82 research outputs found
Drug management of atrial fibrillation in light of guidelines and current evidence: an Italian Survey on behalf of Italian Association of Arrhythmology and Cardiac Pacing
AimAtrial fibrillation is a multifaceted disease requiring personalized treatment, in accordance with current ESC guidelines. Despite a wide range of literature, we still have various aspects dividing the opinion of the experts in rate control, rhythm control and thromboembolic prophylaxis. The aim of this survey was to provide a country-wide picture of current practice regarding atrial fibrillation pharmacological management according to a patient's characteristics.MethodsData were collected using an in-person survey that was administered to members of the Italian Association of Arrhythmology and Cardiac Pacing.ResultsWe collected data from 106 physicians, working in 72 Italian hospitals from 15 of 21 regions. Our work evidenced a high inhomogeneity in atrial fibrillation management regarding rhythm control, rate control and thromboembolic prophylaxis in both acute and chronic patients. This element was more pronounced in settings in which literature shows a lack of evidence and, consequently, the indications provided by the guidelines are weak or absent.ConclusionThis National survey evidenced a high inhomogeneity in current approaches adopted for atrial fibrillation management by a sample of Italian cardiologist experts in arrhythmia management. Further studies are needed to explore if these divergences are associated with different long-term outcomes
Post-graduate medical education in public health: The case of Italy and a call for action
Public health technical expertise is of crucial importance to inform decision makers\u2019
action in the field of health and its broader determinants. Improving education and
training of public health professionals for both practice and research is the starting
point to strengthen the role of public health so that current health challenges can
be efficiently tackled. At the Association of Schools of Public Health in the European
Region (ASPHER) Deans\u2019 & Directors\u2019 2017 Annual Retreat, we presented the structure
and management of public health training system in Italy, and we reported recent data
on Italian public health specialists\u2019 educational experience, employment opportunities
and job satisfaction. Public health training in Italy is implemented in the context
of the post-graduate medical education residency programme in Hygiene and
Preventive Medicine, delivered by 34 University-based Schools of Public Health.
We report relatively high employment rates across the county and wide
spectrum of career opportunities for young public health specialists. However,
job security is low and training expectations only partially met. We call upon
other Schools of Public Health to scale up the survey within the broad ASPHER
community in a shared and coordinated action of systematically collecting useful
data that can inform the development of public health education and training
models, their implementation and fruitful interaction with population health,
health systems and services
Complexity and indeterminism of evidence-based public health: an analytical framework.
Improving the evidence in public health is an important goal for the health promotion community. With better evidence, health professionals can make better decisions to achieve effectiveness in their interventions. The relative failure of such evidence in public health is well-known, and it is due to several factors. Briefly, from an epistemological point of view, it is not easy to develop evidence-based public health because public health interventions are highly complex and indeterminate. This paper proposes an analytical explanation of the complexity and indeterminacy of public health interventions in terms of 12 points. Public health interventions are considered as a causal chain constituted by three elements (intervention, risk factor, and disease) and two levels of evaluation (risk factor and disease). Public health interventions thus differ from clinical interventions, which comprise two causal elements and one level of evaluation. From the two levels of evaluation, we suggest a classification of evidence into four typologies: evidence of both relations; evidence of the second (disease) but not of the first (risk factor) relation; evidence of the first but not of the second relation; and no evidence of either relation. In addition, a grading of indeterminacy of public health interventions is introduced. This theoretical point of view could be useful for public health professionals to better define and classify the public health interventions before acting
Measuring health literacy in Southern Italy: A cross-sectional study
Introduction Health Literacy (HL) is an important determinant of individual health. Limited HL is an increasing problem affecting the general population. This study aims to assess the level of HL in patients attending outpatient medical facilities in general medicine located in Naples and Caserta and investigate the association of HL with health behaviours and health status. Materials and methods The study involved patients attending outpatient medical facilities in general medicine. The questionnaire had four sections the sociodemographic information, the 16-items version of the European Health Literacy Survey questionnaire, the general self-efficacy scale (GSE) and the health status scale (EQ-VAS). Univariate and multivariate analyses were performed to investigate the sociodemographic determinants of HL. The Pearson correlation coefficients were determined to compare HL with health behaviours (GSE) and health status (EQ-VAS). Results The study showed that 61.6% of 503 patients had a low level of HL. After the multivariate analysis, HL was found to be higher among patients with higher education level and general self-efficacy score ?30. There were no differences in HL between the age groups and people with or without chronic diseases. HL was stronger correlated with GSE than with EQVAS (0.53 vs 0.27). Conclusion This is the first study on HL for Southern Italy. It showed a low level of HL. As the sample was not representative of the reference population, we cannot derive a corresponding conclusion for the general population of Southern Italy. Therefore, more data in Italy are needed to plan actions for improving HL
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