On the importance of primary and community healthcare in relation to global health and environmental threats:Lessons from the COVID-19 crisis

In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (PCHC) system's weaknesses worldwide. In many instances, PCHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of a € planetary health'. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that PCHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the EU COHEIRS Project on Environment and Health

The EPIKIT (Epidemiology of Cancer in Italy) Study Group is a result of the COHEIRS project (Civic Observers for Health and Environment: Initiative of Responsibility and Sustainibility), funded by the Europe for Citizens Program 2013–2014 to address the issue of Precautionary Principle applicatio

A geochemical atlas of the ground- and running waters of Arezzo (Tuscany, Italy)

Since 2000 a joint project between the Department of Earth Science of Florence and the Unit of Environment and Health of the Municipality of Arezzo has allowed to geochemically characterise the superficial and ground waters of the municipal territory of Arezzo in order to establish the water quality and to investigate the main natural and anthropic processes responsible of their composition. The available geochemical data-base consists of more than 500 samples sites (90% of which are private wells and 7 and 3% are springs and running waters, respectively) on which physical parameters (temperature and electrical conductivity) and major, minor and trace dissolved species (pH, Ca, Mg, Na, K, NH4, HCO3, SO4, NO3, NO2, Cl, Br, F, heavy metals) have been performed by using the same sampling procedure and analytical methodology in order to have a consistent set of data. Fifteen selected sites have been analysed twice per year to evidence possible seasonal effects. No significant differences have been recorded. The Arezzo Basin, formed since Upper Pliocene, is a structural depression limited to the North and to the East by the Pratomagno and Chianti belts, respectively, and to the South and to the East by two tectonic lineaments (Val d’Arbia-Val Marecchia transversal and Chitignano normal faults). Along these tectonic discontinuities CO2-rich manifestations either seep out or exploited by private companies. Hydrogeologically, three main aquifers are recognised: i) a relatively deep aquifer hosted in Tertiary sandstone formations; ii) an intermediate aquifer hosted in Quaternary fluvio-lacustrine sediments and iii) a shallow aquifer in recent alluvional sediments. The content in Total Dissolved Solids (TDS) allows to classify the Arezzo waters in: oligomineral (69%), medium-mineral (30%) and mineral (1%) and they can be regarded as Ca(Mg)-HCO3 (87 %), Na(K)-HCO3 (7%), Ca(Mg)-SO4 (5%) and Na(K)-Cl (1%). It is noteworthy to point of that the Na(K)-HCO3 waters are aligned along the above mentioned tectonic systems. The quality of Arezzo waters has been referred to the Italian legislation that is addressed to the definition of the Maximum Admissible Concentration (MAC, DPR 236/88, Dlgs 31/01) and the Reference Value (RV, DPR 236/88) in terms of waters for the human consumption. Waters from the northern area of Arezzo overcome MAC for chlorides, sulphates and sodium; if we consider nitrogen species (NH4, NO2, NO3) the values overcome CMA for those waters collected into the city, its peripheral areas and in the south-western suburbs. Thematic maps has been produced, on the basis of the principles of linear Geostatistics, in order to analyse the spatial behaviour of the analysed variables. The aim was to find correlations with lithology, use of the soils, drainage density, pressure of antrophic activities and so on, and to identify sensible areas to monitor in their time evolution. The investigation has been developed starting from a detailed variographic analysis by means of the geochemical behaviour of each variable has been analysed in the different directions of the space while the estimation procedure to obtain the maps has been based on the application of sequential Gaussian simulation procedures.PublishedSpoleto, Italy2.4. TTC - Laboratori di geochimica dei fluidiope

Atlante geochimico delle acque di Arezzo: dal dato di campagna alle mappe tematiche

In this paper thematic maps produced on the basis of the principles of linear geostatistics are described in order to characterise the superficial and ground waters of the municipal territory of Arezzo. The aim is to assess the correlation with lithology, use of soil, drainage density and anthropogenic pressure and identify sensible areas to be periodically monitored in time. This study has used an original geochemical data-base consisting of about 500 water samples. A statistical approach has been used for the identification of anomalous values and homogenous populations. This step was followed by a detailed variographic study in order to analyse the spatial behaviour of the variables. Subsequently, an estimation procedure based on the application of ordinary kriging algorithm and sequential Gaussian simulation methods was applied to obtain the maps.PublishedSan Giovanni valdarno (AR), Italy2.4. TTC - Laboratori di geochimica dei fluidiope

A geochemical atlas of the ground- and running waters of Arezzo (Tuscany, Italy)

Since 2000 a joint project between the Department of Earth Science of Florence and the Unit of Environment and Health of the Municipality of Arezzo has allowed to geochemically characterise the superficial and ground waters of the municipal territory of Arezzo in order to establish the water quality and to investigate the main natural and anthropic processes responsible of their composition. The available geochemical data-base consists of more than 500 samples sites (90% of which are private wells and 7 and 3% are springs and running waters, respectively) on which physical parameters (temperature and electrical conductivity) and major, minor and trace dissolved species (pH, Ca, Mg, Na, K, NH4, HCO3, SO4, NO3, NO2, Cl, Br, F, heavy metals) have been performed by using the same sampling procedure and analytical methodology in order to have a consistent set of data. Fifteen selected sites have been analysed twice per year to evidence possible seasonal effects. No significant differences have been recorded. The Arezzo Basin, formed since Upper Pliocene, is a structural depression limited to the North and to the East by the Pratomagno and Chianti belts, respectively, and to the South and to the East by two tectonic lineaments (Val d’Arbia-Val Marecchia transversal and Chitignano normal faults). Along these tectonic discontinuities CO2-rich manifestations either seep out or exploited by private companies. Hydrogeologically, three main aquifers are recognised: i) a relatively deep aquifer hosted in Tertiary sandstone formations; ii) an intermediate aquifer hosted in Quaternary fluvio-lacustrine sediments and iii) a shallow aquifer in recent alluvional sediments. The content in Total Dissolved Solids (TDS) allows to classify the Arezzo waters in: oligomineral (69%), medium-mineral (30%) and mineral (1%) and they can be regarded as Ca(Mg)-HCO3 (87 %), Na(K)-HCO3 (7%), Ca(Mg)-SO4 (5%) and Na(K)-Cl (1%). It is noteworthy to point of that the Na(K)-HCO3 waters are aligned along the above mentioned tectonic systems. The quality of Arezzo waters has been referred to the Italian legislation that is addressed to the definition of the Maximum Admissible Concentration (MAC, DPR 236/88, Dlgs 31/01) and the Reference Value (RV, DPR 236/88) in terms of waters for the human consumption. Waters from the northern area of Arezzo overcome MAC for chlorides, sulphates and sodium; if we consider nitrogen species (NH4, NO2, NO3) the values overcome CMA for those waters collected into the city, its peripheral areas and in the south-western suburbs. Thematic maps has been produced, on the basis of the principles of linear Geostatistics, in order to analyse the spatial behaviour of the analysed variables. The aim was to find correlations with lithology, use of the soils, drainage density, pressure of antrophic activities and so on, and to identify sensible areas to monitor in their time evolution. The investigation has been developed starting from a detailed variographic analysis by means of the geochemical behaviour of each variable has been analysed in the different directions of the space while the estimation procedure to obtain the maps has been based on the application of sequential Gaussian simulation procedures

Voice Improvement in Patients with Functional Dysphonia Treated with the Proprioceptive-Elastic (PROEL) Method

The objective of the study was to analyze the outcome of the proprioceptive-elastic (PROEL) voice therapy method in patients with functional dysphonia (FD). Fifty-two patients with FD were involved in the study; they were composed of three subgroups of patients with (1) FD without glottal insufficiency (n = 28), (2) FD and glottal insufficiency (n = 9), and (3) FD, glottal insufficiency, and vocal nodules (n = 15). A multidimensional assessment protocol including videolaryngostroboscopy; maximum phonation time; perceptual evaluation of dysphonia with the Grade, Instability, Roughness, Breathiness, Asthenia, and Strain (GIRBAS) scale; and 10-item version of the Voice Handicap Index was conducted before and after 15 sessions of voice therapy. All voice therapy sessions were conducted by the same speech-language pathologist. The comparison between voice assessment before and after voice therapy with the PROEL method in patients with FD, in all the three subgroups, revealed a statistically significant improvement in periodicity and the mucosal wave in the laryngostroboscopy, maximum phonation time, GIRBAS scale scores, and VHI-10.Voice of patients with FD improved after treatment with the PROEL method. Further studies are needed to analyze the efficacy of the PROEL method with randomized double-blind clinical trials using different methods for voice therapy. At present, the PROEL method represents an alternative tool for the speech pathologist to improve voice in patients with FD

On the importance of primary and community healthcare in relation to global health threats: lessons from the COVID-19 crisis.

Role primary healthcare systems during COVID-19 pandemic In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. Strengthening the role op P&CHC The COVID-19 pandemic has shown the primary and community healthcare (P&CHC) system’s weaknesses worldwide. In many instances, P&CHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of ‘planetary health’. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. Proposition This paper proposes that P&CHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic

On the importance of primary and community healthcare in relation to global health and environmental threats: Lessons from the COVID-19 crisis

In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support and also in promoting good community advice and awareness in coordination with secondary healthcare and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community healthcare (P&CHC) system’s weaknesses worldwide. In many instances, P&CHC played only a minor role, the emphasis being on hospital and intensive care beds. This was compounded by political failures, in supporting local community resilience. Placing community building, social cohesion and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of ‘planetary health’. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that P&CHC should take on two critical roles: first, to support local problem-solving efforts and to serve as a partner in innovative approaches to safeguarding community well-being; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic

On the importance of primary and community health care in relation to global health and environmental threats: lessons from the COVID-19 crisis

In the course of the COVID-19 pandemic, it has become clear that primary healthcare systems play a critical role in clinical care, such as patient screening, triage, physical and psychological support, and also in promoting good community advice and awareness in coordination with secondary health care and preventive care. Because of the role of social and environmental factors in COVID-19 transmission and burden of disease, it is essential to ensure that there is adequate coordination of population-based health services and public health interventions. The COVID-19 pandemic has shown the primary and community health care (P&CHC) system's weaknesses worldwide. In many instances P&CHC played only a minor role, the emphasis being on hospital and intensive care beds. Political failures compounded this in supporting local community resilience. Placing community building, social cohesion, and resilience at the forefront of dealing with the COVID-19 crisis can help align solutions that provide a vision of “planetary health”. This can be achieved by involving local well-being and participation in the face of any pervasive health and environmental crisis, including other epidemics and large-scale ecological crises. This paper proposes that P&CHC should take on two critical roles: first, to support local problemsolving efforts and to serve as a partner in innovative approaches to safeguarding community wellbeing; and second, to understand the local environment and health risks in the context of the global health perspective. We see this as an opportunity of immediate value and broad consequence beyond the control of the COVID-19 pandemic