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Soriolo N, Benoni R, Dalla Valle D, Zunino F, Olivieri A, Campagna I, Tardivo S, Augusta Gonella L, Russo F, Tonon M, Da Re F, Moretti U, Zanoni G, Moretti F. Adverse events following Measles-Mumps-Rubella and varicella immunization: A safety profile analysis and comparison of different vaccination schedules based on the Italian Pharmacovigilance Network in the Veneto Region. Prev Med Rep 2024; 41:102711. [PMID: 38606113 PMCID: PMC11007536 DOI: 10.1016/j.pmedr.2024.102711] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
Objective The vaccines for measles, mumps, rubella and varicella (MMR and V) have been mandatory in Italy since 2017. Two different vaccination strategies are suggested for the first dose: trivalent MMR and a separate V vaccine or the tetravalent MMRV vaccine. Our aim is to compare the safety profile of MMRV and MMR-V vaccines through the passive adverse event reporting system in the Veneto region and to perform a case-by-case review of a few conditions of interest (febrile and afebrile seizures, ataxia, encephalitis, Guillain-Barré Syndrome, thrombocytopenia, neutropenia and Henoch-Schönlein Purpura). Age and sex differences were also explored. Methods We identified all reports following MMRV or MMR-V vaccination in the Veneto Region and received into the National Pharmacovigilance Network between 2007 and April 30, 2022. Results 9,510 reports were retrieved, of which 5,662 (59.5 %) were related to MMRV and 3,848 (40.5 %) to MMR-V. No safety signals were detected supporting the evidence that MMRV and MMR-V vaccinations have a good safety profile. The reporting rate (RR) for serious events between 2007 and 2022 resulted in 13.67 per 10,000 administered doses for MMRV and 10.90 for MMR-V. Conclusion Passive surveillance data show a significantly higher rate of serious events for males 0-2 years old, both overall and stratified per vaccination strategy. Further studies are needed to confirm this observation. The analyses suggest that retrieved differences do not have a significant impact on the overall safety of both formulations.
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Affiliation(s)
- Nicola Soriolo
- University of Verona, Diagnostics and Public Health Department, Section of Hygiene and Preventive Medicine, Verona, Italy
| | - Roberto Benoni
- University of Verona, Diagnostics and Public Health Department, Section of Hygiene and Preventive Medicine, Verona, Italy
| | - Diana Dalla Valle
- University of Verona, Diagnostics and Public Health Department, Section of Hygiene and Preventive Medicine, Verona, Italy
| | - Francesco Zunino
- University of Verona, Diagnostics and Public Health Department, Section of Hygiene and Preventive Medicine, Verona, Italy
| | - Adele Olivieri
- University of Verona, Diagnostics and Public Health Department, Section of Hygiene and Preventive Medicine, Verona, Italy
| | - Irene Campagna
- University of Verona, Diagnostics and Public Health Department, Section of Hygiene and Preventive Medicine, Verona, Italy
| | - Stefano Tardivo
- University of Verona, Diagnostics and Public Health Department, Section of Hygiene and Preventive Medicine, Verona, Italy
| | - Laura Augusta Gonella
- University of Verona, Diagnostics and Public Health Department, Section of Pharmacology, Verona, Italy
| | - Francesca Russo
- Directorate for Prevention, Food Safety, Veterinary - Public Health Veneto Region, Italy
| | - Michele Tonon
- Directorate for Prevention, Food Safety, Veterinary - Public Health Veneto Region, Italy
| | - Filippo Da Re
- Directorate for Prevention, Food Safety, Veterinary - Public Health Veneto Region, Italy
| | - Ugo Moretti
- University of Verona, Diagnostics and Public Health Department, Section of Pharmacology, Verona, Italy
| | - Giovanna Zanoni
- University Hospital of Verona, Pathology and Diagnostics Department, Immunology Unit, Verona, Italy
| | - Francesca Moretti
- University of Verona, Neurosciences, Biomedicine and Movement Sciences Department, Verona, Italy
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Benoni R, Sartorello A, Mazzi M, Berti L, Sorina M, Paiola E, Varischi G, Tardivo S, Rimondini M, Moretti F. The use of 12-item General Health Questionnaire (GHQ-12) in Ukrainian refugees: translation and validation study of the Ukrainian version. Health Qual Life Outcomes 2024; 22:6. [PMID: 38218847 PMCID: PMC10788012 DOI: 10.1186/s12955-024-02226-1] [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] [Received: 06/27/2023] [Accepted: 01/02/2024] [Indexed: 01/15/2024] Open
Abstract
Following the Russian-Ukrainian conflict, the well-being of millions of Ukrainians has been jeopardised. This study aims to translate and test the psychometric features of the Ukrainian version of the General Health Questionnaire 12 (GHQ-12). The study included Ukrainian refugees housed in Verona (Italy) between November/2022 and February/2023. The Ukrainian translation was obtained through a 'forward-backward' translation. Questionnaire was completed by 141 refugees (females: 78.7%). Median age was 36 years (IQR 23-43). Individuals with a score suggestive of psychological distress were 97 (68.8%). Cronbach's coefficient was 0.84 (0.95CI 0.80-0.88). According to confirmatory factor analysis, both single- (modelB1) and two-factor (model B2) structures with bimodal scoring method fitted the data satisfactorily. The two factors of model B2 had a 0.88 correlation. Pearson coefficient showed a positive significant correlation between the GHQ-12 and International Trauma Questionnaire scores (ρ = 0.53, 0.95CI 0.40-0.64, p < 0.001). The GHQ-12 Ukrainian translation showed good psychometric features being a reliable and valid instrument to assess Ukrainian refugees' general well-being.
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Affiliation(s)
- Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
| | - Anna Sartorello
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Mariangela Mazzi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Loretta Berti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Marina Sorina
- "Malve di Ucraina" Non-profit Organization (NPO), Verona, Italy
| | - Elena Paiola
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Giovanna Varischi
- Prevention Department, Unità Locale Socio Sanitaria (ULSS) 9, Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Michela Rimondini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesca Moretti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Di Gennaro G, Chamitava L, Pertile P, Ambrosi E, Mosci D, Fila A, Alemayohu MA, Cazzoletti L, Tardivo S, Zanolin ME. A stepped-wedge randomised controlled trial to assess efficacy and cost-effectiveness of a care-bundle to prevent falls in older hospitalised patients. Age Ageing 2024; 53:afad244. [PMID: 38251740 PMCID: PMC10801830 DOI: 10.1093/ageing/afad244] [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] [Received: 05/17/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Patient accidental falls in a hospital environment are a serious problem for patient safety, and for the additional costs due to associated medical interventions. OBJECTIVE The endpoints of this study were the assessment of the fall incidence in the hospital before and after the implementation of a multidisciplinary care-bundle, along with a cost-effectiveness evaluation. DESIGN A stepped-wedge trial was conducted between April 2015 and December 2016 in Bologna University Hospital. METHODS Incidence rates (IRs) of falls in both the control and intervention periods were calculated. A multilevel mixed-effects generalised linear model with logit link function, adjusted for age, sex, cluster cross-over timing and patients' clinical severity was used to estimate odds ratios (OR) of fall risk of patients of the intervention group respect to the controls.Intervention costs associated with the introduction of the care-bundle intervention were spread between patients per cluster-period-group of exposure. Incremental cost-effectiveness ratio was evaluated using total costs in the intervention and control groups. RESULTS IRs of falls in control and intervention periods were respectively 3.15 and 2.58 for 1,000 bed-days. After adjustment, the subjects receiving the intervention had a statistically significant reduced risk of falling with respect to those who did not (OR = 0.71, 95% confidence interval: 0.60-0.84). According to the cost-effectiveness analysis, the incremental cost per fall prevented was €873.92 considering all costs, and €1644.45 excluding costs related falls. CONCLUSIONS Care-bundle had a protective effect on patients, with a statistically significant reduction of the fall risk. This type of intervention appears cost-effective compared to routine practices.
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Affiliation(s)
- Gianfranco Di Gennaro
- Department of Health Sciences, University of Catanzaro "Magna Græcia", Catanzaro, Italy
| | - Liliya Chamitava
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Paolo Pertile
- Department of Economics, University of Verona, Verona, Italy
| | - Elisa Ambrosi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Daniela Mosci
- Hospital Hygiene and Prevention, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alice Fila
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Lucia Cazzoletti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Zamboni F, Ferrari P, Cazzoletti L, Setti A, Bertoldo F, Dalle Carbonare LG, Danese E, Tardivo S, Crisafulli E, Ferrari M. Bone Mineral Density in Mountain, Road Cyclists and Untrained Controls: Exercise, Diet and Hormones. Res Q Exerc Sport 2023:1-8. [PMID: 37540285 DOI: 10.1080/02701367.2023.2242417] [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] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Purpose: The aim of the study was to compare bone mineral density (BMD) in the lumbar spine (LSBMD) and the femoral neck (FBMD) in male road cyclists (RC n = 39), mountain cyclists (MC n = 30) and controls (C n = 27) and to determine the factors associated with BMD in the same group of participants. Methods: BMD, fat mass (FM) and fat-free mass (FFM) were measured using DXA. Calcium intake (Cal), exercise energy expenditure (EEE) and energy availability (EA) were assessed using self-reported questionnaires. Samples for circulating hormones were also obtained. VO2max was estimated by a cycloergometric test. Results: After adjustment for body mass, in cyclists LSBMD (RC 0.98 ± 0.12; MC 0.98 ± 0.10 g/cm2) was significantly lower than in C (1.11 ± 0.10; p < .001), while FBMD resulted in no significant difference in cyclists compared to C (p = 0.213). EA (kcal/FFM/day) was different in cyclists and in C (p < .05). In C, EEE and EA were positively associated with LSBMD (R = 0.561, R = 0.656, respectively, p < .01), whereas only EA was associated with FBMD (R = 0.554, p < .05); a positive association between EA and FBMD was found in MC (R = 0.464, p < .05). A negative relationship between VO2max and LSBMD in RC (R = -0.418, p < .05) and a positive one between EEE and LSBMD in MC were found (R = 0.605, p < .001). CaI, free testosterone and cortisol were unrelated to BMD. Conclusion: Both the RC and MC had lower LSBMD than C, whereas no difference was found between the two groups of cyclists. The factors associated with BMD are manifold, vary in relation to the measurement site and are likely different in RC, MC and C.
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Tocco Tussardi I, Cazzoletti L, Zanolin ME, Comini A, Visentin D, Torri E, Tardivo S, Moretti F. Patient Safety Subcultures among Nursing Home Staff in Italy: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:1962. [PMID: 37444796 DOI: 10.3390/healthcare11131962] [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: 05/08/2023] [Revised: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
Nursing home (NH) residents are vulnerable subjects and highly susceptible to adverse events. Knowledge of patient safety culture (PSC) is essential for an organization to ensure patient safety. However, research on PSC in NHs, and its variability among staff, is still scarce. This study aimed to explore whether and how PSC differed among NH staff (Managers, Nurses, Direct Care Staff, Support Staff, Administrative Staff and Other Providers) in the Autonomous Province of Trento, Italy. This study employed a cross-sectional design and collected data from 1145 NH providers using the Nursing Home Survey on Patient Safety Culture (NHSPSC). Data were analyzed using linear mixed models, with each of the 12 NHSPSC domains as a response variable. The majority of the respondents (61.6%) were Direct Care Staff members. 'Feedback and Communication about Incidents' and 'Overall Perceptions of Resident Safety' were the domains with the highest proportions of positive answers (PPAs). For most staff categories, 'Staffing' was the domain with the lowest PPA. Support Staff showed significantly lower scores in the majority of domains (8/12). Shorter job tenure, fewer weekly working hours, working mostly during the day and working in highly specialized areas were associated with higher scores in several domains. Interventions to improve PSC must consider the differences between professional groups. Further research is needed to explore the relationship between job-related features and perceptions of patient safety among NH workers.
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Affiliation(s)
- Ilaria Tocco Tussardi
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy
| | - Lucia Cazzoletti
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
| | - Maria Elisabetta Zanolin
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
| | - Annarita Comini
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy
| | - Donatella Visentin
- Department of Prevention, Healthcare Trust of the Autonomous Province of Trento, 38123 Trento, Italy
| | - Emanuele Torri
- Clinical Governance Service, Healthcare Trust of the Autonomous Province of Trento, 38123 Trento, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy
| | - Francesca Moretti
- Department of Neurosciences, Biomedicine and Movement, University of Verona, 37134 Verona, Italy
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Benoni R, Sartorello A, Moretti F, Marchiori F, Accordini L, Postiglione C, Coffele V, Tardivo S. Disparities in access to COVID-19 vaccine in Verona, Italy: a cohort study using local health immunization data. Front Public Health 2023; 11:1167414. [PMID: 37397767 PMCID: PMC10310303 DOI: 10.3389/fpubh.2023.1167414] [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: 02/16/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Migrant populations worldwide were disproportionately impacted by the COVID-19 pandemic. Although substantial resources have been invested in scaling COVID-19 vaccination campaigns, globally vaccine rate and uptake remained low among migrants from across many countries. This study aimed to explore the country of birth as a factor influencing access to the COVID-19 vaccine. Methods This retrospective cohort study included adults vaccinated against SARS-CoV-2 receiving at least one dose in the Verona province between 27 December 2020 and 31 December 2021. Time-to-vaccination was estimated as the difference between the actual date of each person's first dose of COVID-19 vaccination and the date in which the local health authorities opened vaccination reservations for the corresponding age group. The birth country was classified based on both the World Health Organization regions and the World Bank country-level economic classification. Results were reported as the average marginal effect (AME) with corresponding 0.95 confidence intervals (CI). Results During the study period, 7,54,004 first doses were administered and 5,06,734 (F = 2,46,399, 48.6%) were included after applying the exclusion criteria, with a mean age of 51.2 years (SD 19.4). Migrants were 85,989 (17.0%, F = 40,277, 46.8%), with a mean age of 42.4 years (SD 13.3). The mean time-to-vaccination for the whole sample was 46.9 days (SD 45.9), 41.8 days (SD 43.5) in the Italian population, and 71.6 days (SD 49.1) in the migrant one (p < 0.001). The AME of the time-to-vaccination compared to the Italian population was higher by 27.6 [0.95 CI 25.4-29.8], 24.5 [0.95 CI 24.0-24.9], 30.5 [0.95 CI 30.1-31.0] and 7.3 [0.95 CI 6.2-8.3] days for migrants from low-, low-middle-, upper-middle- and high-income countries, respectively. Considering the WHO region, the AME of the time-to-vaccination compared to the Italian group was higher by 31.5 [0.95 CI 30.6-32.5], 31.1 [0.95 CI 30.6-31.5], and 29.2 [0.95 CI 28.5-29.9] days for migrants from African, European, and East-Mediterranean regions, respectively. Overall, time-to-vaccination decreased with increasing age (p < 0.001). Although both migrants and Italians mainly used hub centers (>90%), migrants also used pharmacies and local health units as alternative sites (2.9% and 1.5%, respectively), while Italians (3.3%) and migrants from the European region (4.2%) relied more on family doctors. Conclusion The birth country of migrants influenced access to COVID-19 vaccine both in terms of time-to-vaccination and vaccination points used, especially for the LIC migrant group. Public health authorities should take socio-cultural and economic factors into consideration for tailored communication to people from migrant communities and for planning a mass vaccination campaign.
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Affiliation(s)
- Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Anna Sartorello
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesca Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Francesco Marchiori
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Luciana Accordini
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Chiara Postiglione
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Viviana Coffele
- Department of Prevention, Unità Locale Socio-Sanitaria (ULSS) 9, Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Lando V, Calciano L, Minelli C, Bombieri C, Ferrari M, Malerba G, Margagliotti A, Murgia N, Nicolis M, Olivieri M, Potts J, Tardivo S, Accordini S. IL18 Gene Polymorphism Is Associated with Total IgE in Adult Subjects with Asthma. J Clin Med 2023; 12:3963. [PMID: 37373658 DOI: 10.3390/jcm12123963] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/01/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
The allergic asthma phenotype is characterized by a T helper type 2 (Th2) immune response, based on Immunoglobulin E (IgE)-mediated type 1 hypersensitivity reactions. Total IgE is the sum of all IgE types produced by the human body and is used as a biomarker of inflammation in asthma. We analysed data collected in 143 asthma cases (median age 42.1 years) from the general Italian population (GEIRD survey; 2008-2010) to identify single nucleotide polymorphisms (SNPs) in candidate genes that are associated with total IgE in adult subjects with asthma. These patients reported respiratory symptoms in response to perennial allergens and provided data on 166 SNPs tagging 50 candidate genes or gene regions. Replication of the statistically significant results was performed in 842 asthma cases from other European countries (ECRHS II survey; 1998-2002). SNP rs549908 in interleukin 18 (IL18) gene was significantly associated with total IgE in GEIRD, and this result was replicated in ECRHS II. SNP rs1063320 in the human leukocyte antigen G (HLA-G) gene was identified in GEIRD, but this association was not replicated in ECRHS II. Further investigating IL18 and its biological pathways could be important for developing new therapeutic targets, due to its involvement in inflammatory response processes.
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Affiliation(s)
- Valentina Lando
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Lucia Calciano
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Cosetta Minelli
- National Heart and Lung Institute, Imperial College London, London SW3 6LR, UK
| | - Cristina Bombieri
- Biology and Genetics Section, Department of Neuroscience, Biomedicine and Movement, University of Verona, 37134 Verona, Italy
| | - Marcello Ferrari
- Respiratory Diseases Section, Department of Medicine, University of Verona, 37134 Verona, Italy
| | - Giovanni Malerba
- Biology and Genetics Section, Department of Neuroscience, Biomedicine and Movement, University of Verona, 37134 Verona, Italy
| | - Antonino Margagliotti
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Nicola Murgia
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Morena Nicolis
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Mario Olivieri
- Unit of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - James Potts
- National Heart and Lung Institute, Imperial College London, London SW3 6LR, UK
| | - Stefano Tardivo
- Unit of Hygiene and Preventive, Environmental and Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy
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Tocco Tussardi I, Tfaily A, Locatelli F, Antonicelli L, Battaglia S, Bono R, Corsico AG, Murgia N, Pirina P, Ferrari M, Tardivo S, Jarvis DL, Verlato G. The Association of Self-Reported Birthweight with Lung Function and Respiratory Diseases: Results from a Multi-Centre, Multi-Case Control Study in Italy. Int J Environ Res Public Health 2022; 19:15062. [PMID: 36429783 PMCID: PMC9690666 DOI: 10.3390/ijerph192215062] [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: 10/10/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 06/16/2023]
Abstract
Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW), however, is conflicting. We examined associations of self-reported BW with lung function and the development of respiratory and also non-respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) project, an Italian multi-centre, multi-case control study involving cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status as response variable; BW as main determinant; and adjusting for sex, age and smoking status. Of the 2287 participants reporting BW, 6.4% (n = 147) had low BW (<2500 g), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Both men and women with low BW were shorter than those with normal BW (mean ± SD: 160.2 ± 5.5 vs. 162.6 ± 6.5 cm in women, p = 0.009; 172.4 ± 6.1 vs. 174.8 ± 7.2 cm in men, p < 0.001). Although FEV1 and FVC were reduced in individuals with low BW, this was explained by associations with sex and height. In multivariable analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before the age of two (10.3% vs. 4.1%; p < 0.001), severe respiratory infection before the age of five (16.9% vs. 8.8%; p = 0.001) and hypertension in adulthood (29.9% vs. 23.7%; p = 0.001); however, they had a lower risk of arrhythmia (2.7% vs. 5.8%; p = 0.027).
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Affiliation(s)
- Ilaria Tocco Tussardi
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy
| | - Ahmad Tfaily
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
| | - Francesca Locatelli
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
| | - Leonardo Antonicelli
- Department of Internal Medicine, University Hospital of Ancona, 60131 Ancona, Italy
| | - Salvatore Battaglia
- ‘ProMISE’ (Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties) Department, University of Palermo, 90133 Palermo, Italy
| | - Roberto Bono
- Department of Public Health and Paediatrics, University of Torino, 10124 Torino, Italy
| | - Angelo G. Corsico
- Department of Internal Medicine and Medical Therapy, University of Pavia, 27100 Pavia, Italy
- Pneumology Unit, Foundation I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy
| | - Nicola Murgia
- Section of Occupational Medicine, Respiratory Diseases and Toxicology, University of Perugia, 06123 Perugia, Italy
| | - Pietro Pirina
- Department of Clinical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | - Marcello Ferrari
- Department of Respiratory Medicine, University of Verona, 37129 Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, 37134 Verona, Italy
| | - Deborah L. Jarvis
- National Heart and Lung Institute, Section of Genomic and Environmental Medicine, Imperial College London, London SW7 2BX, UK
| | - Giuseppe Verlato
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, 37134 Verona, Italy
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Tocco Tussardi I, Tfaily A, Antonicelli L, Bono R, Corsico AG, Murgia N, Pirina P, Tardivo S, Jarvis DL, Verlato G. Association of birthweight with lung function and respiratory diseases: results from the GEIRD study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.561] [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
Early life conditions are associated with lung function and the development of respiratory and non-respiratory illnesses. The relationship with birthweight (BW) is however conflicting. We examined associations of BW with lung function and respiratory diseases within the GEIRD (Gene-Environment Interaction in Respiratory Diseases) study.
Methods
GEIRD is an Italian multi-centre, multi-case control study of people aged 20-84 from the general population conducted from 2008 to 2014. The study included cases of COPD, asthma, allergic rhinitis and controls. Multinomial logistic regression was performed with case/control status (control/COPD/asthma/allergic rhinitis) as response variable, and BW as main determinant adjusting for sex, age and smoking status.
Results
Of 2,287 reporting BW, 6.4 % (n = 147) had low BW (<2500 gr), and this proportion was greater in women than men (7.8% vs. 5.1%; p = 0.006). Lung volumes were significantly lower in individuals with low than normal BW. Median FEV1 was 3.01 L (p25-p75=2.60-3.45 L) versus 3.16 L (2.65-3.86 L) (p = 0.019) and median FVC was 3.68 L (3.19-4.34 L) versus 3.91 (3.34-4.81 L) (p = 0.003). However, FEV1 and FVC were not affected by BW when expressed as percent predicted. Of note, both men and women with low BW were shorter than those with normal BW (mean±SD: 160.2±5.5 vs. 162.6±6.5 cm in women, p = 0.009; 172.4±6.1 vs. 174.8±7.2 cm in men, p < 0.001). FEV1/FVC expressed as absolute ratio or as percent predicted, was not affected by BW. In multinomial analysis, BW was not associated with respiratory diseases in adulthood. However, those with low BW had a higher risk of self-reported hospitalisation for lung disease before age 2 (10.3% vs. 4.1%) and severe respiratory infection before age 5 (16.9% vs. 8.8%) (p = 0.003).
Conclusions
BW was not associated with lung function in adulthood, when controlling for sex and height. Low BW was a risk factor for respiratory diseases in childhood, not in adulthood.
Key messages
• Low birthweight was associated with respiratory diseases in childhood but not in adulthood.
• Although spirometrically-assessed lung volumes were lower in adults with low birthweight, this is likely explained by associations of low birthweight with sex and height.
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Affiliation(s)
- I Tocco Tussardi
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - A Tfaily
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - L Antonicelli
- Department of Internal Medicine, Ospedali Riuniti di Ancona , Ancona, Italy
| | - R Bono
- Department of Public Health and Pediatrics, University of Torino , Turin, Italy
| | - AG Corsico
- Department of Internal Medicine, University of Pavia , Pavia, Italy
| | - N Murgia
- Section of Occupational Medicine, University of Perugia , Perugia, Italy
| | - P Pirina
- Department of Clinical, Surgical Sciences, University of Sassari , Sassari, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - DL Jarvis
- National Heart and Lung Institute, Imperial College , London, UK
| | - G Verlato
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
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10
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Sartorello A, Paiola E, Moretti F, Accordini L, Postiglione C, Tardivo S, Benoni R. Inequality in access to COVID-19 vaccines: an annual experience in Verona (Italy). Eur J Public Health 2022. [PMCID: PMC9594382 DOI: 10.1093/eurpub/ckac131.115] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
COVID-19 vaccination campaigns involved massive resources worldwide. However, the disparity in vaccine accessibility is a global issue. The study evaluated whether birthplace is a barrier to healthcare access in a high-income country (HIC). The retrospective cohort study included fully vaccinated adults in the Verona district between 27/12/2020 and 31/12/2021. In Italy, the vaccination was opened at different times according to the risk category. Two multiple linear regression models explored the relationship between (1) days before getting the first shot (IV) and (2) the distance between the municipality of residence and the vaccination point, and age, sex, and Income Group (IG, as defined by the World Bank). Distance (km) was estimated with Q-GIS. Results are reported as Marginal Effect at the Mean (MEM) with a confidence interval of 0.95. 500,001 first doses were included, with a mean age of 47 years (SD = 21) and a mean IV of 47.5 days. 6% of the sample was UpperMiddle (UMIC), 6% Lower-Middle (LMIC), and 0.3% Low-Income Countries (LIC). The mean age was higher for HIC (p < 0.05). Male outnumbered females in LMIC (61%) and LIC (69%), but not in HIC and UMIC (p < 0.001). LMIC and LIC were vaccinated at local facilities (5.8%) and pharmacies (4.2%) more than other groups (3%) and at hub centers less (p < 0.05). The IV was lower for subjects from HIC (p < 0.05) with a MEM of 24 [22; 26] for LIC, 21 [21; 22] for LMIC and 27 [26; 27] for UMIC. Men from UMIC (9 [4; 14]), LMIC (7 [6; 8]) and LIC (4 [3; 5]) had a higher IV than women. All variables being equal, IV decreased with age (MEM -0.48 [-0.49; -0.47]). Distance was shorter for LMIC and LIC than for HIC (p < 0.05). The MEM on the distance of the Income group was -2.8 [-3.5; -2.2] for LIC and -2.0 [-2.1; -1.8] for LMIC (p < 0.05). The Income Group of one’s birth country is a barrier to vaccine accessibility in Italy, a HIC. Hence, we address public health workers to improve access to vaccination in community settings to narrow this gap. Key messages • Birthplace Income Group could be linked to vaccine accessibility in High Income Countries. • Public Health stakeholders should consider community and social barriers to healthcare access when planning health interventions.
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Affiliation(s)
- A Sartorello
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - E Paiola
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - L Accordini
- Prevention Department and Public Health , AULSS 9 Scaligera, Verona, Italy
| | - C Postiglione
- Prevention Department and Public Health , AULSS 9 Scaligera, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - R Benoni
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
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11
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Benoni R, Sartorello A, Paiola E, Andreani G, Moretti F, Tsegaye A, Tardivo S, Manenti F. Epidemiological factors affecting health service utilization in diabetic patients in Ethiopia. Eur J Public Health 2022. [PMCID: PMC9594848 DOI: 10.1093/eurpub/ckac131.114] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Diabetes-related deaths reached 2 million in 2019. The highest percentage of undiagnosed diabetes (59.7%) was observed in Africa, where accessibility to health services is pivotal to improving the outcome of diabetic patients. The study aims to assess the association between diabetic patients’ epidemiological factors and accessibility to healthcare services in a low-income country. The retrospective cohort study included diabetes-related outpatient department (OPD) visits and hospitalizations from 01/01/2018 to 31/08/2021 at St Luke Hospital (Ethiopia). Potential predictors were sociodemographic factors, COVID-19 cases, mean monthly temperature, and precipitations. The ARIMA method was applied to OPD visits and hospitalizations time series. OPD visits increased over time (p < 0.001) while hospitalizations were stable. The time series model was ARIMA(0,1,1) for OPD visits and ARIMA(0,0,0) for hospitalizations. Diabetes OPD patients were 1,685 (F = 732, 43%). Females had an average of 16% fewer OPD accesses per month (p = 0.002). Patients missing follow-up were 801 (48%). The time between follow-ups was longer as age increased (p < 0.001). There were 57 fewer forecast OPD visits per month on average using COVID-19 cases as ARIMA regressor. OPD visits decreased differently by geographic area as COVID-19 cases increased (p < 0.001). Hospitalized patients for diabetes were 408, 85 (20.8%) newly diagnosed. The odds ratio (OR) of diagnosis at admission was lower as age increased (OR 0.98, p = 0.009). Compared to type 1 diabetes, hospitalized females with type 2 (117-39.7%) were fewer than males (p = 0.019). Readmissions were 52, 10 (19.2%) within 30 days, without OR difference by sex, age, or diabetes type. Despite an increase in OPD visits for diabetic patients over the study period, the number of losses at follow-up and diagnoses at hospitalization remains high. Gender and age influenced service utilization. Females’ access to care is still problematic (concept of “missing women”). Key messages • Primary health care should be implemented to improve access to health services and diabetes management. • Ensuring equity in healthcare accessibility should be a priority in low-income countries.
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Affiliation(s)
- R Benoni
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - A Sartorello
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - E Paiola
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - G Andreani
- Doctors with Africa CUAMM , Padua, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - A Tsegaye
- Doctors with Africa CUAMM , Padua, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - F Manenti
- Doctors with Africa CUAMM , Padua, Italy
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12
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Benoni R, Sartorello A, Paiola E, Moretti F, Buson R, Tsegaye A, Tardivo S, Manenti F. Cross-sectional nutrition assessment in a refugee camp in Gambella region, Ethiopia. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.518] [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: 11/15/2022] Open
Abstract
Abstract
Minors account for 20 percent of the world’s migrants, reaching 33 million in 2019. The prevalence of malnutrition has been reported between 17 and 21% among refugees. However, data about Sub-Saharan African refugees is lacking. The study evaluates the nutritional status of refugees in the Nguenyyiel camp in Gambella (Ethiopia). The retrospective cohort study included all children under five attending the first visit to the refugee camp’s health post between 01/06/2021 and 31/08/2021. Sociodemographic data, body weight, and upper arm circumference (MUAC) were recorded. The z-score of weight for age (WFA) and MUAC for age (MUACZ) were estimated using the R ‘anthro’ package developed by the World Health Organization (WHO). Children with WFA <-2 standard deviations (SD) were considered underweight, those >2SD overweight. A MUACZ <-2SD defined acute malnutrition. Among the 782 patients admitted, 415 (53%) were under five. Females were 195 (47%). The mean age was 2.1 years (SD 1.6). The mean body weight was 11kg (SD 5). Considering the WFA, 200 (48%) children were within +2 SD. Children with WFA <-2SD were 92 (29%), those > 2SD were 28 (9%). The frequency of children with WFA <-2SD was higher in boys (p = 0.049). There were no differences in the frequency of children with WFA >2SD based on sex (p = 0.998). WFA decreased as age increased (p = 0.048). MUAC was recorded for 273 (66%) children. The mean MUAC was 14.2mm (SD 2.4). Children with MUAC z-scores within +2SD were 245 (77%). Children <-2SD were 92 (8%). The frequency of children with MUACZ <-2SD was not significantly different based on sex or age (p = 0.125, p = 0.324). The prevalence of malnutrition was moderate in the Nguenyyiel camp. At the same time, the frequency of underweight children was high, particularly among boys (34%) and with increasing age.
Key messages
• Nutrition remains a problem in refugee camp settings, especially in children.
• Ensuring the health of refugees, as vulnerable population, should be a priority for both governments and international organizations.
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Affiliation(s)
- R Benoni
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - A Sartorello
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - E Paiola
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - R Buson
- Doctors with Africa CUAMM , Padua, Italy
| | - A Tsegaye
- Doctors with Africa CUAMM , Padua, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - F Manenti
- Doctors with Africa CUAMM , Padua, Italy
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13
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Paiola E, Sartorello A, Andreani G, Tsegaye A, Tardivo S, Manenti F, Benoni R. Diabetic ketoacidosis among patients admitted to a general hospital in Ethiopia: a spatial analysis. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.649] [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: 11/12/2022] Open
Abstract
Abstract
Non-Communicable diseases are rapidly increasing in low- and middle-income countries. The number of patients with diabetes is estimated to reach 4.7 million in Ethiopia by 2045. Ensuring access to care is critical to improving the management and clinical outcome of diabetic patients. The study describes the characteristics of patients with diabetic ketoacidosis (DKA) and evaluates the relationship between the severity of clinical presentation and the travel time to the hospital. A retrospective cohort study was conducted on the charts of patients admitted for DKA at St. Luke Catholic Hospital (SLCH), Wolisso, Oromia Region (Ethiopia), between 01/01/2021 and 31/08/2021. Demographic and clinical data were collected. Negative binomial regression was used to explore the relationship between the incidence of admissions for DKA and travel time to the hospital. Logistic regression was used to estimate the odds of insulin treatment. Results were presented with 95% confidence intervals. During the study period, 651 patients were admitted, including 77 (11.8%) for DKA (33 females (42.9%) and 44 males (57.1%)), with no differences based on diabetes type (p = 0.258). The mean age was 35 years (IQR 19.0-52.0). Mean BMI was 18.4 kg/m2 (IQR 15.6-19.5), with no differences based on diabetes type (p = 0.639). Cumulative incidence of hospitalizations was significantly correlated to travel time to the hospital (p = 0.039) with an Incident Rate Ratio of 1.01%[1.00-1.02]. The cumulative incidence ranged from 7.0%[4.5-10.3] in Wolisso to 30.8%[14.3-51.8] in Ameya, the most distant district. The relative probability of insulin treatment was higher with increasing time to SLCH (OR 1.11[1.02-1.21] p = 0.027). The hospitalization rate for DKA was significantly correlated with the travel time to the hospital. Access to care is therefore a key factor for health that should be taken into account by improvement programs and the spatial analysis of travel time could help focus on priority areas.
Key messages
• Spatial analysis can be a robust tool to tailor population healthcare needs on its own topography.
• Health policies must consider that accessibility can influence the severity of clinical presentation.
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Affiliation(s)
- E Paiola
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - A Sartorello
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - G Andreani
- Doctors with Africa CUAMM , Padua, Italy
| | - A Tsegaye
- Doctors with Africa CUAMM , Padua, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - F Manenti
- Doctors with Africa CUAMM , Padua, Italy
| | - R Benoni
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
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14
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Benoni R, Campagna I, Moretti F, Tardivo S. Comparing swab- and different symptoms-based strategies to ascertain COVID-19 recovery in healthcare workers: a cost-effectiveness analysis. Cost Eff Resour Alloc 2022; 20:50. [PMID: 36096794 PMCID: PMC9465662 DOI: 10.1186/s12962-022-00385-w] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/13/2022] [Indexed: 11/15/2022] Open
Abstract
Objective Given the human and economic cost of the COVID-19 pandemic, protecting healthcare workers (HCW) and ensuring continuity of care is critical. The aim of this study is to evaluate the cost-effectiveness of different strategies to ascertain COVID-19 recovery in HCWs. Methods Data were collected from the hospital health surveillance program on HCWs at the University Hospital of Verona between 29/02/2020 and 14/04/2021. The diagnosis of SARS-CoV-2 infection and the assessment of the recovery were made through RT-PCR on oro-nasopharyngeal swab-sample. Recovery time and probability were estimated through Kaplan–Meier estimate. For each recovery assessment strategy costs (laboratory diagnostics and human resources), expressed in local currency (euro—€), and working days saved (WDS—effectiveness) were estimated. A decision-tree was created where each knot was a time point scheduled by the different recovery assessment strategies. A Monte Carlo simulation method was used, and probabilistic sensitivity analysis assessed the effect of input uncertainty. Results In the study period 916 (9.9%) HCWs tested positive. Recovery time through symptom-based strategy (21 days 0.95 CI 16–24) was significantly lower compared to swab-based one (25 days 0.95 CI 23–28, p < 0.001). The swab-based strategy was dominated by all symptoms-based ones. Symptoms-based with a swab on days 14 and 17 had an ICER of 2 €/WDS and 27 €/WDS compared to the one scheduled on days 10 and 17 and with only one swab on the 17th day. Conclusions Scheduling swabs on days 14 and 17 in a symptom-based strategy was the most cost-effective, saving 7.5 more working days than the standard one with swabs on days 10 and 17. Supplementary Information The online version contains supplementary material available at 10.1186/s12962-022-00385-w.
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15
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Genovese C, La Fauci V, Di Pietro A, Trimarchi G, Odone A, Casuccio A, Costantino C, Restivo V, Fantini M, Gori D, Azara A, Deiana G, Castaldi S, Righi E, Palandri L, Panciroli G, Bianco A, Licata F, Cosentino S, Mistretta A, Marranzano M, Ragusa R, Gabutti G, Stefanati A, Prato R, Fortunato F, Martinelli D, Icardi G, Panatto D, Amicizia D, Fabiani L, Moretti A, Di Risio D, Siliquini R, Voglino G, Bert F, Lorini C, Bonaccorsi G, Torre I, Pennino F, Pavia M, Di Giuseppe G, Paolantonio A, Villari P, Marzuillo C, Messina G, Rivieri C, Nante N, Majori S, Tardivo S, Moretti F, D'Amato S, Mazzitelli F, Giunta I, Lo Giudice D, Pantò G, Signorelli C, Squeri R. COVID-19: opinions and behavior of Italian general population during the first epidemic phase. Acta Biomed 2022; 93:e2022262. [PMID: 35775780 PMCID: PMC9335423 DOI: 10.23750/abm.v93i3.12262] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/13/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND AIM On January 9, 2020, the World Health Organization (WHO) declared that Chinese health authorities had identified a new coronavirus strain never before isolated in humans, the 2019-nCoV later redefined SARS-CoV-2, that still today represent a public health problem. The present survey started on 10 February 2020 with the aim of a) assessing the risk perception in healthcare workers and young students, following the evolution of attitudes, perception and knowledge over time, b) provide useful information to the general population during survey. RESULTS A study sample consisting of 4116 Italian individuals of both sexes was enrolled. High levels of risk perception, low perception of self-efficacy and low levels of knowledge scores (24.55 ± 5.76 SD) were obtained indicating the need for continuous population monitoring as well as further communication strategies carried out at institution levels. CONCLUSION The results of the present study could help public health authorities in carrying out informative campaigns for general population and could be an important tool in evaluating public knowledge and misperceptions during the management of the COVID-19. (www.actabiomedica.it).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Giovanni Panciroli
- Department of Biomedical, Metabolic and Neuroscience Sciences; University of Modena and Reggio Emilia, -Modena, Italy.
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16
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Tocco Tussardi I, Tardivo S. Improving Risk Management by Learning from Adverse Events: Report on One Year of COVID-19 Vaccination Campaign in Verona (Northeastern Italy). Int J Environ Res Public Health 2022; 19:ijerph19063635. [PMID: 35329322 PMCID: PMC8953314 DOI: 10.3390/ijerph19063635] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 02/01/2023]
Abstract
Background: The COVID-19 mass vaccination campaign posed new challenges not only from a healthcare perspective, but also in terms of distribution, logistics, and organization. Managing clinical risk in off-site vaccination centers during a pandemic provided a new opportunity for the training and acquisition of competencies through continuous learning from adverse events. The aim of this report, based on a review of activity, was to identify the most recurrent and high-risk failures of the vaccination process in a mass vaccination center. Methods: Adverse events and near misses reported during the first 11 months of activity (February 2021–January 2022) in the mass vaccination center of Verona (Italy) were evaluated. Results: From 15 February 2021 to 17 January 2022 the center administered about 460,000 doses to the population and nine adverse events and one near miss were reported. Most of the events were errors in vaccine administration, either in principle, dosage, or timing with respect to the indicated schedule. All events had minor outcomes. Communication errors, inadequate training, and general organizational issues were the most recurrent factors contributing to the events. Conclusions: Risk mitigation during mass vaccination in temporary sites is an essential element of a successful vaccination campaign. The reporting of adverse events should be encouraged in order to obtain as much information as possible for a continuous improvement of the activity.
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17
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Cazzoletti L, Zanolin ME, Tocco Tussardi I, Alemayohu MA, Zanetel E, Visentin D, Fabbri L, Giordani M, Ruscitti G, Benetollo PP, Tardivo S, Torri E. Correction: Cazzoletti et al. Risk Factors Associated with Nursing Home COVID-19 Outbreaks: A Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 8434. Int J Environ Res Public Health 2021; 18:ijerph182413175. [PMID: 34949038 PMCID: PMC8701741 DOI: 10.3390/ijerph182413175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Lucia Cazzoletti
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (M.E.Z.); (I.T.T.); (M.A.A.); (E.Z.); (D.V.)
| | - Maria Elisabetta Zanolin
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (M.E.Z.); (I.T.T.); (M.A.A.); (E.Z.); (D.V.)
| | - Ilaria Tocco Tussardi
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (M.E.Z.); (I.T.T.); (M.A.A.); (E.Z.); (D.V.)
| | - Mulubirhan Assefa Alemayohu
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (M.E.Z.); (I.T.T.); (M.A.A.); (E.Z.); (D.V.)
| | - Ernesto Zanetel
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (M.E.Z.); (I.T.T.); (M.A.A.); (E.Z.); (D.V.)
| | - Donatella Visentin
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (M.E.Z.); (I.T.T.); (M.A.A.); (E.Z.); (D.V.)
| | - Luca Fabbri
- Azienda Provinciale per i Servizi Sanitari, Autonomous Province of Trento, 38123 Trento, Italy; (L.F.); (P.P.B.)
| | - Massimo Giordani
- Unione Provinciale Istituzioni per l’Assistenza, Autonomous Province of Trento, 38122 Trento, Italy;
| | - Giancarlo Ruscitti
- Department of Health and Social Policies, Autonomous Province of Trento, 38123 Trento, Italy; (G.R.); (E.T.)
| | - Pier Paolo Benetollo
- Azienda Provinciale per i Servizi Sanitari, Autonomous Province of Trento, 38123 Trento, Italy; (L.F.); (P.P.B.)
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (L.C.); (M.E.Z.); (I.T.T.); (M.A.A.); (E.Z.); (D.V.)
- Correspondence: ; Tel.: +39-045-802-7660
| | - Emanuele Torri
- Department of Health and Social Policies, Autonomous Province of Trento, 38123 Trento, Italy; (G.R.); (E.T.)
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18
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Gallè F, Valeriani F, Marotta D, De Giorgi A, Bargellini A, Bianco A, Colucci ME, Coniglio MA, Dallolio L, De Giglio O, Di Giuseppe G, Diella G, Laganà P, Licata F, Liguori G, Marchesi I, Marini S, Montagna MT, Napoli C, Orsi GB, Pasquarella C, Pelullo CP, Ricciardi L, Romano Spica V, Sacchetti R, Tardivo S, Veronesi L, Vitali M, Protano C. What about Your Body Ornament? Experiences of Tattoo and Piercing among Italian Youths. Int J Environ Res Public Health 2021; 18:12429. [PMID: 34886155 PMCID: PMC8657262 DOI: 10.3390/ijerph182312429] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND tattooing and piercing are increasingly common, especially among youths. However, several health complications may be associated with these practices if basic hygiene rules are not respected. This multicenter study was aimed at exploring tattoo and piercing experiences reported by a large sample of Italian undergraduate students through a public health perspective. METHODS tattooed and/or pierced students attending 12 Italian universities were asked to complete a web-based questionnaire regarding their body art experience. RESULTS out of 1472 respondents, 833 (56.6%) were tattooed and 1009 (68.5%) were pierced. The greatest proportion of tattooed students (93.9%) got her/his first tattoo in a tattoo studio, while most of the pierced were serviced in a jewelry store (48.0%). The pierced ones were less informed on health issues related to the procedure (56.0% versus 77.8% of tattooed p < 0.001), and tattooists were reportedly more attentive to hygiene rules (instrument sterilization 91.5% versus 79.1% of piercers, p < 0.001; use of disposable gloves 98.2% versus 71% of piercers, p < 0.001). CONCLUSIONS educational interventions for both professionals and communities are needed to improve the awareness and the control of health risks related to body art throughout the Italian territory.
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Affiliation(s)
- Francesca Gallè
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Federica Valeriani
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Daniela Marotta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Andrea De Giorgi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Annalisa Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (I.M.)
| | - Aida Bianco
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.B.); (F.L.)
| | - Maria Eugenia Colucci
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (M.E.C.); (C.P.); (L.V.)
| | - Maria Anna Coniglio
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy;
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Sciences Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (L.D.); (S.M.)
| | - Osvalda De Giglio
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (O.D.G.); (G.D.); (M.T.M.)
| | - Gabriella Di Giuseppe
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.G.); (C.P.P.)
| | - Giusy Diella
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (O.D.G.); (G.D.); (M.T.M.)
| | - Pasqualina Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy;
| | - Francesca Licata
- Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, Italy; (A.B.); (F.L.)
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Isabella Marchesi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (I.M.)
| | - Sofia Marini
- Department of Biomedical and Neuromotor Sciences Alma Mater Studiorum, University of Bologna, 40126 Bologna, Italy; (L.D.); (S.M.)
| | - Maria Teresa Montagna
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, 70124 Bari, Italy; (O.D.G.); (G.D.); (M.T.M.)
| | - Christian Napoli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, 00139 Rome, Italy;
| | - Giovanni Battista Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Cesira Pasquarella
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (M.E.C.); (C.P.); (L.V.)
| | - Concetta Paola Pelullo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy; (G.D.G.); (C.P.P.)
| | - Luca Ricciardi
- Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Sapienza University of Rome, 00189 Rome, Italy;
| | - Vincenzo Romano Spica
- Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Rossella Sacchetti
- Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, 40126 Bologna, Italy;
| | - Stefano Tardivo
- Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Italy;
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy; (M.E.C.); (C.P.); (L.V.)
| | - Matteo Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
| | - Carmela Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (D.M.); (A.D.G.); (G.B.O.); (M.V.); (C.P.)
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19
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Tocco Tussardi I, Benoni R, Moretti F, Tardivo S, Poli A, Wu AW, Rimondini M, Busch IM. Patient safety attitudes in the next generation of healthcare providers. A review of the literature. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.669] [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
A comprehensive understanding of the attitudes towards patient safety of the new generation of healthcare workers is fundamental not only for ensuring safe, high-quality care in the present but also for creating a safer healthcare setting in the future. This study aimed to systematically review the literature on patient safety attitudes of health professional students, new graduates, newly registered health professionals, and resident trainees, and to examine potential differences in this population with respect to year of study, specialty, and gender.
Methods
We searched four databases (i.e., PubMed, Web of Science, Scopus, and PsycInfo) up to 20/02/2020 and screened also additional sources, including weekly, automatic e-mailed search alerts up to 18/10/2020. Two reviewers independently performed all methodological steps (i.e., search, study selection, quality appraisal, data extraction and formal narrative synthesis), including a third reviewer in case of disagreement.
Results
We identified 6606 records, assessed 188 full-texts, and included 31 articles. Across studies, healthcare students and young professionals reported more positive patient safety attitudes in certain domains (e.g., teamwork climate, error inevitability, received patient safety training) but showed more negative attitudes in other areas (e.g., management support, safety climate, disclosure responsibility). Women and persons with more years of study and training demonstrated more positive attitudes towards patient safety.
Conclusions
Healthcare students should receive early curricular education in patient safety to build a solid foundation for the development of a strong and healthy safety culture. Understanding the differences in attitudes between aspiring healthcare providers from different areas is important to tailor teaching and training to the specific needs of certain populations.
Key messages
According to the reviewed literature, young healthcare students and professionals’ attitudes towards patient safety differed across domains. Institutions should increase education and training on patient safety for aspiring healthcare professionals, tailor them to the specific needs of this population, and monitor attitudes over time.
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Affiliation(s)
- I Tocco Tussardi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - R Benoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Poli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - AW Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - M Rimondini
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - IM Busch
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
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20
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Tocco Tussardi I, Mazzi M, Benoni R, Astorino G, Fila A, Tardivo S, Majori S, Busch IM, Rimondini M, Moretti F. Knowledge on sexually transmitted diseases: results from a survey among Italian university students. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.382] [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: 11/12/2022] Open
Abstract
Abstract
Background
Sexually transmitted diseases (STDs) are one of the most pressing public health concerns in many countries. Adolescents and young adults are the most affected population. Given that risky sexual behaviors are a growing trend, awareness must be increased. To identify the most important issues contributing to STDs spreading in the young population, we designed a project aimed to explore knowledge, attitudes, and behaviors related to STDs among students from an Italian University. As part of this bigger project, the present study focused on data regarding knowledge, information/education sources, and awareness on non-sexual ways of transmission.
Methods
A descriptive, cross-sectional study was carried out at the University of Verona, Italy. An ad-hoc questionnaire was developed based on existing literature and expert consensus and was administered to the students from December 2, 2020 to January 7, 2021. The project was approved by the Committee for Human Research of the University of Verona.
Results
A total number of 2258 individuals (76% women) answered the survey. Results were not quite satisfactory, especially regarding the knowledge on ways of STD transmission and carcinogenic viruses, and students showed misperceptions about general knowledge related to STDs. The study also demonstrated that students collect information on STDs primarily from the internet but would turn to a specialist in case of doubt. Misbeliefs regarding non-sexual ways of transmission were observed. Regarding differences between genders, the female population was tendentially more aware of the link between Papilloma Virus infection and cancer.
Conclusions
This study indicates that current educational efforts to disseminate knowledge on STDs and thus contain infections are not sufficient. To prevent future spreading of STDs, information activities regarding STDs should be increased and health education in schools and universities promoted.
Key messages
Early information and education are among the pillars of controlling the spread of STDs, but at the moment they still seem to need better implementation. Assessing which areas of knowledge must be improved in different groups can facilitate the development of targeted interventions to achieve better results in terms of disease awareness and prevention.
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Affiliation(s)
- I Tocco Tussardi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - M Mazzi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - R Benoni
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - G Astorino
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Fila
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - S Majori
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - IM Busch
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - M Rimondini
- Department of Neuroscience, Biomedicine and Movement Science, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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21
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Tocco Tussardi I, Moretti F, Capasso M, Niero V, Visentin D, Dalla Barba L, Tardivo S. Improving the culture of safety among healthcare workers: Integration of different instruments to gain major insights and drive effective changes. Int J Health Plann Manage 2021; 37:429-451. [PMID: 34647358 PMCID: PMC9293423 DOI: 10.1002/hpm.3348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/12/2020] [Revised: 09/04/2021] [Accepted: 09/28/2021] [Indexed: 11/08/2022] Open
Abstract
The Safety Attitude Questionnaire (SAQ) and Manchester Patient Safety Framework (MaPSaF) are known as effective tools to assess patient safety culture and climate and develop targeted strategies. However, they are seldom applied in an integrated way. The aim of this study was to conduct an implementation project through a novel use of both instruments to gain unique insights. The Italian version of MaPSaF and SAQ were administered to 1,759 healthcare workers from three Italian hospitals (response rate: MaPSaF 70.5%, SAQ 61.6%). MaPSaF evaluation proved an overall bureaucratic level of patient safety culture. SAQ scores showed a predominance of neutral scores (75.99%). The dimension perception of management gained the lowest mean score (53.32), while Stress recognition obtained the highest (75.17). Safety climate perception differed significantly among groups: working in a small hospital, in a medical department, and being a physician were associated with the most positive results. The majority (67.1%) of responders to both MaPSaF and SAQ considered the two instruments as providing with different and complementary information. Overall, results showed that an integrated approach in the evaluation of an organisation's safety culture may result useful for an in-depth analysis of the criticalities and the adoption of appropriate improvement strategies.
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Affiliation(s)
| | - Francesca Moretti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Mario Capasso
- Veneto Region Local Health Authority n. 2, "Marca Trevigiana", Treviso, Italy
| | - Valentina Niero
- Veneto Region Local Health Authority n. 8, "Berica", Arzignano (VI), Italy
| | - Donatella Visentin
- Health Services Trust of the Autonomous Province of Trento, Trento, Italy
| | - Livio Dalla Barba
- Veneto Region Local Health Authority n. 3, "Serenissima", Mirano-Dolo (VE), Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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22
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Mortaro A, Moretti F, Pascu D, Tessari L, Tardivo S, Pancheri S, Marta G, Romano G, Mazzi M, Montresor P, Naessens JM. Adverse Events Detection Through Global Trigger Tool Methodology: Results From a 5-Year Study in an Italian Hospital and Opportunities to Improve Interrater Reliability. J Patient Saf 2021; 17:451-457. [PMID: 28598897 DOI: 10.1097/pts.0000000000000381] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Global Trigger Tool (GTT) has been proposed as a low-cost method to detect adverse events (AEs). The validity of the methodology has been questioned because of moderate interrater agreement. Continuous training has been suggested as a means to improve consistency over time. We present the main findings of the implementation of the Italian version of the GTT and evaluate efforts to improve the interrater reliability over time. METHODS The Italian version of the GTT was developed and implemented at the San Bonifacio Hospital, a 270-bed secondary care acute hospital in Verona, Italy. Ten clinical records randomly selected every 2 weeks were reviewed from 2009 to 2014. Two-stage interrater reliability assessment between team members was conducted on 2 subsamples of 50 clinical records before and after the implementation of specific review rules and staff training. RESULTS Among 1320 medical records reviewed, a total of 366 AEs were found with at least 1 AE on 20.2% of all discharges, 27.7 AEs/100 admissions, and 30.6 AEs/1000 patient-days. Adverse events with harm score E and F were respectively 58.2% (n = 213) and 38.8% (n = 142). First round interrater reliability was comparable with other international studies. The interrater agreement improved significantly after intervention (κ interrater I = 0.52, κ interrater II = 0.80, P < 0.001). CONCLUSIONS Despite the improvements in the interrater consistency, overall results did not show any significant trend in AEs over time. Future studies may be directed to apply and adapt the GTT methodology to more specific settings to explore how to improve its sensitivity.
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Affiliation(s)
- Alberto Mortaro
- From the University of Verona, Department of Diagnostic and Public Health
| | - Francesca Moretti
- From the University of Verona, Department of Diagnostic and Public Health
| | - Diana Pascu
- Health Care Trust 20, San Bonifacio Hospital, Medical Board, Verona, Italy
| | - Lorella Tessari
- Health Care Trust 20, San Bonifacio Hospital, Medical Board, Verona, Italy
| | - Stefano Tardivo
- From the University of Verona, Department of Diagnostic and Public Health
| | - Serena Pancheri
- From the University of Verona, Department of Diagnostic and Public Health
| | - Garon Marta
- From the University of Verona, Department of Diagnostic and Public Health
| | - Gabriele Romano
- From the University of Verona, Department of Diagnostic and Public Health
| | - Mariangela Mazzi
- From the University of Verona, Department of Diagnostic and Public Health
| | - Paolo Montresor
- Health Care Trust 20, San Bonifacio Hospital, Medical Board, Verona, Italy
| | - James M Naessens
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
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23
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Tocco Tussardi I, Benoni R, Moretti F, Tardivo S, Poli A, Wu AW, Rimondini M, Busch IM. Patient Safety in the Eyes of Aspiring Healthcare Professionals: A Systematic Review of Their Attitudes. Int J Environ Res Public Health 2021; 18:ijerph18147524. [PMID: 34299975 PMCID: PMC8306767 DOI: 10.3390/ijerph18147524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022]
Abstract
A culture of safety is important for the delivery of safe, high-quality care, as well as for healthcare providers' wellbeing. This systematic review aimed to describe and synthesize the literature on patient safety attitudes of the next generation of healthcare workers (health professional students, new graduates, newly registered health professionals, resident trainees) and assess potential differences in this population related to years of study, specialties, and gender. We screened four electronic databases up to 20 February 2020 and additional sources, including weekly e-mailed search alerts up to 18 October 2020. Two independent reviewers conducted the search, study selection, quality rating, data extraction, and formal narrative synthesis, involving a third reviewer in case of dissent. We retrieved 6606 records, assessed 188 full-texts, and included 31 studies. Across articles, healthcare students and young professionals showed overwhelmingly positive patient safety attitudes in some areas (e.g., teamwork climate, error inevitability) but more negative perceptions in other domains (e.g., safety climate, disclosure responsibility). Women tend to report more positive attitudes. To improve safety culture in medical settings, health professions educators and institutions should ensure education and training on patient safety.
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Affiliation(s)
- Ilaria Tocco Tussardi
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Francesca Moretti
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; (F.M.); (I.M.B.)
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Albino Poli
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.T.T.); (R.B.); (S.T.); (A.P.)
| | - Albert W. Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Michela Rimondini
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; (F.M.); (I.M.B.)
- Correspondence:
| | - Isolde Martina Busch
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy; (F.M.); (I.M.B.)
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24
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Tocco-Tussardi I, Fila A, Tralli V, Bordin P, Gazzani D, Majori S, Postiglione C, Tardivo S, Moretti F. Screening for hepatitis B virus infection among refugees diagnosed with latent tuberculosis in an Italian community. Ann Ig 2021; 33:602-614. [PMID: 34213522 DOI: 10.7416/ai.2021.2452] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Refugees are a growing population in the EU-27 area with specific health needs that are to be addressed in the most rapid and effective way at their arrival in the host country. Screening for Hepatitis B Virus infection is offered to specific categories and it could be useful and effective to extend its indications. The aim of this study was to define the epidemiological profile regarding Hepatitis B Virus infection in re-fugees hosted in the Asylum Seekers Centers of Verona (Italy), diagnosed with latent tuberculosis infection and eligible for chemoprophylaxis. Methods We conducted a retrospective study in 715 refugees diagnosed with latent tuberculosis infection from January 1st, 2015 to December 31st, 2017. Screening for Hepatitis B Virus infection was offered to la-tent tuberculosis infection patients who were due to commence treatment. Subjects were tested for Hepatitis B surface Antigen and Hepatitis B core antigen total antibodies. None of the screened patients reported previous vaccination for hepatitis B. Results Among the 715 refugees diagnosed with latent tuberculosis infection, 593 were eligible for treatment for latent tuberculosis infection. Of these, 211 (35.6%) accepted to be screened for Hepatitis B Virus infection. One hundred and ninety-five of the 211 (92.4%) came from African countries, and 16 (7.6%) from Asia; the majority (80.9%) were males. Median age was 23 years (95% CI 22-24). Of the 211, 58 individuals (27.5%) were Hepatitis B surface Antigen and Hepatitis B core antigen total antibodies positive; 74 (35.1%) were Hepatitis B surface Antigen negative and Hepatitis B core antigen total antibodies positive; and 79 (37.4%) were Hepatitis B surface Antigen and Hepatitis B core antigen total antibodies negative. Male gender and African origin were associated with a lower probability of being Hepatitis B surface Antigen- and Hepatitis B core antigen total antibodies-negative. Conclusions Screening for Hepatitis B Virus is of paramount importance not only for the control and prevention of infection, but also in terms of long-term healthcare issues. Making screening more systematic can have an important impact on public health, while always considering cost-effectiveness and promotion of awareness among ethnic groups in order to gain their compliance to treatment/vaccination.
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Affiliation(s)
- I Tocco-Tussardi
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - A Fila
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - V Tralli
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - P Bordin
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - D Gazzani
- Service of Hygiene and Public Health, Territorial Department of Prevention of Verona, Verona, Italy
| | - S Majori
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - C Postiglione
- Service of Hygiene and Public Health, Territorial Department of Prevention of Verona, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
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25
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Porru S, Monaco MGL, Carta A, Spiteri G, Parpaiola M, Battaggia A, Galligioni G, Ferrazzi B, Lo Cascio G, Gibellini D, Peretti A, Brutti M, Tardivo S, Ghirlanda G, Verlato G, Gaino S, Peserico D, Bassi A, Lippi G. SARS-CoV-2 Infection in Health Workers: Analysis from Verona SIEROEPID Study during the Pre-Vaccination Era. Int J Environ Res Public Health 2021; 18:ijerph18126446. [PMID: 34198715 PMCID: PMC8296263 DOI: 10.3390/ijerph18126446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/10/2021] [Accepted: 06/10/2021] [Indexed: 12/24/2022]
Abstract
Background: To report the baseline phase of the SIEROEPID study on SARS-CoV-2 infection seroprevalence among health workers at the University Hospital of Verona, Italy, between spring and fall 2020; to compare performances of several laboratory tests for SARS-CoV-2 antibody detection. Methods: 5299 voluntary health workers were enrolled from 28 April 2020 to 28 July 2020 to assess immunological response to SARS-CoV-2 infection throughout IgM, IgG and IgA serum levels titration by four laboratory tests. Association of antibody titre with several demographic variables, swab tests and performance tests (sensitivity, specificity, and agreement) were statistically analyzed. Results: The overall seroprevalence was 6%, considering either IgG and IgM, and 4.8% considering IgG. Working in COVID-19 Units was not associated with a statistically significant increase in the number of infected workers. Cohen’s kappa of agreement between MaglumiTM and VivaDiagTM was quite good when considering IgG only (Cohen’s kappa = 78.1%, 95% CI 74.0–82.0%), but was lower considering IgM (Cohen’s kappa = 13.3%, 95% CI 7.8–18.7%). Conclusion: The large sample size with high participation (84.7%), the biobank and the longitudinal design were significant achievements, offering a baseline dataset as the benchmark for risk assessment, health surveillance and management of SARS-CoV-2 infection for the hospital workforce, especially considering the ongoing vaccination campaign. Study results support the national regulator guidelines on using swabs for SARS-CoV-2 screening with health workers and using the serological tests to contribute to the epidemiological assessment of the spread of the virus.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (S.P.); (A.C.)
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
| | - Maria Grazia Lourdes Monaco
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
- Correspondence: ; Tel.: +0039-0458123946
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (S.P.); (A.C.)
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
| | - Gianluca Spiteri
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona, Italy;
| | - Marco Parpaiola
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | - Andrea Battaggia
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | - Giulia Galligioni
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | - Beatrice Ferrazzi
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy; (M.P.); (A.B.); (G.G.); (B.F.)
| | | | - Davide Gibellini
- Section of Microbiology, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona, Italy; (A.P.); (M.B.)
| | - Angelo Peretti
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona, Italy; (A.P.); (M.B.)
| | - Martina Brutti
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona, Italy; (A.P.); (M.B.)
| | - Stefano Tardivo
- Section of Hygiene, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | | | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy;
| | - Stefania Gaino
- Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, 37134 Verona, Italy; (S.G.); (A.B.); (G.L.)
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Denise Peserico
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Antonella Bassi
- Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, 37134 Verona, Italy; (S.G.); (A.B.); (G.L.)
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
| | - Giuseppe Lippi
- Laboratory of Clinical Chemistry and Hematology, University Hospital of Verona, 37134 Verona, Italy; (S.G.); (A.B.); (G.L.)
- Section of Clinical Biochemistry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy;
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Benoni R, Panunzi S, Campagna I, Moretti F, Lo Cascio G, Spiteri G, Porru S, Tardivo S. The Effect of Test Timing on the Probability of Positive SARS-CoV-2 Swab Test Results: Mixed Model Approach. JMIR Public Health Surveill 2021; 7:e27189. [PMID: 34003761 PMCID: PMC8176944 DOI: 10.2196/27189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/14/2021] [Revised: 04/08/2021] [Accepted: 05/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, swab tests proved to be effective in containing the infection and served as a means for early diagnosis and contact tracing. However, little evidence exists regarding the correct timing for the execution of the swab test, especially for asymptomatic individuals and health care workers. OBJECTIVE The objective of this study was to analyze changes in the positive findings over time in individual SARS-CoV-2 swab tests during a health surveillance program. METHODS The study was conducted with 2071 health care workers at the University Hospital of Verona, with a known date of close contact with a patient with COVID-19, between February 29 and April 17, 2020. The health care workers underwent a health surveillance program with repeated swab tests to track their virological status. A generalized additive mixed model was used to investigate how the probability of a positive test result changes over time since the last known date of close contact, in an overall sample of individuals who tested positive for COVID-19 and in a subset of individuals with an initial negative swab test finding before being proven positive, to assess different surveillance time intervals. RESULTS Among the 2071 health care workers in this study, 191 (9.2%) tested positive for COVID-19, and 103 (54%) were asymptomatic with no differences based on sex or age. Among 49 (25.7%) cases, the initial swab test yielded negative findings after close contact with a patient with COVID-19. Sex, age, symptoms, and the time of sampling were not different between individuals with an initial negative swab test finding and those who initially tested positive after close contact. In the overall sample, the estimated probability of testing positive was 0.74 on day 1 after close contact, which increased to 0.77 between days 5 and 8. In the 3 different scenarios for scheduled repeated testing intervals (3, 5, and 7 days) in the subgroup of individuals with an initially negative swab test finding, the probability peaked on the sixth, ninth and tenth, and 13th and 14th days, respectively. CONCLUSIONS Swab tests can initially yield false-negative outcomes. The probability of testing positive increases from day 1, peaking between days 5 and 8 after close contact with a patient with COVID-19. Early testing, especially in this final time window, is recommended together with a health surveillance program scheduled in close intervals.
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Affiliation(s)
- Roberto Benoni
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - Silvia Panunzi
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Irene Campagna
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - Francesca Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Gianluca Spiteri
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Porru
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Benoni R, Campagna I, Panunzi S, Varalta MS, Salandini G, De Mattia G, Turrina G, Moretti F, Lo Cascio G, Spiteri G, Porru S, Tardivo S, Poli A, Bovo C. Estimating COVID-19 recovery time in a cohort of Italian healthcare workers who underwent surveillance swab testing. Public Health 2021; 196:52-58. [PMID: 34144335 PMCID: PMC8133387 DOI: 10.1016/j.puhe.2021.05.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 12/07/2020] [Revised: 04/26/2021] [Accepted: 05/12/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The COVID-19 pandemic is putting a huge strain on the provision and continuity of care. The length of sickness absence of the healthcare workers as a result of SARS-CoV-2 infection plays a pivotal role in hospital staff management. Therefore, the aim of this study was to explore the timing of COVID-19 recovery and viral clearance, and its predictive factors, in a large sample of healthcare workers. STUDY DESIGN This is a retrospective cohort study. METHODS The analysis was conducted on data collected during the hospital health surveillance programme for healthcare staff at the University Hospital of Verona; healthcare workers were tested for SARS-CoV-2 through RT-PCR with oronasopharyngeal swab samples. The health surveillance programme targeted healthcare workers who either had close contact with SARS-CoV-2-infected patients or were tested as part of the screening-based strategy implemented according to national and regional requirements. Recovery time was estimated from the first positive swab to two consecutive negative swabs, collected 24 h apart, using survival analysis for both right-censored and interval-censored data. Cox proportional hazard was used for multivariate analysis. RESULTS During the health surveillance programme, 6455 healthcare workers were tested for SARS-CoV-2 and 248 (3.8%, 95% confidence interval [CI]: 3.4-4.3) reported positive results; among those who tested positive, 49% were asymptomatic, with a median age of 39.8 years, which is significantly younger than symptomatic healthcare workers (48.2 years, P < 0.001). Screening tests as part of the health surveillance programme identified 31 (12.5%) of the positive cases. Median recovery time was 24 days (95% CI: 23-26) and 21.5 days (95% CI: 15.5-30.5) in right- and interval-censoring analysis, respectively, with no association with age, sex or presence of symptoms. Overall, 63% of participants required >20 days to test negative on two consecutive swabs. Hospitalised healthcare workers (4.8%) were older and had a significantly longer recovery time compared with non-hospitalised healthcare workers in both analyses (33.5 vs 24 days, P = 0.005). CONCLUSIONS Recovery from COVID-19 and viral clearance may take a long time, especially in individuals who are hospitalised. To detect asymptomatic cases, screening programmes for healthcare workers is recommended.
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Affiliation(s)
- R Benoni
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy.
| | - I Campagna
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - S Panunzi
- Department of Diagnostics and Public Health, Unit of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
| | - M S Varalta
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - G Salandini
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - G De Mattia
- Postgraduate School of Hygiene and Preventive Medicine, University of Verona, Verona, Italy
| | - G Turrina
- Postgraduate School of Occupational Medicine, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, Verona, Italy
| | - G Lo Cascio
- Department of Pathology, Microbiology and Virology Unit, University Hospital of Verona, Verona, Italy
| | - G Spiteri
- Department of Diagnostics and Public Health, Section of Occupational Medicine, University of Verona, Verona, Italy
| | - S Porru
- Department of Diagnostics and Public Health, Section of Occupational Medicine, University of Verona, Verona, Italy; Clinical Unit of Occupational Medicine, University Hospital of Verona, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, Verona, Italy; Medical Direction, University Hospital of Verona, Verona, Italy
| | - A Poli
- Department of Diagnostics and Public Health, Section of Hygiene, University of Verona, Verona, Italy
| | - C Bovo
- Medical Direction, University Hospital of Verona, Verona, Italy
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Busch IM, Moretti F, Campagna I, Benoni R, Tardivo S, Wu AW, Rimondini M. Promoting the Psychological Well-Being of Healthcare Providers Facing the Burden of Adverse Events: A Systematic Review of Second Victim Support Resources. Int J Environ Res Public Health 2021; 18:ijerph18105080. [PMID: 34064913 PMCID: PMC8151650 DOI: 10.3390/ijerph18105080] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
Abstract
Given the negative impact of adverse events on the wellbeing of healthcare providers, easy access to psychological support is crucial. We aimed to describe the types of support resources available in healthcare organizations, their benefits for second victims, peer supporters’ experiences, and implementation challenges. We also explored how these resources incorporate aspects of Safety I and Safety II. We searched six databases up to 19 December 2019 and additional literature, including weekly search alerts until 21 January 2021. Two reviewers independently performed all methodological steps (search, selection, quality assessment, data extraction, formal narrative synthesis). The 16 included studies described 12 second victim support resources, implemented between 2006 and 2017. Preliminary data indicated beneficial effects not only for the affected staff but also for the peer responders who considered their role to be challenging but gratifying. Challenges during program implementation included persistent blame culture, limited awareness of program availability, and lack of financial resources. Common goals of the support programs (e.g., fostering coping strategies, promoting individual resilience) are consistent with Safety II and may promote system resilience. Investing in second victim support structures should be a top priority for healthcare institutions adopting a systemic approach to safety and striving for just culture.
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Affiliation(s)
- Isolde Martina Busch
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Policlinico G.B. Rossi Piazzale L.A. Scuro 10, 37134 Verona, Italy; (I.M.B.); (F.M.)
| | - Francesca Moretti
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Policlinico G.B. Rossi Piazzale L.A. Scuro 10, 37134 Verona, Italy; (I.M.B.); (F.M.)
| | - Irene Campagna
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.C.); (R.B.); (S.T.)
| | - Roberto Benoni
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.C.); (R.B.); (S.T.)
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (I.C.); (R.B.); (S.T.)
| | - Albert W. Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Michela Rimondini
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Policlinico G.B. Rossi Piazzale L.A. Scuro 10, 37134 Verona, Italy; (I.M.B.); (F.M.)
- Correspondence:
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29
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Tocco-Tussardi I, De Mattia G, Gasabelli V, Mazzer M, Vanin S, Ramaroli DA, Schiesaro G, Salandini G, Varalta MS, Benoni R, Zanetel E, Fagherazzi J, Tardivo S. COVID-19 pandemic: an Italian single institution's experience and lessons learned by public health residents' workforce. Ann Ig 2021; 33:410-425. [PMID: 33565569 DOI: 10.7416/ai.2021.2438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Methods We hereby provide a systematic description of the response actions in which the public health residents' workforce was pivotal, in a large tertiary hospital. Background The Coronavirus Disease 2019 pandemic has posed incredible challenges to healthcare workers worldwide. The residents have been affected by an almost complete upheaval of the previous setting of activities, with a near total focus on service during the peak of the emergency. In our Institution, residents in public health were extensively involved in leading activities in the management of Coronavirus Disease 2019 pandemic. Results The key role played by residents in the response to Coronavirus Disease 2019 pandemic is highlighted by the diversity of contributions provided, from cooperation in the rearrangement of hospital paths for continuity of care, to establishing and running new services to support healthcare professionals. Overall, they constituted a workforce that turned essential in governing efficiently such a complex scenario. Conclusions Despite the difficulties posed by the contingency and the sacrifice of many training activities, Coronavirus Disease 2019 pandemic turned out to be a unique opportunity of learning and measuring one's capabilities and limits in a context of absolute novelty and uncertainty.
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Affiliation(s)
- I Tocco-Tussardi
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - G De Mattia
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - V Gasabelli
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - M Mazzer
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - S Vanin
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - D A Ramaroli
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - G Schiesaro
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - G Salandini
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - M S Varalta
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - R Benoni
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - E Zanetel
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - J Fagherazzi
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, and Medical Direction Unit, Integrated University Hospital of Verona, Verona, Italy
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Tralli V, Bertoni C, Colucci L, Postiglione C, Valsecchi M, Tocco-Tussardi I, Tardivo S, Majori S, Moretti F. Active TB screening among homeless people attending soup kitchens in Verona (Italy). Ann Ig 2021; 33:332-336. [PMID: 33565570 DOI: 10.7416/ai.2021.2416] [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] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background The hard-to-reach populations, including the homeless, are particularly vulnerable to the development of active tuberculosis. According to the World Health Organization, tuberculosis rates among the homeless in industrialized Countries are up to 20 times higher if compared with the general popula-tion, representing a relevant public health problem. The aim of our study was to describe the results of an active tuberculosis screening applied in order to find out suspected active TB cases among the homeless in Verona. Methods As part of a partnership between the non-profit association Medici per la Pace and one of the Local Health Units of Veneto Region (ULSS 9 Scaligera) in 2018, a tuberculosis screening, based on thoracic radiographs, was offered to the homeless guests of two Verona's soup kitchens. Results The studied population included 139 people, and three cases of suspected active tuberculosis, all in males, were observed. Among these, two received a diagnostic confirmation of active tuberculosis (a prevalence of 1.44% - CI: 0,17 - 5,1). Moreover, radiographic patterns of tuberculosis aftermaths were found in six additional subjects. Conclusions Interventions specifically dedicated to hard-to-reach populations, can be useful in identifying tuberculosis active cases and controlling the disease in low tuberculosis burden countries. In particular, the active research of subjects, the screening carried out with mobile X-ray, and also the constant caring of the patients with active disease, could be the right method to keep under control this relevant public health problem.
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Affiliation(s)
- V Tralli
- Postgraduate Specialization in "Hygiene and Preventive Medicine". University of Verona, Italy
| | - C Bertoni
- Postgraduate Specialization in "Hygiene and Preventive Medicine". University of Verona, Italy
| | - L Colucci
- Prevention Department, Hygiene and Public Health Service, AULSS 9 Scaligera, Verona, Italy
| | - C Postiglione
- Prevention Department, Hygiene and Public Health Service, AULSS 9 Scaligera, Verona, Italy
| | - M Valsecchi
- Onlus "Medici per la Pace" Volunteer Doctor, Verona, Italy
| | - I Tocco-Tussardi
- Postgraduate Specialization in "Hygiene and Preventive Medicine". University of Verona, Italy
| | - S Tardivo
- Department of Public Health and Community Medicine & Hygiene and Environmental Occupational Preventive Medicine Division, University of Verona, Italy
| | - S Majori
- Department of Public Health and Community Medicine & Hygiene and Environmental Occupational Preventive Medicine Division, University of Verona, Italy
| | - F Moretti
- Department of Public Health and Community Medicine & Hygiene and Environmental Occupational Preventive Medicine Division, University of Verona, Italy
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Lesa L, Brunelli L, Valent F, Aprili I, Cametti E, Ferrari S, Camussi E, Degan S, De Corti D, Bellomo F, Tardivo S, Siliquini R, Brusaferro S. The underestimated burden of aspiration event and pneumonia within hospitals: what happens after dysphagia. Ann Ig 2021; 33:555-563. [PMID: 33565565 DOI: 10.7416/ai.2021.2436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Study design Prospective observational study. Background Despite dysphagia large prevalence and the growing ageing phenomenon occurring in European countries, aspiration events among inpatients are often underestimated, given their frequent spontaneous resolution or silent contribution to aspiration syndromes. Our main objective was to evaluate the incidence of aspiration events among medical inpatients and to identify risk factors influencing the outcome of the event. Methods Data about aspiration events - day, hour, type and outcome of the event occurred - along with underlying patient clinical conditions at the admission were collected. Between May 2015 and September 2016, data about aspiration event occurred among medical inpatients were collected in three large Italian hospitals. Results Patients affected by aspiration events were 135 on 102,619 cumulative days of hospitalization; they were mostly females (53%) with an average age of 82. The total incidence of aspiration events was of 1.4 every 1,000 days of hospitalization (C.I. 95%: 1.2-1.7) and the most frequent manifestation was cough (61.6%). The addition of drugs or an infection diagnosis during the 24 hours preceding the event acted as risk factors for those events that needed additional interventions during the hospitalization (OR 3.1 e OR 1.9 respectively), while the elimination of one or more prescribed drugs seemed to lead to aspiration events without impact on the hospitalization. Conclusions Results showed a large incidence of aspiration events within medical wards, many of them influencing patient outcomes. Healthcare professionals' attention concerning aspiration events should be fostered during the first hours and days of hospitalization.
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Affiliation(s)
- L Lesa
- Department of Medicine, University of Udine, Italy.,Medical Directorate, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - L Brunelli
- Department of Medicine, University of Udine, Italy.,Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - F Valent
- Hygiene and Clinical Epidemiology Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - I Aprili
- Diagnostic and Public Health Department, University of Verona, Italy
| | - E Cametti
- Diagnostic and Public Health Department, University of Verona, Italy
| | - S Ferrari
- Diagnostic and Public Health Department, University of Verona, Italy
| | - E Camussi
- Public Health and Pediatric Science Department, University of Torino, Italy
| | - S Degan
- Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - D De Corti
- Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - F Bellomo
- Quality Unit, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - S Tardivo
- Diagnostic and Public Health Department, University of Verona, Italy
| | - R Siliquini
- Public Health and Pediatric Science Department, University of Torino, Italy
| | - S Brusaferro
- Department of Medicine, University of Udine, Italy
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Lasalvia A, Amaddeo F, Porru S, Carta A, Tardivo S, Bovo C, Ruggeri M, Bonetto C. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open 2021; 11:e045127. [PMID: 33455940 PMCID: PMC7813385 DOI: 10.1136/bmjopen-2020-045127] [Citation(s) in RCA: 130] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To determine burn-out levels and associated factors among healthcare personnel working in a tertiary hospital of a highly burdened area of north-east Italy during the COVID-19 pandemic. DESIGN Observational study conducted from 21 April to 6 May 2020 using a web-based questionnaire. SETTING Research conducted in the Verona University Hospital (Veneto, Italy). PARTICIPANTS Out of 2195 eligible participants, 1961 healthcare workers with the full range of professional profiles (89.3%) completed the survey. PRIMARY OUTCOME MEASURE Levels of burn-out, assessed by the Maslach Burnout Inventory-General Survey (MBI-GS). Multivariable logistic regression analysis was performed to identify factors associated with burn-out in each MBI-GS dimension (emotional exhaustion, EX; professional efficacy, EF; cynicism, CY). RESULTS Overall, 38.3% displayed high EX, 46.5% low EF and 26.5% high CY. Burn-out was frequent among staff working in intensive care units (EX 57.0%; EF 47.8%; CY 40.1%), and among residents (EX 34.9%; EF 63.9%; CY 33.4%) and nurses (EX 49.2%; EF 46.9%; CY 29.7%). Being a resident increased the risk of burn-out (by nearly 2.5 times) in all the three MBI subscales and being a nurse increased the risk of burn-out in the EX dimension in comparison to physicians. Healthcare staff directly engaged with patients with COVID-19 showed more EX and CY than those working in non-COVID wards. Finally, the risk of burn-out was higher in staff showing pre-existing psychological problems, in those having experienced a COVID-related traumatic event and in those having experienced interpersonal avoidance in the workplace and personal life. CONCLUSIONS Burn-out represents a great concern for healthcare staff working in a large tertiary hospital during the COVID-19 pandemic and its impact is more burdensome for front-line junior physicians. This study underlines the need to carefully address psychological well-being of healthcare workers to prevent the increase of burn-out in the event of a new COVID-19 healthcare emergency.
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Affiliation(s)
- Antonio Lasalvia
- UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Amaddeo
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- UOC Psicosomatica e Psicologia Medica, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
| | - Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona and Clinical Unit of Occupational Medicine, Integrated University Hospital of Verona, Verona, Italy
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona and Clinical Unit of Occupational Medicine, Integrated University Hospital of Verona, Verona, Italy
| | - Stefano Tardivo
- Section of Hygiene, Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - Chiara Bovo
- Health Director, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
| | - Mirella Ruggeri
- UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Chiara Bonetto
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Smaniotto C, Battistella C, Brunelli L, Ruscio E, Agodi A, Auxilia F, Baccolini V, Gelatti U, Odone A, Prato R, Tardivo S, Voglino G, Valent F, Brusaferro S, Balzarini F, Barchitta M, Carli A, Castelli F, Coppola C, Iannelli G, Milazzo M, Rosina B, Salerno C, Siliquini R, Sisi S. Sustainable Development Goals and 2030 Agenda: Awareness, Knowledge and Attitudes in Nine Italian Universities, 2019. Int J Environ Res Public Health 2020; 17:ijerph17238968. [PMID: 33276530 PMCID: PMC7730411 DOI: 10.3390/ijerph17238968] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/26/2020] [Accepted: 11/27/2020] [Indexed: 11/26/2022]
Abstract
Sustainable Development Goals (SDGs) and 2030 Agenda represent global development programs. Education can widen the acknowledgement of their relevance and their applications. This survey aims to assess awareness, knowledge and attitudes towards SDGs and sustainability among first-year students in nine Italian Universities. A Likert scale-based online questionnaire of 70 items was compiled by students from March to July 2019. It examined knowledge and expectations referred to sustainable development concepts, indicators and documents/models accounting for sociodemographic variables. Statistical analyses performed were Chi-square test, Fisher’s Exact test, Kendall’s W correlation coefficient, univariate and multivariate analysis. The questionnaire was completed by 1676 students. A low percentage referred a good knowledge of SDGs and 2030 Agenda, most of them had never attended related educational activities previously. Better knowledge of SDGs and 2030 Agenda was observed in case of previous specific educational activities (p < 0.001). The expectation towards university guaranteeing an education on SDGs was high, both for personal wisdom and for usefulness in future professional context. A significant difference (p < 0.001) in such expectations was found, as healthcare students were less interested than colleagues of other areas. The results showed low knowledge but interest towards sustainable development. A scheduled implementation of academic initiatives should be considered.
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Affiliation(s)
- Cecilia Smaniotto
- Department of Medicine, University of Udine, 33100 Udine, Friuli Venezia Giulia, Italy; (C.B.); (L.B.); (E.R.); (S.B.)
- Correspondence: ; Tel.: +39-0432-554767
| | - Claudio Battistella
- Department of Medicine, University of Udine, 33100 Udine, Friuli Venezia Giulia, Italy; (C.B.); (L.B.); (E.R.); (S.B.)
| | - Laura Brunelli
- Department of Medicine, University of Udine, 33100 Udine, Friuli Venezia Giulia, Italy; (C.B.); (L.B.); (E.R.); (S.B.)
- Friuli Centrale Healthcare and University Integrated Trust, 33100 Udine, Friuli Venezia Giulia, Italy;
| | - Edoardo Ruscio
- Department of Medicine, University of Udine, 33100 Udine, Friuli Venezia Giulia, Italy; (C.B.); (L.B.); (E.R.); (S.B.)
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Sicilia, Italy; (A.A.); (M.B.)
| | - Francesco Auxilia
- Department of Biomedical Sciences for Health, University of Milan, 20122 Milan, Lombardia, Italy;
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Lazio, Italy; (V.B.); (C.S.)
| | - Umberto Gelatti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, 25123 Brescia, Lombardia, Italy;
| | - Anna Odone
- Faculty of Medicine and Surgery, University Vita-Salute San Raffaele, 20132 Milan, Lombardia, Italy; (A.O.); (F.B.)
| | - Rosa Prato
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Puglia, Italy; (R.P.); (C.C.); (G.I.); (M.M.); (S.S.)
| | - Stefano Tardivo
- Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Veneto, Italy; (S.T.); (A.C.)
| | - Gianluca Voglino
- Department of Public Health Sciences and Pediatrics, University of Turin, 10124 Turin, Piemonte, Italy; (G.V.); (R.S.)
| | - Francesca Valent
- Friuli Centrale Healthcare and University Integrated Trust, 33100 Udine, Friuli Venezia Giulia, Italy;
| | - Silvio Brusaferro
- Department of Medicine, University of Udine, 33100 Udine, Friuli Venezia Giulia, Italy; (C.B.); (L.B.); (E.R.); (S.B.)
| | - Federica Balzarini
- Faculty of Medicine and Surgery, University Vita-Salute San Raffaele, 20132 Milan, Lombardia, Italy; (A.O.); (F.B.)
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Sicilia, Italy; (A.A.); (M.B.)
| | - Alberto Carli
- Department of Diagnostic and Public Health, University of Verona, 37134 Verona, Veneto, Italy; (S.T.); (A.C.)
| | - Francesco Castelli
- University Research and Documentation Center for the 2030 Sustainable Development Agenda, Department of Infectious and Tropical Diseases, University of Brescia and Brescia Spedali Civili General Hospital, 25123 Brescia, Lombardia, Italy;
| | - Cristina Coppola
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Puglia, Italy; (R.P.); (C.C.); (G.I.); (M.M.); (S.S.)
| | - Giuseppina Iannelli
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Puglia, Italy; (R.P.); (C.C.); (G.I.); (M.M.); (S.S.)
| | - Marica Milazzo
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Puglia, Italy; (R.P.); (C.C.); (G.I.); (M.M.); (S.S.)
| | - Barbara Rosina
- Advisory and Career Service, University of Milan, 20122 Milan, Lombardia, Italy;
| | - Carla Salerno
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Lazio, Italy; (V.B.); (C.S.)
| | - Roberta Siliquini
- Department of Public Health Sciences and Pediatrics, University of Turin, 10124 Turin, Piemonte, Italy; (G.V.); (R.S.)
| | - Sauro Sisi
- Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Puglia, Italy; (R.P.); (C.C.); (G.I.); (M.M.); (S.S.)
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Filippetti M, Cazzoletti L, Zamboni F, Ferrari P, Caimmi C, Smania N, Tardivo S, Ferrari M. Effect of a tailored home-based exercise program in patients with systemic sclerosis: A randomized controlled trial. Scand J Med Sci Sports 2020; 30:1675-1684. [PMID: 32350931 PMCID: PMC7496851 DOI: 10.1111/sms.13702] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/26/2020] [Accepted: 04/20/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim was to evaluate the effect of a home-based exercise program on functional capacity, health-related quality of life (HRQoL), and disability, in patients with systemic sclerosis (SSc). METHODS A 6-month randomized controlled trial was conducted on SSc patients by comparing a home-based minimally supervised exercise program (exercise on a stationary cycle and strengthening of upper limbs; stretching of the hands) with usual care. At baseline and after 3 and 6 months, the patients underwent: 6 minutes walking test; hand mobility in scleroderma test; maximal exercise test on an ergocycle; strength measures (handgrip, quadriceps, and biceps). HRQoL (short-form 36 [SF-36]) and disability (health assessment questionnaire disability index [HAQ-DI]) were measured at the same time. RESULTS Forty-four patients participated in the study. Twenty-two were randomly assigned to the intervention group (IG, mean age 63.60 ± 10.40 years) and 22 to the control group (CG, 61.80 ± 14.40 years). At 6 months, the distance walked in 6 minutes increased by 46 m (baseline 486, 95% CI 458-513 m; 6 months 532, 95% CI 504-561 m) in IG, whereas it decreased by 5 m (baseline 464, 95% CI 431-497 m; 6 months 459, 95% CI 427-490 m) in CG with a significantly different temporal trend at the between-groups comparison (P < .001). An improvement was also observed for strength measures (handgrip, P = .003; quadriceps, P < .001; biceps, P < .001), for the SF-36 physical component score (P < .001) and for the HAQ-DI (P = .011). CONCLUSIONS This study indicates that in SSc patients, a minimally supervised home-based exercise program improves physical performance, quality of life, and disability in comparison with usual care.
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Affiliation(s)
- Mirko Filippetti
- Unit of Respiratory Disease and Sports MedicineDepartment of MedicineUniversity of VeronaVeronaItaly
- Neuromotor and Cognitive Rehabilitation Research CenterDepartment of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Lucia Cazzoletti
- Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
| | - Francesco Zamboni
- Unit of Respiratory Disease and Sports MedicineDepartment of MedicineUniversity of VeronaVeronaItaly
| | - Pietro Ferrari
- Unit of Respiratory Disease and Sports MedicineDepartment of MedicineUniversity of VeronaVeronaItaly
| | - Cristian Caimmi
- Rheumatology UnitDepartment of MedicineUniversity of VeronaVeronaItaly
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research CenterDepartment of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Stefano Tardivo
- Department of Diagnostics and Public HealthUniversity of VeronaVeronaItaly
| | - Marcello Ferrari
- Unit of Respiratory Disease and Sports MedicineDepartment of MedicineUniversity of VeronaVeronaItaly
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Porru S, Carta A, Monaco MGL, Verlato G, Battaggia A, Parpaiola M, Lo Cascio G, Pegoraro M, Militello V, Moretti F, Tardivo S. Health Surveillance and Response to SARS-CoV-2 Mass Testing in Health Workers of a Large Italian Hospital in Verona, Veneto. Int J Environ Res Public Health 2020; 17:ijerph17145104. [PMID: 32679773 PMCID: PMC7399926 DOI: 10.3390/ijerph17145104] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 06/27/2020] [Accepted: 07/09/2020] [Indexed: 12/15/2022]
Abstract
Italy presented the first largest COVID-19 outbreak outside of China. Veneto currently ranks fourth among the Italian regions for COVID-19 confirmed cases (~19,000). This study presents health surveillance data for SARS-CoV-2 in 6100 health workers (HW) employed in a large public hospital. Workers underwent oropharyngeal and nasopharyngeal swabs, with a total of 5942 participants (97.5% of the population). A total of 11,890 specimens were tested for SARS-CoV-2 infection using PCR, identifying the viral genes E, RdRP, and N. Positive tests were returned for 238 workers (cumulative incidence of 4.0%, similar in both COVID and nonCOVID units). SARS-CoV-2 risk was not affected by gender, age, or job type, whereas work setting and occupation were both predictors of infection. The risk was higher in medical wards (OR 2.7, 95% CI 1.9–3.9) and health services (OR 4.3, 95% CI 2.4–7.6), and lower in surgical wards and administration areas. To our knowledge, this study represents the largest available HW case list swab-tested for SARS-CoV-2, covering almost the total workforce. Mass screening enabled the isolation of HW, improved risk assessment, allowed for close contacts of and infected HW to return to work, provided evidence of SARS-CoV-2 diffusion, and presented solid ground to prevent nosocomial SARS-CoV-2 infections. The ongoing concurrent sero-epidemiological study aims to enable the improvement of health surveillance to maintain the safety of HWs and the communities they serve.
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Affiliation(s)
- Stefano Porru
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona VR, Italy;
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona VR, Italy;
| | - Angela Carta
- Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona VR, Italy;
- Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona VR, Italy;
- Correspondence: ; Tel.: +39-0458128270
| | | | - Giuseppe Verlato
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, 37134 Verona VR, Italy;
| | - Andrea Battaggia
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona VR, Italy; (A.B.); (M.P.)
| | - Marco Parpaiola
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona VR, Italy; (A.B.); (M.P.)
| | - Giuliana Lo Cascio
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona VR, Italy; (G.L.C.); (M.P.); (V.M.)
| | - Manuela Pegoraro
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona VR, Italy; (G.L.C.); (M.P.); (V.M.)
| | - Valentina Militello
- Unit of Microbiology and Virology, University Hospital of Verona, 37134 Verona VR, Italy; (G.L.C.); (M.P.); (V.M.)
| | - Francesca Moretti
- Section of Hygiene, Department of Diagnostics and Public Health, University of Verona and Medical Direction, University Hospital of Verona, 37134 Verona VR, Italy; (F.M.); (S.T.)
| | - Stefano Tardivo
- Section of Hygiene, Department of Diagnostics and Public Health, University of Verona and Medical Direction, University Hospital of Verona, 37134 Verona VR, Italy; (F.M.); (S.T.)
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Tardivo S, Zenere A, Moretti F, Marchiori F, Berti D, Migliorini M, Tomasi A, Ferrari S, Tognon F, Napolitano G, Rossanese A. Corrigendum to: The Traveller's Risk Perception (TRiP) questionnaire: pre-travel assessment and post-travel changes. Int Health 2020; 12:234. [PMID: 31777922 PMCID: PMC7320420 DOI: 10.1093/inthealth/ihz100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/18/2019] [Accepted: 06/14/2019] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - F Marchiori
- Corresponding author: Tel: +039 3922862331; E-mail:
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Tardivo S, Zenere A, Moretti F, Marchiori F, Berti D, Migliorini M, Tomasi A, Ferrari S, Tognon F, Napoletano G, Rossanese A. The Traveller's Risk Perception (TRiP) questionnaire: pre-travel assessment and post-travel changes. Int Health 2020; 12:116-124. [PMID: 31294781 PMCID: PMC7057134 DOI: 10.1093/inthealth/ihz033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 03/18/2019] [Accepted: 06/14/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Travellers' risk perception is a key component of travel risk assessment because it influences the adequate implementation of safety precautions. The aims of this study are to validate a tool to analyse travellers' risk perception to identify which factors can influence it and how it changes upon return. METHODS The Traveller's Risk Perception (TRiP) questionnaire was developed and administered to outpatients before and after travel in three travel clinics. A principal component analysis (PCA) was performed to validate the questionnaire and multivariate regression analysis was used to evaluate the effect of travellers' characteristics on the risk scores. RESULTS A total of 1020 travellers completed the questionnaire. PCA identified two latent factors: 'generic-disseminated risks' and 'specific-circumstantial risks'. Cronbach's α was acceptable (0.76 and 0.70, respectively). The 'generic-disseminated risks' dimension scored higher than the 'specific-circumstantial risks' (p<0.001). The items with the highest scores were insect bites, gastrointestinal disorders and malaria. The mean scores were significantly lower after the travel for all items but one. CONCLUSIONS The TRiP questionnaire is a valid and reliable tool for rating travellers' perceptions. Staff in travel clinics should be trained to systematically assess travellers' risk perception in order to tailor the consultation according to specific information needs.
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Affiliation(s)
- S Tardivo
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - A Zenere
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - F Moretti
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - F Marchiori
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - D Berti
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - M Migliorini
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - A Tomasi
- Public Health Department, Lucca, Italy
| | - S Ferrari
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | - F Tognon
- Departments of Diagnostics and Public Health University of Verona, Verona, Italy
| | | | - A Rossanese
- IRCCS Sacro Cuore Don Calabria Hospital, Verona, Italy
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Mortaro A, Pascu D, Pancheri S, Mazzi M, Tardivo S, Bellamoli C, Ferrarese F, Poli A, Romano G, Moretti F. Reducing interruptions during medication preparation and administration. Int J Health Care Qual Assur 2020; 32:941-957. [PMID: 31282257 DOI: 10.1108/ijhcqa-12-2017-0238] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE According to literature, interruptions during drug administration lead to a significant proportion of medication errors. Evidence on the effectiveness of interventions to reduce interruption is still limited. The purpose of this paper is to explore main reasons for interruptions during drug administration rounds in a geriatric ward of an Italian secondary hospital and test the effectiveness of a combined intervention. DESIGN/METHODOLOGY/APPROACH This is a pre and post-intervention observational study based on direct observation. All nurse staff (24) participated to the study that lead to observe a total of 44 drug dispensing rounds with 945 drugs administered to 491 patients in T0 and 994 drugs to 506 patients in T1. FINDINGS A significant reduction of raw number of interruptions (mean per round from 17.31 in T0 to 9.09 in T1, p<0.01), interruptions/patient rate (from 0.78 in T0 to 0.40 in T1, p<0.01) and interruptions/drugs rate (from 0.44 in T0 to 0.22 in T1, p<0.01) were observed. Needs for further improvements were elicited (e.g. a greater involvement of support staff). PRACTICAL IMPLICATIONS Nurse staff should be adequately trained on the risks related to interruptions during drug administration since routine activity is at high risk of distractions due to its repetitive and skill-based nature. ORIGINALITY/VALUE A strong involvement of both MB and leadership, together with the frontline staff, helped to raise staff motivation and guide a bottom-up approach, able to identify tailored interventions and serve concurrently as training instrument tool.
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Affiliation(s)
- Alberto Mortaro
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Diana Pascu
- Department of Medical Board, Ospedale Girolamo Fracastoro, San Bonifacio, Italy
| | - Serena Pancheri
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Mariangela Mazzi
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Claudio Bellamoli
- Department of Medical, Ospedale Girolamo Fracastoro, San Bonifacio, Italy
| | - Federica Ferrarese
- Department of Medical, Ospedale Girolamo Fracastoro, San Bonifacio, Italy
| | - Albino Poli
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Gabriele Romano
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
| | - Francesca Moretti
- Department of Diagnostics and Public Health, University of Verona , Verona, Italy
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Montagna MT, Mascipinto S, Pousis C, Bianchi FP, Caggiano G, Carpagnano LF, De Giglio O, Barbuti G, Auxilia F, Destrebecq A, Castaldi S, Baldovin T, Bargellini A, Righi E, Boccia G, Santoro E, Casini B, Baggiani A, Novati R, Oriani R, Odone A, Mezzoiuso AG, Orsi GB, Napoli C, Pasquarella C, Veronesi L, Ripabelli G, Sammarco ML, Rossini A, Squeri R, Laganà P, Antonuccio GM, Genovese C, Tardivo S, Torre I, Alfano R, Pennino F, Torregrossa MV, Barchitta M, Agodi A. Knowledge, experiences, and attitudes toward Mantoux test among medical and health professional students in Italy: a cross-sectional study. Ann Ig 2019; 30:86-98. [PMID: 30374514 DOI: 10.7416/ai.2018.2253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The World Health Organization's Action Framework for tuberculosis elimination in low-tuberculosis incidence countries includes the screening for active and latent tuberculosis in selected high-risk groups, including health care workers. In this context, medical and health profession students, exposed to nosocomial tuberculosis transmission during training and clinical rotations, are target populations for tuberculosis screening. No updated data are available on tuberculosis screening practice and knowledge of medical and health profession students in Italy. METHODS Within the activities Italian Study Group on Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health, we carried out a multicentre cross-sectional study to assess knowledge, attitude and practices on tuberculosis prevention and control among Medical, Dentistry, Nursing and other health professions' students. Students were enrolled in the study on a voluntary basis and were administered a previously piloted structured questionnaire. Logistic regression models were applied to explore knowledge on tuberculosis prevention by selected socio-demographic variables and University-based tuberculosis prevention practice. RESULTS Students of seventeen Universities across Italy participated in the study, and 58.2% of them received compulsory tuberculin skin test either at enrollment or while attending clinical practice. A total of 5,209 students filled the questionnaire. 37.7% were medicine and dentistry students (Group 1), 44.9% were nursing students (Group 2) and 17.4% were other health professions' students (Group 3). Age and gender had different distributions by groups, as well as knowledge and practice on tuberculin skin test. 84.4% of the study population (95% CI = 83.3-85.3) was aware of the existence of the tuberculin skin test, 74.4% (95% CI = 73.2-75.6) knew what is the first-level screening test for latent tuberculosis and only 22.5% (95% CI = 21.4-23.6) knew how to proceed after a positive tuberculin skin test result. Overall, knowledge on tuberculosis prevention was higher in Group 2 and lower Group 3, as compared to Group 1. CONCLUSION In Italy, the knowledge on tuberculosis screening among University students is generally good. To reduce some of the criticalities found among the different study courses, it would be appropriate to harmonize both the regulations on tuberculosis screening practices for admission to University courses, and the educational activities on the topic of tuberculosis, to be extended to all workers involved in health care setting.
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Affiliation(s)
- M T Montagna
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - S Mascipinto
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - C Pousis
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - F P Bianchi
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - G Caggiano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - L F Carpagnano
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - O De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - G Barbuti
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - F Auxilia
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - A Destrebecq
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - S Castaldi
- Department of Biomedical Sciences for Health, University of Milano, Milano, Italy
| | - T Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Hygiene and Public Health Unit, Padova, Italy
| | - A Bargellini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - E Righi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Boccia
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - E Santoro
- Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - B Casini
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Pisa, Italy
| | - A Baggiani
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Pisa, Italy
| | - R Novati
- Medical Direction, Aosta Regional Hospital, Aosta, Italy
| | - R Oriani
- Medical Direction, Aosta Regional Hospital, Aosta, Italy
| | - A Odone
- Faculty of Medicine and Surgery, University Vita-Salute San Raffaele, Milan, Italy
| | - A G Mezzoiuso
- Faculty of Medicine and Surgery, University Vita-Salute San Raffaele, Milan, Italy
| | - G B Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Napoli
- Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - L Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - G Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - M L Sammarco
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - A Rossini
- Fondazione Santa Lucia, Institute for Research and Health Care, IRCCS, University of Tor Vergata, Rome, Italy
| | - R Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - P Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - G M Antonuccio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - C Genovese
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - S Tardivo
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - I Torre
- Department of Public Health, University of Napoli "Federico II", Napoli, Italy
| | - R Alfano
- Department of Public Health, University of Napoli "Federico II", Napoli, Italy
| | - F Pennino
- Department of Public Health, University of Napoli "Federico II", Napoli, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
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Tardivo S, Moretti F, Agodi A, Appignanesi R, Baldovin T, Barchitta M, Brusaferro S, Canino R, Carli A, D'Errico MM, Giuliani G, Moro M, Mura I, Nobile M, Novati R, Pasquarella C, Privitera G, Rossini A, Sodano L, Torregrossa MV, Torri E, Auxilia F. Essential strategies in HAI prevention and control: performance assessment through the implementation of the HAI-CoSIP tool of the GISIO-SItI group. A pilot study in a sample of Italian Organizations. Ann Ig 2019; 30:502-508. [PMID: 30374513 DOI: 10.7416/ai.2018.225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare-Associated Infections are a great concern for worldwide healthcare systems and represent a considerable threat to patient safety, leading to adverse clinical outcomes. A defined panel of indicators represents a key element to guide Healthcare Organizations towards identification of main gaps, implementation of effective actions and continuous improvements on Healthcare-Associated Infections prevention and control activities. A review on accreditation systems conducted by the Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene Preventive Medicine and Public Health revealed a substantial heterogeneity of implemented standards and led to the development of a core set of indicators and requirements for Healthcare-Associated Infections' prevention and control within the hospital setting. The main aim of the study was to test the feasibility of the Healthcare-Associated Infections' prevention and control within the hospital setting tool to calculate performance scores on a sample of Italian Healthcare Organizations and to identify major critical issues. The potential benefits of the possibility of future implementation of the tool within Institutional Accreditation Programs is discussed. STUDY DESIGN Cross sectional pilot survey. METHODS The Healthcare-Associated Infections' prevention and control within the hospital setting included 96 criteria and 20 key areas including an area for outcomes indicators. For applicable criteria, standards fulfilment was evaluated according to a 4 point Likert scale. A composite score was calculated for each Healthcare Organization and five performance levels were identified. Data were further analysed by computing performance scores at the level of each area and requirement. RESULTS 20 Healthcare Organizations agreed to take part in this pilot study including two rehabilitative Healthcare Organizations. Among the whole sample a mean of 12.20% of requirements resulted not fulfilled, leaving space for further improvements. Critical areas were easily identified and the instrument was able to capture substantial differences between Healthcare Organizations. Only a few number of standards resulted "Not Applicable" (Mean = 4.71%) and most of them regarded Rehabilitative Healthcare Organizations. Mean composite performance index resulted 74.06% (SD = 16.96, range 36.30 - 94.27%); area of outcome indicators obtained a mean score of 56.17. CONCLUSION The Healthcare-Associated Infections' prevention and control within the hospital setting resulted an useful tool to assess Healthcare Organizations' performance in the field of Healthcare-Associated Infections prevention and control and to identify necessary actions for further improvements. The distribution of total scores by Healthcare Organizations showed a high heterogeneity. Implementation of the Healthcare-Associated Infections' prevention and control within the hospital setting tool as an institutional accreditation tool may help to drive the required harmonization at a national level of Healthcare-Associated Infections management and control strategies and overcome current substantial regional differences.
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Affiliation(s)
- S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - R Appignanesi
- Management Department, Asur Zt 12, San Benedetto del Tronto, Italy
| | - T Baldovin
- Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy
| | - M Barchitta
- Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy
| | - S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - R Canino
- Medical Direction Department, Oglio-Po Hospital, Vicomoscano - Casalmaggiore, Cremona, Italy
| | - A Carli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - M M D'Errico
- Department of Biomedical Science and Public Health, Polytechnic University of Marche, Torrette di Ancona, Ancona, Italy
| | - G Giuliani
- Medical Direction Department, Infections Control Committee, G.Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | - M Moro
- Medical Direction Department, Infections Control Committee, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - I Mura
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - M Nobile
- Management Department, G. Pini Orthopedic Institute, University of Milan, Milan, Italy
| | - R Novati
- Medical Direction Department, Aosta Regional Hospital, Aosta, Italy
| | - C Pasquarella
- Department of Hygiene and Public Health, University of Parma, Parma, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - A Rossini
- Medical Direction Department, IRCCS Santa Lucia Scientific Institute, Rome, Italy
| | - L Sodano
- Medical Direction Department San Camillo Forlanini Hospital, Rome, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion "G. D'Alessandro", Hygiene Section, University of Palermo, Palermo, ItalY
| | - E Torri
- Department of Health and Social Policy, P.A. Trento, Trento, Italy
| | - F Auxilia
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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Agodi A, Barchitta M, Auxilia F, Brusaferro S, D'Errico MM, Montagna MT, Pasquarella C, Tardivo S, Arrigoni C, Fabiani L, Laurenti P, Mattaliano AR, Orsi GB, Squeri R, Torregrossa MV, Mura I. Epidemiology of intensive care unit-acquired sepsis in Italy: results of the SPIN-UTI network. Ann Ig 2019; 30:470-481. [PMID: 30374508 DOI: 10.7416/ai.2018.2247] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. STUDY DESIGN Prospective multicenter study. METHODS The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. RESULTS During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. CONCLUSION Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients.
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Affiliation(s)
- A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - F Auxilia
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - S Brusaferro
- Department of Medicine, University of Udine, Udine, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, Ancona, Italy
| | - M T Montagna
- Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - S Tardivo
- Department of Diagnostic and Public Health, University of Verona, Verona, Italy
| | - C Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Hygiene, University of Pavia, Pavia, Italy
| | - L Fabiani
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - P Laurenti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia; Institute of Public Health, Hygiene Section, Università Cattolica del Sacro Cuore, Roma, Italia
| | | | - G B Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - R Squeri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
| | - I Mura
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Nobile M, Agodi A, Barchitta M, Brusaferro S, Castaldi S, D'Alessandro D, Montagna MT, Mura I, Tardivo S, Torregrossa MV, Zannini L, Pasquarella C, Auxilia F. The effectiveness of educational interventions in university training on hospital hygiene: results of action research. Ann Ig 2019; 30:111-120. [PMID: 30374516 DOI: 10.7416/ai.2018.2255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine and Public Health promoted and conducted a study on teaching hospital hygiene, with particular reference to the prevention and control of healthcare-associated infections, with the aim of developing effective educational material starting from the results collected. MATERIAL AND METHODS First of all, a survey was carried out, targeting lecturers in hospital hygiene, with the purpose of investigating their perceptions regarding this issue. The available scientific literature was also reviewed in order to identify effective educational/teaching strategies for the prevention of healthcare-associated infections, so that valid training interventions could be subsequently developed. Finally, a trial-training intervention was implemented, and specific audio-visual teaching material was also tested. RESULTS The overall response rate to the survey was 42%, with good country-wide representativeness. The level of awareness of hospital hygiene issues by students resulted higher among trainee nurses (65%) than among medical students (44%). The teaching staff identified alternative educational methodologies to substitute the classical lecture (e.g.: case discussions) and, in most cases, the alternative solution appeared to be preferable. The teaching of hospital hygiene was better integrated with other disciplines and professional training activities in the degree courses for nurses than in those for doctors; the total number of hours assigned to such teaching was variable. The literature review highlighted that various educational approaches are used. The most common are presentations or lectures, but videos, posters, questionnaires and e-learning strategies are also used. Combining different instruments when designing an educational programme has proven to be an effective strategy. The training activity tested was positively evaluated by the participants; the possibility of multidisciplinary exchange of knowledge was particularly appreciated. CONCLUSION Having considered the issue of teaching hospital hygiene from the points of view of the different protagonists involved (educators and students), this enabled us to develop useful training material and a proposal for a shared educational intervention. The subject of hospital hygiene, in particular the one related to the prevention of healthcare-associated infections, is addressed in various courses and with different modalities; it is, therefore, important to standardize course contents and teaching methods, in order to facilitate multidisciplinary debate, especially starting from case studies.
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Affiliation(s)
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Italy
| | - M Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Italy
| | - S Brusaferro
- Department of Medicine, University of Udine, Italy
| | - S Castaldi
- Department of Medical Sciences for Health, University of Milan, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - D D'Alessandro
- Department of Civil, Building and Environmental Engineering, Sapienza University of Rome, Italy
| | - M T Montagna
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Italy
| | - I Mura
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - S Tardivo
- Department of Diagnostic and Public Health, University of Verona, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Italy
| | - L Zannini
- Department of Biomedical Siences for Health, University of Milan, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Italy
| | - F Auxilia
- Department of Medical Sciences for Health, University of Milan, IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Gazzani D, Zamboni F, Spelta F, Ferrari P, Mattioli V, Cazzoletti L, Zanolin E, Tardivo S, Ferrari M. Vegetable but not animal protein intake is associated to a better physical performance: a study on a general population sample of adults. Food Nutr Res 2019; 63:3422. [PMID: 31565042 PMCID: PMC6756227 DOI: 10.29219/fnr.v63.3422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 01/09/2019] [Revised: 06/03/2019] [Accepted: 06/24/2019] [Indexed: 01/16/2023] Open
Abstract
Background The research was conducted in the frame of a population-based, case control study, called Genes Environment Interaction in Respiratory Disease. Objective To assess the association between protein intake and physical performance in a general population sample. Design Researchers investigated the association between the participants’ dietary information and their physical performance using the 6-min walking test and the distance walked in metres (6MWD) as main outcome measure. Information on dietary intake was collected using the validated European Investigation into Cancer and Nutrition food frequency questionnaires (FFQs). Then, daily intake of energy and macronutrients was estimated by means of the NAF software (nutritional analysis of FFQ). Linear regression models were used to evaluate the associations between vegetable, animal and total protein intakes and the 6MWD. The models were adjusted for socio-demographic features, total fats and available carbohydrate intakes. Results The participants were 223 subjects (57% females) aged between 23 and 68 years. Their mean vegetable and animal proteins intake for gram/kg of body weight/day were, respectively, 0.4 and 0.7. After adjusting for all the potential confounders, there was a significant increase of 20.0 (95% CI 0.8; 39.2) m in the distance walked for an increase in 10 g/day of vegetable proteins and non-significant variations of −1.8 (95% CI −9.3; 5.7) m for an increase in 10 g/day of animal proteins and of 0.5 (95% CI −6.8; 7.7) for an increase in 10 g/day of total proteins. Discussion and conclusions Our result suggests a positive role of vegetable proteins on physical performance. Whether this result is related to the high protein intake itself or may be a consequence of the other properties of plant-based foods deserves further investigation.
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Affiliation(s)
- Diana Gazzani
- Department of Diagnostics and Public Health, Unit of Hygiene and Preventive, Environmental and Occupational Medicine, University of Verona, Verona, Italy
| | - Francesco Zamboni
- Department of Medicine, Unit of Respiratory Disease and Sports Medicine, University of Verona, Italy
| | - Francesco Spelta
- Department of Medicine, Unit of Respiratory Disease and Sports Medicine, University of Verona, Italy
| | - Pietro Ferrari
- Department of Medicine, Unit of Respiratory Disease and Sports Medicine, University of Verona, Italy
| | - Veronica Mattioli
- Department of Diagnostics and Public Health, Unit of Epidemiology and Statistical Medicine, University of Verona, Italy
| | - Lucia Cazzoletti
- Department of Diagnostics and Public Health, Unit of Epidemiology and Statistical Medicine, University of Verona, Italy
| | - Elisabetta Zanolin
- Department of Diagnostics and Public Health, Unit of Epidemiology and Statistical Medicine, University of Verona, Italy
| | - Stefano Tardivo
- Department of Diagnostics and Public Health, Unit of Hygiene and Preventive, Environmental and Occupational Medicine, University of Verona, Verona, Italy
| | - Marcello Ferrari
- Department of Medicine, Unit of Respiratory Disease and Sports Medicine, University of Verona, Italy
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La Regina GEM, Romano E, Tardivo S, Trinchero E. Rischio clinico in sanità e prevenzione dei rischi del paziente ricoverato in ospedale. Ital J Med 2019. [DOI: 10.4081/itjm.q.2019.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
L’approccio sistemico alla gestione dei rischi in sanitàE. Trinchero
Rischio clinico e sicurezza del paziente: presente e futuroS. Tardivo, M. Capasso
Rischio clinico: livelli di staffing infermieristico ed esiti correlati alle cure infermieristicheG. Pentella, L. Tesei
Il ruolo delle competenze non tecniche (non technical skill) nella dinamica del rischio clinicoF. Moretti, M. Rimondini
Rischio clinico e carico di lavoro: alcuni spunti di riflessioneP. Gnerre, A. Fontanella, D. Montemurro, C. Palermo
Il punto di vista di un Direttore Generale internistaG. Scannapieco, E. Croci
Il punto di vista di un Direttore Sanitario internistaF. Orlandini
Il punto di vista di un Direttore Sanitario igienistaC. Bovo
Il punto di vista di un Direttore di Medicina InternaS. De Carli
La metà oscura del rischio clinico: i sinistri in medicina internaF. Corradi
La corretta identificazione del pazienteR. Gallo, F. Bertoncini, C. Gatta
Fase diagnostica: evitare misdiagnosi e ritardiM. Giorgi-Pierfranceschi
Sicurezza in terapia farmacologicaE. Romano
Novità nella prevenzione delle caduteR. Re, G. Ferrotti
Protezione dalle infezioni correlate all’assistenzaA. Maffettone, C. Peirce, S. Di Fraia
Safe HandoverR. Rapetti
Prevenzione dei rischi in Medicina Interna, casi particolari: atti autolesivi, vagabondaggio, intrappolamento nel paziente ospedalizzatoR. Nardi, D. Tirotta, G. Pinna, G. Pirini
Gestione ricoveri in appoggio e rischio clinicoM. La Regina, F. Guarneri, T. Bellandi, R. Tartaglia, A. Brucato, D. Manfellotto
Innovazioni organizzative in Medicina Interna per la sicurezza del paziente: dall’Ambulatorio Integrato Diagnostico-Terapeutico alla Sezione di Decisione ClinicaR. Castello, A. Carli
OssigenoterapiaM. La Regina
VentiloterapiaM. La Regina
Strumenti per una gestione sicura delle procedure invasiveM. La Regina
La prevenzione del tromboembolismo venosoF. Pomero, E. Nicola, P. Salomone, R. Risso
Sicurezza nella gestione della terapia anticoagulante oraleM. La Regina, F. Pomero
Strumenti per una gestione sicura delle terapie inalatorieC. Tieri
Strumenti per una gestione sicura della terapia ipoglicemizzanteT.M. Attardo
Strumenti per una gestione sicura delle allergie a farmaci e delle interazioni farmacologicheT.M. Attardo
Mobilizzazione dei pazientiG. Querci, A. Spadaro
Il rischio clinico: conclusioniA. Fontanella
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Battistella C, Quattrin R, Celotto D, d'Angelo M, Fabbro E, Brusaferro S, Agodi A, Astengo M, Baldo V, Baldovin T, Bert F, Biancone L, Calò LA, Canale A, Castellino P, Carli A, Icardi G, Lopalco PL, Righi A, Siliquini R, Tardivo S, Tassinari F, Veroux M. Factors predicting influenza vaccination adherence among patients in dialysis: an Italian survey. Hum Vaccin Immunother 2019; 15:2434-2439. [PMID: 30852938 DOI: 10.1080/21645515.2019.1588005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Introduction: The aim of this study was to investigate knowledge and practices about influenza among patients on dialysis services of Italian hospitals at risk of severe influenza infection and vaccine and to identify predictive factors to vaccination adherence. Methods: A cross-sectional observational study was carried out from January 2017 to July 2017 after the 2016/2017 influenza vaccination campaign. The questionnaire was administered to all patients treated in seven large Italian dialysis services. It consisted of influenza vaccination coverage, knowledge about influenza and its vaccination, perceived risk of influenza complications, recommendations on influenza uptake received by general practitioner (GP) and nephrologist. Results: Response rate was 90% (703/781). Patients' knowledge about influenza infection and vaccine were detected by nine closed questions: 35.6% of responders answered correctly to ≥ 6 sentences, 47.5% of them reported that "influenza vaccine can cause influenza" and 45.7% believed that "antibiotics are a correct strategy to treat influenza". Levels of perceived risks of hospitalisation and death were low in 39.3% and 16.5% of patients respectively. The adherence to the last seasonal influenza vaccination was 57.5%. The multivariate predictors of influenza vaccination uptake resulted: age ≥65, male, consulting TV/radio, asking information to GP and/or nephrologist. Conclusions: The study reveals the low adherence to influenza vaccination and the subotpimal level of knowledge in dialysis patients. Different strategies, including a greater alliance among nephrologists and GPs to prevent influenza should be encouraged to improve the adherence to influenza vaccination in this at risk group.
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Affiliation(s)
| | - Rosanna Quattrin
- Department of Organisation of Hospital Services, Azienda Sanitaria Universitaria Integrata di Udine , Udine , Italy
| | | | | | - Elisa Fabbro
- Department of Medicine, University of Udine , Udine , Italy
| | | | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania , Catania , Italy
| | - Matteo Astengo
- Dipartimento Scienze della Salute, University of Genova , Genova , Italy
| | - Vincenzo Baldo
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padova , Padova , Italy
| | - Tatjana Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, Public Health Unit, University of Padova , Padova , Italy
| | - Fabrizio Bert
- Dipartimento Scienze della Sanita' Pubblica, University of Turin , Torino , Italy.,Citta' della Salute e della Scienza Torino , Torino , Piemonte , Italy
| | - Luigi Biancone
- Citta' della Salute e della Scienza Torino , Torino , Piemonte , Italy.,Dipartimento Scienze Mediche, University of Turin , Torino , Italy
| | - Lorenzo A Calò
- Department of Medicine (DIMED), Nephrology, University of Padova , Padova , Italy
| | - Alice Canale
- Department of Translational Research and New Technologies in Medicine and Surgery, Hygiene and Epidemiology Section, University of Pisa , Pisa , Italy
| | - Pietro Castellino
- Department of Clinical and Experimental Medicine, Internal Medicine, University of Catania , Catania , Italy
| | - Alberto Carli
- Department of Diagnostic and Public Health, University of Verona , Verona , Italy
| | - Giancarlo Icardi
- Dipartimento Scienze della Salute, University of Genova , Genova , Italy
| | - Pietro Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, Hygiene and Epidemiology Section, University of Pisa , Pisa , Italy
| | - Anna Righi
- Department of Translational Research and New Technologies in Medicine and Surgery, Hygiene and Epidemiology Section, University of Pisa , Pisa , Italy
| | - Roberta Siliquini
- Dipartimento Scienze della Sanita' Pubblica, University of Turin , Torino , Italy.,Citta' della Salute e della Scienza Torino , Torino , Piemonte , Italy
| | - Stefano Tardivo
- Department of Diagnostic and Public Health, University of Verona , Verona , Italy
| | - Federico Tassinari
- Dipartimento Scienze della Salute, University of Genova , Genova , Italy
| | - Massimiliano Veroux
- Department of Medical and Surgical Sciences and Advanced Technologies, Vascular Surgery and Organ Transplant Unit, University Hospital of Catania , Catania , Italy
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Celotto D, Battistella C, D'Angelo M, Agodi A, Baldo V, Icardi G, Privitera G, Siliquini R, Tardivo S, Quattrin R, Brusaferro S. Influenza vaccination knowledge, attitudes and behaviors in dialysis patients: a national survey. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky212.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Celotto
- Department of Medicine, University of Udine, Udine, Italy
| | - C Battistella
- Department of Medicine, University of Udine, Udine, Italy
| | | | - A Agodi
- Medical, Surgical and Advanced Technologies, Catania, Italy
| | - V Baldo
- Department of Cardiology, Thoracic and Vascular Sciences, University of Padua, Padova, Italy
| | - G Icardi
- Department of Health Sciences (DISSAL), University of Genoa, Genova, Italy
| | - G Privitera
- Department of Translational Research, University of Pisa, Pisa, Italy
| | - R Siliquini
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - R Quattrin
- Accreditation, Clinical Risk Management and Performance Assessment Unit, Udine Healthcare and University Integrated Trust, Udine, Italy
| | - S Brusaferro
- Accreditation, Clinical Risk Management and Performance Assessment Unit, Udine Healthcare and University Integrated Trust - Department of Medicine, University of Udine, Udine, Italy
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Carli A, Moretti F, Giovanazzi G, Niero V, Perilli V, Ghirlanda G, Bovo C, Tardivo S. "Should I stay or Should I go": patient who leave Emergency Department of an Italian Third-Level Teaching Hospital. Acta Biomed 2018; 89:430-436. [PMID: 30333450 PMCID: PMC6502131 DOI: 10.23750/abm.v89i3.7596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 08/08/2018] [Indexed: 11/23/2022]
Abstract
Background and Aim: Patients could leave ED not receiving the desired care either Without Being Seen by a doctor (LWBS) or Against Medical Advice (DAMA). In term of care quality, LWBS may be related to inappropriate access and process of care, while DAMA may lead to increased risk of mortality and re-admissions. This study aims to identify frequency of patients who leave ED, determine their characteristics and identify associated factor. Methods: This was a retrospective observational study of patients that attended EDs of University Hospital Trust of Verona in 2017. Demographic and ED access associated variables were collected for LWBS, DAMA and completed-ED-treatment patients. Univariate and multivariate data analyses was based on EMUR-PS administrative data.Results: 5,901 of 127,180 ED accesses were uncompleted treatment (4.64%); LWBS were 4,664 (79.04%) and DAMA 1,237 (20.96%). Those who leave ED tended to be younger (39.35 vs. 45.56, p<0.01). Independent factors associated with ED leaving resulted: i) non-urgent triage category (OR: 2.941, 95%CI: 2.405-3.596) ii) non-Italian-nationality (OR: 1.695, 95%CI: 1.493-1.924) and requiring psychiatric consult (OR:6.16 95%IC 4.82-7.87); while protective factors resulted: i) female gender (OR: 0.713, 95%CI: 0.633-0.803); i) Paediatric ED (OR: 0.593, 95%CI: 0.437-0.805); ii) Obstetrics-Gynaecology ED (OR: 0.284, 95%CI: 0.193-0.416) iii) inclusion in fast track pathways (OR: 0.747, 95%CI: 0.602-0.927). Higher ED leaving rate were observed during night-time and Sunday, either overcrowding resulted not associated.Conclusion: Results show the necessity to implement primary care-ED integrated pathway, mainly in frail sub-population, improve awareness on healthcare service use and refine communication skills in ED-team. (www.actabiomedica.it)
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Affiliation(s)
- Alberto Carli
- School of Specialization in Hygiene and Preventive Medicine - University of Verona.
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Montagna MT, De Giglio O, Napoli C, Diella G, Rutigliano S, Agodi A, Auxilia F, Baldovin T, Bisetto F, Arnoldo L, Brusaferro S, Busetti M, Calagreti G, Casini B, Cristina ML, Di Luzio R, Fiorio M, Formoso M, Liguori G, Martini E, Molino A, Mondello P, Mura I, Novati R, Orsi GB, Patroni A, Poli A, Privitera G, Ripabelli G, Rocchetti A, Rose F, Sarti M, Savini S, Silvestri A, Sodano L, Spagnolo AM, Tardivo S, Teti V, Torregrossa MV, Torri E, Veronesi L, Zarrilli R, Pacifico C, Goglio A, Moro M, Pasquarella C. Control and prevention measures for legionellosis in hospitals: A cross-sectional survey in Italy. Environ Res 2018; 166:55-60. [PMID: 29864633 DOI: 10.1016/j.envres.2018.05.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 03/21/2018] [Revised: 05/09/2018] [Accepted: 05/27/2018] [Indexed: 06/08/2023]
Abstract
Risk assessment, environmental monitoring, and the disinfection of water systems are the key elements in preventing legionellosis risk. The Italian Study Group of Hospital Hygiene of the Italian Society of Hygiene, Preventive Medicine, and Public Health and the Italian Multidisciplinary Society for the Prevention of Health Care-Associated Infections carried out a national cross-sectional survey to investigate the measures taken to prevent and control legionellosis in Italian hospitals. A multiple-choice questionnaire was developed, comprising 71 questions regarding hospital location, general characteristics, clinical and environmental surveillance, and control and preventive measures for legionellosis in 2015. Overall, 739 hospitals were enrolled from February to June 2017, and 178 anonymous questionnaires were correctly completed and evaluated (response rate: 24.1%). The survey was conducted using the SurveyMonkey® platform, and the data were analyzed using Stata 12 software. Of the participating hospitals, 63.2% reported at least one case of legionellosis, of which 28.2% were of proven nosocomial origin. The highest case numbers were reported in the Northern Italy, in hospitals with a pavilion structure or cooling towers, and in hospitals with higher numbers of beds, wards and operating theaters. Laboratory diagnosis was performed using urinary antigen testing alone (31.9%), both urinary antigen testing and single antibody titer (17.8%), or with seroconversion also added (21.5%). Culture-based or molecular investigations were performed in 28.8% and 22.1% of the clinical specimens, respectively. The water systems were routinely tested for Legionella in 97.4% of the hospitals, 62% of which detected a positive result (> 1000 cfu/L). Legionella pneumophila serogroup 2-15 was the most frequently isolated species (58.4%). The most common control measures were the disinfection of the water system (73.7%), mostly through thermal shock (37.4%) and chlorine dioxide (34.4%), and the replacement (69.7%) or cleaning (70.4%) of faucets and showerheads. A dedicated multidisciplinary team was present in 52.8% of the hospitals, and 73% of the hospitals performed risk assessment. Targeted training courses were organized in 36.5% of the hospitals, involving nurses (30.7%), physicians (28.8%), biologists (21.5%), technicians (26.4%), and cleaners (11%). Control and prevention measures for legionellosis are present in Italian hospitals, but some critical aspects should be improved. More appropriate risk assessment is necessary, especially in large facilities with a high number of hospitalizations. Moreover, more sensitive diagnostic tests should be used, and dedicated training courses should be implemented.
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Affiliation(s)
- Maria Teresa Montagna
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy.
| | - Osvalda De Giglio
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy
| | - Christian Napoli
- Department of Medical and S urgical Sciences and Translational Medicine, Sapienza University of Roma, Square A. Moro 5, 00185 Roma, Italy
| | - Giusy Diella
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy
| | - Serafina Rutigliano
- Department of Biomedical Science and Human Oncology, University of Bari Aldo Moro, Square G. Cesare 11, 70124 Bari, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Str. S. Sofia, 87, Comparto 10 Edificio C, 95123 Catania, Italy
| | - Francesco Auxilia
- Department of Biomedical Sciences for Health, University of Milano, Str. Pascal 36, 20133 Milano, Italy
| | - Tatjana Baldovin
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Hygiene and Public Health Unit, Str. Loredan, 18.35131 Padova, Italy
| | - Francesco Bisetto
- Presidio Ospedaliero di Camposampiero, AULss6 Euganea Str. P. Cosma 1, 35012 Camposampiero, PD, Italy
| | - Luca Arnoldo
- Department of Medicine, University of Udine, Str. Colugna 50, 33100 Udine, Italy
| | - Silvio Brusaferro
- Department of Medicine, University of Udine, Str. Colugna 50, 33100 Udine, Italy
| | - Marina Busetti
- University Hospital ASUITS, Microbiology Unit, Strada di Fiume, 447, 34149 Trieste, Italy
| | - Gioia Calagreti
- Hospital "Alto Tevere", AUSL Umbria 1, Città di Castello, PG, Italy
| | - Beatrice Casini
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Str. S. Zeno 35-39, 56127 Pisa, Italy
| | - Maria Luisa Cristina
- Department of Health Sciences, University of Genova, Str. A. Pastore 1, 16132 Genova, Italy
| | | | | | - Maurizio Formoso
- Hospital "Miulli", Str. 127 km 4.1, Santeramo-Acquaviva delle Fonti, BA, Italy
| | - Giorgio Liguori
- Department of Movement Sciences and Wellbeing, University "Parthenope", Napoli, Italy
| | - Enrica Martini
- AOU "Ospedali Riuniti", Str. Conca, 71, 60126 Ancona, Italy
| | - Andrea Molino
- Hospital "Madonna delle Grazie", Contrada Cattedra Ambulante s.nc. 75100 Matera, Italy
| | | | - Ida Mura
- Department of Biomedical Science, University of Sassari, Sassari, Italy
| | | | - Giovanni Battista Orsi
- Department of Public Health and Infectious Disease, Sapienza University of Roma, Roma, Italy
| | - Andrea Patroni
- ASST Valcamonica, Str. Manzoni 142, 25040 Esine, BS, Italy
| | - Anna Poli
- Hospital "San Giovanni di Dio", Str. Torre Galli 3, 50143 Firenze, Italy
| | - Gaetano Privitera
- Department of Translational Research, N.T.M.S. - Hygiene and Epidemiology Unit, University of Pisa, Str. S. Zeno 35-39, 56127 Pisa, Italy
| | - Giancarlo Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Andrea Rocchetti
- ASO "SS. Antonio, Biagio and C. Arrigo", Str. Venezia 17, 15121 Alessandria, Italy
| | | | - Mario Sarti
- Hospital "OCSAE", Str. Giardini 1355, Baggiovara, MO, Italy
| | - Sandra Savini
- AOU "Ospedali Riuniti", Str. Conca, 71, 60126 Ancona, Italy
| | - Antonio Silvestri
- Hospital "San Camillo Forlanini", Circonvallazione Gianicolense 87, 00152 Roma, Italy
| | - Luisa Sodano
- Hospital "San Camillo Forlanini", Circonvallazione Gianicolense 87, 00152 Roma, Italy
| | - Anna Maria Spagnolo
- Department of Health Sciences, University of Genova, Str. A. Pastore 1, 16132 Genova, Italy
| | - Stefano Tardivo
- Department of Diagnostic and Public Health, University of Verona, Str. Le Grazie 8, 37134 Verona, Italy
| | | | - Maria Valeria Torregrossa
- Department of Sciences for Health Promotion and Mother-Child Care "G. D'Alessandro", University of Palermo, Str. Vespro, 133, 90127 Palermo, Italy
| | - Emanuele Torri
- Department of Health ans Social Policy, Str. Gilli 4, 38123 Trento, Italy
| | - Licia Veronesi
- Department of Medicine and Surgery, University of Parma, Str. Volturno 39, Parma, Italy
| | - Raffaele Zarrilli
- Department of Public Health, University of Napoli "Federico II", Str. S. Pansini, 5, Napoli, Italy
| | - Claudia Pacifico
- Centre of Biostatistics for Clinical Epidemiology, School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | | | - Matteo Moro
- Hospital "San Raffaele", Str. Olgettina 60, 20132 Milano, Italy
| | - Cesira Pasquarella
- Department of Medicine and Surgery, University of Parma, Str. Volturno 39, Parma, Italy
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49
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Cristina ML, Valeriani F, Casini B, Agodi A, D'Errico MM, Gianfranceschi G, Laganà P, Liguori G, Liguori R, Mucci N, Mura I, Pasquarella C, Piana A, Sotgiu G, Privitera G, Protano C, Quattrocchi A, Ripabelli G, Rossini A, Scaramucci E, Spagnolo AM, Tamburro M, Tardivo S, Veronesi L, Vitali M, Romano Spica V. Procedures in endoscope reprocessing and monitoring: an Italian survey. Ann Ig 2018; 30:45-63. [PMID: 30374511 DOI: 10.7416/ai.2018.2250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND The high diffusion of endoscopes worldwide and the need for effective reprocessing methods requested the development of guidelines and implementation of surveillance procedures at local level. STUDY DESIGN In order to collect data on everyday's practice and adherence to available guidelines, endoscopy units from different public institutions were surveyed using a dedicated questionnaire. METHODS Between July and November 2015 a survey was carried in 12 main hospitals from 10 different Italian regions, involving 22 endoscopy units. The state of the art of national and international guidelines was investigated to compare the protocols adopted at local level. RESULTS In all the surveyed hospitals, the reprocessing activity is based on pre-established protocols in adherence with principal guidelines. Enzymatic detergents, which are recommended by the international guidelines, are used in 55.6% of units and peracetic acid is currently the most widely used chemical disinfectant. Discrepancies were observed in the application of periodic quality controls. CONCLUSION Updated guidelines are generally applied in reprocessing practice. Quality controls may represent a critical issue to improve effectiveness and surveillance. The whole of acquired data can promote a positive trend towards the application of best practices.
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Affiliation(s)
- M L Cristina
- Department of Health Sciences, University of Genoa - UOS Igiene Ospedaliera E.O. Ospedali Galliera, Genoa, Italy
| | - F Valeriani
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - B Casini
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - M M D'Errico
- Department of Biomedical Sciences and Public Health, Politechnic University of Marche, Ancona, Italy
| | - G Gianfranceschi
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - P Laganà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - G Liguori
- Department of Movement and Health Sciences, University "Parthenope," Napoli, Italy
| | - R Liguori
- Department of Science and Technology, University "Parthenope," Napoli, Italy
| | - N Mucci
- Department of Technological Innovations and Safety of Plants, Products and Anthropic Settlements, National Institute for Insurance against Accidents at Work, INAIL, Rome, Italy
| | - I Mura
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - C Pasquarella
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - A Piana
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - G Sotgiu
- Department of Biomedical Science-Hygiene Section, University of Sassari, Sassari, Italy
| | - G Privitera
- Department of Translational Research and New Technologies in Medicine and Surgery, Pisa University, Pisa, Italy
| | - C Protano
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - A Quattrocchi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - G Ripabelli
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - A Rossini
- Fondazione Santa Lucia Institute for Research and Health Care, IRCCS, Rome, Italy
| | | | - A M Spagnolo
- Department of Health Sciences, University of Genoa - UOS Igiene Ospedaliera E.O. Ospedali Galliera, Genoa, Italy
| | - M Tamburro
- Department of Medicine and Health Sciences "Vincenzo Tiberio," University of Molise, Campobasso, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - L Veronesi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M Vitali
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - V Romano Spica
- Unit of Public Health, Department of Movement, Human and Health Sciences, University of Rome 'Foro Italico', Rome, Italy
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50
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Tardivo S, Moretti F, Nobile M, Agodi A, Appignanesi R, Arrigoni C, Baldovin T, Brusaferro S, Canino R, Carli A, Chiesa R, D'Alessandro D, D'Errico MM, Giuliani G, Montagna MT, Moro M, Mura II, Novati R, Orsi GB, Pasquarella C, Privitera G, Ripabelli G, Rossini A, Saia M, Sodano L, Torregrossa MV, Torri E, Zarrilli R, Auxilia F, SItI G. Definition of criteria and indicators for the prevention of Healthcare-Associated Infections (HAIs) in hospitals for the purposes of Italian institutional accreditation and performance monitoring. Ann Ig 2018; 29:529-547. [PMID: 29048451 DOI: 10.7416/ai.2017.2183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) are an important issue in terms of quality of care. HAIs impact patient safety by contributing to higher rates of preventable mortality and prolonged hospitalizations. In Italy, analysis of the currently available accreditation systems shows a substantial heterogeneity of approaches for the prevention and surveillance of HAIs in hospitals. The aim of the present study is to develop and propose the use of a synthetic assessment tool that could be implemented homogenously throughout the nation. METHODS An analysis of nine international and of the 21 Italian regional accreditation systems was conducted in order to identify requirements and indicators implemented for HAI prevention and control. Two relevant reviews on this topic were further analyzed to identify additional evidence-based criteria. The project team evaluated all the requirements and indicators with consensus meeting methodology, then those applicable to the Italian context were grouped into a set of "focus areas". RESULTS The analysis of international systems and Italian regional accreditation manuals led to the identification respectively of 19 and 14 main requirements, with relevant heterogeneity in their application. Additional evidence-based criteria were included from the reviews analysis. From the consensus among the project team members all the standards were compared and 20 different thematic areas were identified, with a total of 96 requirements and indicators for preventing and monitoring HAIs. CONCLUSIONS The study reveals a great heterogeneity in the definition of accreditation criteria between the Italian regions. The introduction of a uniform, synthetic assessment instrument, based on the review of national and international standards, may serve as a self-assessment tool to evaluate the achievement of a minimum standards set for HAIs prevention and control in healthcare facilities. This may be used as an assessment tool by the Italian institutional accreditation system, also useful to reduce regional disparities.
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Affiliation(s)
- S Tardivo
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - M Nobile
- Management Department, G. Pini Orthopedic Institute, University of Milan, Milan, Italy
| | - A Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies 'GF Ingrassia', University of Catania, Catania, Italy
| | - R Appignanesi
- Management Department, Asur Zt 12, San Benedetto del Tronto, Italy
| | - C Arrigoni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - T Baldovin
- Department of Molecular Medicine, Section of Public Health, University of Padova, Padova, Italy
| | - S Brusaferro
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - R Canino
- Medical Direction Department, Oglio-Po Hospital, Vicomoscano - Casalmaggiore, Cremona, Italy
| | - A Carli
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - R Chiesa
- Programming Acquisition and Control Department, Asl Brescia, Brescia, Italy
| | - D D'Alessandro
- Department of Civil Building and Environmental Engineering, Sapienza University of Rome, Rome, Italy
| | - M M D'Errico
- Department of Biomedical Science and Public Health, Polytechnic University of Marche, Torrette di Ancona, Ancona, Italy
| | - G Giuliani
- Department of Medical Direction, Infections Control Committee, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | - M T Montagna
- Department of Biomedical Science and Human Oncology, University of Bari "Aldo Moro", Bari, Italy
| | - M Moro
- Department of Medical Direction, Infections Control Committee, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - I I Mura
- Department of Biomedical Sciences, Hygiene Unit, University of Sassari, Sassari, Italy
| | - R Novati
- Medical Direction, Aosta Regional Hospital, Aosta, Italy
| | - G B Orsi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - C Pasquarella
- Department of Hygiene and Public Health, University of Parma, Parma, Italy
| | - G Privitera
- Department of Translational Research, N.T.M.S., University of Pisa, Pisa, Italy
| | - G Ripabelli
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | - A Rossini
- Department of Medical Direction, IRCCS Santa Lucia Scientific Institute, Rome, Italy
| | - M Saia
- Veneto Region Health Directorate, Palazzo Molin San Polo Venice, Italy
| | - L Sodano
- Department of Medical Direction, San Camillo Forlanini Hospital, Rome, Italy
| | - M V Torregrossa
- Department of Sciences for Health Promotion "G. D'Alessandro" - Hygiene Section, University of Palermo, Palermo, Italy
| | - E Torri
- Department of Health and Social Policy, Trento, Italy
| | - R Zarrilli
- Department of Public Health, University of Naples "Federico II", Naples, Italy
| | - F Auxilia
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Gisio SItI
- Italian Study Group of Hospital Hygiene - Italian Society of Hygiene, Preventive Medicine and Public Health, Italy
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