Knowledge of public health informatics among Italian medical residents: design and preliminary validation of a questionnaire

Background: public health requires strong information skills and competencies, as it is information-intensive and information-driven. Public health informatics has been defined as the “systematic application of information, computer science, and technology to public health practice, research, and learning”. New information and communication technologies offer unprecedented opportunities, such as linking smart-phones and mobiles devices to web based tools for data collection, enabling and enhancing participatory epidemiology. However, being an emerging discipline, despite its potential and importance, public health informatics is often neglected and overlooked, being rarely offered as course. The present study was designed as a pilot study, with the aim of designing and validating a questionnaire on the knowledge of public health informatics among medical residents in public health in Italy.  Methods and Results: thirty-two Italian residents in public health volunteered to take part into the study. Mean age of the sample was 31.44±2.23 years, most responders were males (68.8%), from northern Italy (53.1%), at the third year of residency (34.4%) and currently doing practical training at the clinical management staff/hospital directorate (34.4%). Other places of training were the Prevention Department (21.9%), the Institute of Hygiene (18.8%), the local health units and the territory (12.5%), the occupational health service (6.3%) and the Regional Health Agency (3.1%). Cronbach’s alpha coefficient yielded a value of 0.909, demonstrating excellent psychometric properties of the instrument.  Conclusion: in conclusion, the developed questionnaire seems to be an appropriate and useful tool to detect gaps concerning knowledge, education and practices of public health informatics among residents in public health.&nbsp

Retrospective Analysis of Injuries and Hospitalizations of Patients Following the 2009 Earthquake of L’Aquila City

The aim of this study was to investigate the injury patterns and the hospitalizations of patients who were admitted to hospital following the 2009 earthquake in the city of L’Aquila, Central Italy. To the best of our knowledge, this is the first study to analyze the patterns of earthquake-related injuries in Italy. We reviewed the hospital discharge data of 171 patients admitted to hospital within the following 96 h from the mainshock. This is an observational and descriptive study: We controlled for variables such as patient demographics, primary and secondary ICD-9-CM (International Classification of Diseases) diagnosis codes in order to identify the multiple injured patients, main type of injury that resulted in the hospital admission, discharge disposition, and average length of stay (LOS). Seventy-three percent of the 171 patients were admitted to hospital on the first day. Multiple injuries accounted for 52% of all trauma admissions, with a female to male ratio of 63% versus 37%. The most common type of injuries involved bone fractures (46.8%), while lower extremities were the most frequently affected sites (38.75%). The average LOS was 12.11 days. This study allows the evaluation of the impact of earthquake-related injuries in relation both to the health needs of the victims and to the use of the health care resources and assistance

Italian policy for asylum seekers health-care: from national to local application

Background: Asylum seekers are refugees who have left their country of origin and have applied for residency in another country. Italy recognises and guarantees international protection and healthcare coverage for asylum seekers. The request for and the decision on a residency permit may require months and during both stages they could be without health-care coverage. Each region is autonomous in its application of national protocols. Our aim was to investigate possible differences between protocols and daily practice, and to better understand the issues related to the procedures initiated immediately after arrival. Methods: The research team was a subgroup of the Inequality Working Group of the Italian Hygiene Society Committee of Residents, with the Regional Immigration and Health Groups (GrIS) of the Italian Society for Migration Medicine (SIMM). The research was conducted in five regions: Emilia-Romagna, Tuscany, Umbria, Abruzzo and Lazio. National and regional protocols on health care for asylum seekers were collected and compared with the protocols of Local Health Units. The application of the protocols was investigated locally by interviews with experts. Results: Preliminary results show differences between the regions and individual Local Health Units, despite agreement between national and regional protocols. In the hub, the first reception centre for health-care, difficulties in continuity of care may occur when extra investigations are needed. A critical point is the transfer to the second reception level, due to incomplete communication of clinical information, which may lead to repeat visits and tests. Conclusions: Asylum seekers may spend different amounts of time in the first level centre depending on their social and clinical situation, affecting continuity of care and the availability of more integrated care. Main messages: National and regional protocols for asylum seekers are not easily implemented at the Local Health Unit level. In a universal health service, there can be difficulties in access for more vulnerable groups

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

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease