Annali Di Igiene[JOURNAL]
Sun
200 papers
How's your waiting list?
Gulino V, Ricci B, Russo S … +6 more , Nigro M, Gallerani E, Lombardo E, Perger P, Campagna A, Buccioli M
Ann Ig · 2025 · PMID 40299542 · Publisher ↗
BACKGROUND: Surgical waiting lists pose a major challenge for public healthcare systems, affecting access to care and the perceived quality of services. However, there is no standardized method for assessing the efficien...
BACKGROUND: Surgical waiting lists pose a major challenge for public healthcare systems, affecting access to care and the perceived quality of services. However, there is no standardized method for assessing the efficiency and management of waiting lists. STUDY DESIGN: This study proposes a model based on Key Performance Indicators (KPIs) to measure the Waiting List sustainability of surgical waiting lists, evaluating their balance, attractiveness, efficiency, and timeliness. METHODS: Three main KPIs were defined and applied to both hypothetical and real datasets, analyzing data collected at the IRCCS Istituto Ortopedico Rizzoli from January 2024 to September 2024. Statistical analysis was conducted using Excel, calculating ratios between enrolled, admitted, canceled, and overdue patients on the waiting list. RESULTS: The analysis showed that some hospital departments have a balanced management of waiting lists, while others exhibit critical issues, with high rates of overdue or canceled patients. The graphical representation of the indicators helped identify areas for improvement in resource management. CONCLUSIONS: The adoption of standardized KPIs could serve as a valuable tool for monitoring and optimizing waiting lists, supporting strategic decisions to enhance access to healthcare services.
Probing the dual burden: assessing psychological distress and substance use among female sex workers in Sonagachi, Kolkata, West Bengal, India.
Bhattacharya M, Chandrasekaran V, Arhanthabailu P … +1 more , Ashok L
Ann Ig · 2025 · PMID 40249713 · Publisher ↗
BACKGROUND: Psychological distress and substance use is a global public health problem. Understanding the mental distress and substance use regarding female sex workers is crucial which is noticeably lacking in India. Th...
BACKGROUND: Psychological distress and substance use is a global public health problem. Understanding the mental distress and substance use regarding female sex workers is crucial which is noticeably lacking in India. The authors of this study investigate the prevalence of psychological distress and substance use among female sex workers in Sonagachi. METHODS: Using convenience sampling 149 participants were invited to participate. Tools included socio-demographic proforma, alcohol use disorder identification test to assess the risk of alcohol consumption and patient health questionnaire used to assess anxiety and depression. RESULTS: Overall, 52.4% reported psychological distress and 66.1% of participants were found to use substances. The factors associated with psychological distress are marital status, education level and number of children. Education, sex under the influence of substances, and number of years working predicted a higher likelihood of substance use such as tobacco, cannabis and alcohol. Additionally, psychological distress was more significant among women who were married, worked for more than 5 years, were forced to enter the sex trade and used condoms inconsistently. CONCLUSION: Education, sex under the influence of alcohol, number of years working, marital status, age of working, reason for sex work and condom use emerged as significant predictors of use of tobacco and cannabis, risk of alcohol consumption and psychological distress.
Measuring Health Literacy among seniors: validation of the European Health Literacy Survey Questionnaire 6 in the Tuscan PASSI sample.
Bonaccorsi G, Zanobini P, Biagi C … +8 more , Volpi M, Possenti V, Minardi V, Masocco M, Mereu G, Cecconi R, Garofalo G, Lorini C
Ann Ig · 2025 · PMID 40249712 · Publisher ↗
BACKGROUND: The demographic transition has led to an increase in the older population, resulting in a rise in individuals with comorbidities and reduced self-sufficiency. Low health literacy levels are associated with po...
BACKGROUND: The demographic transition has led to an increase in the older population, resulting in a rise in individuals with comorbidities and reduced self-sufficiency. Low health literacy levels are associated with poor health outcomes especially among vulnerable groups (like older individuals). Enhancing health literacy through targeted programs is crucial for improving self-care in chronic conditions. To date, in Italy, there are no validated tools to measure health literacy in older people. Thus, the aim of this study is to validate the European Health Literacy Survey Questionnaire 6 in a Tuscan (Italy) sample of senior individuals. STUDY DESIGN: Cross-sectional. METHODS: The sample was drawn from the Surveillance System of Advancements in health of the Italian Local Healthcare Units from 2017 to 2019. Item analysis, Cronbach's alpha and confirmatory factor analysis were used to validate the scale. Additionally, associations between Health Literacy levels and sociodemographic characteristics were analyzed. RESULTS: A total of 11,000 subjects were interviewed, with 1,080 (10%) aged 65-69. Cronbach's alpha was 0.89. In the older subgroup, the percentage of missing responses ranged from 4.54% to 11.85%, with the fourth item having the highest percentage of missing values. The confirmatory factor analysis revealed that the three-factor model showed a better fit to the data compared to the unidimensional model. Similar findings were observed in the 18-65-year-old population. In both groups, individuals with economic difficulties or lower education were at higher risk of having inadequate levels of health literacy. Moreover, in the 18-64 age group, being female reduced the probability of having an inadequate health literacy level, while being inactive/retired or a foreigner increased it. CONCLUSIONS: The study provides preliminary evidence supporting the validity and reliability of the European Health Literacy Survey Questionnaire 6 for assessing health literacy in the Italian older population. Further research is necessary to confirm these findings, particularly in samples of individuals aged over 69 years.
Disposable sheaths use versus instruments reprocessing for nasopharyngolaryngoscopy in ENT-clinic: a cost-minimization analysis.
Nurchis MC, Gianino MM, Di Pumpo M … +7 more , De Vita V, Moffa A, Giorgi L, Sabatino L, Sommella L, Casale M, Damiani G
Ann Ig · 2025 · PMID 40241507 · Publisher ↗
BACKGROUND: Nasopharyngolaryngoscopes reprocessing is often suboptimal and breaches in reprocessing protocols are commonly reported. Single-use sheaths help in reducing endoscope contamination. The aim of the study is to...
BACKGROUND: Nasopharyngolaryngoscopes reprocessing is often suboptimal and breaches in reprocessing protocols are commonly reported. Single-use sheaths help in reducing endoscope contamination. The aim of the study is to compare costs related to disposable instruments reprocessing and the single-use sheaths alternative. RESEARCH DESIGN AND METHODS: A cost-minimization analysis to compare fiberoptic nasopharyngolaryngoscopy instruments reprocessing with disposable sheaths use was performed through the micro-costing approach with data from teaching hospital and costs in euros referred to 2022, following the Consolidated Health Economic Evaluation Reporting Standards. RESULTS: In the base-case scenario, using disposable sheaths costs € 2,600 less than using cleaning and sterilization procedures. The analysis of direct medical costs, which included personnel, equipment and operating costs, and consumables, revealed higher costs related to personnel for the cleaning and sterilization alternative. Sensitivity analysis further supported the robustness of the cost-saving findings, with variations in disposable sheaths cost and sterilization kits demonstrating significant impacts on the cost difference between the two alternatives. CONCLUSIONS: Based on the study findings, this economic analysis shows that using disposable sheaths covering nasopharyngolaryngoscopes is an appropriate cost-saving strategy. Further studies on a larger scale are needed to confirm these encouraging results.
The New Guarantee System for Monitoring Healthcare Services Delivery in Italy: technical remarks and recommendations.
Signorelli C, Blandi L, Cuciniello R … +6 more , Calabretta R, Pregliasco F, Odone A, Gelatti U, Castaldi S, Pelissero G
Ann Ig · 2025 · PMID 40237191 · Publisher ↗
BACKGROUND: Over the past 15 years, Italy's National Health Service has been the object of increased governmental attention, due to the need to control public spending, reduce waste, and maintain acceptable levels of qua...
BACKGROUND: Over the past 15 years, Italy's National Health Service has been the object of increased governmental attention, due to the need to control public spending, reduce waste, and maintain acceptable levels of quality, accessibility and appropriateness of healthcare services. METHODS: One of the key mechanisms to achieve this has been the implementation of performance assessment systems. Among these is the New Guarantee System, introduced in 2019, which utilizes 88 indicators across three key macro-areas - public health and prevention, primary health care, and hospital care - to assess the quality and equity of essential healthcare services. RESULTS: This paper critically analyzes the 2025 New Guarantee System report, identifying strengths, limitations, and potential improvements for a more effective monitoring system. The findings reveal significant gaps in the current healthcare performance evaluation system. The reliance on descriptive statistics limits the ability to interpret healthcare outcomes accurately. The absence of indicators addressing chronic diseases, health inequalities, new technologies and qualitative patient experiences suggests the urgent need of a more comprehensive evaluation approach. CONCLUSIONS: To improve the healthcare performance evaluation system, it is recommended to incorporate more comprehensive indicators that address the identified gaps. Enhanced data integration, qualitative assessments, and an increased focus on chronic diseases and health disparities are essential to provide a more accurate evaluation of healthcare services.
Action Maze and Role Playing in comparison: A Randomized Field Trial on simulation-based teaching methodologies in critical care.
Colacci T, Bonavoglia F, Dibattista F … +3 more , Gargaro V, Taborri S, La Torre G
Ann Ig · 2025 · PMID 40223496 · Publisher ↗
BACKGROUND: The training of healthcare professionals requires continuous innovation in teaching methodologies to foster the development of professional skills. The use of simulation in critical care is a proven effective...
BACKGROUND: The training of healthcare professionals requires continuous innovation in teaching methodologies to foster the development of professional skills. The use of simulation in critical care is a proven effective technique, allowing students to acquire and consolidate the necessary knowledge to plan and implement nursing care in clinical practice. Interactive teaching strategies aim to increase student engagement and motivation in order to improve the learning process, decision-making, and critical thinking. New technologies that leverage gamification provide further advancements in interactive learning and represent a valuable and promising tool for training in various healthcare contexts. This study aims to analyze and compare two simulated teaching methodologies, Role Playing and Action Maze, and assess their effectiveness in terms of the acquisition of specific knowledge in the critical care field and the level of satisfaction among nursing students. MATERIALS AND METHODS: A Randomized Field Trial was conducted. A total of 130 third-year nursing students from the Sapienza University of Rome were enrolled in the study, with 60 students from course D and 70 students from course X. An initial lecture was given on nursing care for critical patients. At the end of the lecture, a custom-designed questionnaire was administered to evaluate the knowledge acquired. The students were then randomly allocated into two groups: one group was assigned to Role Playing, and the other to Action Maze. At the end of the two simulated teaching activities, the questionnaire was administered again to assess changing in knowledge. Additionally, two validated scales, the Educational Practice Questionnaire Student Version and the Simulation Design Scale Student Version, were administered to assess student satisfaction and perception regarding the simulation techniques performed. RESULTS: The Wilcoxon signed-rank test with Z=-2.1 and p=0.03, performed on the correct post-intervention responses, was significant with a p-value of <0.05 for the Action Maze group compared to the Role Playing group. The Simulation Design Scale Student Version scale showed a p-value of <0.05 for both the "teaching methodology" and "importance of elements" sections. The Educational Practice Questionnaire Student Version scale showed a p-value of 0.076 for the evaluation of the "importance of elements" section. CONCLUSIONS: The results of the study indicated that the Action Maze simulation teaching methodology was more effective, both in terms of knowledge acquisition and student satisfaction, compared to the Role Playing methodology. Further comparative studies are recommended to evaluate the effectiveness of the Action Maze compared to other simulated teaching methods.
Insect-based novel food: is Italy ready for the food of the future? A survey on entomophagy among Italian people.
Buongiovanni R, Pisano MT, Rossi F … +5 more , Spagnolo FMA, Locorriere D, Lorini C, Del Riccio M, Bonaccorsi G
Ann Ig · 2025 · PMID 40223495 · Publisher ↗
INTRODUCTION: According to the European Food Safety Authority (EFSA), novel food is defined as food that had not been consumed to a significant degree by humans in the EU before May 15th 1997, when the first regulation o...
INTRODUCTION: According to the European Food Safety Authority (EFSA), novel food is defined as food that had not been consumed to a significant degree by humans in the EU before May 15th 1997, when the first regulation of novel food came into force. This study investigates the consumption of insect-based novel food in Italy, where cultural aversions and particular disgust are major barriers to acceptance. METHODS: A cross-sectional study was conducted using a three-sections questionnaire shared through social media platforms (Facebook, Instagram, WhatsApp). The questionnaire explored socio-demographic characteristics, prior knowledge of novel food, willingness to consume insect-based food, and the impact of packaging on consumer choices. Frequencies for different items were calculated and reported in tables and charts. RESULTS: The sample showed that the majority of respondents were female (56.3%) and aged 26-35 years (24.8%). Most participants were from Southern Italy (61.8%) and had a high school diploma (45.6%). However, the majority of novel food consumers appears to be male, less than 35 years-old and born in Northern Italy. Disgust is the main obstacle towards the consumption of insects (n=261, 78.4%) while, conversely, curiosity was also significant (72.9%). Packaging had a considerable influence on consumer choices: 74.1% were willing to try chips made from cricket flour, while only 15.0% were willing to try whole insects. CONCLUSION: Despite strong cultural barriers, strategies such as improved information and appealing packaging could increase acceptance of insect-based foods in Italy, particularly among younger, educated consumers.
Examining the relationship between COVID-19 vaccines and recall rates in breast screening.
Squillace L, Pizzi L, Chiereghin A … +5 more , Bazzani C, Saguatti G, Tafà A, Roti L, Mezzetti F
Ann Ig · 2025 · PMID 40223494 · Publisher ↗
BACKGROUND: It has been observed that women vaccinated against coronavirus disease 2019 (COVID-19) may show axillary lymphadenopathy at screening mammogram, which may become suspicious for malignancy, leading to an incre...
BACKGROUND: It has been observed that women vaccinated against coronavirus disease 2019 (COVID-19) may show axillary lymphadenopathy at screening mammogram, which may become suspicious for malignancy, leading to an increased recall rate for further diagnostic evaluations and a higher number of false-positive results, as well as considerable emotional distress for the women involved. STUDY DESIGN: The study aimed to assess the incidence of doubt/positive results in the 1st level mammogram among women who received a COVID-19 vaccine within 4 weeks before mammogram, compared to unvaccinated women. Further aims included the analysis of the distribution of doubt/positive 1st level screening mammogram results according to different women-related and diagnostic work-up-related characteristics, and the evaluation of the incidence of false-positive results observed at the 2nd level. METHODS: The cohort study was carried out by retrospectively reviewing electronic data records related to the breast screening program of the Local Health Authority of Bologna in 2021 concerning women between 45 and 74 years old. Excluded were the women outside the age range, with prior breast cancer history, or receiving COVID-19 vaccination more than 4 weeks before the mammogram. RESULTS: A total of 43,856 (mean age 56.6 ± 8.7) women met the study's inclusion criteria. Among all enrolled women, the recall rate was 5.5% (N=2,394). There were no statistically significant differences in doubt/positive results between vaccinated within 4 weeks before the mammogram and unvaccinated women (5.5% versus 5.4%, p=0.649). However, those who received the Pfizer vaccine showed a significantly higher rate of doubt/positive results. CONCLUSIONS: Healthcare professionals' awareness of vaccine records and educating patients about rare adverse effects can help prevent unnecessary biopsies, interventions, and changes in patient management. Further research is needed to confirm our findings.
A critical analysis of national dementia plans: comparison of preventive strategies in five European countries.
Blandi L, Clemens T, Gentile L … +3 more , Vecchio R, Brand H, Odone A
Ann Ig · 2025 · PMID 40197827 · Publisher ↗
BACKGROUND: Preventive measures can avert up to 45% of dementia cases worldwide. The aim of the study is to analyse some selected national dementia prevention strategic plans. METHODS: A qualitative comparative analysis...
BACKGROUND: Preventive measures can avert up to 45% of dementia cases worldwide. The aim of the study is to analyse some selected national dementia prevention strategic plans. METHODS: A qualitative comparative analysis was performed between national dementia plans of the European countries with the best healthy life expectancy among the elderly. The national dementia plans of France, Ireland, Italy, Spain and Sweden were included. The consensus on priority actions and key elements of prevention policies was evaluated, according to the World Health Organization recommendations and to an analysis tool designed for evaluating chronic diseases policies. RESULTS: All the countries emphasized the importance of prevention policies within their dementia plans and established monitoring committees. However, not all countries defined timelines for policy implementation and only Spain updated its national plan so far. The integration of dementia prevention with other chronic disease preventive campaigns is still lacking, and also a clear allocation of funds for dementia plans is absent so far. CONCLUSIONS: All countries extensively followed the World Health Organization's recommendations. However, the plans have not been updated. Thus, they do not address all the current known risk factors for dementia, preventing only a fraction of potentially preventable cases. Moreover, the need for financial support in national dementia plans are critical but inadequately addressed, with inconsistent or undefined funding sources to implement their goals.
Vaccine hesitancy among nurses in the Marche Region.
Fortunato C, Gasperini B, Mengarelli Rinaldini D … +4 more , Peconi C, Lanari A, Sarti D, Pelusi G
Ann Ig · 2025 · PMID 40110759 · Publisher ↗
BACKGROUND: Vaccine hesitancy is considered one of the top ten threats to global health by the World Health Organization due to the potential public health consequences. Since April 1, 2021, the Italian Government has ma...
BACKGROUND: Vaccine hesitancy is considered one of the top ten threats to global health by the World Health Organization due to the potential public health consequences. Since April 1, 2021, the Italian Government has made COVID-19 vaccination mandatory for healthcare workers. Those who refused to undergo vaccination were suspended from activities involving patient care. This study aims to describe vaccine hesitancy among nurses in the Marche Region one year after the start of the COVID-19 vaccination campaign. STUDY DESIGN: Observational study. METHODS: All nurses belongijg to the National Federation of Nursing Professions Orders of the Marche Region were included in the study. Data from December 27, 2021, to January 1, 2022, were provided by the FNOPI Presidents of provincial FNOPI for Pesaro-Urbino, Ancona, Macerata and Fermo. RESULTS: Among the 9,611 registered nurses, 1.34% were suspended because they refused to be vaccinated. The majority of suspended nurses were women (73.6%), 35.7% aged 50-59 years, and 29.4% aged 40-49 years, 21.7% aged 30-39 years, 10.1% aged ≥60 years and 3.8% aged <30 years. Vaccination hesitancy exhibited a north-south gradient: in particular, there was a prevalence of 1.73% suspended workers in Pesaro-Urbino, 1.46% in Ancona, 1.05% in Macerata and 0.71% in Fermo province. CONCLUSIONS: Our study confirms the existence of vaccine hesitancy among nurses. The mandate imposed by the Government favored a higher adherence compared to the general population in the Marche Region, although it failed to reach full coverage by the entire nursing staff.
Impact of Mandatory Measles Vaccination on Coverage in Italy and the European Union: an observational study.
Gaeta M, Fugazza S, Carbone M … +5 more , Marjin C, Parrini A, Raso E, Viviani L, Odone A
Ann Ig · 2025 · PMID 40110758 · Publisher ↗
INTRODUCTION: Measles is a highly contagious disease, but it is preventable through vaccination. Despite the availability of measles vaccines, outbreaks continue to occur, due to factors such as vaccine hesitancy. In Ita...
INTRODUCTION: Measles is a highly contagious disease, but it is preventable through vaccination. Despite the availability of measles vaccines, outbreaks continue to occur, due to factors such as vaccine hesitancy. In Italy, measles vaccination has been mandatory since 2017. METHODS: This study analyses vaccination coverage trends to assess the impact of this mandatory vaccination policy at regionjqal, national, and European Union levels. RESULTS: Results show a significant increase in measles vaccination coverage within Italy following implementation of the mandate, both at the national (+5,2%) and regional levels. However, the comparison of European countries with and without mandatory vaccination policies did not reveal statistically significant differences in coverage. CONCLUSION: This suggests that while mandatory vaccination can improve coverage within a nation, additional strategies may be needed to address vaccine hesitancy and achieve herd immunity across broader geographical areas.
The impact of Mindfulness-based stress reduction on Covid-19 survivors. A randomized controlled trial.
Murano L, Damico V, Cossalter L … +4 more , Riggio M, Calabresi F, Zappia L, Margosio V
Ann Ig · 2025 · PMID 40110757 · Publisher ↗
INTRODUCTION: Long-COVID represents a clinical condition characterized by the inability of the patient who survived COVID-19 to regain the same state of health prior to the acute infection. Mindfulness-based stress reduc...
INTRODUCTION: Long-COVID represents a clinical condition characterized by the inability of the patient who survived COVID-19 to regain the same state of health prior to the acute infection. Mindfulness-based stress reduction focuses on increasing awareness and acceptance of moment-to-moment experiences including difficult emotions and physical discomfort. OBJECTIVE: To examine the effects of a Mindfulness-based stress reduction intervention on the functional and psychosocial outcomes of Long-COVID patients. DESIGN: A two-arm randomized controlled trial with repeated-measures design. SETTING: Department of Anesthesia and critical care. PARTICIPANTS: COVID-19 survivors (105 patients). METHODS: The patients were randomly allocated to either psychoeducation (intervention group) or usual care (control group) (53 vs 52 patients per group). A Mindfulnes program was implemented in the intervention group included an 8-week Mindfulnes-program (2 hours per week) in a group format. Study outcomes included Chronic pain (pain intensity and pain interference) assessed with Brief Pain Inventory (primary outcomes), Anxiety and Depression assessed with Hospital anxiety and depression scale, Insomnia assessed with the Insomnia Severity Index. Data were collected at 6 month and 12 months after Mindfulness-program. RESULTS: A reduction in pain intensity and pain interference on some activities of daily living were observed 6 and 12 months after intervention. A statistically significant difference emerged in the mean score of symptoms of anxiety in favor of the intervention group (11.28 vs 13.15, t= -3.636, p< .001) at 6 month and at 12 months (10.88 vs 13.41, t= -5.167, p< .001) and in the mean score of the symptoms of depression in favor of the intervention group (9.95 vs 11.23, t= -2.823, p= .007) at 6 month and at 12 months (9.67 vs 10.69, t= -2.458, p= .018). Symptoms of insomnia were statistically reduced 6 months after the Mindfulness-program (score: 53.2 vs 30.4, x= 4.944, p= .026). CONCLUSIONS: In light of what emerged from our study, we suggest a Mindfulness program in addition to drug therapy to be carried out once a year on patients with consequences of COVID-19. Studies with larger sample sizes that attempt to test a Mindfulness-program twice a year are needed.
Exploring the depths: correlates of depression among seafarers in Mumbai, India.
Krishnan A, Sumit K, Chandra Sekaran V
Ann Ig · 2025 · PMID 40066682 · Publisher ↗
BACKGROUND: Seafarers experience unique challenges related to their profession, including risks for mental health. The present study explored the correlates of depression among seafarers in India. METHODS: Following ethi...
BACKGROUND: Seafarers experience unique challenges related to their profession, including risks for mental health. The present study explored the correlates of depression among seafarers in India. METHODS: Following ethics clearance, this cross-sectional study was conducted at an international shipping company in Mumbai, India. Using time-bound convenience sampling, 105 multi-state seafarers were recruited following verbal consent. The Beck Depression Inventory and Work-Related Quality of Life scale were used to screen for the study outcomes. Data analysis was performed using Jamovi 2.0. Descriptive statistics and Chi-square tests were used to assess associations, and logistic regression was performed to identify correlates of depression. RESULTS: Of 105 seafarers, the majority (98.1%) were male, most were married (80%), and were aged between 18-35 years (56.2%). About 42.9% had an income of INR 3 lakh (≈$3604) and above monthly. An overwhelming majority had mild mood disturbances, which was found among 90.5% and 8.6% reported depression. Seafarers who engaged in regular physical activity and had higher monthly incomes had higher Work-Related Quality of Life. A significant association was found between depression and isolation (p=0.031) as well as with Work-Related Quality of Life (p=0.012). On logistic regression, we found that the number of hours of work per day, experiencing isolation and Work-Related Quality of Life, significantly predicted depression. CONCLUSIONS: The existing burden and treatment gap for mental health morbidity among seafarers needs to be addressed. To address early indications of mental health conditions among seafarers, implementing mental health screening and offering counseling services on board may be the way forward.
Knowledge and perception of modern learning approaches in Continuing Medical Education: a cross-sectional study.
Lugli C, Murani F, Bellini C … +4 more , Favazzi UM, Mazzaccara A, Vinceti M, Filippini T
Ann Ig · 2025 · PMID 40059715 · Publisher ↗
BACKGROUND: Continuing Medical Education (CME) is essential for enhancing professional performance. Modern CME approaches should prioritize adaptability and engagement through interactive and experiential learning, foste...
BACKGROUND: Continuing Medical Education (CME) is essential for enhancing professional performance. Modern CME approaches should prioritize adaptability and engagement through interactive and experiential learning, fostering better knowledge retention, skill application, and innovation to meet evolving healthcare challenges. This study aims to assess knowledge and perceptions of perceived role of engagement and active learning techniques in CME in the Italian population. METHODS: We conducted a pilot study with cross-sectional design among graduate and post-graduate students from the University of Modena and Reggio Emilia in 2023, by administering a 17-item questionnaire about knowledge, and perceptions of CME. RESULTS: We included 43 participants (median age 25, 72% females). Role of CME was recognized by 72.1%, and 53.5% were aware of its benefits. Likert responses showed high perceived importance of CME and engagement (mean scores 3.79 and 4.40). Active approaches like simulation (68.3%) and role-playing (65.9%) were familiar, but gamification (36.6%) was far less known. CONCLUSIONS: While methods like simulation, role-playing, case-based learning, and problem-based learning were familiar to study participants for their strong evidence of effectiveness, emerging approaches such as gamification and team-based learning were less known. Such approaches require further implementation in educational programs to show their benefits.
Lifestyle Interventions in Weight Loss Programs for Community-Based Patients with Severe Mental Disorders: A Scoping Review.
Picardo G, Donnoli C, Liotta G
Ann Ig · 2025 · PMID 39945287 · Publisher ↗
BACKGROUND: Patients with psychiatric disorders face exacerbated physical health issues and reduced life expectancy, primarily due to premature cardiovascular diseases. The intricate relationship between lifestyle factor...
BACKGROUND: Patients with psychiatric disorders face exacerbated physical health issues and reduced life expectancy, primarily due to premature cardiovascular diseases. The intricate relationship between lifestyle factors, illness, and psychotropic medications contributes to this phenomenon. The focus of this research is to evaluate weight management interventions for individuals with Severe Mental Disorders through a comprehensive scoping review, investigating the characteristics, types, modalities and topics of interventions to provide a useful tool for professionals who want to promote lifestyle interventions for people with Severe Mental Disorders. METHODS: Eligible articles were peer-reviewed studies that reported an intervention targeted to patients with Severe Mental Disorders and aimed at promoting health through nonpharmacological interventions (including but not limited to nutritional education, physical activity and exercise interventions). RESULTS: A total of 20 studies with a total of 3,886 participants were evaluated.The studies included patients with a weighted mean age of 44.37 (SD=4.72) and a mean Body Mass Index of 34.7 kg/m2 (SD=3.56). Varied interventions, mostly conducted in the US, showed promising weight reduction and cardiovascular risk management results among patients with psychiatric disorders. However, disparate methods used in the studies hindered the evaluation of outcomes. The studies, which yielded the most interesting results, included parallel cluster randomized controlled trials, which showed improvements in HDL cholesterol and metabolic indicators, (HR 0.085; 95% CI:0.007-0.16) using IMPACT therapy, and a pragmatic randomized controlled trial which reported that with the InShape intervention 51% of participants achieved clinically significant reduction in overall cardiovascular risk. CONCLUSION: Such a synthesis of findings provides valuable insights for future research, emphasizing the need for standardized outcome measures and more extended, comprehensive interventions.
Organisational management of the time-dependent network for the treatment of acute coronary syndrome.
Capitani E, Nante N, Montomoli E … +10 more , Limbruno U, Biancofiore A, Aloia E, Mohammed A, Taddeini F, Limaj S, D'Amato MG, Turillazzi R, De Luca A, D'Urso A
Ann Ig · 2025 · PMID 39907085 · Publisher ↗
INTRODUCTION: Cardiovascular diseases are the leading cause of death in Italy, being responsible for 227,350 deaths in 2020, according to the National Institute of Statistics. The implementation of timely reperfusion the...
INTRODUCTION: Cardiovascular diseases are the leading cause of death in Italy, being responsible for 227,350 deaths in 2020, according to the National Institute of Statistics. The implementation of timely reperfusion therapy is crucial to improve patient outcomes, and time-dependent networks for the treatment of Acute Coronary Syndrome, particularly ST-elevation myocardial infarction, have been established. In Tuscany, the network for the treatment of Acute Coronary Syndrome-ST-elevation myocardial infarction covers a vast area encompassing three Local Health Authorities, including all of South-Eastern Tuscany. Key features include equity of access, patient safety, improving the quality of care, standardization, the enhancement of professional skills, technological innovation, increasing case volumes and multi-professional integration across emergency services, hospital facilities and primary care networks. The Tuscan Acute Coronary Syndrome network provides comprehensive treatment for Acute Coronary Syndrome-ST-elevation myocardial infarction in 12 hospitals with 24-hour hemodynamics laboratories and has been extended to new territories, namely Piombino and the Island of Elba. The aim of the present study was to assess the impact of an analytical system for monitoring times to reperfusion treatment and subsequent actions, in order to improve the performance of the network. MATERIALS AND METHODS: In this retrospective study, we conducted an analytical evaluation of the network's performance, including reperfusion treatment times and factors causing delay. The study utilized data on patient transport, times from symptom onset to medical contact, and outcomes from the National Outcomes Program (NOP; "Programma Nazionale Esiti" in Italian). Analytical evaluations in 2021 measured the network's overall performance and identified the main causes of delay. The treatment process was divided into periods, from symptom onset to coronary reperfusion; interventions such as public awareness campaigns, electrocardiogram tele-transmission, and fast-track transfers were implemented in order to minimize delays. RESULTS: The lowest 30-day mortality rate in Acute Coronary Syndrome patients was recorded in hospitals that treated over 300 cases annually, according to the 2020 and 2021 National Outcomes Program of. Improvements continued into 2022 and 2023, with mortality rates also declining in patients initially admitted to peripheral hospitals. Among residents of Piombino and the Island of Elba, 30-day mortality decreased from 8.8% (2017-2020) to 5.7% in 2022. In 2022, the Grosseto Hub treated 80% of ST-elevation myocardial infarction patients within 90 minutes. CONCLUSIONS: The establishment of a well-organized time-dependent network for the treatment of Acute Coronary Syndrome-ST-elevation myocardial infarction in Tuscany significantly improved patient outcomes, thus demonstrating the critical role of timely and efficient care pathways. Our network's success is attributable to several factors, including improved accessibility, enhanced coordination among healthcare facilities, and the efficient use of technology and resources. These findings highlight the importance of structured clinical-care pathways in delivering high-quality care for Acute Coronary Syndrome patients.
The association between secondhand smoke exposure and risk of developing active tuberculosis in individuals with latent tuberculosis infection: a systematic literature review.
Sujana SP, Hamda FH, Siddiq MA … +2 more , Latif YI, Asyary A
Ann Ig · 2025 · PMID 39878029 · Publisher ↗
BACKGROUND: Tuberculosis is one of the leading causes of death from infectious diseases in the world, with approximately 25% of the global population having latent tuberculosis infection. Secondhand smoke exposure has be...
BACKGROUND: Tuberculosis is one of the leading causes of death from infectious diseases in the world, with approximately 25% of the global population having latent tuberculosis infection. Secondhand smoke exposure has been recognised as a significant risk factor in the development of active Tuberculosis in individuals with latent tuberculosis infection. STUDY DESIGN AND METHODS: This study used the Systematic Literature Review method based on PRISMA guidelines. Relevant articles published between 2014-2024 were identified through PubMed, ProQuest, and Scopus databases using related keywords. A total of 13 articles met the inclusion criteria for analysis. RESULTS: Secondhand smoke exposure significantly increases the risk of latent tuberculosis infection conversion to active Tuberculosis, with a stronger effect in vulnerable groups such as children and individuals who are in close contact with active Tuberculosis patient and live in the same household with heavy smokers. This risk of exposure to secondhand smoke follows a dose-response pattern, where longer duration and higher intensity of exposure directly increase the likelihood of Tuberculosis activation in individuals with latent tuberculosis infection. The biological mechanisms involve immune suppression and lung damage caused by toxic particles in the tobacco smoke, which weaken the body's defenses against Mycobacterium tuberculosis and facilitate the progression of latent tuberculosis infection to active Tuberculosis. Therefore, reducing exposure to secondhand smoke is important to mitigate its impact on active Tuberculosis progression. CONCLUSION: Secondhand smoke exposure has been consistently shown to increase the risk of developing active Tuberculosis in individuals with latent tuberculosis infection. To support the global Tuberculosis elimination programme, concerted efforts are needed to reduce exposure to secondhand smoke, especially in individuals with latent tuberculosis infection.
Sleep Patterns Among Athletes and Non-Athletes During Ramadan intermittent fasting: Systematic Review, Meta-Analysis and Meta-Regression.
El-Jaziz A, Lotfi S
Ann Ig · 2025 · PMID 39840806 · Publisher ↗
BACKGROUND: Ramadan fasting is a religious observance practiced regularly by Muslims and may have an effect on sleep quality, especially for athletes. Our systematic review with meta-analysis aims to identify the effect...
BACKGROUND: Ramadan fasting is a religious observance practiced regularly by Muslims and may have an effect on sleep quality, especially for athletes. Our systematic review with meta-analysis aims to identify the effect of Ramadan observance on the sleep patterns of athletes and non-athletes during Ramadan fasting over the teen years (2014-2024). STUDY DESIGN: A systematic search of Scopus, Web of Science, and Pubmed, was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses. METHODS: After a deep search in the three databases, we downloaded all the references that respected our request. all the references were imported into the COVIDENCE platform. Two independent researchers were designated to look for the criteria inclusion and to appraise each study. A third reviewer resolved conflicts if there is a divergence of judgment. Then, we obtained an Excel file that compiles all the data collected. The meta-analysis and meta-regression were compilated. RESULTS: 345 documents were found. Of these, 14 respected all the criteria. Our findings revealed that while sleep latency and di-sturbance remained unaffected by Ramadan, sleep duration and efficiency were negatively impacted, particularly among amateur athletes. Interestingly, the overall sleep quality, daytime dysfunction, and subjective sleep quality showed a positive impact from Ramadan, which was more evident among amateur athletes. CONCLUSIONS: In the context of Ramadan fasting, these results suggest that Ramadan has a negative impact on the sleep patterns of athletes and non-athletes.
Introduction to the Operation Room Management technology: Interrupted Time Series analysis in an urban acute care hospital facility in Rome, Italy.
Marte M, Piunno G, Furia G … +8 more , Vinci A, Ingravalle F, Ungaro S, Bardhi D, D'Agostino G, Chierchini P, De Vito C, Maurici M
Ann Ig · 2025 · PMID 39840805 · Publisher ↗
BACKGROUND: The surgical pathway represents a fundamental process in hospital productivity, and its digitalization is a major focus for hospital management. ASL Roma 1 health authority has taken up this digitalization ch...
BACKGROUND: The surgical pathway represents a fundamental process in hospital productivity, and its digitalization is a major focus for hospital management. ASL Roma 1 health authority has taken up this digitalization challenge by introducing an Operation Room Management (ORM) system within the operating block of one of its hospital facilities in 2022. STUDY DESIGN: Interrupted Time Series analysis. METHODS: To evaluate the impact of Operation Room Management system adoption, data on surgery were collected from all inter-ventions performed during two periods: January-June 2019 and January-June 2023. Analysis of the Operation Room Management system utilization rate since its introduction was performed, to estimate staff adaptation to the new software. RESULTS: As of June 2023, paper-registered interventions were 9%, nearing 100% for elective procedures only. The difference between the average intervention times was significantly in favor of the Operation Room Management cohort when restricting the analysis to Orthopedics (-9.02 minutes, p=0.006) and Surgery (8.47 min, p = 0.03). There was a modest but significant impact of Operation Room Management on the 'entering Operation Room to Incision' time (5 min, p < 0.01). CONCLUSION: Overall, the adoption of the Operation Room Management did not worsen process outcomes. Operation Room Mana-gement offers advantages in real-time data quality, integrated with territorial and hospital platforms, contributing to a favorable cost-benefit assessment of digitalization.
The Italian version of the Nurses' Cancer Pain Management Competency Scale: a validation study.
Damico V, Demoro G, Cossalter L … +7 more , Murano L, D'Alessandro A, Fermi L, Milani M, Russello G, Pedrini M, Margosio V
Ann Ig · 2025 · PMID 39840804 · Publisher ↗
BACKGROUND AND AIM: The Nurses' Cancer Pain Management Competency Scale is a tool to explore nurses' competencies and subjective experiences in cancer pain management, and to help nurses understand their current shortcom...
BACKGROUND AND AIM: The Nurses' Cancer Pain Management Competency Scale is a tool to explore nurses' competencies and subjective experiences in cancer pain management, and to help nurses understand their current shortcomings in cancer pain management. Furthermore, based on the scale's specific score, nurses can evaluate their lack of understanding about cancer pain management, advance research into this area, and enhance their capacity to control cancer pain while providing patient care. The scale is currently available only in English and in Chinese. The aim of this study was to translate the new scale and measure its reliability and validity in the Italian context. STUDY DESIGN: Methodological research model. METHODS: The population of this methodological study included Italian nurses working in the oncology departments of 21 hospitals in Northern, Southern and Central Italy; the sample involved 243 nurses who met the inclusion criteria. RESULTS: Cronbach's alpha of the scale was 0.814. The Guttman half-reliability of the scale was 0.819. Nurses' cancer pain management competency includes four factors, which accounted for 71.43% of the cumulative variance: the context of pain management, pain assessment and measurement, management of pain, and multidimensional nature of pain. On a 4-point scale for total competency, the mean score was 2.65 ±0.89. The multidimensional nature of pain (2.88 ±0.76) was the factor that showed the highest mean score, whereas the management of pain factor was the lowest (2.52 ±0.73). CONCLUSION: Nurses' cancer pain management competency can be assessed using the Italian version of the Nurses' Cancer Pain Management Competency Scale, which has strong validity and reliability.
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