Hospitalisation among immigrants in Italy

BACKGROUND: Immigration is increasing in Italy. In 2003, 2.6 million foreign citizens lived in the country; 52% were men and the majority were young adults who migrated for work. The purpose of this study was to investigate differences in hospitalisation between immigrants and the resident population during the year 2000 in the Lazio region. METHODS: Hospital admissions of immigrants from Less Developed Countries were compared to those of residents. We measured differences in hospitalisation rates and proportions admitted. RESULTS: Adult immigrants have lower hospitalisation rates than residents (134.6 vs. 160.5 per thousand population for acute care; 26.4 vs. 38.3 for day care). However, hospitalisation rates for some specific causes (injuries, particularly for men, infectious diseases, deliveries and induced abortions, ill-defined conditions) were higher for immigrants than for residents. Immigrants under 18 years seem to be generally healthy; causes of admission in this group are similar to those of residents of the same age (respiratory diseases, injuries and poisoning). The only important differences are for infectious and parasitic diseases, with a higher proportion among immigrant youths. CONCLUSION: The low hospitalisation rates for foreigners may suggest that they are a population with good health status. However, critical areas, related to poor living and working conditions and to social vulnerability, have been identified. Under-utilisation of services and low day care rates may be partially due to administrative, linguistic, and cultural barriers. As the presence of foreigners becomes an established phenomenon, it is important to evaluate their epidemiological profile, develop instruments to monitor and fulfil their specific health needs and plan health services for a multi-ethnic population

Toward a Comprehensive and Integrated Strategy of the European Marine Research Infrastructures for Ocean Observations

Research Infrastructures (RIs) are large-scale facilities encompassing instruments, resources, data and services used by the scientific community to conduct high-level research in their respective fields. The development and integration of marine environmental RIs as European Research Vessel Operators [ERVO] (2020) is the response of the European Commission (EC) to global marine challenges through research, technological development and innovation. These infrastructures (EMSO ERIC, Euro-Argo ERIC, ICOS-ERIC Marine, LifeWatch ERIC, and EMBRC-ERIC) include specialized vessels, fixed-point monitoring systems, Lagrangian floats, test facilities, genomics observatories, bio-sensing, and Virtual Research Environments (VREs), among others. Marine ecosystems are vital for life on Earth. Global climate change is progressing rapidly, and geo-hazards, such as earthquakes, volcanic eruptions, and tsunamis, cause large losses of human life and have massive worldwide socio-economic impacts. Enhancing our marine environmental monitoring and prediction capabilities will increase our ability to respond adequately to major challenges and efficiently. Collaboration among European marine RIs aligns with and has contributed to the OceanObs’19 Conference statement and the objectives of the UN Decade of Ocean Science for Sustainable Development (2021–2030). This collaboration actively participates and supports concrete actions to increase the quality and quantity of more integrated and sustained observations in the ocean worldwide. From an innovation perspective, the next decade will increasingly count on marine RIs to support the development of new technologies and their validation in the field, increasing market uptake and produce a shift in observing capabilities and strategies.Peer reviewe

Randomized trial of standard versus ClearWay-infused abciximab and thrombectomy in myocardial infarction: rationale and design of the COCTAIL II study

Background Patients with ST-elevation myocardial infarction (STEMI) are at substantial risk of suboptimal procedural results and late adverse events. Angiography and optical coherence tomography (OCT) studies have identified residual coronary thrombus and microcirculatory injury as potential culprits for these adverse outcomes. We hypothesized that coronary thrombectomy and local infusion of glycoprotein IIb/IIIa inhibitors by means of a dedicated infusion device can synergistically improve results of percutaneous coronary intervention (PCI) for STEMI, as appraised by OCT. Methods A total of 128 patients with STEMI will be randomized, to one of the following: abciximab infusion with the ClearWay coronary catheter (C), standard abciximab infusion (A), thrombectomy followed by abciximab infusion with the ClearWay catheter (T+C), or thrombectomy followed by standard abciximab infusion (T+A). The primary objective is to demonstrate that abciximab infusion with the ClearWay catheter with or without manual thrombus aspiration (groups C or T+C) will result in a significant reduction of intrastent thrombus formations when compared with intravenous or intracoronary abciximab with or without thrombectomy (groups A or T+A). The primary endpoint will be the number of cross-sections with thrombus area more than 10% immediately after stent implantation as assessed with OCT. Additional angiographic, ECG and clinical endpoints will be collected and adjudicated. Conclusion This trial will provide important mechanistic insights on the most appropriate invasive treatment strategy for patients with STEMI and significant thrombus burden, by exploiting its factorial design and reliance on sensitive OCT endpoints

EMSO ERIC Growth Strategy to Increase the Value of Existing European Ocean Observatories Optimizing Interrelated Scientific Resources and Benefits

American Geophysical Union (AGU) Fall Meeting, 9-13 December 2019, San FranciscoEMSO ERIC, a pan-European Research Infrastructure, is supported by an integrated system of Regional Facilities involving 11 multi-sensor fixed-point Regional facilities-platforms deployed in ‘key environmental sites’ across the European seas. These platforms are engaged to the long-term multidisciplinary observation of the deep-sea ocean and water column to better understanding environmental changes, particularly the interactions between hydrosphere, biosphere and geosphere to face environmental challenges as Marine Ecosystems, Climate Change and Geo-Hazards, and thus support science, strategic policy, industry, civil society.The Distributed Research Infrastructure is part of a broader scientific research landscape, which connects national and European marine research strategies, producing scientific services responding to societal demands to understand climate change impact, minimize the effects, and planning scenarios to mitigate the impacts of several hazards. EMSO aims to integrate the existing fixed-point ocean observatories in Europe and represents a great added value due to the scalability from local to regional, as well as the acquisition of marine data operated in an open best practice approach. It aims to maintain and to invest in existing structures, encouraging the key concepts to underpin the Framework for Ocean Observing which EMSO embrace. The EMSO growth builds upon its strategic framework, a path towards integration based on a 3-phase approach aimed to identify the value of the EMSO RFs and the gaps to fill. A 'dedicated roadmap' is accelerating the growth process of EMSO. It aims to consolidate synergies and boost the link with member countries and to attract new ones. National strategic priorities are the key elements, as well as the primary technological, social, political and scientific drivers, together with the high quality of data, services, and fast access to the information following the FAIR principle

Reproducibility of coronary optical coherence tomography for lumen and length measurements in humans (the CLI-VAR [centro per la lotta contro l'infarto-variability] study)

Frequency-domain optical coherence tomography (FD-OCT) is becoming a useful diagnostic tool for coronary imaging for quantitative coronary analysis. Second-generation FD-OCT produces detailed coronary lumen images. However, the reproducibility of coronary measurements using FD-OCT in humans has not been thoroughly explored. Our goal was to determine the intraobserver, interobserver, and interpullback reproducibility of the in vivo FD-OCT measurements of the lumen area and/or lesion length. Twenty-five patients undergoing coronary angioplasty were included. In all subjects, FD-OCT pullbacks (20 mm/s) were acquired twice from the same coronary segment different from the target lesion, at an interval of 5 minutes, with no other intervention. A total of 9,396 cross-sectional lumen area frames and the relative coronary lesion length of each pullback were analyzed off-line with dedicated software by 2 independent expert readers (A and B). We compared the lumen area and length measurements as follows: pullback 1, read by reader A twice at an interval of 7 days (intraobserver analysis); pullback 1, independently read by readers A and B (interobserver comparison); and pullback 1 versus pullback 2, read by reader A (interpullback comparison). The per-segment and per-frame analyses showed very high and significant correlation coefficients for the interobserver, intraobserver, and interpullback comparisons for the lumen area and lesion length (R <0.95 and p <0.001 in all cases). Accordingly, the Bland-Altman estimates of bias showed nonsignificant differences in the interobserver, intraobserver, and interpullback comparisons at all levels, with average biases never >0.150 mm2 for the lumen area or 0.200 mm for the lesion length. In conclusion, coronary imaging using FD-OCT showed excellent reproducibility, with low intraobserver, interobserver, and interpullback variability for both lumen area and lesion length measurements in humans. Thus, FD-OCT can be proposed for precise analysis in the catheterization laboratory to guide decision making and in clinical trials focusing on imaging end points. © 2012 Elsevier Inc

Healthy and Resilient Communities Evaluation

The Centre for Rural Health , Tasmania was commissioned b Rural Alive and Well (RAW) to conduct an evaluation of RAW’s Healthy and Resilience Communities (HaRC) program. … The HaRC program is one of three mental health and suicide prevention programs delivered to rural Tasmanian communities by RAW. The primary goal of the HaRC program is to enhance mental health and wellbeing community protective factors such as coping capability, resilience and connectedness, to better equip rural Tasmanian communities to react to challenging life experiences