La walkability quale determinante ambientale negli interventi di comunità per la promozione dello stile di vita attivo: risultati di uno studio di validazione condotto nel territorio della ASL di Teramo (Regione Abruzzo).

Introduzione. Il WHO-Europe Action Plan 2012–2016 per la prevenzione delle MCNT delinea tra le strategie di lotta all’inattività e alla sedentarietà gli interventi di comunità, come i gruppi di cammino, ossia gruppi di persone che si ritrovano nel proprio ambiente di vita (quartiere o paese) per svolgere attività fisica di tipo ricreativo. Studi a disegno sperimentale e metanalisi ne hanno dimostrato l’efficacia e analizzato le determinanti, tra cui la pedonabilità o ‘walkability’ dell’ambiente fisico circostante. Scopo della ricerca è stata la validazione di una versione in italiano della NEWS-A Scale, un questionario utilizzato in studi multicentrici internazionali. Metodi. È stato condotto uno studio a disegno test-retest per verificare la riproducibilità del questionario tradotto. Tra i mesi di maggio e giugno 2016 nel territorio della ASL di Teramo (Regione Abruzzo), 148 adulti (età media 45 anni), arruolati su base volontaria, hanno compilato il questionario in due momenti, a distanza di una settimana. L’analisi statistica ha valutato la coerenza interna delle scale Likert (Alpha di Cronbach) e la riproducibilità test-retest (Rho di Spearman). Risultati. Su un totale di 7 subscales, le 3 relative a connettività stradale, infrastrutture e sicurezza presentano un livello di coerenza interna insufficiente (alpha<0.60). Riguardo alla stabilità test-retest, solo un item risulta problematico (strade senza uscita) e quindi andrebbe modificato o eliminato. I restanti presentano un livello ‘accettabile di stabilità’ (13 su 53, il 24.5%) o ‘elevato’ (39 su 53, il 73.6%). Non sono rilevabili differenze sostanziali nella stabilità rispetto alle variabili socio-demografiche. Conclusioni. La buona riproducibilità dimostra che la versione validata della NEWS-A scale può essere utilizzata nella popolazione italiana. La bassa coerenza interna di alcune subscales potrebbe dipendere dalla variabilità oggettiva dell’ambiente costruito nell’esperienza dei diversi osservatori

Adapted Physical Activity for the Promotion of Health and the Prevention of Multifactorial Chronic Diseases: the Erice Charter

The Erice Charter was unanimously approved at the conclusion of the 47th Residential Course "Adapted Physical Activity in Sport, Wellness and Fitness: New Challenges for Prevention and Health Promotion", held on 20-24 April 2015 in Erice, Italy, at the "Ettore Majorana" Foundation and Centre for Scientific Culture, and promoted by the International School of Epidemiology and Preventive Medicine "G. D'Alessandro" and the Study Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health.After an intense discussion the participants identified the main points associated with the relevance of physical activity for Public Health, claiming the pivotal role of the Department of Prevention in coordinating and managing preventive actions. The participants underlined the importance of the physicians specialized in Hygiene, Preventive Medicine and Public Health. The contribution of other operators such as physicians specialized in Sport Medicine was stressed. Further, the holders of the new degree in Human Movement and Sport Sciences were considered fundamental contributors for the performance of physical activity and their presence was seen as a promising opportunity for the Departments of Prevention. Primary prevention based on recreational physical activities should become easily accessible for the population, avoiding obstacles such as certification steps or complex bureaucracy. The Sport Doctor is recognized as the principal referent for preliminary physical evaluation and clinical monitoring in secondary and tertiary prevention actions based on adapted physical activities. Developing research in the field is essential as well as implementing higher education on physical activity management in Schools of Public Health

Adapted Physical Activity for the Promotion of Health and the Prevention of Multifactorial Chronic Diseases: the Erice Charter

The Erice Charter was unanimously approved at the conclusion of the 47th Residential Course "Adapted Physical Activity in Sport, Wellness and Fitness: New Challenges for Prevention and Health Promotion", held on 20-24 April 2015 in Erice, Italy, at the "Ettore Majorana" Foundation and Centre for Scientific Culture, and promoted by the International School of Epidemiology and Preventive Medicine "G. D'Alessandro" and the Study Group on Movement Sciences for Health of the Italian Society of Hygiene, Preventive Medicine and Public Health. After an intense discussion the participants identified the main points associated with the relevance of physical activity for Public Health, claiming the pivotal role of the Department of Prevention in coordinating and managing preventive actions. The participants underlined the importance of the physicians specialized in Hygiene, Preventive Medicine and Public Health. The contribution of other operators such as physicians specialized in Sport Medicine was stressed. Further, the holders of the new degree in Human Movement and Sport Sciences were considered fundamental contributors for the performance of physical activity and their presence was seen as a promising opportunity for the Departments of Prevention. Primary prevention based on recreational physical activities should become easily accessible for the population, avoiding obstacles such as certification steps or complex bureaucracy. The Sport Doctor is recognized as the principal referent for preliminary physical evaluation and clinical monitoring in secondary and tertiary prevention actions based on adapted physical activities. Developing research in the field is essential as well as implementing higher education on physical activity management in Schools of Public Health

Epidemiology of intensive care unit-acquired sepsis in Italy: Results of the SPIN-UTI network

Background. Sepsis is the major cause of mortality from any infectious disease worldwide. Sepsis may be the result of a healthcare associated infection (HAI): the most frequent adverse events during care delivery especially in Intensive Care Units (ICUs). The main aim of the present study was to describe the epidemiology of ICU-acquired sepsis and related outcomes among patients enrolled in the framework of the Italian Nosocomial Infections Surveillance in ICUs - SPIN-UTI project. Study design. Prospective multicenter study. Methods. The SPIN-UTI network adopted the European protocols for patient-based HAI surveillance. Results. During the five editions of the SPIN-UTI project, from 2008 to 2017, 47.0% of HAIs has led to sepsis in 832 patients. Overall, 57.0% episodes were classified as sepsis, 20.5% as severe sepsis and 22.5% as septic shock. The most common isolated microorganisms from sepsis episodes were Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa. The case fatality rate increased with the severity of sepsis and the mean length of ICU-stay was significantly higher in patients with ICU-acquired sepsis than in patients without. Conclusions. Our study provides evidence that ICU-acquired sepsis occurs frequently in Italian ICU patients and is associated with a high case fatality rate and increased length of stay. However, in order to explain these findings further analyses are needed in this population of ICU patients