Beliefs and Opinions of Health Care Workers and Students Regarding Influenza and Influenza Vaccination in Tuscany, Central Italy

Immunization of health care workers (HCWs) against influenza has been associated with improvements in patient safety. The aim of this study is to assess the beliefs, attitudes, and knowledge of HCWs and health profession students regarding influenza. An anonymous questionnaire was distributed to HCWs in three local Florentine healthcare units, at Careggi University Teaching Hospital, and to students in health profession degree programs. A total of 2576 questionnaires were fully completed. A total of 12.3% of subjects responded that they were “always vaccinated” in all three of the seasonal vaccination campaigns studied (2007–2008 to 2009–2010), 13.1% had been vaccinated once or twice, and 74.6% had not received vaccinations. Although the enrolled subjects tended to respond that they were “never vaccinated,” they considered influenza to be a serious illness and believed that the influenza vaccine is effective. The subjects who refused vaccination more frequently believed that the vaccine could cause influenza and that it could have serious side effects. More than 60% of the “always vaccinated” group completely agreed that HCWs should be vaccinated. Self-protection and protecting family members or other people close to the respondent from being infected and representing potential sources of influenza infection can be considered motivating factors for vaccination. The results highlight the importance of improving vaccination rates among all HCWs through multi-component interventions. Knowledge of influenza should be reinforced

Waiting times for prostate cancer: a review

Prostate cancer is one of the most common diagnosed cancer in men and the waiting time has become an important issue not only for clinical reasons, but mostly for the psychological implications on patients. The aim of our study was to review and analyze the literature on waiting times for prostate cancer. In February-March 2019 we performed a search for original peer-reviewed papers in the electronic database PubMed (MEDLINE). The key search terms were “prostate cancer AND waiting list”, “prostate cancer AND waiting times”. We included in our narrative review articles in Italian, English or French, published in 2009-2019 containing original data about the waiting times for prostate cancer. The literature search yielded 680 publications. Finally, we identified 8 manuscripts eligible for the review. The articles were published between 2010 and 2019; the studies involved a minimum of 16 to a maximum of 95,438 participants. Studies have been conducted in 6 countries. The waiting times from cancer suspicion to histopathological diagnosis and to treatment had an important reduction in the last years, and this constant decrease could lead to an increase of patients' satisfaction

Accreditation and Quality in the Italian National Health Care System: a 10 years long review

  Background: Italian accreditation and OECI accreditation are recognized as tools to ensure an adequate level of quality in healthcare setting. The aim of our study was to review the scientific literature about these topics looking for original experiences of accreditation.  Methods: In March-April 2019 we conducted a search on original peer-reviewed papers in the electronic database PubMed (MEDLINE). The key search terms were “accreditation AND Italy”, “hospital accreditation AND Italy”. We looked for studies published between 2009 and 2019, reporting information about Accreditation experiences. 13.  Results: The literature search yielded 562 publications. Finally, we identified 16 manuscripts eligible for the review. The studies were published between 2010 and 2016; they were conducted from 2007 to 2015; they involved a minimum of 1 to a maximum of 183 centres located in different Italian regions and cities. They concerned different fields such as oncology, haematology, health physics, health direction, paediatrics, and surgery. Accreditation led to a general enhancement of quality, and offered suggestions for further improvement.  Conclusion: Each healthcare system should achieve the best possible levels of quality and safety.  Accreditation, combined with further strategies could ensure the highest level of quality

Health services and health literacy: from the rationale to the many facets of a fundamental concept. A literature review.

Background. The aim of this study is to make a critical analysis of the different definitions of health literacy to provide a framework of the concept. Methods. A literature search was conducted in PubMed, Embase, PsycINFO, ERIC, Health Evidence, Centre for Reviews and Dissemination and Cochrane Library. Google and OpenGrey were searched to find additional papers and unpublished works. Results. Among 7000 papers founded, we selected 26 works. During the 1990s, authors began to systematically study the relationship between health literacy and health status, according to a public health view. In the first decade of the new century, a new fundamental definition established three progressive degrees of health literacy: functional, interactive and critical health literacy. Sørensen (in 2012) provided a framework for the development of new assessment tools and interventions. Conclusion. The improvement of health literacy is a powerful tool for the development of a new type of relationship between individuals and the health system. 

Process, structural, and outcome quality indicators of nutritional care in nursing homes: a systematic review

Abstract Background The quality of nursing homes (NHs) has attracted a lot of interest in recent years and is one of the most challenging issues for policy-makers. Nutritional care should be considered an important variable to be measured from the perspective of quality management. The aim of this systematic review is to describe the use of structural, process, and outcome indicators of nutritional care in NHs and the relationship among them. Methods The literature search was carried out in Pubmed, Embase, Scopus, and Web of Science. A temporal filter was applied in order to select papers published in the last 10 years. All types of studies were included, with the exception of reviews, conference proceedings, editorials, and letters to the editor. Papers published in languages other than English, Italian, and Spanish were excluded. Results From the database search, 1063 potentially relevant studies were obtained. Of these, 19 full-text articles were considered eligible for the final synthesis. Most of the studies adopted an observational cross-sectional design. They generally assessed the quality of nutritional care using several indicators, usually including a mixture of many different structural, process, and outcome indicators. Only one of the 19 studies described the quality of care by comparing the results with the threshold values. Nine papers assessed the relationship between indicators and six of them described some significant associations—in the NHs that have a policy related to nutritional risk assessment or a suitable scale to weigh the residents, the prevalence or risk of malnutrition is lower. Finally, only four papers of these nine included risk adjustment. This could limit the comparability of the results. Conclusion Our findings show that a consensus must be reached for defining a set of indicators and standards to improve quality in NHs. Establishing the relationship between structural, process, and outcome indicators is a challenge. There are grounds for investigating this theme by means of prospective longitudinal studies that take the risk adjustment into account

Evaluating the costs and benefits of pneumococcal vaccination in adults

Introduction: Pneumococcal infection is a public health concern that disproportionately affects the young, the elderly, and the immunocompromised. There is an open debate on the implementation of polysaccharide and/or conjugate vaccines for pneumococcal diseases in adults and the elderly in many countries. The aim of this paper is to systematically review the economic profile of pneumococcal vaccines in adults in terms of costs and benefits. Areas covered: The search for economic studies on pneumococcal vaccination was carried out in Pubmed, Embase, Scopus, and the HTA and NHS EED databases and through a manual search in journals dealing with economic evaluations. We included original articles and reviews with economic evaluation of polysaccharide 23-valent (PPV23) and/or conjugate pneumococcal vaccine 13-valent (PCV13) use in adults, the elderly, and at-risk groups to provide a systematic review of economical evaluation. Expert commentary: Pneumococcal vaccination is strongly recommended for all adults, especially subjects at risk and the elderly. Pneumococcal vaccination with PCV13 or PPV23 in adults is good value for money and should be a priority for the decision-makers. The main issue is how vaccination could be offered

Stato della ricerca scientifica in materia di alimentazione e nutrizione

La sanità pubblica italiana sta vivendo una difficile fase di ripensamento dei suoi assetti organizzativi e della capacità di dare risposta ai bisogni dei cittadini. Il razionamento delle prestazioni, insieme con la riduzione delle risorse umane e tecnologiche, sembrano farsi particolarmente sentire in uno dei capisaldi del Dipartimento di prevenzione, il Servizio di igiene degli alimenti e della nutrizione (SIAN). Il sostegno alla ricerca in igiene alimentare e nutrizionale trova la sua ragione anche nella pericolosa deriva efficientista imboccata dal nostro Paese. Per comprendere l’orientamento della ricerca in materia di igiene degli alimenti e igiene della nutrizione abbiamo interrogato Pubmed e utilizzato Google Ngram Viewer©, grazie ai quali abbiamo approfondito alcune aree tematiche di interesse in termini di novità e di miglioramento potenziale della pratica professionale. Il contributo italiano alla ricerca alimentare è, nel complesso, ancora limitato. Tale esplorazione ha permesso di delineare come, oggi, ricerca e servizi territoriali debbano creare un’alleanza virtuosa per la creazione di sistemi sanitari sostenibili