.A.); (P.M.); (M.B.); (A.L.); (D.B.); (M.T.)
| | - Annalisa Lombardi
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy; (P.A.); (P.M.); (M.B.); (A.L.); (D.B.); (M.T.)
| | - Patrizia Riccio
- Department of Molecular Medicine and Medical Biotechnology, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy;
| | - Maria Ragosta
- School of Engineering, University of Basilicata, V.le dell’Ateneo Lucano N° 10, 85100 Potenza, Italy;
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy; (P.A.); (P.M.); (M.B.); (A.L.); (D.B.); (M.T.)
| | - Dario Bruzzese
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy; (P.A.); (P.M.); (M.B.); (A.L.); (D.B.); (M.T.)
| | - Maria Triassi
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy; (P.A.); (P.M.); (M.B.); (A.L.); (D.B.); (M.T.)
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16
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Pennino F, Di Lillo M, Sorrentino M, Fiorilla C, Parisi A, Mirizzi PD, De Simone B, Montuori P, Triassi M, Nardone A. Understanding Hearing Health: A Cross-Sectional Study of Determinants in a Metropolitan Area. Healthcare (Basel) 2023; 11:2253. [PMID: 37628453 PMCID: PMC10454096 DOI: 10.3390/healthcare11162253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/02/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Hearing health prevention has emerged as a significant public health concern worldwide. With nearly two and a half billion people experiencing some degree of hearing loss, and around seven hundred million requiring medical intervention, the impact on global health is substantial. The economic burden is equally substantial, with estimated health costs reaching 980 billion dollars in the United States alone. To shed light on this issue, we conducted a survey-based cross-sectional study involving 1150 individuals. Utilizing multiple linear regression across three models, we aimed to explore the association between demographic variables and knowledge, attitude, and behaviors related to hearing health. In Model I, we observed a correlation between knowledge and several factors, including age, smoking habits, marital status, and education. In Model II, attitudes were found to associate with non-smoking habits, education, and knowledge. Model III revealed a statistically significant correlation between behaviors and age, gender, parenthood, knowledge, and attitudes. These findings emphasize the importance of targeted public health programs aimed at improving behaviors among the general population. Such interventions can be both effective and relatively inexpensive. By addressing these determinants, we can enhance overall hearing health in the community. Our study contributes valuable information about the knowledge, attitudes, and behaviors related to hearing health in the general population. Understanding these factors is crucial in developing evidence-based strategies to promote hearing health and prevent hearing loss effectively. As we continue to work towards better hearing health, the findings from this study can serve as a cornerstone for informed decision-making and successful intervention implementation.
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Affiliation(s)
- Francesca Pennino
- Department of Public Health, “Federico II” University, Via Sergio Pansini nº 5, 80131 Naples, Italy
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17
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Montella E, Iodice S, Bernardo C, Frangiosa A, Pascarella G, Santalucia I, Triassi M. Integrated System for the Proactive Analysis on Infection Risk at a University Health Care Establishment Servicing a Large Area in the South of Italy. J Patient Saf 2023; 19:313-322. [PMID: 37366611 PMCID: PMC10373839 DOI: 10.1097/pts.0000000000001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVES Our study proposes the use of a proactive system to manage risk combining the new Risk Identification Framework by the World Health Organization, the Lean method, and the hospital's Procedure Analysis.The system was tested for the prevention of surgical site infections in the University Hospital of Naples "Federico II" on the surgical paths, where they were usually applied individually. METHODS We conducted a retrospective observational study from March 18, 2019, to June 30, 2019, at the University Hospital "Federico II" of Naples, Italy (Europe).The study is structured in 3 phases: phase 1, application of each proactive risk management tool (March 18-April 15, 2019); phase 2, analysis and integration of the results, and elaboration of an overview of critical and control points (April 15-20, 2019); and phase 3, evaluation of the outcomes as variation of surgical site infection's incidence between the 3-month period of the 2019 and the same period of the 2018, when each tool was implemented separately (April 30-June 30, 2019). RESULTS (1) The application of the single tool has detected different criticalities; (2) the combined system allowed us to draw a risk map and identify "improving" macroareas; and (3) the infection rate, with the application of this system, was equal to 1.9%; in the same period of the previous year, it was equal to 4%. CONCLUSIONS Our study demonstrates that "integrated system" has been more effective to proactively identify surgical route risks compared with the application of each single instrument.
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Affiliation(s)
- Emma Montella
- From the Department of Public Health, University of Naples “Federico II”
| | - Sabrina Iodice
- From the Department of Public Health, University of Naples “Federico II”
| | - Carlo Bernardo
- From the Department of Public Health, University of Naples “Federico II”
| | | | | | - Ida Santalucia
- From the Department of Public Health, University of Naples “Federico II”
| | - Maria Triassi
- Department of Public Health and Interdepartmental Centre for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II,” Naples, Italy
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Mercogliano M, Fiorilla C, Esposito F, Sorrentino M, Mirizzi PD, Parisi A, Tajani A, Buonocore G, Triassi M, Palladino R. Knowledge and attitude factors associated with the prevalence of Tdap (tetanus, diphtheria, and acellular pertussis) booster vaccination in healthcare workers in a large academic hospital in Southern Italy in 2022: a cross-sectional study. Front Public Health 2023; 11:1173482. [PMID: 37522000 PMCID: PMC10374026 DOI: 10.3389/fpubh.2023.1173482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/13/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction In Europe, there is still suboptimal tetanus, diphtheria, and acellular pertussis (Tdap) booster coverage. This study aimed to assess coverage status, knowledge, and attitude on Tdap vaccination in healthcare workers (HcWs) of the University Hospital "Federico II" in Naples, Southern Italy, in 2022, to improve current vaccination strategies. Methods A cross-sectional study was conducted using a validated anonymous questionnaire. Knowledge and attitude were measured as scores. Multivariable logistic and linear regression models were employed to identify correlates of Tdap booster and knowledge and attitude toward the vaccination, as appropriate. Models were controlled for age, sex, profession, department, and job seniority. Results A total of 206 questionnaires were administered among HcWs, and 143 (69.4%) were medical doctors. In total, 71 (34.47%) HcWs received the Tdap booster. Those who have worked 5-9 years at the hospital had a 78% lower likelihood of being vaccinated with the Tdap booster (5-9 years-OR: 0.22, CI: 0.06 | 0.85) as compared with newly hired HcWs. No differences in the average knowledge score were found. Other healthcare workers had a lower attitude as compared to medical doctors (Other-Coef. -2.15; CI: -4.14 | -0.15) and, as compared with those who worked in a clinical department, those who worked in a diagnostic-therapeutic department or medical management had 3.1 and 2.0 lower attitude scores, on average, respectively (diagnostic-therapeutic-Coef. -3.12, CI: -5.13 | -1.12; public health-Coef. -1.98, CI: -3.41 | -0.56). Discussion The study findings support the necessity to implement public health strategies and improve knowledge and attitude toward vaccinations and specifically highlight the importance of Tdap booster every 10 years as a prevention tool to protect high-risk populations.
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Affiliation(s)
| | - Claudio Fiorilla
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Federica Esposito
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | | | - Antonio Parisi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Andrea Tajani
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Gaetano Buonocore
- Clinical Directorate, University Hospital “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), Naples, Italy
- Department of Primary Care and Public Health, School of Public Health, Imperial College, London, United Kingdom
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Marino MR, Bottino V, Negri G, Stingone MA, Russo MA, Triassi M. Effect of Clinical and Demographic Variables on the Hospital Stay of Patients Undergoing Total Knee Arthroplasty. Stud Health Technol Inform 2023; 305:131-134. [PMID: 37386975 DOI: 10.3233/shti230441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The knee is the joint most affected by osteoarthritis and in its severe form can significantly affect people's physical and functional abilities. The increased demand for surgery leads to greater attention by health care management to be able to keep costs down. A major expense item for this procedure is Length of Stay (LOS). In this study, several Machine Learning algorithms were tested in order to construct not only a valid predictor of LOS but also to know among the selected variables the main risk factors. To do so, activity data from the Evangelical Hospital "Betania" in Naples, Italy, from 2019-2020 were used. Among the algorithms, the best are the classification algorithms with accuracy values exceeding 90%. Finally, the results are in line with those shown by two other comparison hospitals in the area.
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Affiliation(s)
| | | | | | | | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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20
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Marino MR, Costaiola C, Magri P, Longo G, Triassi M, Improta G. COVID-19 in Eye Surgery: The Case of a University Hospital. Stud Health Technol Inform 2023; 305:479-482. [PMID: 37387071 DOI: 10.3233/shti230537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Coronavirus epidemic has quickly become a global health threat. The ophthalmology department, like all other departments, have adopted resource management and personnel adjustment maneuvers. The aim of this work was to describe the impact of covid on the Ophthalmology Department of University Hospital "Federico II" of Naples. In the study logistical regression was used for a comparison between the pandemic and the previous period, analyzing patient features. The analysis showed a decrease in the number of accesses; reduction of the length of stay; and the statistically dependent variables are as follows: LOS, discharge procedures and admission procedure.
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Affiliation(s)
| | - Ciro Costaiola
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Paola Magri
- "Federico II" University Hospital, Naples, Italy
| | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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21
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D'Amore A, D'Onofrio G, Ascione F, Sarnelli R, Triassi M, Marino MR. Modeling Cholecystectomy Hospital Stay Through a Linear Approach. Stud Health Technol Inform 2023; 305:249-252. [PMID: 37387009 DOI: 10.3233/shti230475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Cholecystectomy is among the most frequent procedures in general surgery. In the healthcare facility organization, it is important to evaluate all interventions and procedures that have a great impact on health management and that have a clear effect on the Length of Stay (LOS). The LOS represents, in fact, an indicator of performance and measure the goodness of a health process. This study was conducted with the aim of providing LOS for all patients undergoing cholecystectomy at the "A.O.R.N. A. Cardarelli" of Naples. Data were collected in the two years 2019 and 2020 and included 650 patients. A MLR model is created in the work to predict the value of LOS as a function of the following variables: gender, age, pre-operative LOS, presence of comorbidities and complication during surgery. The results obtained are as follows: R=0.941 and R2=0.885.
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Affiliation(s)
| | | | | | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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22
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D'Onofrio G, D'Amore A, Onofaro F, Caputi E, Napoli A, Triassi M, Marino MR. Prediction of Hospital Length Stay for Patients Undergoing Mastectomy. Stud Health Technol Inform 2023; 305:261-264. [PMID: 37387012 DOI: 10.3233/shti230478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The prolonged length of stay is an important aspect to be considered for the healthcare management since this affect both the health-related expenditure of the hospital and the quality of the offered service. In the light of these consideration is important for hospitals to be able to predict the LOS of patients and to work on the principal aspect affecting it in order to reduce LOS as much as possible. In this work we focus on patients undergoing mastectomy. The data were collected form 989 patients who underwent mastectomy surgery in the Surgery Department of the AORN "A. Cardarelli" of Naples. Different models have been tested and characterized and the one with the best performance was identified.
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Affiliation(s)
| | | | | | | | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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23
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D'Amore A, D'Onofrio G, Fidecicchi A, Triassi M, Marino MR. Predicting In-Hospital Mortality During the COVID-19 Pandemic in Patients with Heart Failure: A Single-Center Exploratory Study. Stud Health Technol Inform 2023; 305:487-490. [PMID: 37387073 DOI: 10.3233/shti230539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The aim of this study was to investigate whether exposure to the pandemic was associated with increased in-hospital mortality for health failure. We collected data from patients hospitalized between 2019 and 2020 and we assessed the likelihood of in-hospital death. Although the positive association of exposure to the COVID period with an increased in-hospital mortality is not statistically significant, this may underscore other factors that may influence mortality. Our study was designed to contribute to a better understanding of the impact of the pandemic on in-hospital mortality and to identify potential areas for intervention in patient care.
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Affiliation(s)
| | | | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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24
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Marino MR, Bottino V, Negri G, Stingone MA, Russo MA, Triassi M. The Classification Algorithms Applied to the Inpatient Stay for Lower Limb Surgery. Stud Health Technol Inform 2023; 305:135-138. [PMID: 37386976 DOI: 10.3233/shti230442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
The revolutions of recent years in health care have involved several areas ranging from patient treatment to resource management. Therefore, several strategies have been put in place to increase patient value while trying to reduce spending. Several indicators have arisen to evaluate the performance of healthcare processes. The main one is Length of Stay (LOS). In this study, classification algorithms were used to predict the LOS of patients undergoing lower extremity surgery, an increasingly common condition given the progressive aging of the population. The context is the Evangelical Hospital "Betania" in Naples (Italy) in 2019-2020, which augments a multicenter study conducted by the same research team on several hospitals in southern Italy. All selected algorithms show an Accuracy above 90% but among them, the best is Logistic Regression with a value reaching 94%.
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Affiliation(s)
| | | | | | | | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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25
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Marino MR, Bottino V, De Falco N, Basile N, Russo MA, Triassi M. A Regressive Model to Study the Hospitalization for Laparoscopic Appendectomy: A Multicenter Study. Stud Health Technol Inform 2023; 305:127-130. [PMID: 37386974 DOI: 10.3233/shti230440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Appendicitis is a most common abdominal condition worldwide, and appendectomy especially laparoscopic appendectomy is among the most commonly performed general surgeries. In this study, data were collected from patients who underwent laparoscopic appendectomy surgery at the Evangelical Hospital "Betania" in Naples, Italy. Linear multiple regression was used to obtain a simple predictor that can also assess which of the independent variables considered to be a risk factor. The model with R2 of 0.699 shows that comorbidities and complications during surgery are the main risk factors for prolonged LOS. This result is validated by other studies conducted in the same area.
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Affiliation(s)
| | | | | | | | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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26
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Riccardi E, Fontana L, Pacella D, Fusco F, Marinaro I, Costanzo G, Vassallo F, Triassi M, Iavicoli I. Impact of Covid-19 pandemic on psychological well-being of firefighters. Saf Health Work 2023:S2093-7911(23)00036-7. [PMID: 37361372 PMCID: PMC10268815 DOI: 10.1016/j.shaw.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/26/2023] [Accepted: 06/10/2023] [Indexed: 06/28/2023] Open
Abstract
Background Covid-19 pandemic represented a unique stressful event that affected the physical health and the psychological well-being (PWB) of individuals and communities. Monitoring PWB is essential to clarify the burden on mental health effects but also to define targeted psychological-supporting measures. This cross-sectional study evaluated the PWB of Italian firefighters during the pandemic. Methods Firefighters recruited during the pandemic period filled out a self-administered questionnaire the Psychological General Well-Being Index during the health surveillance medical examination. This tool is usually used to assess the global PWB and explores six subdomains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. The influencing role of age, gender, working activities, Covid-19 and pandemic restrictive measures was also explored. Results A total of 742 firefighters completed the survey. The aggregate median PWB global score was in the "no distress" range (94.3±10.3) resulting higher than that observed in studies conducted using the same tool in the Italian general population during the same pandemic period. Similar findings were observed in the specific subdomains thus suggesting that investigated population was in good PWB condition. Interestingly, significantly better outcomes were detected in the younger firefighters. Conclusion Our data showed a satisfactory PWB situation in firefighters that could be related to different professional factors such as work organization, mental and physical training. In particular, our results would suggest the hypothesis that in firefighters, the maintaining of a minimum/moderate level of physical activity (consisting of even just going to work) might had a profoundly positive impact on psychological health and well-being.
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Affiliation(s)
- Elisabetta Riccardi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Luca Fontana
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Fabio Fusco
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Ilaria Marinaro
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanna Costanzo
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Francesco Vassallo
- Regional Direction of Campania Firefighters, Via del Sole 10, 80138 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples "Federico II", Via S. Pansini 5, 80131 Naples, Italy
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27
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Montuori P, De Rosa E, Cerino P, Pizzolante A, Nicodemo F, Gallo A, Rofrano G, De Vita S, Limone A, Triassi M. Estimation of Polycyclic Aromatic Hydrocarbons in Groundwater from Campania Plain: Spatial Distribution, Source Attribution and Health Cancer Risk Evaluation. Toxics 2023; 11:toxics11050435. [PMID: 37235250 DOI: 10.3390/toxics11050435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/23/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023]
Abstract
The aim of this study was to evaluate the concentrations of polycyclic aromatic hydrocarbons (PAHs) in 1168 groundwater samples of the Campania Plain (Southern Italy), taken using a municipal environmental pressure index (MIEP), and to analyze the distribution of these compounds to determine source PAHs using ratios of isomers diagnostic. Lastly, this study also aimed to estimate the potential health cancer risk in groundwaters. The data indicated that the highest concentration of PAHs was found in groundwater from Caserta Province and the contents of BghiP, Phe, and Nap were detected in the samples. The spatial distribution of these pollutants was evaluated using the Jenks method; moreover, the data indicated that incremental lifetime cancer risk ILCRingestion ranged from 7.31 × 10-20 to 4.96 × 10-19, while ILCRdermal ranged from 4.32 × 10-11 to 2.93 × 10-10. These research findings may provide information about the Campania Plain's groundwater quality and aid in the development of preventative measures to lessen PAH contamination in groundwater.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, "Federico II" University, Via Sergio Pansini No. 5, 80131 Naples, Italy
| | - Elvira De Rosa
- Department of Public Health, "Federico II" University, Via Sergio Pansini No. 5, 80131 Naples, Italy
| | - Pellegrino Cerino
- Department of Public Health, "Federico II" University, Via Sergio Pansini No. 5, 80131 Naples, Italy
| | - Antonio Pizzolante
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute No. 2, 80055 Naples, Italy
| | - Federico Nicodemo
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute No. 2, 80055 Naples, Italy
| | - Alfonso Gallo
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute No. 2, 80055 Naples, Italy
| | - Giuseppe Rofrano
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute No. 2, 80055 Naples, Italy
| | - Sabato De Vita
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute No. 2, 80055 Naples, Italy
| | - Antonio Limone
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute No. 2, 80055 Naples, Italy
| | - Maria Triassi
- Department of Public Health, "Federico II" University, Via Sergio Pansini No. 5, 80131 Naples, Italy
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28
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Montuori P, Gioia M, Sorrentino M, Di Duca F, Pennino F, Messineo G, Maccauro ML, Riello S, Trama U, Triassi M, Nardone A. Determinants Analysis Regarding Household Chemical Indoor Pollution. Toxics 2023; 11:264. [PMID: 36977029 PMCID: PMC10059753 DOI: 10.3390/toxics11030264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 06/18/2023]
Abstract
Indoor household pollution is not yet sufficiently studied in the general population. Over 4 million people die prematurely every year due to air pollution in households. This study aimed to propose quantitative data research through the administration of a KAP (Knowledge, Attitudes, and Practices) Survey Questionnaire. This cross-sectional study administered questionnaires to adults from the metropolitan city of Naples (Italy). Three Multiple Linear Regression Analyses (MLRA) were developed, including Knowledge, Attitudes, and Behavior regarding household chemical air pollution and the related risks. One thousand six hundred seventy subjects received a questionnaire to be filled out and collected anonymously. The mean age of the sample was 44.68 years, ranging from 21-78 years. Most of the people interviewed (76.13%) had good attitudes toward house cleaning, and 56.69% stated paying attention to cleaning products. Results of the regression analysis indicated that positive attitudes were significantly higher among subjects who graduated, with older age, male and non-smokers, but they were correlated with lower knowledge. In conclusion, a behavioral and attitudinal program targeted those with knowledge, such as younger subjects with high educational levels, but do not engage in correct practices towards household indoor chemical pollution.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Mariagiovanna Gioia
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Fabiana Di Duca
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Giuseppe Messineo
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Maria Luisa Maccauro
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Simonetta Riello
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale Is. C3, 80143 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
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De Luca V, Femminella GD, Leonardini L, Patumi L, Palummeri E, Roba I, Aronni W, Toccoli S, Sforzin S, Denisi F, Basso AM, Ruatta M, Obbia P, Rizzo A, Borgioli M, Eccher C, Farina R, Conforti D, Mercurio L, Salvatore E, Gentile M, Bocchino M, Sanduzzi Zamparelli A, Viceconte G, Gentile I, Ruosi C, Ferrara N, Fabbrocini G, Colao A, Triassi M, Iaccarino G, Liotta G, Illario M. Digital Health Service for Identification of Frailty Risk Factors in Community-Dwelling Older Adults: The SUNFRAIL+ Study Protocol. Int J Environ Res Public Health 2023; 20:3861. [PMID: 36900872 PMCID: PMC10001419 DOI: 10.3390/ijerph20053861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
This article reports the study protocol of a nationwide multicentric study in seven Italian regions aimed at assessing the effectiveness of a digitally supported approach for the early screening of frailty risk factors in community-dwelling older adults. SUNFRAIL+ is a prospective observational cohort study aimed at carrying out a multidimensional assessment of community-dwelling older adults through an IT platform, which allows to connect the items of the SUNFRAIL frailty assessment tool with a cascading multidimensional in-depth assessment of the bio-psycho-social domains of frailty. Seven centers in seven Italian regions will administer the SUNFRAIL questionnaire to 100 older adults. According to the answers provided by older adults, they will be subjected to one or more validated in-depth scale tests in order to perform further diagnostic or dimensional evaluations. The study aims to contribute to the implementation and validation of a multiprofessional and multistakeholder service model for the screening of frailty in community-dwelling older adult population.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Lisa Leonardini
- Programma Mattone Internazionale Salute, Azienda ULSS 4 Veneto Orientale, 30027 San Donà di Piave, Italy
| | - Lola Patumi
- Programma Mattone Internazionale Salute, Azienda ULSS 4 Veneto Orientale, 30027 San Donà di Piave, Italy
| | - Ernesto Palummeri
- A.li.sa. (Azienda Ligure Sanitaria), Regione Liguria, 16121 Genova, Italy
| | - Isabella Roba
- A.li.sa. (Azienda Ligure Sanitaria), Regione Liguria, 16121 Genova, Italy
| | - Walter Aronni
- Dipartimento di Cure Primarie e Attività Distrettuali, Azienda Sociosanitaria Ligure 4, 16043 Chiavari, Italy
| | - Stefano Toccoli
- Dipartimento Cure Primarie, Azienda Provinciale per i Servizi Sanitari di Trento, 38123 Trento, Italy
| | - Simona Sforzin
- Dipartimento Cure Primarie, Azienda Provinciale per i Servizi Sanitari di Trento, 38123 Trento, Italy
| | | | - Anna Maddalena Basso
- Direzione Professioni Sanitarie, Azienda Sanitaria Locale Cuneo 1, 12100 Cuneo, Italy
| | - Manuela Ruatta
- Rete Della Cronicità e Fragilità, Azienda Sanitaria Locale Cuneo 1, 12100 Cuneo, Italy
| | - Paola Obbia
- Dipartimento di Scienze Della Sanità Pubblica e Pediatriche, Università Degli Studi di Torino, 10126 Torino, Italy
| | - Alessio Rizzo
- Settore Sistemi Organizzativi e Risorse Umane Della Direzione Sanità e Welfare, Regione Piemonte, 10144 Torino, Italy
| | - Moira Borgioli
- Unità Operativa Complessa Progettazione, Sviluppo, Formazione e Ricerca, Azienda Unità Sanitaria Locale Nord-Ovest, 56121 Pisa, Italy
| | - Claudio Eccher
- eHealth Unit, Fondazione Bruno Kessler, 38123 Trento, Italy
| | - Riccardo Farina
- Dipartimento Salute e Politiche Sociali, Provincia Autonoma di Trento, 38122 Trento, Italy
| | - Diego Conforti
- Dipartimento Salute e Politiche Sociali, Provincia Autonoma di Trento, 38122 Trento, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maurizio Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Marialuisa Bocchino
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Giulio Viceconte
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Ivan Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Carlo Ruosi
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Nicola Ferrara
- Dipartimento di Scienze Mediche Traslazionali, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Gabriella Fabbrocini
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università Degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
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30
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Di Duca F, Montuori P, Trama U, Masucci A, Borrelli GM, Triassi M. Health Risk Assessment of PAHs from Estuarine Sediments in the South of Italy. Toxics 2023; 11:toxics11020172. [PMID: 36851047 PMCID: PMC9964163 DOI: 10.3390/toxics11020172] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/01/2023] [Accepted: 02/11/2023] [Indexed: 06/01/2023]
Abstract
Increased concerns about the toxicities of Polycyclic Aromatic Hydrocarbons (PAHs), ubiquitous and persistent compounds, as well as the associated ecotoxicology issue in estuarine sediments, have drawn attention worldwide in the last few years. The levels of PAHs in the Sele, Sarno, and Volturno Rivers sediments were evaluated. Moreover, the cancerogenic risk resulting from dermal and ingestion exposure to PAHs was estimated using the incremental lifetime cancer risk (ILCR) assessment and the toxic equivalent concentration (TEQBaP). For Sele River, the results showed that the total PAH concentration ranged from 632.42 to 844.93 ng g-1 dw, with an average value of 738.68 ng g-1 dw. ∑PAHs were in the range of 5.2-678.6 ng g-1 dw and 434.8-872.1 ng g-1 dw for the Sarno and Volturno River sediments, respectively. The cancerogenic risk from the accidental ingestion of PAHs in estuarine sediments was low at all sampling sites. However, based on the ILCRdermal values obtained, the risk of cancer associated with exposure by dermal contact with the PAHs present in the sediments was moderate, with a mean ILCRdermal value of 2.77 × 10-6. This study revealed the pollution levels of PAHs across the South of Italy and provided a scientific basis for PAH pollution control and environmental protection.
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Affiliation(s)
- Fabiana Di Duca
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale Is. C3, 80143 Naples, Italy
| | - Armando Masucci
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Gennaro Maria Borrelli
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
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Montuori P, Cennamo LM, Sorrentino M, Pennino F, Ferrante B, Nardo A, Mazzei G, Grasso S, Salomone M, Trama U, Triassi M, Nardone A. Assessment on Practicing Correct Body Posture and Determinant Analyses in a Large Population of a Metropolitan Area. Behav Sci (Basel) 2023; 13:bs13020144. [PMID: 36829373 PMCID: PMC9952460 DOI: 10.3390/bs13020144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023] Open
Abstract
An incorrect posture can generate stress of the spine and can be the cause of musculoskeletal disorders. Considering the extensive use of the computer, which worsens posture disorders, among workers, is important to analyze the phenomenon in order to reduce his impact on industry. The aim of this study is to assess determinants regarding posture in a large population of a metropolitan area. A total of 1177 questionnaires was analyzed. The majority of sample showed good knowledge and attitude regarding correct posture; most of the sample, 70.4% was aware of the definition of posture and 68.7% feel that not enough attention is paid at posture at workplace. Despite the good predisposition, only 2.8% of the sample consult a specialist for posture. The multiple linear regression analysis shows that those who have higher knowledge and best attitudes will consequently have good behaviors in maintaining a correct posture. Furthermore, age and education resulted main drivers of correct posture in any model considered. The results enlighten the necessity of conducting further studies to analyze attitudes of the general population and suggest improving educational and training programs to the enrichment of knowledge and to correct posture behaviors.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
- Correspondence:
| | - Luigi Mauro Cennamo
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Bartolomeo Ferrante
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Alfonso Nardo
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Giovanni Mazzei
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Sebastiano Grasso
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Marco Salomone
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale is. C3, 80143 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, University “Federico II”, Via Sergio Pansini n° 5, 80131 Naples, Italy
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Triassi M, Cerino P, Montuori P, Pizzolante A, Trama U, Nicodemo F, D’Auria JL, De Vita S, De Rosa E, Limone A. Heavy Metals in Groundwater of Southern Italy: Occurrence and Potential Adverse Effects on the Environment and Human Health. Int J Environ Res Public Health 2023; 20:1693. [PMID: 36767059 PMCID: PMC9914834 DOI: 10.3390/ijerph20031693] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 06/18/2023]
Abstract
This study reports the data on the contamination caused by heavy metals in the groundwater of the Campania Plain (CP) in Southern Italy. A total of 1093 groundwater samples were obtained from the following aquifers: coastal plains (GAR, VCP, VES, SAR, and SEL), volcanic districts (PHLE and VES), and carbonate massifs (MAS and LAT). In this study, the investigation depth ranged from 5 m (GAR) to 200 m (PHLE). The sequence of heavy metal content in groundwater samples was B > Fe > Al > Mn > Zn > Ba > Ni > As > Cu > V > Se > Pb > Cd. The heavy metal pollution index (HPI) and heavy metal evaluation (HEI) demonstrated that the study areas in which groundwater samples were sampled are not risk zones. Moreover, health risk assessment shows that hazard index (HI) values for heavy metals were found to be significantly low in groundwater samples. In non-carcinogenic risk evaluation for the adult group, the risk was low, whereas for children and infants, the risk was >1 for arsenic alone. Carcinogenic risk assessment (CR) was found lower for adults, children, and infants. The Jenks optimization method was used to evaluate the distribution of heavy metals in the groundwater of CP, and the principal component analysis technique (PCA) was employed to determine the source of heavy metals, and it was found that mixed sources (natural and anthropogenic) may be responsible for heavy metals presence.
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Affiliation(s)
- Maria Triassi
- Department of Public Health, “Federico II” University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Pellegrino Cerino
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute nº 2, 80055 Portici, Italy
| | - Paolo Montuori
- Department of Public Health, “Federico II” University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Pizzolante
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute nº 2, 80055 Portici, Italy
| | - Ugo Trama
- General Directorate of Health, Campania Region, Centro Direzionale is. C3, 80143 Naples, Italy
| | - Federico Nicodemo
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute nº 2, 80055 Portici, Italy
| | - Jacopo Luigi D’Auria
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute nº 2, 80055 Portici, Italy
| | - Sabato De Vita
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute nº 2, 80055 Portici, Italy
| | - Elvira De Rosa
- Department of Public Health, “Federico II” University, Via Sergio Pansini nº 5, 80131 Naples, Italy
| | - Antonio Limone
- Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute nº 2, 80055 Portici, Italy
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Palladino R, Pan T, Mercer SW, Atun R, McPake B, Rubba F, Triassi M, Lee JT. Multimorbidity and out-of-pocket expenditure on medicine in Europe: Longitudinal analysis of 13 European countries between 2013 and 2015. Front Public Health 2023; 10:1053515. [PMID: 36684900 PMCID: PMC9850796 DOI: 10.3389/fpubh.2022.1053515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 12/12/2022] [Indexed: 01/07/2023] Open
Abstract
Background Many European Health Systems are implementing or increasing levels of cost-sharing for medicine in response to the growing constrains on public spending on health despite their negative impact on population health due to delay in seeking care. Objective This study aims to examine the relationships between multimorbidity (two or more coexisting chronic diseases, CDs), complex multimorbidity (three or more CDs impacting at least three different body systems), and out-of-pocket expenditure (OOPE) for medicine across European nations. Methods This study utilized data on participants aged 50 years and above from two recent waves of the Survey of Health, Aging, and Retirement in Europe conducted in 2013 (n = 55,806) and 2015 (n = 51,237). Pooled cross-sectional and longitudinal study designs were used, as well as a two-part model, to analyse the association between multimorbidity and OOPE for medicine. Results The prevalence of multimorbidity was 50.4% in 2013 and 48.2% in 2015. Nearly half of those with multimorbidity had complex multimorbidity. Each additional CD was associated with a 34% greater likelihood of incurring any OOPE for medicine (Odds ratio = 1.34, 95% CI = 1.31-1.36). The average incremental OOPE for medicine was 26.4 euros for each additional CD (95% CI = 25.1-27·7), and 32.1 euros for each additional body system affected (95% CI 30.6-33.7). In stratified analyses for country-specific quartiles of household income the average incremental OOPE for medicine was not significantly different across groups. Conclusion Between 2013 and 2015 in 13 European Health Systems increased prevalence of CDs was associated with greater likelihood of having OOPE on medication and an increase in the average amount spent when one occurred. Monitoring this indicator is important considering the negative association with treatment adherence and subsequent effects on health.
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Affiliation(s)
- Raffaele Palladino
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, Naples, Italy
| | - Tianxin Pan
- Health Economics Unit, Center for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Stewart W. Mercer
- Centre for Population Health Sciences, The Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Rifat Atun
- Department of Global Health and Population, Harvard T H Chan School of Public Health and Department of Global Health and Social Medicine, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Barbara McPake
- Melbourne School of Population and Global Health, Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Fabiana Rubba
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, Naples, Italy
- Interdepartmental Research Center in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, Naples, Italy
| | - John Tayu Lee
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
- Melbourne School of Population and Global Health, Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Dallera G, Affinito G, Caliendo D, Petracca M, Carotenuto A, Triassi M, Brescia Morra V, Palladino R, Moccia M. The independent contribution of brain, spinal cord and gadolinium MRI in treatment decision in multiple sclerosis: A population-based retrospective study. Mult Scler Relat Disord 2023; 69:104423. [PMID: 36436395 DOI: 10.1016/j.msard.2022.104423] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/29/2022] [Accepted: 11/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Spinal cord and gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) can provide additional information to brain MRI to determine prognosis of multiple sclerosis (MS). However, the real-world impact of routine use of brain MRI with spinal cord and/or Gd sequences is unknown. Our aim was to evaluate the effect of brain, spinal cord and Gd MRI on treatment decisions in MS. METHODS In this 2015-2020 population-based study, we performed a retrospective analysis on MS patients resident in the Campania Region (South Italy), with disease modifying treatment (DMT) prescription (n = 6,161). DMTs were classified as platform (dimethyl fumarate, glatiramer acetate, interferon-beta, peg-interferon-beta, teriflunomide), or high-efficacy (alemtuzumab, cladribine, fingolimod, natalizumab, ocrelizumab). We evaluated the association between binary MRI variables and switch from platform to high-efficacy DMT using multivariable logistic regression. RESULTS The likelihood of switch from platform to high-efficacy DMT was 47% higher when including post-Gd acquisitions to brain and/or spinal cord MRI, 59% higher when including spinal cord acquisitions to brain MRI, and 132% higher when including any MRI compared with no MRI (all p < 0.05). The likelihood of switch to high-efficacy DMT decreased over time from treatment start. CONCLUSION Our results show that spinal cord and Gd MRI acquisitions can provide relevant information to influence subsequent treatment decisions, especially in early treatment phases, compared with stand-alone brain MRI.
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Affiliation(s)
- Giulia Dallera
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom; Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Giuseppina Affinito
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Daniele Caliendo
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, via Sergio Pansini 5, Naples 80131, Italy
| | - Maria Petracca
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, via Sergio Pansini 5, Naples 80131, Italy
| | - Antonio Carotenuto
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, via Sergio Pansini 5, Naples 80131, Italy
| | - Maria Triassi
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, via Sergio Pansini 5, Naples 80131, Italy
| | - Raffaele Palladino
- Department of Primary Care and Public Health, Imperial College London, London, United Kingdom; Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Marcello Moccia
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, via Sergio Pansini 5, Naples 80131, Italy.
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Moccia M, Fontana L, Palladino R, Falco F, Finiello F, Fedele M, Lanzillo R, Reppuccia L, Triassi M, Brescia Morra V, Iavicoli I. Determinants of early working impairments in multiple sclerosis. Front Neurol 2022; 13:1062847. [PMID: 36570442 PMCID: PMC9784221 DOI: 10.3389/fneur.2022.1062847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 11/24/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Unemployment can directly affect social status and identity. Assessing and adjusting determinants of early working impairments in a chronic disease can thus reduce its long-term burden. Hereby, we aim to evaluate differences in occupational history and early working impairments between people with multiple sclerosis (MS) and healthy workers. Methods This is a cross-sectional study comparing 71 workers with MS [age 41.7 ± 9.4 years; females 59.1%; EDSS 2.0 (1.0-6.0)] and 71 controls (age 42.6 ± 11.9 years; females 33.8%). All participants filled in Work Ability Index (WAI), Work Productivity and Activity Impairment (WPAI), European Questionnaire for Quality of Life (EuroQoL), Beck Depression Inventory II (BDI-II), and Pittsburgh Sleep Quality Index (PSQI). In MS, we further collected expanded disability status scale (EDSS), MS Questionnaire for Job difficulties (MSQ-Job), Fatigue severity scale (FSS), and the Brief International Cognitive Assessment for MS (BICAMS). Results Workers with MS were more working disabled (p < 0.01), less exposed to workplace risks (p < 0.01), and more limited in fitness to work (p = 0.01), compared with controls. On linear regression models adjusted by age, sex, education, and type of contract, people with MS had worse WAI (Coeff=-5.47; 95% CI = -7.41, -3.53; p < 0.01), EuroQoL (Coeff = -4.24; 95% CI = -17.85, -6.50; p < 0.01), BDI-II (Coeff = 3.99; 95% CI = 2.37, 7.01; p < 0.01), and PSQI (Coeff = 4.74; 95% CI = 3.13, 7.61; p < 0.01), compared with controls, but no differences in WPAI (p = 0.60). EuroQoL, BDI-II, and PSQI were equally associated with both WAI and WPAI in MS and controls (all p< 0.01). In MS, worse MSQJob was associated with higher EDSS (Coeff = 5.22; 95% CI = 2.24, 7.95; p < 0.01), progressive disease (Coeff = 14.62; 95% CI = 5.56, 23.69; p < 0.01), EuroQoL (Coeff = 4.63; 95% CI = 2.92, 6.35; p < 0.01), FSS (Coeff = 0.55; 95% CI = 0.38, 0.72; p < 0.01), and cognitive impairment (Coeff = 4.42; 95% CI = 0.67, 8.22; p = 0.02). Discussion Early factors associated with working difficulties in MS include disability, fatigue, depression, and cognitive dysfunction. Early identification of clinical features potentially causing working difficulties should be considered to enhance job retention, along with targeted prevention and protection measures.
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Affiliation(s)
- Marcello Moccia
- Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Naples, Italy,Multiple Sclerosis Clinical Unit, Federico II University Hospital, Naples, Italy,*Correspondence: Marcello Moccia
| | - Luca Fontana
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, Federico II University of Naples, Naples, Italy,Department of Primary Care and Public Health, Imperial College, London, United Kingdom
| | - Fabrizia Falco
- Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Ferdinando Finiello
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Mauro Fedele
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Unit, Federico II University Hospital, Naples, Italy,Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Liberata Reppuccia
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Maria Triassi
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Clinical Unit, Federico II University Hospital, Naples, Italy,Department of Neuroscience, Reproductive Science and Odontostomatology, Federico II University of Naples, Naples, Italy
| | - Ivo Iavicoli
- Occupational Health Unit, Department of Public Health, Federico II University of Naples, Naples, Italy
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De Luca V, Femminella GD, Patalano R, Formosa V, Lorusso G, Rivetta C, Di Lullo F, Mercurio L, Rea T, Salvatore E, Korkmaz Yaylagul N, Apostolo J, Silva RC, Dantas C, van Staalduinen WH, Liotta G, Iaccarino G, Triassi M, Illario M. Assessment Tools of Biopsychosocial Frailty Dimensions in Community-Dwelling Older Adults: A Narrative Review. Int J Environ Res Public Health 2022; 19:16050. [PMID: 36498125 PMCID: PMC9739796 DOI: 10.3390/ijerph192316050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Frailty is a complex interplay between several factors, including physiological changes in ageing, multimorbidities, malnutrition, living environment, genetics, and lifestyle. Early screening for frailty risk factors in community-dwelling older people allows for preventive interventions on the clinical and social determinants of frailty, which allows adverse events to be avoided. By conducting a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aimed to develop an updated framework for the main measurement tools to assess frailty risks in older adults, paying attention to use in the community and primary care settings. This search focused on the biopsychosocial domains of frailty that are covered in the SUNFRAIL tool. The study selected 178 reviews (polypharmacy: 20; nutrition: 13; physical activity: 74; medical visits: 0; falls: 39; cognitive decline: 12; loneliness: 15; social support: 5; economic constraints: 0) published between January 2010 and December 2021. Within the selected reviews, 123 assessment tools were identified (polypharmacy: 15; nutrition: 15; physical activity: 25; medical visits: 0; falls: 26; cognitive decline: 18; loneliness: 9; social support: 15; economic constraints: 0). The narrative review allowed us to evaluate assessment tools of frailty domains to be adopted for multidimensional health promotion and prevention interventions in community and primary care.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Roberta Patalano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Valeria Formosa
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Grazia Lorusso
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Cristiano Rivetta
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Federica Di Lullo
- Specializzazione in Igiene e Medicina Preventiva, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Teresa Rea
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Joao Apostolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | - Rosa Carla Silva
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, 3004-011 Coimbra, Portugal
| | | | | | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy
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Colella Y, Di Laura D, Borrelli A, Triassi M, Amato F, Improta G. Overcrowding analysis in emergency department through indexes: a single center study. BMC Emerg Med 2022; 22:181. [PMID: 36401158 PMCID: PMC9673888 DOI: 10.1186/s12873-022-00735-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 10/27/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Overcrowding in the Emergency Department (ED) is one of the major issues that must be addressed in order to improve the services provided in emergency circumstances and to optimize their quality. As a result, in order to help the patients and professionals engaged, hospital organizations must implement remedial and preventative measures. Overcrowding has a number of consequences, including inadequate treatment and longer hospital stays; as a result, mortality and the average duration of stay in critical care units both rise. In the literature, a number of indicators have been used to measure ED congestion. EDWIN, NEDOCS and READI scales are considered the most efficient ones, each of which is based on different parameters regarding the patient management in the ED. Methods In this work, EDWIN Index and NEDOCS Index have been calculated every hour for a month period from February 9th to March 9th, 2020 and for a month period from March 10th to April 9th, 2020. The choice of the period is related to the date of the establishment of the lockdown in Italy due to the spread of Coronavirus; in fact on 9 March 2020 the Italian government issued the first decree regarding the urgent provisions in relation to the COVID-19 emergency. Besides, the Pearson correlation coefficient has been used to evaluate how much the EDWIN and NEDOCS indexes are linearly dependent. Results EDWIN index follows a trend consistent with the situation of the first lockdown period in Italy, defined by extreme limitations imposed by Covid-19 pandemic. The 8:00–20:00 time frame was the most congested, with peak values between 8:00 and 12:00. on the contrary, in NEDOCS index doesn’t show a trend similar to the EDWIN one, resulting less reliable. The Pearson correlation coefficient between the two scales is 0,317. Conclusion In this study, the EDWIN Index and the NEDOCS Index were compared and correlated in order to assess their efficacy, applying them to the case study of the Emergency Department of “San Giovanni di Dio e Ruggi d’Aragona” University Hospital during the Covid-19 pandemic. The EDWIN scale turned out to be the most realistic model in relation to the actual crowding of the ED subject of our study. Besides, the two scales didn’t show a significant correlation value.
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Affiliation(s)
- Ylenia Colella
- grid.4691.a0000 0001 0790 385XDepartment of Electrical Engineering and Information Technologies, University of Naples “Federico II”, Naples, Italy
| | - Danilo Di Laura
- grid.4691.a0000 0001 0790 385XDepartment of Electrical Engineering and Information Technologies, University of Naples “Federico II”, Naples, Italy
| | - Anna Borrelli
- “San Giovanni Di Dio E Ruggi d’Aragona” University Hospital, Salerno, Italy
| | - Maria Triassi
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples “Federico II”, Naples, Italy ,grid.4691.a0000 0001 0790 385XInterdepartmental center for research in healthcare management and innovation in healthcare (CIRMIS), University of Naples “Federico II”, Naples, Italy
| | - Francesco Amato
- grid.4691.a0000 0001 0790 385XDepartment of Electrical Engineering and Information Technologies, University of Naples “Federico II”, Naples, Italy
| | - Giovanni Improta
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples “Federico II”, Naples, Italy ,grid.4691.a0000 0001 0790 385XInterdepartmental center for research in healthcare management and innovation in healthcare (CIRMIS), University of Naples “Federico II”, Naples, Italy
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Gentile M, De Luca V, Patalano R, Laudisio D, Tramontano G, Lindner-Rabl S, Mercurio L, Salvatore E, Farrell J, Roller-Wirnsberger R, Kubitschke L, Triassi M, Colao A, Illario M. Innovative approaches to service integration addressing the unmet needs of irritable bowel syndrome patients and new approaches for the needs of IBS patients. Front Med (Lausanne) 2022; 9:998838. [DOI: 10.3389/fmed.2022.998838] [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] [Received: 07/20/2022] [Accepted: 10/04/2022] [Indexed: 11/18/2022] Open
Abstract
BackgroundIrritable bowel syndrome (IBS) is a common multifactorial condition that affects the large intestine and is characterized by chronic and relapsing abdominal pain and altered bowel habit. IBS is due to a combination of genetic, environmental and dietary factors. It's usually a lifelong problem very frustrating to live with and can have a big impact on quality of life, as single-agent therapy ra.ObjectiveTo analyze the approaches and solutions that address the social and health unmet needs of patients with IBS.DesignA quantitative-qualitative approach was adopted in the current study to identify and specify key digital solution and high impact user scenarios applied to IBS patients, through an adaptation of the “Blueprint on Digital Transformation in Health and Care in an Ageing Society” persona methodology.SettingsDigital health solutions bring the potential of supporting health interventions through mobile apps, wearable devices, telemedicine.PatientsA Survey was administered to a group of patients in an anonymous form, and no need for Medical Ethical Committee approval was identified.InterventionsThe theoretical elaboration IBS personas was developed through an interdisciplinary Focus Group, which also mapped the pathway for the patient's management.Main outcomeThree main needs were identified to be met to improve IBS patient's lifestyle: access to psychological support, mHealth solutions supporting diet and adapted physical activity, and home-based digital health support. mHealth intervention has been identified for diet adherence, physical exercise and psychological well-being. The process has been mapped and adapted to integrate the new solutions into the care pathway.LimitationFurther research is needed to evaluate how mHealth services enable IBS patients to manage their conditions and improve their quality of life.ConclusionThe person-centered approach was implemented through a multidisciplinary Focus group that enabled the identification of the need for a mHealth intervention.
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De Rosa E, Montuori P, Triassi M, Masucci A, Nardone A. Occurrence and Distribution of Persistent Organic Pollutants (POPs) from Sele River, Southern Italy: Analysis of Polychlorinated Biphenyls and Organochlorine Pesticides in a Water-Sediment System. Toxics 2022; 10:662. [PMID: 36355953 PMCID: PMC9697341 DOI: 10.3390/toxics10110662] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
The concentrations, possible sources, and ecological risk of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were studied by analyzing water column (DP), suspended particulate matter (SPM) and sediment samples from 10 sites on the Sele River. Total PCBs concentration ranged from 2.94 to 54.4 ng/L and 5.01 to 79.3 ng/g in the seawater and sediment samples, with OCPs concentration in the range of 0.51 to 8.76 ng/L and 0.50 to 10.2 ng/g, respectively. Pollutants loads in the seaside were measured in approximately 89.7 kg/year (73.2 kg/year of PCBs and 16.5 kg/year of OCPs), indicating that the watercourse could be an important cause of contamination to the Tyrrhenian Sea. Statistical analysis indicates that all polychlorinated biphenyls analytes are more probable to derive from surface runoff than an atmospheric deposition. The results explain that higher concentrations of these pollutants were built in sediment samples rather than in the other two phases, which are evidence of historical loads of PCBs and OCPs contaminants. The Sediment Quality Guidelines (SQGs), the Ecological Risk Index (ERI) and the Risk Quotient (RQ) show that the Sele river and its estuary would reputedly be a zone possibly at risk.
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Montuori P, Sorrentino M, Sarnacchiaro P, Di Duca F, Nardo A, Ferrante B, D’Angelo D, Di Sarno S, Pennino F, Masucci A, Triassi M, Nardone A. Job Satisfaction: Knowledge, Attitudes, and Practices Analysis in a Well-Educated Population. Int J Environ Res Public Health 2022; 19:14214. [PMID: 36361094 PMCID: PMC9656398 DOI: 10.3390/ijerph192114214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/22/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
Job satisfaction has a huge impact on overall life quality involving social relationships, family connection and perceived health status, affecting job performances, work absenteeism and job turnover. Over the past decades, the attention towards it has grown constantly. The aim of this study is to analyze simultaneously knowledge, attitudes, and practices toward job satisfaction in a general population in a large metropolitan area. The data acquired from 1043 questionnaires-administered to subjects with an average age of 35.24 years-revealed that only 30% is satisfied by his job. Moreover, among all the tested sample, 12% receive, or often receive intimidation by their superior, and 23% wake up unhappy to go to work. Marital status and having children seem to be an important factor that negatively influences job satisfaction through worst behaviours. The multiple linear regression analysis shows how knowledge is negatively correlated to practices; although this correlation is not present in a simple linear regression showing a mediation role of attitudes in forming practices. On the contrary, attitudes, correlated both to knowledge and practices, greatly affect perceived satisfaction, leading us to target our proposed intervention toward mindfulness and to improve welfare regulation towards couples with children.
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Affiliation(s)
- Paolo Montuori
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Michele Sorrentino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | | | - Fabiana Di Duca
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Alfonso Nardo
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Bartolomeo Ferrante
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Daniela D’Angelo
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Salvatore Di Sarno
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Francesca Pennino
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Armando Masucci
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
| | - Antonio Nardone
- Department of Public Health, University “Federico II”, Via Sergio Pansini N° 5, 80131 Naples, Italy
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Balato G, Palladino R, Montella E, Diana L, Coviello A, Festa E, Iervolino A, Rubba F, Mariconda M, Triassi M. A training ground Lay out improves rehabilitation after trauma surgery: A Fast Track Policy. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Fracture patients are frail and have high mortality. We investigated whether introducing a fast-track strategy during post-surgery care and including early rehabilitation protocols may shorten the length of hospital stay (LOS) while improving the overall clinical effectiveness. A training ground was built inside the inpatient area dedicated to trauma settings. Usual postoperative care consists of immobilization during the first day, but patients may start rehabilitation earlier, 24 hours after the surgical procedure, with a fast-track strategy. In general, gait speed, step length, and self-assessment in terms of mobility improve significantly in the first six postoperative weeks in fracture patients. As delayed postoperative mobility during hospitalization was observed, the established training ground may help with this concern. The expert physiotherapist may contribute to ameliorating the indicators showing great potential in postoperative rehabilitation regardless of fracture pattern. The primary outcome was postoperative physical functioning. Secondary outcomes included the patient’s assessment of therapeutic effect (overall improvement), perceived pain intensity, health services utilization, treatment side effects, and adverse events. Data were analyzed by univariate analysis and binary logistic regression showing a reduction of LOS of almost three days. Further, the optimized hip fracture program reduced the rate of in-hospital postoperative complications and mortality. Adding to the schedule, some PROMPTS (Patient-reported outcome measures) could further integrate the patient empowerment perspective into the quality set of values. For this reason, ‘fast track’ may define a crucial policy able to guarantee rapid rehabilitation, becoming a key factor to achieving a good clinical effect. Fast-track rehabilitation facilitates a shortened hospital stay and cost-saving and can be used to optimize the patient’s condition before admission to a rehabilitation facility
Key messages
• Early rehabilitation protocols may shorten the length of hospital stay (LOS) while improving the overall clinical effectiveness.
• Human factors and patients empowerments may help.
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Affiliation(s)
- G Balato
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - R Palladino
- Public Health Department, AOU Federico II , Naples, Italy
| | - E Montella
- Public Health Department, AOU Federico II , Naples, Italy
| | - L Diana
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - A Coviello
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - E Festa
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - A Iervolino
- University Hospital, AOU Federico II , Naples, Italy
| | - F Rubba
- Public Health Department, AOU Federico II , Naples, Italy
| | - M Mariconda
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
| | - M Triassi
- Othopedics Surgery Units, AOU Federico II , Naples, Italy
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Montella E, Iodice S, Bellopede S, Frangiosa A, Giovagnoli A, Mazia G, Triassi M. Integrated system for the proactive analisys of risk infection in patient’s surgical route. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The most common hospital safety incidents are Hospital-Acquired-Infections (HAI) and among these Surgical Site Infections (SSIs). Our study proposes the use of a proactive system to manage risk combining the new Risk Identification Framework by WHO (IPCAF), the Lean method and the hospital’s Procedure Analysis. Each of the methods has pros and cons, and there is no existing literature that researches the concurrent use of all three methods. We focused on analysing patients’ surgical route to demonstrate that using an integrated system for preventing SSIs delivers enhanced results and significantly contibutes to a reduction in occurence of SSIs.
Methods
We conducted a retrospective observational study from 18 March 2019 to 20 April 2019 at Azienda Ospedaliera Universitaria Federico II di Napoli, Italia (Europa). The study is structured in 3 phases:
Phase 1- application of proactive risk management tools (18 March- 15 April 2019);
Phase 2-integration of results with the elaboration of a single system for proactive risk management (15-20 April 2019);
Phase 3- collection of epidemiologic data concerning SSI. We used the incidence of surgical site as efficiency indicator (1-10 March 2022).
The endpoints identified were:
Primary Endpoint: a reduction of infection occurrence in surgical sites
Secondary Endpoint: identification of critical points and control points within the surgical process with relevant corrective measures
Results
The rate of incidence of SSIs was selected as the efficacy indicator for the system. Our study recorded a 2.40% incidence rate for SSIs in 2020, compared to an incidence rate of 3.80% in 2018 and of 3.5% in 2017.
Conclusions
Considering the economic impact of the infections, along with the increased incidence of mortality and morbidity, employing all available tools to try and reduce SSIs incidence becomes paramount. A small reduction can produce significant cost savings that can be invested in other prevention programs.
Key messages
• Integrated system in proactively and promptly identifying risks related to patients’ surgical routes is effectiveness.
• The system can be adapted to different healthcare settings, to prevent adverse incidents by employing a risk management strategy, and to further enhance existing strategies.
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Affiliation(s)
- E Montella
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - S Iodice
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - S Bellopede
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - A Frangiosa
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - A Giovagnoli
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - G Mazia
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
| | - M Triassi
- Public Healt Departement, Università degli Studi di Napoli , Naples, Italy
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Palladino R, Alfano R, Moccia M, Barone-Adesi F, Majeed A, Triassi M, Millett C. Association between institutional affiliations of academic editors and authors in medical journals. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Most of the literature on conflict of interest (COI) has not focused on the role of academic editors and their possible COIs, although academic editors often hold senior faculty positions at universities, which might be considered a COI if this influences towards a more favourable processing to articles submitted by institutional colleagues. The current study aims to assess whether academic editor affiliation, a potential COI, can influence academic institution ranking as top contributor in the biomedical field.
Methods
We conducted a cross-sectional analysis extracting publicly available data from the 2019 Clarivate InCites Journal Citation Reports for journals in the “Medicine, General & Internal” category and from each journal website. We constructed the following study outcomes: i) being a top 5 academic contributor for the peer-review journal of interest (yes/no), ii) being a top 10 academic contributor for the peer-review journal of interest (yes/no), and iii) ranking position as top 50 academic contributor for the peer-review journal of interest. Mixed-effect linear and logistic regression models were employed, as appropriate.
Results
We included 114 journals in our analysis, 49% were open-access only. Sharing same affiliation of any of the editorial board members was associated with a 6.7 and 5.6 greater likelihood of being top 5 and top 10 contributors, respectively (95%CI 5.07-8.73 and 4.34-7.22). Similarly, sharing same affiliation was associated with being 12.1 places higher as top contributor (95%CI 10.35-13.81). When considering the editor in chief affiliation solely, association was even stronger.
Conclusions
We found that academic editors sharing the same institutional affiliation with authors was strongly associated with the likelihood of that institution of being a top contributor. Shared institutional affiliations between editors and authors should be clearly stated as part of an open and transparent peer-review process.
Key messages
• Editors sharing same affiliation with authors was strongly associated with the likelihood for the institution the editor was affiliated with of being top contributor for academic medical journals.
• Shared institutional affiliations between editors and authors should be clearly stated as part of an open and transparent peer-review process.
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Affiliation(s)
- R Palladino
- Public Health Policy Evaluation Unit, Imperial College , London, UK
- Department of Public Health, University , Naples, Italy
- CIRMIS, University , Naples, Italy
| | - R Alfano
- Centre for Environmental Sciences, Hasselt University , Diepenbeek, Belgium
| | - M Moccia
- MS Clinical Care and Research Centre, Department of Neuroscience , Naples, Italy
| | - F Barone-Adesi
- Department of Translational Medicine, Università del Piemonte Orientale , Novara, Italy
- Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale , Novara, Italy
| | - A Majeed
- Department of Primary Care and Public Health, Imperial College of London , London, UK
| | - M Triassi
- Department of Public Health, University , Naples, Italy
- CIRMIS, University , Naples, Italy
| | - C Millett
- Public Health Policy Evaluation Unit, Imperial College , London, UK
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Sheikh-Assadi M, Naderi R, Salami SA, Kafi M, Fatahi R, Shariati V, Martinelli F, Cicatelli A, Triassi M, Guarino F, Improta G, Claros MG. Normalized Workflow to Optimize Hybrid De Novo Transcriptome Assembly for Non-Model Species: A Case Study in Lilium ledebourii (Baker) Boiss. Plants 2022; 11:plants11182365. [PMID: 36145766 PMCID: PMC9503428 DOI: 10.3390/plants11182365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/21/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022]
Abstract
A high-quality transcriptome is required to advance numerous bioinformatics workflows. Nevertheless, the effectuality of tools for de novo assembly and real precision assembled transcriptomes looks somewhat unexplored, particularly for non-model organisms with complicated (very long, heterozygous, polyploid) genomes. To disclose the performance of various transcriptome assembly programs, this study built 11 single assemblies and analyzed their performance on some significant reference-free and reference-based criteria. As well as to reconfirm the outputs of benchmarks, 55 BLAST were performed and compared using 11 constructed transcriptomes. Concisely, normalized benchmarking demonstrated that Velvet–Oases suffer from the worst results, while the EvidentialGene strategy can provide the most comprehensive and accurate transcriptome of Lilium ledebourii (Baker) Boiss. The BLAST results also confirmed the superiority of EvidentialGene, so it could capture even up to 59% more (than Velvet–Oases) unique gene hits. To promote assembly optimization, with the help of normalized benchmarking, PCA and AHC, it is emphasized that each metric can only provide part of the transcriptome status, and one should never settle for just a few evaluation criteria. This study supplies a framework for benchmarking and optimizing the efficiency of assembly approaches to analyze RNA-Seq data and reveals that selecting an inefficient assembly strategy might result in less identification of unique gene hits.
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Affiliation(s)
- Morteza Sheikh-Assadi
- Department of Horticultural Science, Faculty of Agricultural Science and Engineering, University of Tehran, Karaj 31587-77871, Iran
- Correspondence: (M.S.-A.); (R.N.)
| | - Roohangiz Naderi
- Department of Horticultural Science, Faculty of Agricultural Science and Engineering, University of Tehran, Karaj 31587-77871, Iran
- Correspondence: (M.S.-A.); (R.N.)
| | - Seyed Alireza Salami
- Department of Horticultural Science, Faculty of Agricultural Science and Engineering, University of Tehran, Karaj 31587-77871, Iran
| | - Mohsen Kafi
- Department of Horticultural Science, Faculty of Agricultural Science and Engineering, University of Tehran, Karaj 31587-77871, Iran
| | - Reza Fatahi
- Department of Horticultural Science, Faculty of Agricultural Science and Engineering, University of Tehran, Karaj 31587-77871, Iran
| | - Vahid Shariati
- NIGEB Genome Center, National Institute of Genetic Engineering and Biotechnology, Tehran 14965/161, Iran
| | - Federico Martinelli
- Department of Biology, University of Florence, 50019 Sesto Fiorentino, Italy
| | - Angela Cicatelli
- Department of Chemistry and Biology “A. Zambelli”, University of Salerno, 84084 Fisciano, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy
| | - Francesco Guarino
- Department of Chemistry and Biology “A. Zambelli”, University of Salerno, 84084 Fisciano, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples “Federico II”, 80131 Naples, Italy
| | - Manuel Gonzalo Claros
- Molecular Biology and Biochemistry Department, University of Málaga, 29071 Málaga, Spain
- CIBER de Enfermedades Raras (CIBERER), 29071 Málaga, Spain
- Institute of Biomedical Research in Málaga (IBIMA), IBIMA-RARE, 29010 Málaga, Spain
- Instituto de Hortofruticultura Subtropical y Mediterránea (IHSM-UMA-CSIC), 29010 Málaga, Spain
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Valdecantos RL, Palladino R, Lo Vecchio A, Montella E, Triassi M, Nardone A. Organisational and Structural Drivers of Childhood Immunisation in the European Region: A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10091390. [PMID: 36146467 PMCID: PMC9505321 DOI: 10.3390/vaccines10091390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022] Open
Abstract
Despite the implementation of widespread vaccination programs, the European Health Systems continue to experience care challenges attributable to organizational and structural issues. This study aimed to review the available data on aspects within the organizational and structural domains that might impact vaccination coverage. We searched a comprehensive range of databases from 1 January 2007 to 6 July 2021 for studies that reported quantitative or qualitative research on interventions to raise childhood vaccine coverage. Outcome assessments comprised organizational and structural factors that contribute to vaccine concern among pediatric parents, as well as data reported influencing the willingness to vaccinate. To analyze the risk of bias, the Ottawa, JBI’s (Joanna Briggs Institute) critical appraisal tool, and Amstar quality assessment were used accordingly. The inclusion criteria were met by 205 studies across 21 articles. The majority of the studies were conducted in the United Kingdom (6), the European Union (3), and Italy (3). A range of interventions studied in primary healthcare settings has been revealed to improve vaccination coverage rates including parental engagement and personalization, mandatory vaccination policies, program redesign, supply chain design, administering multiple/combination vaccines, improved vaccination timing and intervals, parental education and reminders, surveillance tools and Supplemental Immunisation Activity (SIA), and information model.
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Affiliation(s)
- Ronan Lemwel Valdecantos
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
- Global Health Workforce Network (GHWN) Youth Hub, World Health Organization, 1211 Geneva, Switzerland
- Correspondence: (R.L.V.); (R.P.)
| | - Raffaele Palladino
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80138 Napoli, Italy
- Department of Primary Care and Public Health, Imperial College, London SW7 2BX, UK
- Correspondence: (R.L.V.); (R.P.)
| | - Andrea Lo Vecchio
- Department of Translational Medical Sciences, Section of Pediatrics, University “Federico II” of Naples, 80138 Napoli, Italy
| | - Emma Montella
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
| | - Maria Triassi
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University “Federico II” of Naples, 80138 Napoli, Italy
| | - Antonio Nardone
- Department of Public Health, University “Federico II” of Naples, 80138 Napoli, Italy
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Gentile I, Iorio M, Zappulo E, Scotto R, Maraolo AE, Buonomo AR, Pinchera B, Muto G, Iervolino C, Villari R, Schiano Moriello N, Scirocco MM, Triassi M, Paternoster M, Russo V, Viceconte G. COVID-19 Post-Exposure Evaluation (COPE) Study: Assessing the Role of Socio-Economic Factors in Household SARS-CoV-2 Transmission within Campania Region (Southern Italy). Int J Environ Res Public Health 2022; 19:10262. [PMID: 36011895 PMCID: PMC9408501 DOI: 10.3390/ijerph191610262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/15/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
Campania is the sixth poorest region of Italy, and it is the region with the highest income inequality. The secondary attack rates of SARS-CoV-2 among households are found to be substantially heterogeneous among published studies and are influenced by socio-economic factors. We conducted a retrospective study to describe the role of socio-economic factors in the household transmission of SARS-CoV-2 among patients living in Campania Region and referring to "Federico II" Hospital. We interviewed 413 subjects followed-up for COVID-19 between the 8 March 2020 and the 24 May 2021 with the aim to collect demographic, clinical, economic, and social data regarding their household and the index cases. The variables associated with SARS-CoV-2 attack rate higher than 50% among households were higher age (p = 0.023) and higher Charlson Comorbidity Index of the index case (p = 0.023) and, for household characteristics, higher number of families per house (p = 0.02), location of the houses in Naples' suburbs (Chi2 = 5.3, p = 0.02) and in Caserta City area (Chi2 = 4, p = 0.04), and renting the house compared to owning it (Chi2 = 5.83, p = 0.01). This study confirms the finding described by other authors that household transmission of SARS-CoV-2 is correlated with the income inequality of the analyzed geographical area as well as with the indicators of health and economic wealth of the families, and this correlation also applies to the Campania Region.
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Affiliation(s)
- Ivan Gentile
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Martina Iorio
- Department of Economist, Roma Tre University, 00154 Rome, Italy
| | - Emanuela Zappulo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Riccardo Scotto
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Alberto Enrico Maraolo
- First Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
| | - Antonio Riccardo Buonomo
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Biagio Pinchera
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Giuseppina Muto
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Carmela Iervolino
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Riccardo Villari
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Nicola Schiano Moriello
- Ninth Division of Infectious Diseases, Cotugno Hospital, AORN dei Colli, 80131 Naples, Italy
| | - Maria Michela Scirocco
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples Federico II, 80138 Naples, Italy
| | - Mariano Paternoster
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Vincenzo Russo
- Department of Medical Translational Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy
| | - Giulio Viceconte
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
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47
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Scala A, Loperto I, Triassi M, Improta G. Risk Factors Analysis of Surgical Infection Using Artificial Intelligence: A Single Center Study. Int J Environ Res Public Health 2022; 19:10021. [PMID: 36011656 PMCID: PMC9408161 DOI: 10.3390/ijerph191610021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Background: Surgical site infections (SSIs) have a major role in the evolution of medical care. Despite centuries of medical progress, the management of surgical infection remains a pressing concern. Nowadays, the SSIs continue to be an important factor able to increase the hospitalization duration, cost, and risk of death, in fact, the SSIs are a leading cause of morbidity and mortality in modern health care. Methods: A study based on statistical test and logistic regression for unveiling the association between SSIs and different risk factors was carried out. Successively, a predictive analysis of SSIs on the basis of risk factors was performed. Results: The obtained data demonstrated that the level of surgery contamination impacts significantly on the infection rate. In addition, data also reveals that the length of postoperative hospital stay increases the rate of surgical infections. Finally, the postoperative length of stay, surgery department and the antibiotic prophylaxis with 2 or more antibiotics are a significant predictor for the development of infection. Conclusions: The data report that the type of surgery department and antibiotic prophylaxis there are a statistically significant predictor of SSIs. Moreover, KNN model better handle the imbalanced dataset (48 infected and 3983 healthy), observing highest accuracy value.
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Affiliation(s)
- Arianna Scala
- Department of Public Health, University of Naples “Federico II”, 80100 Naples, Italy
| | - Ilaria Loperto
- Department of Public Health, University of Naples “Federico II”, 80100 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80100 Naples, Italy
- Interdepartmental Center for Research in Health Care Management and Innovation in Health Care (CIRMIS), University of Naples “Federico II”, 80100 Naples, Italy
| | - Giovanni Improta
- Department of Public Health, University of Naples “Federico II”, 80100 Naples, Italy
- Interdepartmental Center for Research in Health Care Management and Innovation in Health Care (CIRMIS), University of Naples “Federico II”, 80100 Naples, Italy
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48
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Moccia M, Affinito G, Berera G, Marrazzo G, Piscitelli R, Carotenuto A, Petracca M, Lanzillo R, Triassi M, Brescia Morra V, Palladino R. Persistence, adherence, healthcare resource utilization and costs for ocrelizumab in the real-world of the Campania Region of Italy. J Neurol 2022; 269:6504-6511. [PMID: 35953597 PMCID: PMC9618479 DOI: 10.1007/s00415-022-11320-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
Aims We aim to provide real-world evidence on the use of ocrelizumab for treating multiple sclerosis (MS), with specific regard to prescription pattern, adherence, persistence, healthcare resource utilization and related costs, also in relation to other disease-modifying treatments (DMTs). Methods We included 2495 people with MS from the Campania Region (South Italy) who received first or switch DMT prescription from Jan 2018 to Dec 2020, and with at least 6-month follow-up. We collected hospital discharge records, drug prescriptions, and related costs, and calculated persistence (time from first prescription to discontinuation or switch to other DMT), adherence (proportion of days covered (PDC)), annualized hospitalization rate (AHR) for MS-related hospital admissions, and DMT costs. Results Ocrelizumab was the most commonly prescribed DMT (n = 399; age = 45.74 ± 10.98 years; females = 224), after dimethyl fumarate (n = 588) and fingolimod (n = 401); 26% patients treated with ocrelizumab were naïve. When compared with ocrelizumab, the risk of discontinuation was higher for other highly active DMTs (HR = 3.78; p = 0.01), and low/medium efficacy DMTs (HR = 7.59; p < 0.01). When compared with ocrelizumab, PDC was similar to other highly active DMTs (Coeff = 0.01; p = 0.31), but higher for low/medium efficacy DMTs (Coeff = 0.09; p < 0.01). When compared with ocrelizumab, AHR was similar to other highly active DMTs (Coeff = 0.01; p = 0.51), and low/medium efficacy DMTs (Coeff = 0.01; p = 0.55). When compared with ocrelizumab, DMT monthly costs were higher for other highly active DMTs (Coeff = 92.30; p < 0.01), but lower for low/medium efficacy DMTs (Coeff = − 1043.61; p < 0.01). Discussion Ocrelizumab was among the most frequently prescribed DMTs, with 26% prescriptions to treatment-naïve patients, suggesting its relevance in addressing unmet clinical needs (e.g., first approved treatment for primary progressive MS). Ocrelizumab was associated with the highest persistence, confirming its favorable benefit-risk profile. Costs for ocrelizumab were lower than those associated to similarly effective DMTs, in absence of changes in healthcare resource utilization.
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Affiliation(s)
- Marcello Moccia
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, via Sergio Pansini 5, 80131, Naples, Italy.
| | - Giuseppina Affinito
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Giulia Berera
- ROCHE Spa, Viale GB Stucchi 110, 20900, Monza, MB, Italy
| | | | | | - Antonio Carotenuto
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, via Sergio Pansini 5, 80131, Naples, Italy
| | - Maria Petracca
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, via Sergio Pansini 5, 80131, Naples, Italy.,Department of Human Neurosciences, Sapienza University, Rome, Italy
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, via Sergio Pansini 5, 80131, Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, via Sergio Pansini 5, 80131, Naples, Italy
| | - Raffaele Palladino
- Department of Public Health, University of Naples Federico II, Naples, Italy.,Department of Primary Care and Public Health, Imperial College, London, UK
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49
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Improta G, Majolo M, Raiola E, Russo G, Longo G, Triassi M. A case study to investigate the impact of overcrowding indices in emergency departments. BMC Emerg Med 2022; 22:143. [PMID: 35945503 PMCID: PMC9360659 DOI: 10.1186/s12873-022-00703-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Emergency department (ED) overcrowding is widespread in hospitals in many countries, causing severe consequences to patient outcomes, staff work and the system, with an overall increase in costs. Therefore, health managers are constantly looking for new preventive and corrective measures to counter this phenomenon. To do this, however, it is necessary to be able to characterize the problem objectively. For this reason, various indices are used in the literature to assess ED crowding. In this work, we explore the use of two of the most widespread crowding indices in an ED of an Italian national hospital, investigate their relationships and discuss their effectiveness. Methods In this study, two of the most widely used indices in the literature, the National Emergency Department Overcrowding Scale (NEDOCS) and the Emergency Department Working Index (EDWIN), were analysed to characterize overcrowding in the ED of A.O.R.N. “A. Cardarelli” of Naples, which included 1678 clinical cases. The measurement was taken every 15 minutes for a period of 7 days. Results The results showed consistency in the use of EDWIN and NEDOCS indices as measures of overcrowding, especially in severe overcrowding conditions. Indeed, in the examined case study, both EDWIN and NEDOCS showed very low rates of occurrence of severe overcrowding (2–3%). In contrast, regarding differences in the estimation of busy to overcrowded ED rates, the EDWIN index proved to be less sensitive in distinguishing these variations in the occupancy of the ED. Furthermore, within the target week considered in the study, the results show that, according to both EDWIN and NEDOCS, higher overcrowding rates occurred during the middle week rather than during the weekend. Finally, a low degree of correlation between the two indices was found. Conclusions The effectiveness of both EDWIN and NEDOCS in measuring ED crowding and overcrowding was investigated, and the main differences and relationships in the use of the indices are highlighted. While both indices are useful ED performance metrics, they are not always interchangeable, and their combined use could provide more details in understanding ED dynamics and possibly predicting future critical conditions, thus enhancing ED management.
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Affiliation(s)
- Giovanni Improta
- Department of Public Health, University of Naples "Federico II", Via Pansini, No. 5 - ZIP, 80131, Naples, Italy. .,Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy.
| | | | | | | | | | - Maria Triassi
- Department of Public Health, University of Naples "Federico II", Via Pansini, No. 5 - ZIP, 80131, Naples, Italy.,Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples "Federico II", Naples, Italy
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50
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Palladino R, Mercogliano M, Fiorilla C, Frangiosa A, Iodice S, Sanduzzi Zamparelli S, Montella E, Triassi M, Sanduzzi Zamparelli A. Association between COVID-19 and Sick Leave for Healthcare Workers in a Large Academic Hospital in Southern Italy: An Observational Study. Int J Environ Res Public Health 2022; 19:9670. [PMID: 35955042 PMCID: PMC9368056 DOI: 10.3390/ijerph19159670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/26/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Studies have shown that the pandemic has led to an increase in sick leave periods among healthcare workers (HCWs); however, this might have changed over time considering increase in vaccination coverage and change in COVID-19 variant predominance. Therefore, we conducted an observational study to evaluate whether the type of symptoms and the duration of sick leave period for healthcare workers working in a large university hospital in the South of Italy changed between January 2021 and January 2022; 398 cases of COVID-19 were identified for a total of 382 subjects involved. A total of 191 subjects answered the questionnaire about symptoms; of these, 79 had COVID-19 during the period from March 2020 until February 2022. The results showed a decrease of about 1.2 days in sick leave period for each quarter without finding significant differences in the perception of symptoms. It is possible to hypothesize a contribution from the Omicron variant to the decrease in sick leave period in the last quarter, from vaccination coverage, from optimization of COVID-19 management, and from change in the regulations for the assessment of positivity.
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Affiliation(s)
- Raffaele Palladino
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
- Department of Primary Care and Public Health, Imperial College London, London W6 8RP, UK
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
| | | | - Claudio Fiorilla
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Alessandro Frangiosa
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Sabrina Iodice
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | | | - Emma Montella
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
- Interdepartmental Center for Research in Healthcare Management and Innovation in Healthcare (CIRMIS), University of Naples “Federico II”, 80131 Naples, Italy
| | - Alessandro Sanduzzi Zamparelli
- Department of Clinical Medicine and Surgery, Section of Respiratory Diseases, University “Federico II”, Azienda Ospedaliera dei Colli-Monaldi Hospital, 80131 Naples, Italy
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