Annali Di Igiene[JOURNAL]
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200 papers
Exploring the gap between notified and diagnosed cases of Foodborne Diseases: evidence from a time-trend analysis in Italy.
Capodici A, Lenzi J, Cavagnis S … +7 more , Ricci M, De Dominicis F, Ambretti S, Gabrielli L, Galli S, Lazzarotto T, Resi D
Ann Ig · 2025 · PMID 39370880 · Publisher ↗
BACKGROUND: Foodborne diseases are a major global public health concern, causing significant morbidity and mortality worldwide. The COVID-19 pandemic has had widespread effects on various aspects of life, including the f...
BACKGROUND: Foodborne diseases are a major global public health concern, causing significant morbidity and mortality worldwide. The COVID-19 pandemic has had widespread effects on various aspects of life, including the food supply chain, potentially impacting the incidence of foodborne diseases. This study aims to analyze the differences between notified and diagnosed cases and investigate the potential impact of the COVID-19 pandemic on foodborne diseases in the metropolitan area of Bologna, Italy. STUDY DESIGN: A retrospective time trend analysis from two databases was conducted. METHODS: The Local Health Authority of Bologna collected data re/Emilia-Romagna Region on the infectious disease reporting system over a six-year period (2017-2022), which included three years of the COVID-19 pandemic. This data was compared with information collected during the same period at the microbiology laboratory serving the entire metropolitan area of Bologna. Statistical methods included percent change calculations, binomial tests, annual averages, gender and age stratification, and trend analysis with regressio. RESULTS: An increase (+34.4%, P-value ≤ 0.01) in notified cases during the pandemic - compared to the pre-pandemic period - was found. However, no differences were observed in diagnosed cases when comparing the two periods. The year 2021 saw a significant increase in reported cases of foodborne diseases among schoolers (+300.0%) and workers (+133.3%) compared to 2020. On the other hand, diagnosed cases decreased significantly in 2020 (-19.1%, P<0.01) and increased in 2021 (+21.9%, P<0.01). In absolute terms, a stark difference was observed between notified and diagnosed cases across all the study years (2017-2022). CONCLUSIONS: This study highlights the discrepancy between notified and diagnosed cases of foodborne diseases and how the COVID-19 pandemic has increased reporting without affecting transmission. These findings contribute to the ongoing discussion on improving foodborne disease reporting systems.
Sleep quality among Italian university students: the UnSleep multicenter study.
Gallè F, Grassi F, Valeriani F … +31 more , Albertini R, Angelillo S, Caggiano G, Bargellini A, Bianco A, Bianco L, Dallolio L, Della Polla G, Di Giuseppe G, Gioffrè ME, Laganà P, Licata F, Liguori F, Lo Moro G, Marchesi I, Martella M, Masini A, Montagna MT, Napoli C, Oliva S, Orsi GB, Paduano S, Pasquarella C, Pelullo CP, Sacchetti R, Siliquini R, Triggiano F, Veronesi L, Spica VR, Vitali M, Protano C
Ann Ig · 2025 · PMID 39370879 · Publisher ↗
BACKGROUND: Scientific evidence demonstrates that poor sleep quality can lead to various health problems. This study aimed to investigate sleep patterns among Italian university students and identify several factors that...
BACKGROUND: Scientific evidence demonstrates that poor sleep quality can lead to various health problems. This study aimed to investigate sleep patterns among Italian university students and identify several factors that may contribute to its quality. STUDY DESIGN: Cross-sectional study. METHODS: An electronic questionnaire regarding sociodemographic characteristics, lifestyle, and sleep-related habits, including the Pittsburgh Sleep Quality Index (PSQI) questionnaire, was distributed between January 2022 and July 2023 among students belonging to 12 universities located in Northern, Central, and Southern Italy. RESULTS: On a total of 1,674 questionnaires collected, the participants (mean age 24.06±4.56 years, 71.3% F) reported an average number of hours of nocturnal sleep equal to 6.89±1.28 hours. A total of 927 (54.6%) of respondents showed a poor sleep quality (PSQI >5). Regression analysis showed that better sleep quality is associated with lower age, attending universities in Northern Italy, less time spent on electronic devices during the day, not being used to study at night and not playing videogames before sleep. CONCLUSION: From a public health perspective, our findings suggest that public health operators should raise the awareness of young adults about the importance of sleep quality for maintaining good health, as well as the impact that certain behaviors can have on sleep.
How outdoor and indoor green spaces affect human health: a literature review.
Paniccià M, Acito M, Grappasonni I
Ann Ig · 2025 · PMID 39370878 · Publisher ↗
BACKGROUND: The analysis of the complex interactions between outdoor or indoor greenness and the health of individuals and ecosystems is a topic of current and growing interest. STUDY DESIGN: This review aims to examine...
BACKGROUND: The analysis of the complex interactions between outdoor or indoor greenness and the health of individuals and ecosystems is a topic of current and growing interest. STUDY DESIGN: This review aims to examine and summarise the results of studies conducted to evaluate the effects of exposure to greenness on various aspects of human health and the natural environment. METHODS: For this purpose, in April 2024 we searched PubMed, Web of Science, and Scopus databases, Google Scholar and specialised books. RESULTS: Evidence gathered demonstrates a remarkable correlation between exposure to outdoor and indoor greenness and the improvement of mental health, including the reduction of stress, anxiety, and depression. Contact with greenness is also associated with improvements in physical health, such as reductions in blood pressure, heart rate, and inflammation, as well as in cognitive abilities, concentration, and overall recovery. These benefits are recognisable both in outdoor spaces, such as urban parks, oases, and public gardens, and in indoor spaces, through the introduction of plants and nature-evoking elements in living and working environments. The presence of vegetation in indoor environments, such as offices, schools, healthcare facilities, prisons, and others, can contribute to improving the quality of social spaces, fostering communication, and collaboration, and attenuating aggressiveness and inequalities, thereby increasing employee satisfaction and work efficiency. The combination of outdoor/indoor green spaces and the well-being of the living environment includes exposure to greater biodiversity, mitigation of extreme weather events, absorption of atmospheric pollutants, attenuation of urban background noise, and increased privacy. The presence of vegetation in urban areas has a positive impact on social cohesion, promoting interpersonal interaction and facilitating the development of more cohesive and inclusive communities, thus supporting a sense of belonging and collective identity. CONCLUSIONS: In conclusion, these results underline the importance of considering contact with greenness as a fundamental element in promoting the psychophysical health and well-being of individuals and ecosystems, suggesting the adoption of nature-based therapies and interventions in public health policies and urban planning practices.
Smart working during the COVID-19 pandemic: the prevalence of musculoskeletal and visual disorders in administrative staff of a large international company.
Santoro PE, Amantea C, Travaglini M … +6 more , Salin G, Borrelli I, Rossi MF, Hashemian DK, Gualano MR, Moscato U
Ann Ig · 2025 · PMID 39263945 · Publisher ↗
INTRODUCTION: During the COVID-19 Pandemic, the use of digital devices during work activities has increased with important repercussions on the psychological and physical well-being of the employees. The aim of this stud...
INTRODUCTION: During the COVID-19 Pandemic, the use of digital devices during work activities has increased with important repercussions on the psychological and physical well-being of the employees. The aim of this study was to investigate the prevalence of musculoskeletal and visual disorders related to the use of computers and home workstation. METHODS: The study is a cross-sectional study. A checklist, from the National Institute of Health, was administered to white collar workers of a large international pharmaceutical company based in Italy. RESULTS: Our study showed that postural breaks have a protective effect on neck/shoulder pain (OR 0.32, CI 0.16-0.62), back and lower extremity pain (OR 0.35, CI 0.18-0.69), and eye burning (OR 0.50, CI 0.27-0.94) of study participants. CONCLUSIONS: The research recommends that remote employees who often change their workstations should establish a suitable work environment and obtaining enough risk training from an occupational physician. This is essential for maintaining their mental and physical well-being.
Vaccinations at home: a new strategy to contain vaccine hesitancy? The experience of ASL Napoli 1 Centro, Italy.
Tesorone M, Ungaro C, Graziano L … +5 more , Vitagliano A, Luminoso I, Corvino M, Papa M, Verdoliva C
Ann Ig · 2025 · PMID 39263944 · Publisher ↗
Vaccination coverage are generally geographically variable, even within large cities; furthermore, across target population are embedded difficult-to-reach clusters. To address this issue and improve coverage of mandator...
Vaccination coverage are generally geographically variable, even within large cities; furthermore, across target population are embedded difficult-to-reach clusters. To address this issue and improve coverage of mandatory vaccinations, a study group explored bringing vaccination at home as an interventional strategy. In a pilot experience, parents of unvaccinated and under vaccinated children of the 2020 birth cohort living in Naples, Italy were contacted by telephone to offer home administration of vaccinations. A specifically trained team arranged vaccinations visits at home. Coverage rates were evaluated at baseline and one month after the intervention strategy. A significant positive increase in hexavalent vaccine (+1.43%) and measles-mumps-rubella (+1.85%) coverage was registered despite the short duration of the pilot program. Home vaccination turned out to be a medical resource consuming but feasible and successful strategy to increase mandatory vaccinations coverage among the most difficult-to-reach and fragile segments of the pediatric population.
Predicting the risk of type 2 diabetes: Standardized diabetes risk score among the Khmer ethnic minority in Vietnam.
Nguyen TTH, Duong LP
Ann Ig · 2025 · PMID 39221477 · Publisher ↗
BACKGROUND: Predicting the risk of progression to type 2 diabetes, as well as identifying the factors that increase this risk, helps the population adjust the modifiable risk factors, improve quality of life, and reduce...
BACKGROUND: Predicting the risk of progression to type 2 diabetes, as well as identifying the factors that increase this risk, helps the population adjust the modifiable risk factors, improve quality of life, and reduce the disease burden. SUBJECTS AND METHODS: A cross-sectional study was conducted on 918 ethnic Khmer minority people aged 40 and above in Vietnam who had never been diagnosed with type 2 diabetes. OBJECTIVE: To predict the 10-year risk of type 2 diabetes, the Finnish Diabetes Risk Scoring Scale, adjusted for the Asian population with modification of the waist circumpherence and Body Mass Index Cut-Offs, was used. RESULTS: The 10-year predicted risk of progression to type 2 diabetes in ethnic Khmer people aged 40 years and older in southern Vietnam, using the Asian-modified Finnish Diabetes Risk Scoring Scale, resulted 10.54% in the total population study, females have a higher risk at 12.62% compared to 8.01% of males. Among the items that make up the Finnish Diabetes Risk Scoring Scale, age, waist circumference, BMI, family history of diabetes, history of high blood glucose, and use of blood pressure medication were the most accurate predictors, with the area under the Receiver operating characteristic (ROC) curve at 0.83, 0.81, 0.77, 0.75, 0.74 and 0.73 respectively. The optimal cut-off score to identify progression to tipe 2 diabetes was 13.5 points (Se = 1.00, Sp = 1.00, p < 0.001). The multivariable logistic regression model shows that factors associated with high risk of type 2 diabetes progression in 10 years are age, gender, occupation, economic status, education level and regular alcohol consumption (p < 0.05). The study results provide a basis for proposing potential solutions to reduce modifiable risk factors for type 2 diabetes in the population. These include providing culturally appropriate health education and changing behavior to address alcohol consumption. DISCUSSION AND CONCLUSIONS: The use of the Asian-modified Finnish Diabetes Risk Scoring Scale to predict the risk of progression to type 2 diabetes and as a screening tool for undiagnosed type 2 diabetes is appropriate for the Vietnamese Khmer population.
Identification of bullet holes in mummified corpse.
Bisogni KS, Magli F, Galassi IA
Ann Ig · 2024 · PMID 39101411 · Publisher ↗
BACKGROUND: The evaluation of the cause of death in a forensic context is often challenging especially when the corpse is in a severely altered state (decomposed, skeletonized, charred, dismembered, etc.), thus making it...
BACKGROUND: The evaluation of the cause of death in a forensic context is often challenging especially when the corpse is in a severely altered state (decomposed, skeletonized, charred, dismembered, etc.), thus making it difficult to obtain an overview of the features and/or lesions suggestive of the dynamics leading to death. CASE REPORT: In this case, the corpse was partly in a state of saponification and partly in a state of mummification with signs of skeletonization. The head, trunk, arms and upper legs were mummified and almost completely dehydrated. CONCLUSION: The use of special techniques such as the rehydration of bodies is an ancient practice. Parts of skin in different states of decomposition with the use of rehydration solution represents a useful procedure for the study of some damaging modalities, being able to identify damaged areas characterized by compression/dehydration effects, hidden by the advanced transformative state of the corpse, highlighting very damaged, in which skin normality can no longer be restored.
Pulmonary embolism: incidence and outcomes in a twelve-year historical series, in Tuscany - Italy (2010-2021).
Cerini G, Lunetta C, Szasz C … +6 more , Misuraca L, Gemmi F, Carluccio M, Lorini C, Bonaccorsi G, Forni S
Ann Ig · 2025 · PMID 39049525 · Publisher ↗
BACKGROUND: Pulmonary embolism poses a global health concern. Administrative databases serve as valuable sources for broad epidemiological studies on the prevalence and incidence of major diagnoses or diseases. The prima...
BACKGROUND: Pulmonary embolism poses a global health concern. Administrative databases serve as valuable sources for broad epidemiological studies on the prevalence and incidence of major diagnoses or diseases. The primary scope is to provide up-to-date insights into Pulmonary Embolism incidence trends, examining shifts in management and outcomes. DESIGN: This retrospective observational study examines a 12-year dataset from hospitals in the Tuscany Region, covering the first two years of the Covid-19 pandemic. METHODS: Administrative data from residents aged 18 and older discharged from hospital between 2010 and 2021 were used for the analysis. RESULTS: Hospitalized pulmonary embolism incidence slightly declined from 2010 to 2019 (64.7 to 60.9 x 100,000; p=0.152). Males under 75 showed a higher incidence rate, while females had higher incidence rates in older age groups. In-hospital and 30-day mortality decreased from 2010 to 2019 (p=0.001 and 0.020 respectively). In 2020, 30-day mortality increased (12.4% vs 10.1%, p=0.029), while in-hospital mortality remained stable. One-year mortality was stable from 2010-2019 but increased in 2020 (32.6% vs 29.4%, p=0.037). Considering the multivariable model, one-year mortality is significantly associated with sex, age, and comorbidities. CONCLUSIONS: Our study shows that Pulmonary Embolism persists as a relevant burden in Tuscany region, but with improvements in management over the past decade and a decisive change in pharmacological treatment. Gender-related differences emerge, highlighting the need for a gender-specific healthcare approach.
Firearm ownership and suicide: Has the time come to discuss uniformity of health and social assessments in aid of regulation? Reflection from a retrospective study on a forensic case series.
Blandino A, Galante N, Cuppone F … +2 more , Giriodi M, Travaini GV
Ann Ig · 2025 · PMID 39041281 · Publisher ↗
BACKGROUND: Firearm-related deaths are an issue of ongoing public interest, from a health and economic perspective. Worldwide, firearm prevalence in suicides varies widely, depending on multiple factors including the ava...
BACKGROUND: Firearm-related deaths are an issue of ongoing public interest, from a health and economic perspective. Worldwide, firearm prevalence in suicides varies widely, depending on multiple factors including the availability of weapons in each country. Although several studies have shown that national laws about gun ownership, reducing legal access to guns, decrease the risk of suicide by firearm, the current situation clashes with widely differing legislations. STUDY DESIGN: Retrospective study on a forensic case series. METHODS: Autopsy reports assessed at the Section of Legal Medicine of Milan (Italy) from January 2014 to December 2023 were retrospectively documented. Only firearm suicides were considered. For each case, a close analysis of the criminal offence reports has been performed to obtain information about the gender and age of the victim, as well as the legal possession of firearms, psychiatric disorders, alcohol, and illicit drug abuse. RESULTS: Among all the 1,164 suicides assessed at the Section of Legal Medicine of Milan over a 10-year-period, 101 cases (8.7%) were firearm-related. The male to female ratio was therefore about 13:1. No seasonal trends were observed. Most of the individuals owned the firearm license. Of the entire dataset, 35.6% suffered from psychiatric disorders, 4% of alcohol abuse and 2% of drug addiction. Among the owners of a firearm license, 42.3% had psychiatric disorders. CONCLUSIONS: Knowledge about firearm suicide and its relation to firearm legal possession is limited and current preventive laws should be reconsidered. Present administrative and clinical examinations required to obtain a firearm license in Italy and in some European territories are dealt with. The evaluation of the firearm-related risk of abuse is an essential but complex procedure, which requires not only clinic-anamnestic data but also in-deep psychiatric information. There is a need to develop and reinvigorate a debate that currently presents very heterogeneous solutions, but which would probably benefit from a common vision of the prevention strategies that can be implemented and enacted for the benefit of the entire community.
Vaccine Literacy and Hesitancy on routine and travelers' vaccines: a preliminary online survey.
Biasio LR, Lorini C, Pecorelli S
Ann Ig · 2025 · PMID 39024053 · Publisher ↗
BACKGROUND: The vast amount of conflicting information during the COVID-19 pandemic might have had a detrimental effect on people's opinions about vaccinations, including groups like travelers. This study aimed at assess...
BACKGROUND: The vast amount of conflicting information during the COVID-19 pandemic might have had a detrimental effect on people's opinions about vaccinations, including groups like travelers. This study aimed at assessing Vaccine Literacy in a sample of the general Italian population, together with antecedents of Vaccine Hesitancy, such as confidence, complacency, and convenience, the so-called "3Cs", and their effects on accepting routine and travelers' vaccines. STUDY DESIGN: A specifically designed anonymous questionnaire was created by using Google forms and validated through a face validity process. Subsequently, it was employed in an online cross-sectional survey. METHODS: The assessment Vaccine Literacy scale used in this survey was similar to that employed in earlier surveys. In addition to demographic data and information sources used by participants, the questionnaire was composed, in total, of nine multiple choice questions on Vaccine Literacy, and six questions on the 3Cs. Considered outcomes were self-reported participants' beliefs, attitudes, behaviors and intentions toward recommended routinary adulthoods vaccines and arboviral vaccines for travelers. A section of the questionnaire focused on chikungunya awareness, taken as an example of arboviral disease that has caused outbreaks in Italy, but not yet vaccine-preventable at the time of the investigation. RESULTS: After cleaning the database, 357 responses were suitable for analysis. Vaccine Literacy mean functional score was 2.81 ± 0.74 (lower than in an earlier survey, p = 0.012), while the interactive-critical (score 3.41 ± 0.50) was higher (p<0.001). Vaccine literacy was confirmed to be associated with attitudes and behaviors towards vaccination, with the 3Cs often acting as a mediator. However, interactive Vaccine Literacy was misaligned with respect to functional and critical ones, as if looking for information sources or discussing about vaccination was less relevant than amidst the pandemic. Also, there was an increase in Vaccine Hesitancy, particularly with regard to travel vaccinations, with 10-17% of individuals refusing to be vaccinated if travelling in areas at risk. The main limitation of the study was the unbalance in demographic variables, in particular the education level. CONCLUSIONS: The study highlights the risks associated with current travel, including those related to climate change and the spread of vector-borne infections. It underscores the importance of raising awareness about arboviral diseases and the vaccines available to prevent them. As with all online surveys that employ convenience sampling, this study might not have provided a comprehensive representation of the entire population. Nevertheless, a dedicated analysis has been conducted to reduce biases and make data interpretation easier. Despite the need for further research, the findings indicate potential new approaches for assessing Vaccine Literacy and Vaccine Hesitancy, to ease the development of new communication strategies to enhance routine and travel vaccinations.
The role of citizenship in the acceptance and completion of COVID-19 vaccine cycle in the resident population with foreign citizenship registered with the Umbrian Health Care System - An analysis of regional data.
Giacchetta I, Primieri C, Chiavarini M … +2 more , de Waure C, Bietta C
Ann Ig · 2025 · PMID 39016100 · Publisher ↗
INTRODUCTION: Non-italian citizens experienced less access to anti-COVID-19 vaccination, compared to the native population. Literature has found differences in adherence to anti-COVID-19 vaccination among these groups; h...
INTRODUCTION: Non-italian citizens experienced less access to anti-COVID-19 vaccination, compared to the native population. Literature has found differences in adherence to anti-COVID-19 vaccination among these groups; however, there are apparently no studies that investigated the role of citizenship. Our objective was to investigate the role of citizenship in vaccine hesitancy toward anti-COVID-19 vaccination and the completion of vaccine cycle, in the non-Italian citizens resident in the Umbria Region. STUDY DESIGN: This is a population study, performed on resident population in Umbria. METHODS: Population data were obtained thanks to a record linkage between the Regional Health Information System and the regional DBCOVID Umbria database. On this dataset, a descriptive and logistic regression analyses were performed. RESULTS: The 19.2% of non-Italian citizens did not take even one dose, 2.1% did not complete it and 40.6% did not take the additional dose. The range of values of which these results are an average, however, is very wide, suggesting important differences in COVID-19 vaccine up taking, among different citizenships. The logistic regression shows that citizenships with the highest probability of non-adherence to vaccination, compared to Philippine, was Romanian (OR=7.8), followed by Macedonian (OR=7.3) and Polish (OR=5.9). CONCLUSIONS: The study provides evidence of differences among citizenships that pinpoint the importance of understanding the reasons behind these behaviours, to support decisions around health policies tailored to each citizenship.
The impact of the COVID-19 pandemic on academic performance among developmental age students: a systematic review with meta-analysis.
Gianfredi V, Scarioni S, Marchesi L … +7 more , Ticozzi EM, Addo MO, D'errico V, Fratantonio L, Liguori L, Pellai A, Castaldi S
Ann Ig · 2025 · PMID 39016099 · Publisher ↗
OBJECTIVE: The COVID-19 pandemic has disrupted educational systems worldwide, raising concerns about its impact on academic performance, particularly among developmental age students. METHODS: A systematic review with me...
OBJECTIVE: The COVID-19 pandemic has disrupted educational systems worldwide, raising concerns about its impact on academic performance, particularly among developmental age students. METHODS: A systematic review with meta-analysis aimed to evaluate the association between the COVID-19 pandemic and the academic performance in this population was performed according to PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus and Embase were searched on December 2023 to identify relevant studies. Both fixed and random effect models were performed. The Effect size was reported as Cohen's d with a 95% Confidence Interval. Studies' quality was assessed using the Newcastle-Ottawa scale. The protocol was registered in PROSPERO. RESULTS: A total of 30 studies met the inclusion criteria, but only 13 could be combined in the meta-analysis. Based on a sample size of 4,893,499 students, pooled Cohen's d was -0.07 [(95% CI = -0.10; -0.03); p-value <0.001]. Subgroup analyses by subject suggested that performance in math was affected the most, Cohen's d= -0.14 [(-0.18; -0.10); p-value <0.001]. CONCLUSION: The findings revealed a significant negative association between the COVID-19 pandemic and academic performance among developmental age students. Interventions to mitigate the adverse effects of the pandemic on educational outcomes in this population are needed.
Machine learning vs. regression models to predict the risk of Legionella contamination in a hospital water network.
De Giglio O, Fasano F, Diella G … +6 more , Spagnuolo V, Triggiano F, Lopuzzo M, Apollonio F, Leone CM, Montagna MT
Ann Ig · 2025 · PMID 38989797 · Publisher ↗
INTRODUCTION: The periodic monitoring of Legionella in hospital water networks allows preventive measures to be taken to avoid the risk of legionellosis to patients and healthcare workers. STUDY DESIGN: The aim of the st...
INTRODUCTION: The periodic monitoring of Legionella in hospital water networks allows preventive measures to be taken to avoid the risk of legionellosis to patients and healthcare workers. STUDY DESIGN: The aim of the study is to standardize a method for predicting the risk of Legionella contamination in the water supply of a hospital facility, by comparing Machine Learning, conventional and combined models. METHODS: During the period July 2021- October 2022, water sampling for Legionella detection was performed in the rooms of an Italian hospital pavilion (89.9% of the total number of rooms). Fifty-eight parameters regarding the structural and environmental characteristics of the water network were collected. Models were built on 70% of the dataset and tested on the remaining 30% to evaluate accuracy, sensitivity, and specificity. RESULTS: A total of 1,053 water samples were analyzed and 57 (5.4%) were positive for Legionella. Of the Machine Learning models tested, the most efficient had an input layer (56 neurons), hidden layer (30 neurons), and output layer (two neurons). Accuracy was 93.4%, sensitivity was 43.8%, and specificity was 96%. The regression model had an accuracy of 82.9%, sensitivity of 20.3%, and specificity of 97.3%. The combination of the models achieved an accuracy of 82.3%, sensitivity of 22.4%, and specificity of 98.4%. The most important parameters that influenced the model results were the type of water network (hot/cold), the replacement of filter valves, and atmospheric temperature. Among the models tested, Machine Learning obtained the best results in terms of accuracy and sensitivity. CONCLUSIONS: Future studies are required to improve these predictive models by expanding the dataset using other parameters and other pavilions of the same hospital.
Why are rare diseases underdiagnosed? A clinical management study on detection of primary biliary cholangitis in primary care.
Donato F, Pigozzi MG, Colarieti G … +2 more , Festa M, Tabaglio E
Ann Ig · 2024 · PMID 38946477 · Publisher ↗
BACKGROUND: There are about 7,000 rare diseases that affect 10% of the world population. Primary biliary cholangitis, an autoimmune chronic liver disease of the interlobular bile ducts, is one of the most common causes o...
BACKGROUND: There are about 7,000 rare diseases that affect 10% of the world population. Primary biliary cholangitis, an autoimmune chronic liver disease of the interlobular bile ducts, is one of the most common causes of chronic cholestasis. However, it is a rare, often underdiagnosed and undertreated, disease which can lead to cirrhosis and liver failure. We aimed to assess the proportion of undetected primary biliary cholangitis patients in primary care through a clinical management process. METHODS: We made two extractions of the clinical data concerning liver diseases, risk factors and laboratory tests from the databases of a sample of general practitioners, with a check and correction of mistakes. The clinical data of the patients without liver disease and major risk factors, and with serum Alkaline Phosphatase above the laboratory reference values, were re-evaluated by each general practitioner with an expert gastroenterologist. The patients with elevated Alkaline Phosphatase values and without evidence of intrahepatic or extrahepatic causes of cholestasis were considered suspected for primary biliary cholangitis and assessed for antimitochondrial antibodies test and specialist' s evaluation, according to present guidelines. RESULTS: A total of 20,480 adults attending 14 general practitioners in the province of Brescia, Northern Italy, were included in the study. Nine patients had a prior primary biliary cholangitis diagnosis, with a prevalence of 43.9/100000. After excluding 2094 (10.2%) patient with liver diseases or other causes of cholestasis, 121 subjects with Alkaline Phosphatase above the reference values were re-evaluated by the general practitioners and gastroenterologist, and 27 patients without symptoms or signs of cholestasis were considered suspected for primary biliary cholangitis: 9 of them were tested for antimitochondrial antibodies, and three new primary biliary cholangitis cases were detected (+33%). DISCUSSION AND CONCLUSIONS: This study shows that there is a not negligible burden of undetected cases of adult rare diseases that can be diagnosed in primary care, through a disease management procedure, without modifying the routine clinical practice.
Training in infection prevention and control: survey on the volume and on the learning demands of healthcare-associated infections control figures in the Emilia-Romagna Region (Northern Italy).
Ferrari E, Scannavini P, Palandri L … +7 more , Fabbri E, Tura G, Bedosti C, Zanni A, Mosci D, Righi E, Vecchi E
Ann Ig · 2025 · PMID 38899568 · Publisher ↗
BACKGROUND: In the context of Infections Prevention and Control activities, the training of healthcare-associated infection control figures is crucial; the COVID-19 pandemic further emphasized the necessity of ensuring a...
BACKGROUND: In the context of Infections Prevention and Control activities, the training of healthcare-associated infection control figures is crucial; the COVID-19 pandemic further emphasized the necessity of ensuring a widespread and stable level of skills over time for such professionals. The present work aims to identify the number and training needs of the personnel working in the Emilia-Romagna Region's healthcare facilities as "healthcare-associated infection control figures". METHODS: Data were collected through a survey created by experts from the Regional Group "Training in the prevention and control of antibiotic resistance". The questionnaire explored the number, professional and educational background, and training requirements of Healthcare-associated infections control figures in Emilia-Romagna. RESULTS: With 73 figures dedicated to Healthcare-associated infections control, the Emilia-Romagna Region appears to be in line with the European standard ratio (1 professional every 125 beds). Professionals with a nursing background, over 50 years old and of female sex prevail in the group, while the training needs expressed include both theoretical and practical aspects. CONCLUSIONS: Healthcare assistants and nursing staff represent a fundamental resource for the implementation of infection prevention and control programs in our healthcare facilities; continuous, multidisciplinary and targeted training of these professionals is confirmed as necessary.
The prevention of medication errors in the home care setting: a scoping review.
Dionisi S, Giannetta N, Liquori G … +5 more , De Leo A, Panattoni N, Caiafa M, Di Muzio M, Di Simone E
Ann Ig · 2025 · PMID 38818734 · Publisher ↗
BACKGROUND: The changes in health, social and demographic needs impose new approaches to cures and care without giving up patients' safety. Although several studies analysed the patient safety approach and strategies, th...
BACKGROUND: The changes in health, social and demographic needs impose new approaches to cures and care without giving up patients' safety. Although several studies analysed the patient safety approach and strategies, the literature considering the home care setting seems still scarce. The analysis of the phenomenon of medication errors in the primary care setting highlights the necessity of exploring the specific variables to understand how to prevent or reduce the occurrence of a medication error in the home context. This review investigates the main preventive strategies implemented at the patient's home to prevent and/or limit the possibility of a medication error. DESIGN: The scoping review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) statement and based on the guidelines of the Joanna Briggs Institute. METHODS: No time or language limit was set to obtain the most comprehensive results possible. The following databases were queried: PubMed, Cochrane, CINAHL, ERIC and PsycINFO via EBSCO. All literature published up to 31 December 2022 was considered for data collection. RESULTS: The main preventive strategies implemented in the patient's home to prevent a medication error are: Multidisciplinary teams, therapeutic reconciliation and computerised systems that improve information sharing. As evidenced by all of the included studies, no educational intervention or preventive strategy individually reduces the risk of making a medication error. CONCLUSIONS: It would be desirable for healthcare professionals to be constantly updated about their knowledge and understand the importance of introducing the aforementioned preventive strategies to guarantee safe care that protects the person from medication errors even at the patient's home.
Enhancing Physicians' Autonomy through Practical Trainings.
Stirparo G, Gambolò L, Bottignole D … +5 more , Solla D, Trapani M, Ristagno G, Pregliasco F, Signorelli C
Ann Ig · 2024 · PMID 38801200 · Publisher ↗
BACKGROUND: In medical emergencies adherence to standardized clinical protocols is crucial to ensure a better outcome for patients. Newly qualified physicians may play several roles in serving the National Health Service...
BACKGROUND: In medical emergencies adherence to standardized clinical protocols is crucial to ensure a better outcome for patients. Newly qualified physicians may play several roles in serving the National Health Service (substituting general practitioners, on-call duty, working in emergency rooms, etc.) in Italy. In these situations, the physician may have to manage critical patients autonomously. Moreover, newly qualified physicians may show a considerable deficiency in routine medical activities. In fact, many universities do not provide a practical simulation training programme, which is why a substantial number of students only face clinical emergencies when they start working after graduation. STUDY DESIGN: A cross-sectional study was performed by engaging medical doctors. Both experienced physicians and newly licensed physicians (graduated less than 24 months ago) were included in the study. METHODS: A questionnaire was distributed to each participant during SIMED's Courses from June 2021 to December 2022. The questionnaire consisted of two sections. The first one analyzed participation in standardized practical courses on medical emer-gencies (Basic Life Support, Advanced Cardiac Life Support, International Trauma Life Support and a course on Advanced Airway Management). The second section analyzed the perceived autonomy of health professionals in the management of five different work settings, using a 5-point likert scale. RESULTS: 2,168 questionnaires were analyzed, of which 68.7% were from newly qualified doctors and 31.3% from more experienced doctors. The highest rate of physicians who undertook training courses was achieved for the basic life support course (77.5%) and the lowest rate for the advanced trauma course (15.9%). Physicians perceive themselves the highest autonomy in Primary Care setting (63.1%), while in the Emergency Department they perceive themselves with less autonomy (24.0%). In the analyzed sample, experienced physicians show a higher percentage of autonomy than newly qualified doctors (31.4% vs 8.1%) in all scenarios.
Mpox: Awareness, knowledge and information channels used by individuals accessing a sexually transmitted infections Helpline.
Gallo P, Galea N, Colucci A … +8 more , Valli R, Schwarz M, Fanales Belasio E, d'Ari A, Furiozzi F, Caraglia A, Dalla Torre R, D'Agostini A
Ann Ig · 2024 · PMID 38801199 · Publisher ↗
BACKGROUND: Up until recently, monkeypox (mpox) was considered to be a rare zoonotic infection restricted to Central and West Africa. However, in July 2022, the World Health Organization declared mpox to be a public heal...
BACKGROUND: Up until recently, monkeypox (mpox) was considered to be a rare zoonotic infection restricted to Central and West Africa. However, in July 2022, the World Health Organization declared mpox to be a public health emergency of international concern, after there were several outbreaks in non-endemic countries. This study assessed the information channels used by individuals accessing the "Telefono Verde AIDS e Infezioni Sessualmente Trasmesse" of Istituto Superiore di Sanità (National Institute of Health in Italy) with regard to mpox. We also evaluated their awareness, and knowledge about mpox focusing on transmission and prevention. METHODS: This is a cross-sectional study conducted on "Telefono Verde AIDS e Infezioni Sessualmente Trasmesse" users, between January and April 2023. The target population was helpline users who were older than 18 years of age, and were phoning the service for the first time (i.e. who have not phoned in the last 12 months). Participants were interviewed using a questionnaire containing 19 questions filled by the interviewer. Collected data were analysed through descriptive statistics, and significance testing. RESULTS: From January to April 2023, "Telefono Verde AIDS e Infezioni Sessualmente Trasmesse" received 2,389 phone calls, 216 of which participated in this study. Most of these were male (85.2%; n=186), single (79.2%; n=171) and in employment (72.2%; n=156). Awareness about mpox was high (71.3%; n=154), with the central and south/islands regional areas having the highest percentage of participants who heard about the virus (84.3%; n=43 vs 72.4%; n=42; p=0.078). Television was the most frequently mentioned source of information about mpox by participants (63%; n=97; p<0.001). This medium was also the most preferred source of information about mpox (39%; n=60; p=0.109). The majority of participants stated that they did not know what mpox is (67.6%; n=146), and less than half knew that it is preventable (42.4%; n=89). Of those who stated that mpox is a preventable illness, less than half knew about the existence of a vaccine (44.9%; n=40; p<0.001). CONCLUSIONS: This study provides insights into the awareness, knowledge, prevention tools and information channels of individuals who contacted the "Telefono Verde AIDS e Infezioni Sessualmente Trasmesse". Useful indications for defining future information campaigns were obtained.
Prevalence and predictors of hand hygiene compliance in clinical, surgical and intensive care unit wards: results of a second cross-sectional study at the Umberto I teaching hospital of Rome.
Ceparano M, Covelli A, Baccolini V … +6 more , Isonne C, Sciurti A, Migliara G, De Giusti M, Marzuillo C, Villari P
Ann Ig · 2025 · PMID 38801198 · Publisher ↗
INTRODUCTION: Hand hygiene is the most cost-effective procedure for the prevention of healthcare-associated infections, but healthcare worker compliance is often insufficient. RESEARCH DESIGN: The objective of this secon...
INTRODUCTION: Hand hygiene is the most cost-effective procedure for the prevention of healthcare-associated infections, but healthcare worker compliance is often insufficient. RESEARCH DESIGN: The objective of this second cross-sectional study was to quantify hand hygiene compliance among the healthcare workers of a large teaching hospital, to explore associated factors and to compare results to those of the 2021 study. METHODS: In 2022, educational sessions were conducted within each hospital department during which hospital healthcare workers received tailored feedback on the hand hygiene compliance registered in the previous year. Then, one month later, direct observations of hand hygiene compliance with five World Health Organization recommendations were collected again by anonymous observers in each ward. Data were grouped by healthcare area (clinical, surgical and intensive care), and three multivariable logistic regression models were built to identify predictors of hand hygiene compliance. RESULTS: Overall, 5,426 observations were collected by 73 observers in three weeks. Hand hygiene compliance was 79.7%, 73.5% and 63.1% in clinical, surgical and intensive care areas, respectively, increasing in clinical wards but decreasing in surgical departments compared to the 2021 study. The multivariable analyses showed that hand hygiene compliance after patient contact was consistently higher than before patient contact, while there was some variability in compliance with other factors across the three areas. CONCLUSION: The study found suboptimal adherence to good hand hygiene practice, with the lowest rates observed before patient interaction, which, together with the variability recorded across departments, underscores the challenges involved in achieving a uniform level of compliance. Hence, additional training is essential to raise awareness among healthcare workers, while repeating this survey over time will also be crucial, so that hand hygiene compliance can be monitored and any major issue identified.
Indoor air pollution: an Italian Knowledge, Attitude and Practice (KAP) study among the general population.
Venuto R, Pappalardo R, Genovese C … +4 more , Trimarchi G, Squeri R, La Spada G, La Fauci V
Ann Ig · 2024 · PMID 38766837 · Publisher ↗
BACKGROUND: Indoor air pollution negatively affects population health and the national health services in terms of socio-economic costs. The presence of indoor pollutants depends a lot on lifestyles. STUDY DESIGN: The ai...
BACKGROUND: Indoor air pollution negatively affects population health and the national health services in terms of socio-economic costs. The presence of indoor pollutants depends a lot on lifestyles. STUDY DESIGN: The aim of this work is to evaluate knowledge, daily habits and the preventive behaviors in order to contrast the effects on health caused by indoor pollutants. METHODS: The study was conducted through the administration of questionnaires to the population resident in the metropolitan city of Messina (Italy), asking about sociodemographic characteristics, knowledge, daily habits and preventive behaviors. RESULTS: The questionnaire was filled by 894 subjects (46.8% M; 53.2% F). Regarding knowledge, 66.8% had heard of indoor air pollution and 94.9% knew what the most common indoor pollutants are; regarding daily habits they often aired out the house (91.9% in the morning and 71.4% after cleaning), 24.8% were smokers and 36.7 of them smoked indoors; regarding preventive behaviors, 41.6% chose the cleaning products based on habit and only 32.9% bought plants able to purify environments. CONCLUSIONS: Although the analyzed population had adequate knowledge of indoor air pollution, this did not strongly impact on the adoption of healthy lifestyles. Therefore, it becomes necessary to intervene on a social level with environmental education activities, starting from school age.
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