FP552A SIMPLE MODEL TO PREDICT ENCAPSULATING PERITONEAL SCLEROSIS IN PATIENTS UNDERGOING PERITONEAL DIALYSIS: A 20 YEARS PROSPECTIVE CONTROLLED LONGITUDINAL COHORT STUDY OF PERITONEAL MEMBRANE FUNCTION

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Workplace health promotion programs in different areas of Europe

Background Aging of the workforce challenges European countries. Keeping aged workers healthy and productive, through health promotion, is a key goal of European labour policy. The aim of the present study was to collect experiences of workplace health promotion for older workers (WHPOW) conducted in 10 representative countries of Central Europe, Eastern Europe and the Mediterranean. Methods A literature review of activities of WHPOW was conducted through a comprehensive search of major scientific databases and on the website of the major European Agencies on worker health promotion. The search was restricted to papers published in English from 2000 to 2015. Companies were asked for additional documentation about WHPOW programmes in a survey conducted with SurveyMonkey. Results A total of 756 initiatives regarding WHPOW were identified. 134 of these were guidelines, regulations, or review studies. The remaining 622 activities were intervention studies performed or promoted in the workplace and targeted at older workers or at the aging of the workforce. Most of the programs were carried out in Central Europe (295, 47.4%), less in East Europe (193, 31.0%) and in Mediterranean countries (134, 21.6%). Conclusion Our study shows that there are only a limited number of WHPOW actions throughout the 10 selected European Countries. While in Central Europe widespread interest in issues of aging workforce has resulted in national policies to encourage WHPO, not all the countries of Eastern Europe are equally well equipped. Lastly, in Southern Europe health promotion activities are largely inadequate compared to needs

Decreasing loneliness and social isolation among the older people: systematic search and narrative review

Introduction The aim of this study is to sum up the current knowledge on the effectiveness of the existing interventions for alleviating loneliness and social isolation among elderly persons. Methods We used a systematic approach and performed a literature search of MEDLINE, ISI Web of science, SCOPUS, The Cochrane Library, and CINAHL databases. After identifying 13 eligible reviews addressing interventions of our interest, we proceeded with a narrative description of the study findings. Results The initiatives largely encompassed one-to-one interventions, group activities or community engagement approaches. In particular, technology interventions were recently given much attention. Overall, the studies showed non-satisfying methodological quality and their results were often inconclusive. Conclusions Although there is a growing body of evidence referring to implementation of interventions targeting social isolation and loneliness among the elderly, future well-designed interventions are necessary in order to draw firm conclusions

Predictors of healthy ageing: Public health policy targets

Background: The public health policy agenda oriented towards healthy ageing becomes the highest priority for the European countries. The article discusses the healthy ageing concept and its possible determinants with an aim to identify behavioral patterns related to healthy ageing in selected European countries. Methods: The healthy ageing is assessed based on a composite indicator of self-assessed health, functional capabilities and life meaningfulness. The logistic regression models are used to assess the impact of the healthy lifestyle index, psycho-social index and socio-economic status on the probability of healthy ageing (i.e. being healthy at older age). The lifestyle and psychosocial indexes are created as a sum of behaviors that might be important for healthy ageing. Models are analyzed for three age groups of older people: 60-67, 68-79 and 80+ as well as for three groups of countries representing Western, Southern and Central-Eastern Europe. Results: The lifestyle index covering vigorous and moderate physical activity, consumption of vegetables and fruits, regular consumption of meals and adequate consumption of liquids is positively related to healthy ageing, increasing the likelihood of being healthy at older age with each of the items specified in the index. The score of the index is found to be significantly higher (on average by 1 point for men and 1.1 for women) for individuals ageing healthily. The psychosocial index covering employment, outdoor social participation, indoor activities and life satisfaction is also found to be significantly related to health increasing the likelihood of healthy ageing with each point of the index score. There is an educational gradient in healthy ageing in the population below the age of 68 and in Southern and Central-Eastern European countries. In Western European countries, income is positively related to healthy ageing for females. Conclusions: Stimulation physical activity and adequate nutrition are crucial domains for a well-defined public health policy oriented towards healthy ageing. The psychosocial elements related to social participation, engagement, networking and life satisfaction are also found to be health beneficial

Structural accreditation of healthcare facilities: comparison of the requirements by Italian Presidential Decree 14/01/1997 and regional regulations. A proposal for updating the minimum environmental units at national level

Background and aim: The Decree of the President of the Italian Republic 14/01/1997 is the reference norm related to the accreditation of public and private healthcare structures. This guideline establishes the minimum structural, technological and organizational requirements that each structure operating in the Italian territory must comply with. Methods: In occasion of the project work for the postgraduate training course in healthcare management by ALTEMS School, a team of researchers conducted a survey on the state of updating of the minimum structural requirements indicated in the norm-in particular those relating to hospital facilities- with those adopted by the individual regions through the analysis of the most up-to-date regional regulations. Results: Precisely starting from the comparison of regional references and from the regulations on the subject of structural accreditation which suggest strategic environmental units and which address some key-aspects relating to the contemporary design of healing environments (i.e. semi-intensive care units, hybrid operating theatres, etc.), the outcome of the project work is to define a proposal to update the national reference document, also in the light of the currently changing needs in terms of hospital design. Conclusions: The research aims to become a starting milestone for future investigations. The team investigated - in this first phase - the functional areas listed in the norm, and the next step aims to extend the analysis also to the innovative functions (i.e. buffer spaces, hybrid operating theatres, sub-intensive care units, etc.) and/or introduced only the last years which have only been regulated in some regions

Intermediate care units in progressive patient care model: a systematic literature review

Background: Progressive patient care (PPC) has been defined as a systematic classification and segregation of patients based on their medical and nursing needs. Aim of the present research was to perform a systematic literature review about existing medical intermediate care unit organizational models and their performance strengths and weaknesses with a specific focus on Italian implementation, respect to US model. Methods: Databases PubMed, Cinahl, Google and Google Scholar were searched until September 2017. The search was limited to Italian and English studies. All study design are included in the review. Results: Ten studies were included in the review. The American studies showed, after the PPC reorganization, an increase in level of satisfaction and nursing care, a reduction in average length of stay, costs and tensions between nurses and an improvement in nurse-physician communication. An Italian study reported the results of a project carried out in three case studies (Forlì, Foligno and Pontedera hospital), redesigning hospital patient flow logistics around the concept of intensity of care: in all three cases, after the reorganization, an increase in bed occupancy rate (before: 71%,81%,65%; after: 78%,84%,82%, respectively) and in hospital case-mix complexity (average DRG weight - before: 0.99,1.07,1.12; after: 1.19,1.09,1.61, respectively) and a reduction in turn-over ratio (before: 2.5,1.4,2.8; after: 1.5,1.2,1.7, respectively) was recorded. Considering Italian healthcare professionals’ point of view, majority of internists supported a hospital remodeling according to PPC model. Conclusions: The PPC model, theorized in US, has found several applications in Italian regional realities. Improvements in quality of care, appropriateness and productivity in healthcare facilities, that adopted the PPC program, were observed

health promotion for the aging workforce in poland

Objectives The aging of the workforce is an issue that calls for concrete measures to promote the health of older workers. This study reports on the results of the European "ProHealth65+" research project interventions conducted in Poland in relation to workplace health promotion for older workers (WHPOW) and the institutions involved in these programs. Material and Methods A three-stage search of peer-reviewed and grey literature on the WHPOW in Poland. Results A total of 59 WHPOW programs were retrieved in Poland in the observation period (2000–2015). Most of these aimed at improving the Qualification and Training or at the Work Climate and attitudes toward older workers. The promotion, organization, and funding of these activities were carried out mainly by supra-national and governmental bodies, enterprises and employers, and educational and trainee institutions. Conclusions Although there is great commitment to the medical surveillance of workers on the part of the Polish occupational health service, our search detected a relatively low number of the WHPOW initiatives. Greater efforts should be made to introduce strategies for addressing aging of the workforce. Int J Occup Med Environ Health 2018;31(6):753–76

Geostatistics – a tool applied to the distribution of Legionella pneumophila in a hospital water system

[b]Introduction.[/b] Legionnaires' disease is normally acquired by inhalation of legionellae from a contaminated environmental source. Water systems of large buildings, such as hospitals, are often contaminated with legionellae and therefore represent a potential risk for the hospital population. The aim of this study was to evaluate the potential contamination of [i]Legionella pneumophila[/i] (LP) in a large hospital in Italy through georeferential statistical analysis to assess the possible sources of dispersion and, consequently, the risk of exposure for both health care staff and patients. [b]Materials and Method. [/b]LP serogroups 1 and 2–14 distribution was considered in the wards housed on two consecutive floors of the hospital building. On the basis of information provided by 53 bacteriological analysis, a 'random' grid of points was chosen and spatial geostatistics or [i]FAIk Kriging[/i] was applied and compared with the results of classical statistical analysis. [b]Results[/b]. Over 50% of the examined samples were positive for [i]Legionella pneumophila[/i]. LP 1 was isolated in 69% of samples from the ground floor and in 60% of sample from the first floor; LP 2–14 in 36% of sample from the ground floor and 24% from the first. The iso-estimation maps show clearly the most contaminated pipe and the difference in the diffusion of the different [i]L. pneumophila[/i] serogroups. [b]Conclusion.[/b] Experimental work has demonstrated that geostatistical methods applied to the microbiological analysis of water matrices allows a better modeling of the phenomenon under study, a greater potential for risk management and a greater choice of methods of prevention and environmental recovery to be put in place with respect to the classical statistical analysis

Sexual behaviours and preconception health in Italian university students

Introduction. Risky sexual behaviours have been recognized as a threat for sexual and reproductive health. Aim. This article shows the results of the “Sportello Salute Giovani” project (“Youth Health Information Desk”) in relation to determining how a large sample of university students in Italy cope with preconception health, especially in the domains of sexual transmitted infections (STIs), fertility and vaccination preventable disease. Methods. Twentythree questions of the “Sportello Salute Giovani” survey about sexual behaviour and reproductive health were analysed. Besides, results were stratified for sex, age class and socio-economic status. Results. 19.7% of students have had first sexual intercourse before age 15. 21.8% of female students used emergency contraception. 66.4% of the 74.0% sexual active students reported using contraceptives, but about 32% of them used methods ineffective against STIs. A general low coverage for rubella, measles and mumps vaccination was revealed. 63.7% of men and 30.9% of woman never had urologic or gynaecological examinations. Discussion. Overall, young adults in Italy are not still enough sensitized on fertility and preconception care. High schools and universities should increas

Peritoneal function in clinical practice: the importance of follow-up and its measurement in patients. Recommendations for patient information and measurement of peritoneal function

A review is given on peritoneal function, especially ultrafiltration and ultrafiltration failure followed by recommendations on how to translate pathophysiology into clinical practice. The subsequent consequences for management of peritoneal membrane function and for patient information are also included