A Comparative Analysis of Inequality in Health Across Europe

The study of inequality in health concerns the relationship between socially structured characteristics and health outcomes. Howewer, health disparities are also linked to purely individual characteristics and contextual ones. In particular, the contextual effect at a national level may reflect differences in the functioning and performing of national health institutions, that may be conceived as further determinants of health inequalities. In this work we aim at estimating the effect of education on self-assessed health across European countries, taking into account potential confounders like age, gender and family social background. Using a multilevel model with individuals nested in countries, we can achieve two aims. First, we can see whether countries differ in their average self-assessed health score. Second, we can test our hypothesis about the existence of a European social gradient, that is that education exerts a relatively constant effect on self-assessed health. We develop our models using data from European Social Surveys (88,842 interviews).Health Inequalities, Health Policies, Public Health Care Systems, Comparative Studies

Granulicatella adiacens and Abiotrophia defectiva Native Vertebral Osteomyelitis: Three Cases and Literature Review of Clinical Characteristics and Treatment Approach

Granulicatella adiacens and Abiotrophia defectiva are an increasingly recognized cause of osteoarticular infections. We describe two cases of G. adiacens and one case of A. defectiva native vertebral osteomyelitis (NVO) and review all published cases. Nine cases of G. adiacens NVO and two cases of A. defectiva NVO were previously described. Patients were usually middle-aged men, and classical risk factors for NVO were present in half of the cases. Concomitant bacteremia was reported in 78.6% of cases, and concurrent infective endocarditis occurred in 36.4% of this sub-group of patients. Many different antibiotic schemes were recorded, with median treatment duration of 6weeks. In the most recent reports, glycopeptides represented the most frequent empirical therapy, possibly due to the increasing emergence of G. adiacens and A. defectiva penicillin-resistant strains. Stabilization surgery was rarely required (14.3% of cases), and clinical cure was generally achieved. In conclusion, Granulicatella spp. and Abiotrophia spp. NVO is rare but increasingly described. A total antibiotic course of six weeks seems to be appropriate for noncomplicated cases, and clinical outcome is generally favorable

From phenotyping to the study of clonal relationship of microbial isolates

The term "typing" is generally used with two meanings: a methods to establish the correct taxonomic collocation of a genus/specie/biotype, b methods for discriminating different bacterial isolates of the same species in order to establish the genetic relationship among the microorganisms involved in a possible outbreak. In this paper we focus our attention on the second aspect, that represents a relevant epidemiological tools in infection prevention and control. Typing systems are traditionally based on two steps workup: the first is the study of phenotypes such as serotype, biotype, phage-type, or antimicrobial susceptibilities of the isolates and this can be easily performed in every microbiology laboratory; the second, examines the relatedness of isolates at a molecular level. Over the years many molecular methods have been developed and efficiently applied in several hospital settings. The large panorama of methods put the microbiologists in trouble to operate the proper choice. Thus, in the present paper, we have reviewed old as well new molecular typing methods in order to provide a useful guide that can represent an overview on molecular methods and particularly of their specific pro and cons

Spazio allo Spazio

“Spazio allo Spazio", active since 2010, involves students aged 5 to 20. This educational project was launched by a group of Italian teachers from the Lower Secondary School Fermi in Villasanta who believed Space exploration could be an efficient way to convey the idea that the extraordinary experience of the astronaut, who on the International Space Station must acquire new skills and be able to dominate a challenging and unpredictable context, similar to a disabled person's routine in daily life. This was a winning choice because gradually international institutions promoted similar initiatives. The central theme of space exploration is used to promote values of sustainability, equity and diversity, allowing students to become acquainted with the world of astronauts while facing subjects related to integration and disability. Several national and international universities and institutions, at the forefront of scientific research, have contributed to this project. The main topics of the project are: 1) Space exploration: the astronaut's experience is the starting point for lessons, cultural exchanges, lectures and interdisciplinary strategies to raise awareness about humans in space, the international cooperation for the International Space Station, physical training, technical, scientific and cultural preparation. 2) Career orientation: meetings with experts in different fields, from Science, Technology, Engineering, Mathematics to Arts and Physical Education, help students achieve better knowledge of themselves, their potential and limits acquiring skills in scientific research methodology in a multilingual environment. 3) Inclusion: as astronauts experience the limits of gravity and disability in Space, students can face their limits, through experiences of adapted physical activity, addressing issues related to the integration and insertion of people with different skills in school and society. 4) Team building: starting from the example of collaboration which takes place in space missions and scientific research, students are encouraged to experience teamwork. This is true for the teachers too, thanks to the strengthening of cooperative teaching, in the sharing of resources and good practices as well as in the implementation of innovative forms of communication and multimedia documentation. The project aims at making students able to face new and more advanced educational challenges and cognitive objectives, developing work strategies by transferring already tested approaches and processes to new situations. This is noticeable in the more self-conscious choices that former students have made about their future. An example is illustrated by an ex-student who directed his training path in the Science and Engineering fiel

Rapid identification of carbapenemase-producing enterobacteriaceae: comparison of two cultivation methods

We evaluated the performance of chromID CARBA compared with direct plating onto MacConkey agar supplemented with meropenem disk (MCM) for the screening and detection of carbapenemase-producing Enterobacteriaceae (CPE) from rectal swabs. Sensitivity and specificity values were 89.9% and 98.7% for MCM, and 92.4% and 98.8% for chromID CARBA

A Comparative Analysis of Inequality in Health Across Europe

Abstract The study of inequality in health concerns the relationship between socially structured characteristics and health outcomes. Howewer, health disparities are also linked to purely individual characteristics and contextual ones. In particular, the contextual effect at a national level may reflect differences in the functioning and performing of national health institutions, that may be conceived as further determinants of health inequalities. In this work we aim at estimating the effect of education on self-assessed health across European countries, taking into account potential confounders like age, gender and family social background. Using a multilevel model with individuals nested in countries, we can achieve two aims. First, we can see whether countries differ in their average self-assessed health score. Second, we can test our hypothesis about the existence of a European social gradient, that is that education exerts a relatively constant effect on self-assessed health. We develop our models using data from European Social Surveys (88,842 interviews)

Histoire de la famille

Antoinette Fauve-Chamoux, maître de conférencesRaffaella Sarti et Mary-Louise Nagata, avec Mario Boleda, professeur à l’Université nationale de Salta (Argentine) Familles, mariages et domesticités : modèles historiques comparés (XVIe-XXe siècle) Les coresponsables du séminaire ont présenté en début d’année l’état d’avancement du projet européen consacré au rôle socio-économique du service domestique et la formation de l’identité européenne. Le service domestique est un phénomène européen, ave..

Histoire de la famille

Antoinette Fauve-Chamoux, maître de conférencesMarie-Pierre Arrizabalaga, maître de conférences à l’Université de Cergy-PontoiseRaffaella Sarti et Mary-Louise Nagata avec Mario Boleda, professeur à l’Université nationale de Salta (Argentine) Familles, mariages et domesticités : modèles historiques comparés (XVIe-XXe siècle) En début d’année, les co-responsables du séminaire ont exposé l’état d’avancement du projet européen consacré au rôle socioéconomique du service domestique et à la formati..

Diagnosis and management of infections caused by multidrug-resistant bacteria: guideline endorsed by the Italian Society of Infection and Tropical Diseases (SIMIT), the Italian Society of Anti-Infective Therapy (SITA), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Association of Clinical Microbiologists (AMCLI) and the Italian Society of Microbiology (SIM)

Management of patients with infections caused by multidrug-resistant organisms is challenging and requires a multidisciplinary approach to achieve successful clinical outcomes. The aim of this paper is to provide recommendations for the diagnosis and optimal management of these infections, with a focus on targeted antibiotic therapy. The document was produced by a panel of experts nominated by the five endorsing Italian societies, namely the Italian Association of Clinical Microbiologists (AMCLI), the Italian Group for Antimicrobial Stewardship (GISA), the Italian Society of Microbiology (SIM), the Italian Society of Infectious and Tropical Diseases (SIMIT) and the Italian Society of Anti-Infective Therapy (SITA). Population, Intervention, Comparison and Outcomes (PICO) questions about microbiological diagnosis, pharmacological strategies and targeted antibiotic therapy were addressed for the following pathogens: carbapenem-resistant Enterobacterales; carbapenem-resistant Pseudomonas aeruginosa; carbapenem-resistant Acinetobacter baumannii; and methicillin-resistant Staphylococcus aureus. A systematic review of the literature published from January 2011 to November 2020 was guided by the PICO strategy. As data from randomised controlled trials (RCTs) were expected to be limited, observational studies were also reviewed. The certainty of evidence was classified using the GRADE approach. Recommendations were classified as strong or conditional. Detailed recommendations were formulated for each pathogen. The majority of available RCTs have serious risk of bias, and many observational studies have several limitations, including small sample size, retrospective design and presence of confounders. Thus, some recommendations are based on low or very-low certainty of evidence. Importantly, these recommendations should be continually updated to reflect emerging evidence from clinical studies and real-world experience

Vancomycin resistant enterococcus risk factors for hospital colonization in hematological patients: a matched case-control study

BackgroundVancomycin-resistant enterococcus (VRE) was the fastest growing pathogen in Europe in 2022 (+ 21%) but its clinical relevance is still unclear. We aim to identify risk factors for acquired VRE rectal colonization in hematological patients and evaluate the clinical impact of VRE colonization on subsequent infection, and 30- and 90-day overall mortality rates, compared to a matched control group.MethodsA retrospective, single center, case-control matched study (ratio 1:1) was conducted in a hematological department from January 2017 to December 2020. Case patients with nosocomial isolation of VRE from rectal swab screening (>= 48 h) were matched to controls by age, sex, ethnicity, and hematologic disease. Univariate and multivariate logistic regression compared risk factors for colonization.ResultsA total of 83 cases were matched with 83 controls. Risk factors for VRE colonization were febrile neutropenia, bone marrow transplant, central venous catheter, bedsores, reduced mobility, altered bowel habits, cachexia, previous hospitalization and antibiotic treatments before and during hospitalization. VRE bacteraemia and Clostridioides difficile infection (CDI) occurred more frequently among cases without any impact on 30 and 90-days overall mortality. Vancomycin administration and altered bowel habits were the only independent risk factors for VRE colonization at multivariate analysis (OR: 3.53 and 3.1; respectively).ConclusionsAntimicrobial stewardship strategies to reduce inappropriate Gram-positive coverage in hematological patients is urgently required, as independent risk factors for VRE nosocomial colonization identified in this study include any use of vancomycin and altered bowel habits. VRE colonization and infection did not influence 30- and 90-day mortality. There was a strong correlation between CDI and VRE, which deserves further investigation to target new therapeutic approaches