Which competences and what managerial training for the health professions

The process of passage to be e-profit and loss organization following the reform of the Italian health system, especially in a context of fiscal federalism and administered competition among the public and private producers, causes implications on the competences of whom develops his/her own professional activity. The aim of the paper is to give some inputs for discussion about the training of manager: starting from the meaning of the word ?management? and using the model elaborated by Mintzberg and Simon with the purpose to identify who is involved in such training, trying to make explicit that the analysis of the organizational positions and the profile of the resource that will go to occupy it is a forced passage for building the training package and to make clear characteristics and contents of the training offer

Radon Concentration by SSNTD in South-East Sicily Buildings

Abstract Radon levels in buildings vary widely from area to area also depending on local geology. Thus, it is important to assess the radon prone area of a geographic region on the basis of geological data and to search for any possible correlation between the local geology and the indoor radon concentrations. We report about indoor radon measurements in Ragusa, a municipality of the SE Sicily, placed in the Hyblean Plateau (northern region of the African Plate), carried out in collaboration with schools. The survey was performed using Solid State Nuclear Track Detectors (SSNTD), CR-39 type, and a well-established methodology for chemical etching and reading, developed at the Radioactivity Laboratory of the Department of Physics - University of Catania

Drivers involved in road traffic accidents in Piedmont Region: psychoactive substances consumption

Introduction. The role played by psychoactive substances in road safety has become object of increasing interest: these substances can reduce driving performance and increase accidents risk. Aims of the study are to establish the dimension of the problem and to describe the characteristics of people involved in accidents under psychoactive substance effects. Methods. Target population consists of people from 18 to 60 years old involved in accidents afferent in Emergency Rooms. Subjects were interviewed by surveyors and a urines was collected for psychoactive substances screening. Results. In 18.5% of people we found substance consumption. Cocaine was the most frequently detected substance (9.5%), then benzodiazepines (7.5%), methadone, morphine and marijuana (THC) (3.5%). In 5.5% of subjects more then one substance was found. Considering only illegal substances detected, female have a higher risk to be consumers (OR = 1.36) and the young age (18-35 years) seems to be at higher prevalence and risk for substance use (OR = 1.86). Discussion. Considering all psychoactive substances detected, clearly the problem about substances consumption and driving is not restricted to youngest but involves all age groups. Conclusions. In order to decrease the number of accidents due to substance use, new prevention programmes able to involve also middle age groups should be planned

Impact of COVID-19 on emergency department use among home care recipients

BACKGROUND: The impact of COVID-19 pandemic on Emergency Department (ED) was remarkable throughout Europe. We focused upon ED utilization among integrated home care (IHC) recipients comparing ED between pandemic period with pre-pandemic (February -December 2020 and 2019, respectively) in Piedmont, Italy. METHODS: A retrospective observational study was conducted. All recipients of IHC during the two periods studied were enrolled and all ED visits that occurred among IHC recipients were accounted for. Several variables related to IHC admission, reason of ED visits and demographic characteristics were collected. The average of ED visits in pre-pandemic and pandemic periods were calculated. Analyses were stratified by all variables. RESULTS: Patients enrolled were 11968 in 2019 and 8938 in 2020. In 2019, 3573 patients had at least one ED visit and 1668 patients in 2020. Number of ED visits was 5503 in 2019 and 2197 in 2020. The average of ED visits in 2020 has reduced in comparison with 2019 (0.464 C.I. [0.44-0.489] and 0.24 C.I. [0.227-0.252], p < 0.001 in 2019 and 2020 respectively). This reduction is regardless of sex, age, duration of IHC, presence of a non-family caregiver or reason for ED visits, except for abdominal pain, cardiac rhythm alteration and gynaecological symptoms. The averages of ED visits were significantly lower for IHC recipients with neoplasm (0.549 C.I. [0.513-0.585] and 0.328 C.I. [0.298-0.358], p < 0.001, and with low level of emergency (1.77 C.I. [1.662-1.877] and 1.397 C.I. [1.348-1.447], p < 0.036), but an increase in mortality rate was not registered. CONCLUSIONS: Our results showed a reduction of ED visits among integrated home care recipients in pandemic period in comparison with pre-pandemic period. If the reduction can be the consequence of an unprepared health service that needs of necessary changes in its organization, these results suggest a great potential of the home care system to reduce the use of the hospital especially for low-risk conditions. KEY MESSAGES: • The COVID-19 pandemic overwhelmed health services of all European Countries. A reduced utilization of ED has been shown by literature, especially during the early phase of the COVID-19 pandemic. • We showed a reduction in IHC recipients and a great decrease in ED visits among IHC patients in 2020 versus 2019, mainly in oncological patients, while an increase in mortality rate was not reported

Burden of COVID-19: Disability-Adjusted Life Years (DALYs) across 16 European countries

OBJECTIVE: The aim of this study is to measure and compare the burden of disease of COVID-19 pandemic in 16 EU/EEA countries through the estimation of Disability-Adjusted Life Years (DALYs) over a long period of time

Determinants of aggression against all health care workers in a large-sized university hospital

Background: The paper aims to describe the 3-year incidence (2015/17) of aggressive acts against all healthcare workers to identify risk factors associated to violence among a variety of demographic and professional determinants of assaulted, and risk factors related to the circumstances surrounding these events. Methods: A retrospective observational study of all 10,970 health workers in a large-sized Italian university hospital was performed. The data, obtained from the "Aggression Reporting Form", which must be completed by assaulted workers within 72 h of aggression, were collected for the following domains: Worker assaulted (sex, age class, years worked); profession (nurses, medical doctors, non-medical support staff, administrative staff, midwives); aggressive acts (activity type during aggressive acts, season, time and location of aggressive acts); and type of aggressive acts (verbal, non-verbal, consequences, aggressors). Results: Three hundred sixty-four (3.3%) workers experienced almost one aggression. The majority of the assaulted workers were female (77.5%), had worked for 6/15 years and were Nurses (64.3%). The majority of aggressive acts occurred during assistance and patient care (38.2%), in the spring and during the afternoon/morning shifts and took place in locations where patients were present (47.3%). The most prevalent aggression type was verbal (76.9%). The patient was the most common aggressor (46.7%). 56% of those assaulted experienced interruptions in their work. Being female, being < 50 years of age, having worked for 6-15 years were significant risk factors for aggression. Midwives suffered the highest risk of experiencing aggression (RR = 12.95). The risk analysis showed that non-verbally aggressive acts were related to assistance and patient care with respect to activity type, to the presence of patients and during the spring and afternoon/evening. Conclusions: The findings suggest the parallel use of future qualitative studies to clarify the motivation behind aggression. These suggestions are needed for the implementation of additional adequate prevention strategies on either an organizational or a personal level