Archie’s beautiful adventure

Archibald “Archie” Cochrane is the brilliant creator of the evidence-based medicine (EBM). His book “Effectiveness and Efficiency: random reflections on health services” is one of the fundamental texts of Medicine today. For his influence on the progress of medicine, Cochrane may be considered one of the greater physicians of all time. He gave an exceptional boost to the improvement of medical practice worldwide. Cochrane’s vision of medicine and his great scientific achievements are still alive through the Cochrane Collaboration, an organization which provides valuable impulses to improving the quality of medical care. Also he was a great epidemiologist, very proud of his epidemiological work, and his life is interesting for adventurous events and extraordinary examples of righteousness and generosity

Charles Everett Koop: the “Family doctor of America”

Charles Everett Koop was a great Surgeon General, probably the most influential in the history of the United States of America. He never missed courage in his life and often he had used it to tackle professional and personal tough problems. In his public activity, he faced controversial health problems of American people as smoking, abortion and the first occurrence of the epidemic Acquired Immune Deficiency Syndrome (AIDS). Koop was a rigorous man. The lodestar that guided Koop in his work, as a public servant was to do the best for health of Americans. In his prestigious and difficult role, he faced the pressing problems of health of millions of people trying to avoid political influence. During his mandate of eight years, Koop increased the influence and authority of his role. His appearance and behaviour were unmistakable: Lincolnesque beard and uniform, conduct hard and pure, exclusively oriented to the health of citizens, over the personal conveniences, political pressure and lobbying. An exemplary man, who for his passion for medicine and his sincere interest in promoting public health, was affectionately considered the "Family Doctor of America"

Ernst L. Wynder: A Pioneer of No Tobacco World

Ernst L Wynder was a great epidemiologist who devoted his career to investigate harmful effects of tobacco smoke, in particular his studies represent a landmark in the history of epidemiological research on lung cancer. The commitment of Ernst Wynder was not limited to the risk factors related to tobacco. In fact, he studied also the role of nutritional factors in the incidence of tumors. His talent, enthusiasm and tireless energy have allowed him to obtain a complete victory despite the difficulties and the initial loneliness

Lorenzo Tomatis: A Great Doctor in the Broadest Sense

Lorenzo Tomatis was a great doctor in the broadest sense: he gave a major contribution to cancer research, devoting himself to study cancer causes and prevention. His job was not only to serve Public Health but to denounce social and health inequalities without threats by political and economic constraints

Austin Bradford Hill: simply the best

Austin Bradford Hill was born on July 8, 1897, third son of Sir Leonard Erskine Hill, a distinguished medical physiologist, Professor of Physiology at The London Hospital. He grew up in an upper class Victorian family. Sir Leonard, who created an ingenious instrument for blood pressure measuring, had a deep influence on his son. In fact, Bradford decided to follow his father example. He attended Chigwell Grammar School, which was established in 1629, but unfortunately, Bradford’s decision to join the Faculty of Medicine coincided with a really big event: First World War. Bradford entered British naval aviation and..

Avedis Donabedian: The Giant

“Giant” is the most frequent word in commemorating Avedis Donabedian. Rarely there was such agreement among scholars worldwide to define the role of a scientist in the field of Public Health. And it’s impossible to disagree. Avedis Donabedian had a really huge role in the progress in Public Health studies. It’s not exaggerated even to say that his insights influenced all scientific research

Economic evaluation of HBV vaccination: a systematic review of recent publications (2000-2013).

Aim: To conduct a systematic review of the economic evaluations (EE) of HBV vaccination, taking also into account the studies published in the new millennium. Methods: An extensive scientific literature review was conducted using two electronic medical journal databases: Scopus and PubMed engines for published studies on EE of HBV vaccination. Results: 22 articles were reviewed, 9, 5 and 8 cost-effectiveness, cost-benefit and cost-utility analysis, respectively. Studies were mainly concerning EE of universal vaccination (UV), mostly with regards to low or low-medium income countries. For high income countries, EE were focused on the possible implementation of HBV vaccination in particular settings, such as diabetic, renal and other chronic conditions care, as well as infectious diseasesUV has usually a very good cost-effectiveness ratio (80%), ranging from cost-saving (China) or few Euro per LY/QALY gained (in Thailand, and Vietnam) to 630.00$/ QALY in USA (Asian and Pacific Islands) Moreover, EE of HBV vaccination are favorable in the infectious diseases field as well as for chronic conditions. In relation to diabetes the studies gave controversial results. Conclusion: This systematic review highlighted the importance of introducing HBV vaccination not only for infant UV program but also for other settings in which patients are people affected by communicable and non-communicable diseases

Gaetano Pieraccini: Public Health giant who created Italian Social Medicine

It’s well known all over the world that Italy is the birthplace of Bernardino Ramazzini (1633 - 1714), the real founder of occupational medicine, and that Italian doctors had a great importance in scientific and cultural development in occupational medicine. One of the most celebrated of them was Luigi Devoto, Professor of Medical Pathology at Pavia in 1901, who undertook a free course of Occupational medicine, creating in the same year the fortnightly journal "Work" - that became "Occupational medicine" since 1925 - and opening a Labour Clinic in Milan in 1910. In 1907 the first two Italian schools of occupational medicine arose in Milan and in Naples. In 1901 Giulio Yule Giglioli wrote the first systematic treatise about workers’ diseases. In this cultural background Gaetano Pieraccini grew and developed his original cultural approach to the field of occupational medicine, which got from him a new dimension: the Social Medicine

Appropriateness of frequent use of emergency departments: A retrospective analysis in Rome, Italy

Background: Frequent users (FUs) are patients who repeatedly and inappropriately visit the emergency department (ED) for low-grade symptoms that could be treated outside the hospital setting. This study aimed to investigate the phenomenon of the FU in Rome by profiling such users and analyzing ED attendance by FUs. Methods: The analysis was carried out for attendance in 2021 at 15 EDs in the Local Health Authority Roma 1 geographical area. A digital app collected data, including information on the following variables: number of attendance, demographic characteristics, emergency medical service (EMS) usage, triage code, and appropriateness of attendance. COVID-19 diagnosis was also studied to analyze any possible influence on ED attendance. Differences between FUs and non-FUs were investigated statistically by t-test and chi-square test. Univariate analysis and multivariable logistic regression were performed to analyze the associated factors. Results: A total of 122,762 ED attendance and 89,036 users were registered. The FU category represented 2.9% of all users, comprising 11.9% of total ED attendance. There was a three times higher frequency of non-urgent codes in attendance of FU patients (FU: 9.7%; non-FU: 3.2%). FUs were slightly more likely to have used the EMS (13.6% vs. 11.4%) and had a lower frequency of appropriate ED attendance (23.8% vs. 27.0%). Multivariate logistic analysis confirmed a significant effect of triage code, gender, age, EMS usage, and COVID-19 diagnosis for the appropriateness of attendance. The results were statistically significant (p < 0.001). Conclusion: The FU profile describes mostly non-urgent and inappropriate attendance at the ED, including during the COVID-19 pandemic. This study represents an important tool for strengthening preventive policies outside the hospital setting. The Italian National Recovery and Resilience Plan represents an excellent opportunity for the development of new strategies to mitigate the phenomenon of FUs

Improving vaccination coverage among healthcare workers in Italy.

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